scholarly journals Accelerated launch of video visits in ambulatory neurology during COVID-19

Neurology ◽  
2020 ◽  
Vol 95 (7) ◽  
pp. 305-311 ◽  
Author(s):  
Laurice Yang ◽  
Cati G. Brown-Johnson ◽  
Rebecca Miller-Kuhlmann ◽  
Samantha M.R. Kling ◽  
Erika A. Saliba-Gustafsson ◽  
...  
Keyword(s):  
Critical Role ◽  
Lessons Learned ◽  
Physician Engagement ◽  
Key Issues ◽  
Software Provider ◽  
Key Drivers ◽  
Rapid Deployment ◽  
Stakeholder Needs ◽  
And Training ◽  
Roll Out

The SARS-CoV-2 (COVID-19) pandemic has rapidly moved telemedicine from discretionary to necessary. Here, we describe how the Stanford Neurology Department (1) rapidly adapted to the COVID-19 pandemic, resulting in over 1,000 video visits within 4 weeks, and (2) accelerated an existing quality improvement plan of a tiered roll out of video visits for ambulatory neurology to a full-scale roll out. Key issues we encountered and addressed were related to equipment/software, provider engagement, workflow/triage, and training. On reflection, the key drivers of our success were provider engagement and dedicated support from a physician champion, who plays a critical role understanding stakeholder needs. Before COVID-19, physician interest in telemedicine was mixed. However, in response to county and state stay-at-home orders related to COVID-19, physician engagement changed completely; all providers wanted to convert a majority of visits to video visits as quickly as possible. Rapid deployment of neurology video visits across all its subspecialties is feasible. Our experience and lessons learned can facilitate broader utilization, acceptance, and normalization of video visits for neurology patients in the present as well as the much anticipated postpandemic era.

Two mechanisms for accelerated diffusion of COVID-19 outbreaks in regions with high intensity of population and polluting industrialization: the air pollution-to-human and human-to-human transmission dynamics (Preprint)

2020 ◽  
Author(s):  
Mario Coccia
Keyword(s):  
Air Pollution ◽  
Wind Speed ◽  
Critical Role ◽  
Meteorological Condition ◽  
Meteorological Conditions ◽  
Lessons Learned ◽  
Transmission Dynamics ◽  
Critical Threshold ◽  
Viral Infectivity ◽  
Low Wind Speed

BACKGROUND Coronavirus disease 2019 (COVID-19) is viral infection that generates a severe acute respiratory syndrome with serious pneumonia that may result in progressive respiratory failure and death. OBJECTIVE This study has two goals. The first is to explain the main factors determining the diffusion of COVID-19 that is generating a high level of deaths. The second is to suggest a strategy to cope with future epidemic threats with of accelerated viral infectivity in society. METHODS Correlation and regression analyses on on data of N=55 Italian province capitals, and data of infected individuals at as of April 2020. RESULTS The main results are: o The accelerate and vast diffusion of COVID-19 in North Italy has a high association with air pollution. o Hinterland cities have average days of exceeding the limits set for PM10 (particulate matter 10 micrometers or less in diameter) equal to 80 days, and an average number of infected more than 2,000 individuals as of April 1st, 2020, coastal cities have days of exceeding the limits set for PM10 equal to 60 days and have about 700 infected in average. o Cities that average number of 125 days exceeding the limits set for PM10, last year, they have an average number of infected individual higher than 3,200 units, whereas cities having less than 100 days (average number of 48 days) exceeding the limits set for PM10, they have an average number of about 900 infected individuals. o The results reveal that accelerated transmission dynamics of COVID-19 in specific environments is due to two mechanisms given by: air pollution-to-human transmission and human-to-human transmission; in particular, the mechanisms of air pollution-to-human transmission play a critical role rather than human-to-human transmission. o The finding here suggests that to minimize future epidemic similar to COVID-19, the max number of days per year in which cities can exceed the limits set for PM10 or for ozone, considering their meteorological condition, is less than 50 days. After this critical threshold, the analytical output here suggests that environmental inconsistencies because of the combination between air pollution and meteorological conditions (with high moisture%, low wind speed and fog) trigger a take-off of viral infectivity (accelerated epidemic diffusion) with damages for health of population, economy and society. CONCLUSIONS Considering the complex interaction between air pollution, meteorological conditions and biological characteristics of viral infectivity, lessons learned for COVID-19 have to be applied for a proactive socioeconomic strategy to cope with future epidemics, especially an environmental policy based on reduction of air pollution mainly in hinterland zones of countries, having low wind speed, high percentage of moisture and fog that create an environment that can damage immune system of people and foster a fast transmission of viral infectivity similar to the COVID-19. CLINICALTRIAL not applicable

How Lives Change

2018 ◽  
Author(s):  
Himanshu ◽  
Peter Lanjouw ◽  
Nicholas Stern
Keyword(s):  
Green Revolution ◽  
Critical Role ◽  
Uttar Pradesh ◽  
North India ◽  
Land Reforms ◽  
Key Drivers ◽  
Growth And Change ◽  
Development Outcomes ◽  
The Village

Development economics is about understanding how and why lives and livelihoods change. This book is about economic development in the village of Palanpur, in Moradabad district, Uttar Pradesh, in north India. It draws on seven decades of detailed data collection by a team of dedicated development economists to describe the evolution of Palanpur’s economy, its society, and its politics. The emerging story of integration of the village economy with the outside world is placed against the backdrop of a rapidly transforming India and, in turn, helps to understand the transformation. The role of, and scope for, public policy in shaping the lives of individuals is examined. The book describes how changes in Palanpur’s economy since the late 1950s were initially driven by the advance of agriculture through land reforms, the expansion of irrigation, and the introduction of ‘green revolution’ technologies. Then, since the mid-1980s, newly emerging off-farm opportunities in nearby towns and outside agriculture became the key drivers of growth and change. These key forces of change have profoundly influenced poverty, income mobility, and inequality in Palanpur. Village institutions such as those governing access to land are shown to have evolved in subtle but clear ways over time, while individual entrepreneurship and initiative is found to play a critical role in driving and responding to the forces of change. And yet, against a backdrop of real economic growth and structural transformation, the book documents how human development outcomes have shown only weak progress and remain stubbornly resistant to change.

scholarly journals Dendritic Cell Tumor Vaccination via Fc Gamma Receptor Targeting: Lessons Learned from Pre-Clinical and Translational Studies

Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 409
Author(s):  
Enrique Gómez Alcaide ◽  
Sinduya Krishnarajah ◽  
Fabian Junker
Keyword(s):  
T Cell ◽  
T Cell Activation ◽  
Cell Activation ◽  
Tumor Antigens ◽  
Checkpoint Inhibitors ◽  
Critical Role ◽  
Lessons Learned ◽  
Antigen Delivery ◽  
Tumor Vaccination ◽  
Translational Studies

Despite significant recent improvements in the field of immunotherapy, cancer remains a heavy burden on patients and healthcare systems. In recent years, immunotherapies have led to remarkable strides in treating certain cancers. However, despite the success of checkpoint inhibitors and the advent of cellular therapies, novel strategies need to be explored to (1) improve treatment in patients where these approaches fail and (2) make such treatments widely and financially accessible. Vaccines based on tumor antigens (Ag) have emerged as an innovative strategy with the potential to address these areas. Here, we review the fundamental aspects relevant for the development of cancer vaccines and the critical role of dendritic cells (DCs) in this process. We first offer a general overview of DC biology and routes of Ag presentation eliciting effective T cell-mediated immune responses. We then present new therapeutic avenues specifically targeting Fc gamma receptors (FcγR) as a means to deliver antigen selectively to DCs and its effects on T-cell activation. We present an overview of the mechanistic aspects of FcγR-mediated DC targeting, as well as potential tumor vaccination strategies based on preclinical and translational studies. In particular, we highlight recent developments in the field of recombinant immune complex-like large molecules and their potential for DC-mediated tumor vaccination in the clinic. These findings go beyond cancer research and may be of relevance for other disease areas that could benefit from FcγR-targeted antigen delivery, such as autoimmunity and infectious diseases.

scholarly journals British Columbia SHIFT: Early Lessons Learned from a Provincial Program for Countering Radicalization to Violent Extremism

Proceedings ◽  
2021 ◽  
Vol 77 (1) ◽  
pp. 8
Author(s):  
Garth Davies ◽  
Madison Reid
Keyword(s):  
British Columbia ◽  
Lessons Learned ◽  
First Year ◽  
Stakeholder Relationships ◽  
Violent Extremism ◽  
Excellent Work ◽  
Services And Supports ◽  
The Right ◽  
Government Initiative ◽  
And Training

Many existing programs for countering violent extremism focus on either end of the radicalization spectrum. On one hand are prevention programs aimed at deterring individuals from starting down the path to violent extremism. On the other hand are disengagement/de-radicalization programs designed for assisting individuals who have been fully radicalized. Conspicuously absent are programs for those who fall in-between, into what might be referred to as the pre-criminal space: individuals who have begun to exhibit signs of radicalization, but for whom radicalization is not yet complete. The British Columbia Shift (BC Shift) initiative was created to assist individuals determined to be in this pre-criminal space; that is, those deemed to be in danger of radicalizing. The goal of BC Shift is to stop individuals from traveling further down the path of radicalization, and, ideally, to turn individuals away from the path. BC Shift operates as a navigational model, connecting at-risk individuals with services and supports in the community. BC Shift is a government initiative supported by the Canada Centre for Community Engagement and Prevention of Violence. It is a civilian organization that partners very closely with, but is separate from, law enforcement. In addition to its primary CRVE mandate, BC Shift has rapidly evolved and expanded into several other responsibilities, including coordination on national CVE standards; liaising with other CVE programs across Canada; maintaining stakeholder relationships; and helping create capacity through dialog and training. Although the program only began accepting referrals in 2019, its operation has already revealed many important lessons for CRVE programs. First, it is critically important to have the right people in the room. There has to be buy-in from the highest levels of partner agencies and stakeholders, particularly early on. Second, programs of this sort should leverage existing resources wherever possible. BC Shift has been lucky enough to coordinate with situation tables, such as the CHART program in Surrey. There are already many organizations doing excellent work in their respective communities; it is very helpful to plug into those resources. Third, even though BC Shift operates as a navigational hub, it has benefitted greatly from having a social worker as part of the team. This skill set is important in helping referred individuals feel comfortable with the process of accessing services and supports. Finally, marketing matters! CRVE programs such as BC Shift have to navigate a complex reality. The very concept of violent extremism is disconcerting to a lot of people in the community; these fears have to be addressed, and difficulties related to differences in perspective and language have to be overcome. BC Shift’s first year-and-a-half of operation has also highlighted several issues that have not yet been satisfactorily resolved. There is, for example, the “low hanging fruit” problem; agencies are typically referring less severe cases. Trying to get agencies to refer more serious cases has proved challenging. We hope that, by outlining these lessons and issues, this presentation proves to be useful to other CRVE initiatives.

scholarly journals Capacity Development for Use of Remote Sensing for REDD+ MRV Using Online and Offline Activities: Impacts and Lessons Learned

2021 ◽  
Vol 13 (11) ◽  
pp. 2172
Author(s):  
Sarah Carter ◽  
Martin Herold ◽  
Inge Jonckheere ◽  
Andres Espejo ◽  
Carly Green ◽  
...  
Keyword(s):  
Remote Sensing ◽  
Forest Cover ◽  
Hybrid Approach ◽  
Remote Sensing Data ◽  
Lessons Learned ◽  
Multiple Partners ◽  
Large Audience ◽  
Forest Cover Changes ◽  
The Impact ◽  
And Training

Four workshops and a webinar series were organized, with the aim of building capacity in countries to use Earth Observation Remote Sensing data to monitor forest cover changes and measure emissions reductions for REDD+ results-based payments. Webinars and workshops covered a variety of relevant tools and methods. The initiative was collaboratively organised by a number of Global Forest Observations Initiative (GFOI) partner institutions with funding from the World Bank’s Forest Carbon Partnership Facility (FCPF). The collaborative approach with multiple partners proved to be efficient and was able to reach a large audience, particularly in the case of the webinars. However, the impact in terms of use of tools and training of others after the events was higher for the workshops. In addition, engagement with experts was higher from workshop participants. In terms of efficiency, webinars are significantly cheaper to organize. A hybrid approach might be considered for future initiatives; and, this study of the effectiveness of both in-person and online capacity building can guide the development of future initiatives, something that is particularly pertinent in a COVID-19 era.

scholarly journals NEET as an Outcome for Care Leavers in South Africa: The Case of Girls and Boys Town

2018 ◽  
Vol 8 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Lisa Dickens ◽  
Peter Marx
Keyword(s):  
Emerging Adults ◽  
South African ◽  
Critical Role ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Care Leavers ◽  
Boys Town ◽  
Employment Education ◽  
Status Of Care ◽  
And Training

A well-documented outcome for emerging adults in determining their “success” is whether they are Not in Employment, Education, or Training (NEET) or engaged in Education, Employment, and Training (EET). Being NEET can create psychological, emotional, financial, and health challenges and is a significant risk factor in youth making successful transitions into adulthood. This article describes and compares the NEET and EET status of care leavers from Girls and Boys Town after 1 and 2 years and in relation to other outcomes. The results suggest that while care leavers’ NEET rates are high, they are not significantly higher than those of the South African general population as seen elsewhere in the world. Furthermore, being NEET is associated with more negative care leaving outcomes than being EET; however, this article also highlights the vulnerability of those who are EET. Relationships with family and support networks play a critical role in helping and supporting these youth.

Case Studies

2018 ◽  
pp. 165-220
Keyword(s):  
Case Studies ◽  
Third Parties ◽  
Lessons Learned ◽  
Entry Points ◽  
Key Issues

This chapter offers a case study comparison in order to extrapolate lessons learned from different contexts and to investigate the key elements of effective mediation. The investigation and exploration looks at the following categories: (1) key lessons learned; (2) background of the conflict, including chronology of main event, causes of incompatibility, and balance of forces1; (3) pre-negotiation phase, including previous attempts to negotiate the issues and highlighting entry points for third parties; (4) negotiation phase, including style and strategy, key issues, participation and inclusivity, special considerations; and (5) assessment, including an appreciation of agreement, context, and outlook.

In Graduate School, I Learned What I Need to Know About Running a Successful Practice

2019 ◽  
pp. 3-6
Author(s):  
Jeffrey E. Barnett ◽  
Jeffrey Zimmerman
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Graduate School ◽  
Health Professionals ◽  
Private Practice ◽  
Clinical Skills ◽  
Early Career ◽  
Key Issues ◽  
Financial Issues ◽  
And Training

Although most mental health professionals receive excellent education and training that helps them to become competent and highly effective clinicians, graduate school tends not to provide training in the business side of practice that is needed for success in private practice. Many trainees and early-career clinicians may think they learned in graduate school all they need to know to be successful in the business of practice. Unfortunately, this is generally not true and many of those who enter private practice are poorly prepared for planning, establishing, and running a successful private practice. This chapter addresses the key issues every mental health clinician should know about when contemplating opening a private practice. Business and financial issues are addressed, including developing a business plan and utilizing various consultants. This chapter addresses the myth that excellent clinical skills are sufficient for success in the business of private mental health practice.

scholarly journals Improved Biosafety and Biosecurity Measures and/or Strategies to Tackle Laboratory-Acquired Infections and Related Risks

2018 ◽  
Vol 15 (12) ◽  
pp. 2697 ◽  
Author(s):  
Huasong Peng ◽  
Muhammad Bilal ◽  
Hafiz Iqbal
Keyword(s):  
Genetically Modified Organisms ◽  
Hazardous Materials ◽  
Education And Training ◽  
Lessons Learned ◽  
Working Environment ◽  
Salmonella Spp ◽  
The Past ◽  
Health Related ◽  
Laboratory Workers ◽  
And Training

Herein, we reviewed laboratory-acquired infections (LAIs) along with their health-related biological risks to provide an evidence base to tackle biosafety/biosecurity and biocontainment issues. Over the past years, a broad spectrum of pathogenic agents, such as bacteria, fungi, viruses, parasites, or genetically modified organisms, have been described and gained a substantial concern due to their profound biological as well as ecological risks. Furthermore, the emergence and/or re-emergence of life-threatening diseases are of supreme concern and come under the biosafety and biosecurity agenda to circumvent LAIs. Though the precise infection risk after an exposure remains uncertain, LAIs inspections revealed that Brucella spp., Mycobacterium tuberculosis, Salmonella spp., Shigella spp., Rickettsia spp., and Neisseria meningitidis are the leading causes. Similarly, the human immunodeficiency virus (HIV) as well as hepatitis B (HBV) and C viruses (HCV), and the dimorphic fungi are accountable for the utmost number of viral and fungal-associated LAIs. In this context, clinical laboratories at large and microbiology, mycology, bacteriology, and virology-oriented laboratories, in particular, necessitate appropriate biosafety and/or biosecurity measures to ensure the safety of laboratory workers and working environment, which are likely to have direct or indirect contact/exposure to hazardous materials or organisms. Laboratory staff education and training are indispensable to gain an adequate awareness to handle biologically hazardous materials as per internationally recognized strategies. In addition, workshops should be organized among laboratory workers to let them know the epidemiology, pathogenicity, and human susceptibility of LAIs. In this way, several health-related threats that result from the biologically hazardous materials can be abridged or minimized and controlled by the correct implementation of nationally and internationally certified protocols that include proper microbiological practices, containment devices/apparatus, satisfactory facilities or resources, protective barriers, and specialized education and training of laboratory staffs. The present work highlights this serious issue of LAIs and associated risks with suitable examples. Potential preventive strategies to tackle an array of causative agents are also discussed. In this respect, the researchers and scientific community may benefit from the lessons learned in the past to anticipate future problems.

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