Designing an eHealth Breastfeeding Resource With Young Mothers Using a Participatory Design

2020 ◽  
pp. 104365962095706
Author(s):  
Jennifer Abbass-Dick ◽  
Barbara Chyzzy ◽  
Amber Newport ◽  
Joanne Huizinga ◽  
Fangli Xie
Keyword(s):  
Health Care Providers ◽  
Participatory Design ◽  
Participatory Approach ◽  
Phase Iii ◽  
Learning Needs ◽  
Young Mothers ◽  
Care Providers ◽  
Breastfeeding Support ◽  
Health Authorities ◽  
Three Phase

Introduction Breastfeeding rates among young mothers are low and do not meet recommendations from health authorities, putting the health of young mothers and their infants at risk. Young mothers require breastfeeding support that meets their learning needs and preferred mode for accessing information. The objective of this study was to work collaboratively with young mothers in order to cocreate an eHealth breastfeeding resource. Methodology A three-phase exploratory study was conducted in Ontario, Canada. In Phases I and II, young mothers and health care providers (HCPs) were recruited and preferences for an eHealth breastfeeding resource were explored. In Phase III, feedback from young mothers and HCPs about the new resource was collected. Results Participants found the breastfeeding eHealth resource visually appealing, engaging, and informative. Discussion Cocreating a tailored breastfeeding eHealth resource with young mothers and HCPs using a participatory approach ensured that the resource design and content met the learning needs of young mothers.

Breastfeeding Experiences of Baccalaureate Nursing Students: A Qualitative Study

2020 ◽  
pp. 089033442097998
Author(s):  
Cheryl Langford ◽  
Marcella Gowan ◽  
Monica Haj
Keyword(s):  
Nursing Students ◽  
Health Care Providers ◽  
Baccalaureate Nursing ◽  
Community Support ◽  
Baccalaureate Nursing Students ◽  
Care Providers ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional

Background Students returning to school who are breastfeeding face unique challenges. There is limited literature on breastfeeding university students. Several researchers have studied breastfeeding employees in the workplace. Institutions of higher education closely mimic the employment environment. Breastfeeding college students who express their milk while at school share similar challenges to employed mothers. A baccalaureate nursing program is rigorous and little is known about the challenges facing breastfeeding student nurses returning to classes. Research aim To explore the breastfeeding experience of baccalaureate nursing students. Methods Our study was a cross-sectional descriptive qualitative design. Purposive sampling was used to enroll participants ( N = 12). In depth, semi-structured interviews were conducted. Qualitative thematic analysis was used to analyze the data both manually and using Dedoose QDA software. Results An overarching theme of pervasive conflict between the role of the breastfeeding mother and the role of the student nurse surfaced. Three interrelated organizing themes also emerged; challenging, vulnerability, and resilience. Time constraints, self-care versus role demands, and structural accommodations contributed to the challenges. Only one participant indicated a knowledge of her breastfeeding rights. All of the participants expressed gratitude for faculty and community support, regardless of conflicts. Conclusion Breastfeeding participants were both vulnerable and resilient. Faculty may improve experiences through providing specific areas of support. A breastfeeding support policy outlining student rights and faculty responsibilities is needed to educate, guide, and enforce protections. Health care providers may enhance breastfeeding students’ experiences through anticipatory guidance, education, and continued support.

Three Versus 6 Months of Oxaliplatin-Based Adjuvant Chemotherapy for Patients With Stage III Colon Cancer: Disease-Free Survival Results From a Randomized, Open-Label, International Duration Evaluation of Adjuvant (IDEA) France, Phase III Trial

2018 ◽  
Vol 36 (15) ◽  
pp. 1469-1477 ◽  
Author(s):  
Thierry André ◽  
Dewi Vernerey ◽  
Laurent Mineur ◽  
Jaafar Bennouna ◽  
Jérôme Desrame ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Health Care Providers ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Stage Iii ◽  
Care Providers ◽  
Free Survival ◽  
Stage Iii Colon Cancer ◽  
Disease Free

Purpose Reduction of adjuvant treatment duration may decrease toxicities without loss of efficacy in stage III colon cancer. This could offer clear advantages to patients and health care providers. Methods In International Duration Evaluation of Adjuvant Chemotherapy (IDEA) France, as part of the IDEA international collaboration, patient with colon cancer patients were randomly assigned to 3 and 6 months of modified FOLFOX6 (mFOLFOX6: infusional fluorouracil, leucovorin, and oxaliplatin) or capecitabine plus oxaliplatin (CAPOX) by physician choice. The primary end point was disease-free survival (DFS), and analyses were descriptive. Results A total of 2,010 eligible patients received either 3 or 6 months of chemotherapy (modified intention-to-treat population); 2,000 (99%) had stage III colon cancer (N1: 75%, N2: 25%); 1,809 (90%) received mFOLFOX6, and 201 (10%) received CAPOX. The median age was 64 years, and the median follow-up time was 4.3 years. Overall, 94% (3 months) and 78% (6 months) of patients completed treatment (fluoropyrimidines ± oxaliplatin). Maximal grade 2 and 3 neuropathy rates were 28% and 8% in the 3-month arm and 41% and 25% in the 6-month arm ( P < .001). Final rates of residual neuropathy greater than grade 1 were 3% in the 3-month arm and 7% in the 6-month arm ( P < .001). There were 578 DFS events: 314 and 264 in the 3- and 6-month arms, respectively. The 3-year DFS rates were 72% and 76% in the 3- and 6-month arms, respectively (hazard ratio [HR], 1.24; 95% CI, 1.05 to 1.46; P = .0112). In the 3 and 6-month arms, respectively, for patients who received mFOLFOX6, the 3-year DFS rates were 72% and 76% (HR, 1.27; 95% CI, 1.07 to 1.51); for the T4 and/or N2 population, they were 58% and 66% (HR, 1.44; 95% CI, 1.14 to 1.82); and for the T1-3N1 population, they were 81% and 83% (HR, 1.15; 95% CI, 0.89 to 1.49). Conclusion IDEA France, in which 90% of patients received mFOLFOX6, shows superiority of 6 months of adjuvant chemotherapy compared with 3 months, especially in the T4 and/or N2 subgroups. These results should be considered alongside the international IDEA collaboration data.

scholarly journals Brazilian guidelines for endovascular treatment of patients with acute ischemic stroke

2017 ◽  
Vol 75 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Octávio Marques Pontes-Neto ◽  
Pedro Cougo ◽  
Sheila Cristina Ouriques Martins ◽  
Daniel G. Abud ◽  
Raul G. Nogueira ◽  
...  
Keyword(s):  
Health Care ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Health Care Providers ◽  
Cerebrovascular Diseases ◽  
Discussion Forums ◽  
Care Providers ◽  
Web Based ◽  
Health Authorities ◽  
Public Health Authorities

ABSTRACT These guidelines are the result of a joint effort from writing groups of the Brazilian Stroke Society, the Scientific Department of Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Stroke Network and the Brazilian Society of Diagnostic and Therapeutic Neuroradiology. Members from these groups participated in web-based discussion forums with predefined themes, followed by videoconference meetings in which controversies and position statements were discussed, leading to a consensus. This guidelines focuses on the implications of the recent clinical trials on endovascular therapy for acute ischemic stroke due to proximal arterial occlusions, and the final text aims to guide health care providers, health care managers and public health authorities in managing patients with this condition in Brazil.

STATUS AND POTENTIAL OF GENE THERAPY IN CLINICAL MEDICINE

2002 ◽  
Vol 18 (3) ◽  
pp. 645-674 ◽  
Author(s):  
Anita Lyngstadaas
Keyword(s):  
Gene Therapy ◽  
Clinical Research ◽  
Clinical Medicine ◽  
Severe Combined Immunodeficiency ◽  
Molecular Medicine ◽  
Phase Iii ◽  
Somatic Therapy ◽  
Health Authorities ◽  
Three Phase ◽  
Somatic Gene

Objective: Somatic gene therapy is a new method in the rapidly expanding field of molecular medicine. Due to recent encouraging results and the promising prospect for some disease groups, Norwegian health authorities wanted to assess somatic therapy with evidence-based standards for strategic use. This article presents the results of this assessment, discussed in the context of the policy-making process in Norway, including ethical and legislational considerations.Methods: Clinical gene therapy protocols, ongoing or completed with published results, where available, were identified through a systematic survey of descriptive protocols and publications. Preclinical literature was also reviewed.Results: Gene therapy is dominated by preclinical and clinical research. Most of the gene therapy protocols identified are in early phases (phases I and II) with only a few patients in each study. Of the protocols included in the assessment, only three phase III studies are represented. Except for the use of soluble antisense oligonucleotides against cytomegalovirus eye infection, gene therapy is presently not an established treatment modality. Promising results have been observed in treatment of cancer and cardiovascular diseases and, most recently, in inherited severe combined immunodeficiency and hemophilia. Several interesting principles addressing a large panel of conditions are currently being developed and tested.Conclusions: Gene therapy is developing into an important medical concept that needs to be included within the Norwegian healthcare system. It is recommended that the Norwegian Ministry of Health and Social Affairs fund a national program to boost infrastructure in selected scientific groups both in preclinical and clinical research. The national procedures regulating approval of gene therapy trials should be made more efficient while at the same time allowing for proper control and ethical considerations. It is emphasized that gene therapy trials should be carefully monitored for side effects.

scholarly journals Development of a qualitative real-time RT-PCR assay for the detection of SARS-CoV-2: A guide and case study in setting up an emergency-use, laboratory-developed molecular assay

2020 ◽  
Author(s):  
Melis N. Anahtar ◽  
Bennett Shaw ◽  
Damien Slater ◽  
Elizabeth H Byrne ◽  
Yolanda Botti-Lodovico ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Health Care Providers ◽  
Diagnostic Testing ◽  
Care Providers ◽  
Effective Response ◽  
Diagnostic Assays ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Set Up ◽  
Crisis Conditions

Developing and deploying new diagnostic tests is difficult, but the need to do so in response to a rapidly emerging pandemic such as COVID-19 is crucially important for an effective response. In the early stages of a pandemic, laboratories play a key role in helping health care providers and public health authorities detect active infection, a task most commonly achieved using nucleic acid-based assays. While the landscape of diagnostics is rapidly evolving, polymerase chain reaction (PCR) remains the gold-standard of nucleic acid-based diagnostic assays, in part due to its reliability, flexibility, and wide deployment. To address a critical local shortage of testing capacity persisting during the COVID-19 outbreak, our hospital set up a molecular based laboratory developed test (LDT) to accurately and safely diagnose SARS-CoV-2. We describe here the process of developing an emergency-use LDT, in the hope that our experience will be useful to other laboratories in future outbreaks and will help to lower barriers to fast and accurate diagnostic testing in crisis conditions.

The risk of bleeding with anticoagulant treatments

Phlebologie ◽  
2011 ◽  
Vol 40 (04) ◽  
pp. 203-209 ◽  
Author(s):  
G. Palareti
Keyword(s):  
Health Care Providers ◽  
Significant Proportion ◽  
New Drugs ◽  
Phase Iii ◽  
Limiting Factors ◽  
Clinical Indication ◽  
Individual Risk ◽  
Anticoagulant Treatment ◽  
Care Providers ◽  
Risk Of Bleeding

SummaryAnticoagulant treatments are given to prevent and/or treat thrombotic complications in many clinical conditions, including atrial fibrillation (the most frequent indication for anticoagulant treatment), venous thromboembolism, acute coronary syndromes and after invasive cardiac procedures. Anticoagulation with vitamin K antagonists (VKAs) is currently almost the unique kind of therapy for chronic anticoagulation. It is highly effective in the prevention or treatment of thrombotic events but it is associated with a non negligible risk of bleeding, that is the most important complication of this therapy and a major concern for both physicians and patients. The risk of bleeding and the difficulties for the patients and health care providers associated with the necessary correct management of this treatment are limiting factors for a more widespread prescription of the treatment, leaving without an effective therapy a significant proportion of patients who would have a clear clinical indication for chronic anticoagulation. This review analyses the treatment- and person-associated risk factors for bleeding during VKAs and the tools that have been proposed to assess the individual risk of bleeding. New oral anticoagulant drugs seem to overcome at least some of the limitations of VKAs. Potentially, they can allow a less demanding and more stable anticoagulant treatment, with less side-effects allowing that more patients can receive an appropriate anticoagulant treatment. Based on the so far available phase III clinical studies, it is possible to assume that also these new drugs are associated with a risk of bleeding, that is probably related to the intensity of treatment.

Innovative Staff Education Techniques

2005 ◽  
Vol 10 (4) ◽  
pp. 193-198 ◽  
Author(s):  
Lynn Hadaway
Keyword(s):  
Staff Development ◽  
Adult Learning ◽  
Health Care Providers ◽  
Clinical Performance ◽  
Learning Needs ◽  
Care Providers ◽  
Educational Approach ◽  
Adult Learning Principles ◽  
Key Concepts ◽  
Learning Principles

Abstract A knowledgeable, skillful staff of health care providers is critical to enhance clinical outcomes for patients; however, there can be much confusion about the processes used by educators to support and develop staff. Although adult-learning principles should be used, it is also important to remember that not all clinical performance problems require an educational approach. Published literature of educational programs that have been documented to reduce catheter-related complications is reviewed along with key concepts of learning needs assessment, transfer of learning, and staff development resources.

Long-Term Breastfeeding in African American Mothers

2017 ◽  
Vol 33 (1) ◽  
pp. 128-139 ◽  
Author(s):  
Tyra Toston Gross ◽  
Marsha Davis ◽  
Alex K. Anderson ◽  
Jori Hall ◽  
Karen Hilyard
Keyword(s):  
African American ◽  
African American Women ◽  
Digital Media ◽  
Health Care Providers ◽  
Low Income ◽  
Lessons Learned ◽  
Care Providers ◽  
Breastfeeding Support ◽  
American Women

Background: According to the Centers for Disease Control and Prevention, 39.1% of African American infants are breastfed at 6 months. However, few studies have explored the breastfeeding experiences of African American women who successfully breastfeed to 6 months or longer durations. Research aim: The goal of this qualitative study was to explore the long-term breastfeeding experiences of low-income African American women using the positive deviance approach. Methods: African American women with breastfeeding experience were recruited through Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counselors. Eligibility criteria included being age 18 or older, currently participating in WIC, and having breastfed one child for at least 6 months in the past 2 years. Semistructured, in-depth interviews were conducted with 11 participants. Interviews were audio-recorded and professionally transcribed. Transcripts were then analyzed for emerging themes using thematic analysis in NVivo software. Results: Participants had on average three children each, with an average length of breastfeeding of 10.5 months per child. Four main themes developed: (a) deciding to breastfeed, (b) initiating breastfeeding, (c) breastfeeding long-term, and (d) expanding breastfeeding support. Participants offered culturally tailored suggestions to improve breastfeeding support for other African American women: prenatal discussions of breastfeeding with health care providers, African American lactation support personnel and breastfeeding support groups, and African American breastfeeding promotion in print and digital media. Conclusion: Women who participated in this study breastfed for longer durations than the national average for African Americans. Findings can inform practice and research efforts to improve breastfeeding rates in this population using lessons learned from successful women.

Peanut Allergen Powder-dnfp: A Novel Oral Immunotherapy to Mitigate Peanut Allergy

2020 ◽  
pp. 106002802094437
Author(s):  
John A. Dougherty ◽  
Justin D. Wagner ◽  
Megan C. Stanton
Keyword(s):  
Health Care Providers ◽  
Peanut Allergy ◽  
Safety Data ◽  
Oral Immunotherapy ◽  
Phase Iii ◽  
Phase 2 ◽  
Care Providers ◽  
Efficacy And Safety ◽  
Peanut Allergen ◽  
Significant Difference

Objective: To review data on efficacy and safety of peanut allergen powder-dnfp (PAP; Palforzia), a novel oral immunotherapy for peanut allergy, a common food allergy. Data Sources: A PubMed/CINAHL search in English was performed from inception to June 30, 2020, using the search words peanut allergy, desensitization, ARA101, and peanut oral immunotherapy. Study Selection and Data Extraction Quantification: Published phase 2 and 3 clinical trials, documents presented to the Food and Drug Administration, and supplemental study documentation were reviewed. Articles evaluated PAP’s pharmacology, pharmacokinetics, mechanism of action, efficacy, and safety. Data Synthesis: PAP was efficacious and safe for treatment of peanut allergy in mostly Caucasian children, 4 to 17 years old. A key phase III clinical trial showed a statistically significant difference (primary end point) between PAP 600 mg and placebo groups (67.2% vs 4%; P < 0.001). During initial dose escalation and updosing phases, gastrointestinal and respiratory tract allergic reactions (ARs) were more common in the PAP group. More epinephrine rescue was used in the PAP group. Relevance to Patient Care and Clinical Practice: Oral immunotherapy for desensitization of peanut allergy was shown to reduce the severity of reactions if accidental allergen exposure occurs. Risk evaluation and mitigation strategy certification is required for pharmacies, health care providers, and clinics. More data in real-world populations will enhance its effectiveness. Conclusions: In patients 4 to 17 years old, PAP mitigated ARs, including anaphylaxis, that may occur with accidental peanut exposure. Although there are risks, it was efficacious in more than two-thirds of participants in phase 2 and phase 3 efficacy trials.

scholarly journals Quality Assurance of Health Wearables Data: Participatory Workshop on Barriers, Solutions, and Expectations (Preprint)

2019 ◽  
Author(s):  
Robab Abdolkhani ◽  
Kathleen Gray ◽  
Ann Borda ◽  
Ruth DeSouza
Keyword(s):  
Health Care ◽  
Quality Assurance ◽  
Data Quality ◽  
Health Care Providers ◽  
Participatory Design ◽  
Clinical Decision Making ◽  
Clinical Care ◽  
Interactive Methods ◽  
Care Providers ◽  
Clinical Practices

BACKGROUND The ubiquity of health wearables and the consequent production of patient-generated health data (PGHD) are rapidly escalating. However, the utilization of PGHD in routine clinical practices is still low because of data quality issues. There is no agreed approach to PGHD quality assurance; therefore, realizing the promise of PGHD requires in-depth discussion among diverse stakeholders to identify the data quality assurance challenges they face and understand their needs for PGHD quality assurance. OBJECTIVE This paper reports findings from a workshop aimed to explore stakeholders’ data quality challenges, identify their needs and expectations, and offer practical solutions. METHODS A qualitative multi-stakeholder workshop was conducted as a half-day event on the campus of an Australian University located in a major health care precinct, namely the Melbourne Parkville Precinct. The 18 participants had experience of PGHD use in clinical care, including people who identified as health care consumers, clinical care providers, wearables suppliers, and health information specialists. Data collection was done by facilitators capturing written notes of the proceedings as attendees engaged in participatory design activities in written and oral formats, using a range of whole-group and small-group interactive methods. The collected data were analyzed thematically, using deductive and inductive coding. RESULTS The participants’ discussions revealed a range of technical, behavioral, operational, and organizational challenges surrounding PGHD, from the time when data are collected by patients to the time data are used by health care providers for clinical decision making. PGHD stakeholders found consensus on training and engagement needs, continuous collaboration among stakeholders, and development of technical and policy standards to assure PGHD quality. CONCLUSIONS Assuring PGHD quality is a complex process that requires the contribution of all PGHD stakeholders. The variety and depth of inputs in our workshop highlighted the importance of co-designing guidance for PGHD quality guidance.

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