scholarly journals Development and assessment of the feasibility of a Zika family support programme: a study protocol

2019 ◽  
Vol 4 ◽  
pp. 80 ◽  
Author(s):  
Antony Duttine ◽  
Tracey Smythe ◽  
Miriam Ribiero Calheiro de Sá ◽  
Silvia Ferrite ◽  
Maria Elisabeth Moreira ◽  
...  
Keyword(s):  
Family Support ◽  
Rio De Janeiro ◽  
Local Community ◽  
List Item ◽  
Scale Up ◽  
Healthcare Services ◽  
Cost Calculation ◽  
List Type ◽  
Care Needs ◽  
Support Programme

The Zika virus outbreak in Brazil in 2015 affected thousands of people. Zika is now known to cause congenital malformations leading to impairments and developmental delays in affected children, including Congenital Zika Syndrome (CZS). Children with CZS have complex care needs. Caregivers require significant levels of support to meet these needs, and there are large gaps in healthcare services. This study aims to develop, pilot and assess the feasibility and scalability of a community-based Family Support Programme for caregivers of children with CZS. The programme is adapted from the Getting to Know Cerebral Palsy (GTKCP) programme for the context of CZS in Brazil. GTKCP is a 10-session programme held with 6-10 caregivers in the local community. It includes practical, educational, peer-support and psychosocial aspects, which aim to improve confidence and capacity to care for a child with CP, and quality of life and empowerment of caregivers. The research project contains four components: Ascertaining need for the caregiver programme: a mixed-methods approach that included two literature reviews, interviews with key stakeholders in country, and incorporation of findings from the Social and Economic Impact of Zika study.Adapting GTKCP for the context of CZS and Brazil: undertaken with guidance from technical experts.Pilot testing the intervention: deliver the 10-session programme to one group of caregivers of children with CZS in Rio de Janeiro and another in Greater Salvador.Update the manual through fast-track learning from participant and facilitator feedback. Assessing the feasibility of the intervention for scale up: deliver the updated programme to two groups each in Rio de Janeiro and Greater Salvador, and evaluate the acceptability, demand, implementation, practicality, adaptation, integration, expansion, and limited efficacy, through questionnaires, direct observation, semi-structured interviews and cost calculation. The project has ethics approval in both the UK and Brazil.

scholarly journals Adopt, adapt, or abandon technology-supported person-centred care initiatives: healthcare providers’ beliefs matter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Dyb ◽  
Gro Rosvold Berntsen ◽  
Lisbeth Kvam
Keyword(s):  
Information Technologies ◽  
Scale Up ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Analytical Framework ◽  
Development Project ◽  
Technology Support ◽  
Care Needs ◽  
Term Care

Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.

scholarly journals Adopt, adapt or abandon: Health care providers’ beliefs matter. Using the NASSS framework to analyse the implementation of four technology-supported person-centred care initiatives from the perspectives of health care providers

2021 ◽  
Author(s):  
Kari Dyb ◽  
Gro Berntsen ◽  
Lisbeth Kvam
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Information Technologies ◽  
Scale Up ◽  
Healthcare Services ◽  
Development Project ◽  
Care Providers ◽  
Care Needs ◽  
Term Care ◽  
Patient Centred Care

Abstract Background: Technology support and patient-centred care are the new mantra for health care programmes in Western societies. While few argue with the overarching philosophy of patient-centred care nor with the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual health care providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for persons with long-term care needs by using the new analytical framework Nonadoption, Abandonment and challenges to the Scale-Up, Spread, and Sustainability of health and care technologies (NASSS). We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement and evaluate technology-supported health care programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016 - 2020). It originates at one of nine work packages in this project.Method: The main data consist of ethnographic field observations at the four innovations arenas and 29 interviews with involved health care providers. To ensured continuous updates and status on work at the four innovation arenas, we have also participated in a total of six annual networks meeting arrange by the project. Results: While the NASSS framework is very useful indeed for identifying and communicating challenges with adoption and spread of technology-supported person-centred- care initiatives, we find it less sensitive towards capturing the dedication, enthusiasm and passion for care transformation that we found among the health care providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved health care providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion: Increased knowledge about the health care providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement and evaluate technology-supported health care programmes.

Topics of Environmental Education Program in Coastal Areas

1992 ◽  
Vol 25 (9) ◽  
pp. 253-259 ◽  
Author(s):  
A. M. O. Rennhack ◽  
D. M. W. Zee ◽  
E. S. Cunha ◽  
M. F. Portilho
Keyword(s):  
Environmental Education ◽  
Rio De Janeiro ◽  
Local Community ◽  
Environmental Problems ◽  
Coastal Areas ◽  
State University ◽  
Urban Centers ◽  
Educational Support ◽  
Wide Range ◽  
Supply Information

Researches and Studies made by the Department of Oceanography of the Institute of Geoscience of the State University of Rio de Janeiro UERJ, evidenced the need for educational support where environment-related questions were concerned. A wide range of environment problems tend to concentrate in coastal areas, owing to disordinate urban growth combined with the lack of substructure to cope with it A large number of these problems can be minimized through the participation of the local community. Thus the goals of environmental education are to supply information, to promote a change in the population's attitude toward environmental problems, besides stimulating its participation by fostering its sense of responsibility. Preliminary results have demonstrated that the community has shown great interest in the work that has been proposed, and it has contributed with participation, promising response. Environmental education is fundamental when we consider possible solutions for environmental problems in coastal urban centers. Only by educating the main cause of environmental problems, man himself, will it be possible to consider the question starting from its very origin. This abstract presents two pioneer experiments in the Municipio of Rio de Janeiro, which are “Muito Prazer Marapendi” (“Glad to know you, Marapendi”) and “Troca de Areias da Praia de Copacabana” (“Exchange of Sands in Copacabana Beach”).

128 Development of an M1-polarized, non-viral chimeric antigen receptor macrophage (CAR-M) platform for cancer immunotherapy

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A141-A141
Author(s):  
Yumi Ohtani ◽  
Kayleigh Ross ◽  
Aditya Dandekar ◽  
Rashid Gabbasov ◽  
Michael Klichinsky
Keyword(s):  
Cancer Immunotherapy ◽  
Chimeric Antigen Receptor ◽  
Scale Up ◽  
Antigen Receptor ◽  
Innate Immune ◽  
List Type ◽  
M1 Phenotype ◽  
The Impact ◽  
Anti Tumor Activity ◽  
Immunosuppressive Factors

BackgroundWe have previously developed CAR-M as a novel cell therapy approach for the treatment of solid tumors.1 CAR-M have the potential to overcome key challenges that cell therapies face in the solid tumor setting – tumor infiltration, immunosuppression, lymphocyte exclusion – and can induce epitope spreading to overcome target antigen heterogeneity. While macrophages transduced with the adenoviral vector Ad5f35 (Ad CAR-M) traffic to tumors, provide robust anti-tumor activity, and recruit and activate T cells, we sought to identify a robust non-viral method of macrophage engineering in order to reduce the cost of goods, manufacturing complexity, and potential immunogenicity associated with viral vectors.MethodsAs innate immune cells, macrophages detect exogenous nucleic acids and respond with inflammatory and apoptotic programs. Thus, we sought to identify a means of mRNA delivery that avoids recognition by innate immune sensors. We screened a broad panel of mRNA encoding an anti-HER2 CAR comprising multiplexed 5’Cap and base modifications using an optimized and scalable electroporation approach and evaluated the impact of interferon-β priming on CAR-M phenotype and function.ResultsWe identified the optimal multiplexed mRNA modifications that led to maximal macrophage viability, transfection efficiency, intensity of CAR expression, and duration of expression. Non-viral HER2 CAR-M phagocytosed and killed human HER2+ tumor cells. Unlike Ad CAR-M, mRNA CAR-M were not skewed toward an M1 state by mRNA electroporation. Priming non-viral CAR-M with IFN-β induced a durable M1 phenotype, as shown by stable upregulation of numerous M1 markers and pathways. IFN-β priming significantly enhanced the anti-tumor activity of CAR but not control macrophages. IFN-β primed mRNA CAR-M were resistant to M2 conversion, maintaining an M1 phenotype despite challenge with various immunosuppressive factors, and converted bystander M2 macrophages toward M1. Interestingly, priming mRNA CAR-M with IFN-β significantly enhanced the persistence of CAR expression, overcoming the known issue of rapid mRNA turnover. RNA-seq analysis revealed that IFN-β priming affected pathways involved in increasing translation and decreasing RNA degradation in human macrophages.ConclusionsWe have established a novel, optimized non-viral CAR-M platform based on chemically modified mRNA and IFN-β priming. IFN-β priming induced a durable M1 phenotype, improved CAR expression, improved CAR persistence, led to enhanced anti-tumor function, and rendered resistance to immunosuppressive factors. This novel platform is amenable to scale-up, GMP manufacturing, and represents an advance in the development of CAR-M.ReferenceKlichinsky M, Ruella M, Shestova O, et al. Human chimeric antigen receptor macrophages for cancer immunotherapy. Nat Biotechnol 2020;38(8):947–953.

scholarly journals Scheduling Delayed Treatment and Surgeries Post-Pandemic: A Stakeholder Analysis

2020 ◽  
Vol 9 (1) ◽  
pp. 10-14
Author(s):  
Emily S. Patterson ◽  
Elizabeth Lerner Papautsky ◽  
Jessica L. Krok-Schoen ◽  
Clara Lee ◽  
Ko Un Park ◽  
...  
Keyword(s):  
Local Community ◽  
Elective Surgery ◽  
Stakeholder Analysis ◽  
Healthcare Providers ◽  
Hospital Staff ◽  
Operating Rooms ◽  
Inpatient Setting ◽  
Care Needs ◽  
Delayed Treatment ◽  
Increased Risk

Many are interested in how to safely ramp up elective surgeries after national, state, and voluntary shutdowns of operating rooms to minimize the spread of COVID-19 infections to patients and providers. We conducted an analysis of diverse perspectives from stakeholders regarding how to trade off risks and benefits to patients, healthcare providers, and the local community. Our findings indicate that there are a large number of different categories of stakeholders impacted by the post-pandemic decisions to reschedule delayed treatments and surgeries. For a delayed surgery, the primary stakeholders are the surgeon with expertise about the clinical benefits of undergoing an operation and the patient’s willingness to tolerate uncertainty and the increased risk of infection. For decisions about how much capacity in the operating rooms and in the inpatient setting after the surgery, the primary considerations are minimizing staff infections, preventing patients from getting COVID-19 during operations and during post-surgical recovery at the hospital, conserving critical resources such as PPE, and meeting the needs of hospital staff for quality of life, such as child care needs and avoiding infecting members of their household. The timing and selection of elective surgery cases has an impact on the ability of hospitals to steward finances, which in turns affects decisions about maintaining employment of staff when operating rooms and inpatient rooms are not being used.

scholarly journals Why did the children stop coming? Reasons for paediatric emergency department attendance decrease during the first wave of the COVID-19 pandemic in the United Kingdom: A qualitative study

2021 ◽  
Author(s):  
Matthew Breckons ◽  
Sophie Thorne ◽  
Rebecca Walsh ◽  
Sunil Bhopal ◽  
Stephen Owens ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
United Kingdom ◽  
Substantial Reduction ◽  
Healthcare Services ◽  
Urgent Care ◽  
List Type ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Health Messaging

AbstractObjectiveTo explore parent’s experiences and views relating to their use of children’s emergency healthcare services during the Covid-19 pandemic.DesignQualitative telephone interview study using in-depth interviews, based on the principles of grounded theory. Recorded, transcribed verbatim, managed in NVivo version 12, analysed by thematic analysis.SettingNorth East England, United Kingdom.ParticipantsParents of children aged 0-8 years.FindingsThree major themes emerged from the interview data: Risk to children and families, Sources of Information, and Making Healthcare-seeking Decisions. These themes encompassed a range of intellectual and emotional responses in the way that parents interpreted information related to Covid-19, and their sense of responsibility towards family and wider society.ConclusionsTogether these themes aid understanding of the changes in paediatric emergency department attendances reported in the early months of the Covid-19 pandemic in the UK. The analysis suggests that public health messaging directed at those seeking urgent care for children may be inadequate and lead to adverse consequences, the impacts of which require further study and refinement.What is known about the subjectFollowing lockdown, there was a substantial reduction in the number of children taken to unscheduled medical care across the countryDelays in presentation can impact on children’s healthIt is not known what parents’ views are on accessing emergency health services in a pandemic situationWhat this study addsParents had to weigh up a number of information sources before deciding on whether to take their child to hospitalPublic health messaging directed at those seeking urgent care for children may lead to a reduction in use of emergency healthcare servicesFuture lockdowns should implement focussed strategies, optimising use of emergency healthcare services, whilst avoiding harm.

scholarly journals Strengthening public COVID-19 response with private facilities in Kisumu, Kenya

2021 ◽  
Author(s):  
Shannen van Duijn ◽  
Hellen C. Barsosio ◽  
Mevis Omollo ◽  
Emmanuel Milimo ◽  
Isdorah A. Odero ◽  
...  
Keyword(s):  
Private Sector ◽  
Healthcare Workers ◽  
Scale Up ◽  
Public Private Partnership ◽  
Healthcare Sector ◽  
List Type ◽  
Private Partnership ◽  
Healthcare Facilities ◽  
New Findings ◽  
The Way

AbstractINTRODUCTIONSARS-CoV-2 testing is one of the options to combat COVID-19 in Kenya. In the first COVID-19 year there was limited tapping of the private sector’s potential to scale up testing in Kenya. In April 2020, we initiated a unique public-private partnership (PPP) project in Kisumu County connecting the private sector to centralized testing supported by the ministry of health (MoH), ‘COVID-Dx’, to accelerate the local response to COVID-19. Within COVID-Dx, we aimed to demonstrate this PPP’s performance as a replicable model for effective public-private collaboration in responding to the COVID-19 pandemic in similar settings.METHODSKEMRI, Department of Health Kisumu County, PharmAccess Foundation, and local faith-based and private healthcare facilities collaborated in COVID-Dx. COVID-Dx was implemented from June 01, 2020, to March 31, 2021, in Kisumu County, Kenya. Trained laboratory technologists in participating healthcare facilities collected nasopharyngeal and oropharyngeal samples from patients meeting the MoH COVID-19 case definition. Samples were tested at the central laboratory in KEMRI via SARS-CoV-2 RT-PCR. Healthcare workers in participating facilities collected data using the digitized MoH COVID-19 Case Identification Form. We shared aggregated results from these data via (semi-) live dashboard to all relevant stakeholders. We did descriptive statistical analyses using Stata 16 to inform project processes.RESULTSNine facilities participated in the project. A total of 4,324 PCR tests for SARS-CoV-2 were done, with 425 positives. We noted differences in positivity rates between the facilities. Healthcare workers were the largest group tested in the project, 1009, representing 43% of the Kisumu healthcare workforce.CONCLUSIONCOVID-Dx can serve as a model for PPPs scale-up testing, especially LMICs, and digitizing the MoH case report form improved reporting efficiency, demonstrating that digital is the way forward. The COVID-Dx PPP has led to another collaboration with Kisumu County aimed towards extending the COVID-Dx model to other counties.SUMMARY BOXWhat is already known?In sub-Saharan Africa, COVID-19 responses are mainly rolled out through the public healthcare sector, even though the private sector plays a significant role in health service deliveryThe challenge is to combine private and public efforts in healthcare delivery in a mutually supportive and collaborative manner, especially during large outbreaks such as COVID-19.What are the new findings?The development of a public-private partnership (COVID-Dx) at the start of a global pandemic - COVID-19 – is challenging, but PPPs are essential for epidemic preparedness.The development of a digital app with a corresponding dashboard, ensures transparency and efficiency. It has shown to enable data-driven decision-making and provides insight into how to prioritize funding streams.What do the new findings imply?This PPP model is replicable and can serve as an example of PPPs for epidemic preparedness in similar settings in LMICs.Digital is the way going forward when combatting large outbreaks in the future, especially in LMICs

scholarly journals Enhanced production of taxadiene in Saccharomyces cerevisiae

2020 ◽  
Author(s):  
Behnaz Nowrouzi ◽  
Rachel Li ◽  
Laura E. Walls ◽  
Leopold d’Espaux ◽  
Koray Malci ◽  
...  
Keyword(s):  
Saccharomyces Cerevisiae ◽  
Shake Flask ◽  
Scale Up ◽  
Cost Effective ◽  
Cancer Drug ◽  
List Type ◽  
Taxadiene Synthase ◽  
Enhanced Production ◽  
Anti Cancer ◽  
Positive Effect

AbstractCost-effective production of the highly effective anti-cancer drug, paclitaxel (Taxol®), remains limited despite growing global demands. Low yields of the critical taxadiene precursor remains a key bottleneck in microbial production. In this study, the key challenge of poor taxadiene synthase (TASY) solubility in S. cerevisiae was revealed, and the strains were strategically engineered to relieve this bottleneck. Multi-copy chromosomal integration of TASY harbouring a selection of fusion solubility tags improved taxadiene titres 22-fold, up to 57 ± 3 mg/L at 30 °C at shake flask scale. The scalability of the process was highlighted through achieving similar titres during scale up to 25 mL and 250 mL in shake flask and bioreactor cultivations, respectively. Maximum taxadiene titres of 129 ± 15 mg/L and 119 mg/L were achieved through shake flask and bioreactor cultivation, respectively, of the optimal strain at a reduced temperature of 20 °C. The results highlight the positive effect of coupling molecular biology tools with bioprocess variable optimisation on synthetic pathway development.HighlightsMaximum taxadiene titre of 129 ± 15 mg/L in Saccharomyces cerevisiae at 20 °CIntegrating fusion protein tagged-taxadiene synthase improved taxadiene titre.Consistent taxadiene titres were achieved at the micro-and mini-bioreactor scales.

scholarly journals The Forms of Social Engagement of Polish Firms

2015 ◽  
Vol 16 (2) ◽  
pp. 61-76
Author(s):  
Krystyna Kietlińska
Keyword(s):  
Social Engagement ◽  
Local Community ◽  
Early Stage ◽  
Social Activity ◽  
Social Needs ◽  
List Type ◽  
Stage Of Development ◽  
The Disabled ◽  
Corporate Social ◽  
Number Of Firms

AbstractThe development of the idea of Corporate Social Responsibility (CSR) depends mainly on the changes in international market and growing competition between countries and enterprises. These factors influence on the behavior of enterprises. This means that the goal of business action is not only profit-making but also fulfilling social needs. The goal of this paper is to present and assess social in Poland. Starting with the concept and scope of CSR, the article presents benefits from responsible business activity and implementation of this idea in Poland.The research carried out in 2012 shows that the main implementers of CSR are large firms with foreign capital. They know the idea of CSR from the experience of Western firms. The main objective is their image and to build better relations with their environment. On this background the article shows the ranking of companies participating in “Leader of Philanthropy” competition. It allowed to choose four firms as an example of good practices in social engagement. Social activity of chosen firms was addressed to: employees,children,local community,the sick, the disabled and the poor,animals.The contacted research proves that social engagement of Polish firms is at the early stage of development. The number of firms increase, but there are mainly large companies. The main reason that the small business share in social engagement results from the limited amount of financial resources at their disposal.

scholarly journals Mulheres que fizeram aborto no Município do Rio de Janeiro, Brasil: aplicação de um modelo hierárquico bayesiano

2020 ◽  
Vol 36 (suppl 1) ◽  
Author(s):  
Natália Santana Paiva ◽  
Daniel Antunes Maciel Villela ◽  
Leonardo Soares Bastos ◽  
Francisco I. Bastos
Keyword(s):  
Rio De Janeiro ◽  
Scale Up ◽  
Network Scale

Resumo: Estimativas de mulheres que fizeram aborto provocado em localidades cujas leis são restritivas ainda são escassas na literatura científica, e a não coincidência de estimativas oriundas dos métodos hoje em uso clama pela aplicação de métodos inovadores, como novos métodos indiretos. Tal necessidade é especialmente aguda nas áreas mais densamente povoadas, como as capitais brasileiras, dada a magnitude do fenômeno e os danos e riscos daí decorrentes. O artigo objetiva estimar o número de mulheres que fez aborto provocado no Município do Rio de Janeiro, Brasil, em 2011, por meio de um modelo hierárquico bayesiano. Ele foi aplicado aos dados de um inquérito domiciliar que subsidiou a utilização do método network scale-up, no Município do Rio de Janeiro, um modelo hierárquico bayesiano utilizando as informações indiretas baseadas na rede de contatos dos participantes selecionados de forma aleatória da população. Das 1.758.145 mulheres de 15-49 anos residentes no Município do Rio de Janeiro (13.025; ICr95%: 10.635; 15.748) mulheres fizeram aborto provocado em 2011, resultando numa incidência acumulada média de 7,41 (ICr95%: 6,05; 8,96) para cada 1.000 mulheres de 15-49 anos. O estudo de autovalidação do modelo permitiu identificar padrões de subestimação em subpopulações estigmatizadas com baixa visibilidade social, como mulheres fizeram aborto provocado. O abortamento provocado é uma prática recorrente entre as mulheres no Município do Rio de Janeiro. Novos métodos de estimação indireta podem contribuir para a apreensão mais precisa do evento, considerando o contexto de ilegalidade, e contribuir para formulação de políticas de saúde.

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