The CTSA Mandate: Are We There Yet?

The ultimate aim of the National Institutes of Health Clinical and Translational Science Award (CTSA) initiative is to accelerate the movement of discoveries that can benefit human health into widespread public use. To accomplish this translational mandate, the contributions of multiple disciplines, such as dentistry, nursing, pharmacy, public health, biostatistics, epidemiology, and bioengineering, are required in addition to medicine. The research community is also mandated to establish new partnerships with organized patient communities and front line health care providers to assure the bidirectional flow of information in order that health priorities experienced by the community inform the research agenda. This article summarizes current clinical research directives, the experience of the University of Michigan faculty during the first 2 years of CTSA support, and recommendations to enhance the effectiveness of future CTSA as well as other interdisciplinary initiatives. While the manuscript focuses most closely on the CTSA Community Engagement mission, the challenges to interdisciplinarity and bidirectionality extend beyond the focus of community engagement.

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4475 Meeting Partners Where They Are: Tailoring Community-Engaged Research Consultation Services

Journal of Clinical and Translational Science ◽

10.1017/cts.2020.275 ◽

2020 ◽

Vol 4 (s1) ◽

pp. 87-88

Author(s):

Adam Paberzs ◽

Patricia Piechowski ◽

Jordan Poll ◽

Meghan Spiroff ◽

Karen Calhoun ◽

...

Keyword(s):

Community Engagement ◽

Lessons Learned ◽

Health Priorities ◽

University Of Michigan ◽

Community Partner ◽

Consultation Process ◽

Grant Applications ◽

Funding Opportunities ◽

The University ◽

Consultation Services

OBJECTIVES/GOALS: One of the most significant challenges to community engagement experienced by Clinical and Translational Science Award (CTSA) institutions is inadequate capacity of academic and community partners to engage in collaborative research. Several CTSAs within the consortium provide consultation services to help address this gap. METHODS/STUDY POPULATION: For over 10 years, the Michigan Institute for Clinical and Health Research (MICHR), a CTSA at the University of Michigan, has provided CEnR-specific consultations to partners seeking support for a variety of needs. Consultations can be requested for assistance with identifying potential partners, developing partnership infrastructure, finding CEnR funding opportunities, and incorporating CEnR approaches into research plans. When a consultation is requested, MICHR’s Community Engagement (CE) Program responds by planning a meeting with staff and faculty who have relevant skills, expertise, and connections. After the initial meeting, the CE Program provides follow-up communication and support based on the needs of the specific request, and often facilitates connections with potential partners. RESULTS/ANTICIPATED RESULTS: The two most frequent types of consultation requests involve 1) making connections with potential researchers or community partner organizations, and 2) providing guidance on research grant applications that involve community engagement. MICHR provides approximately 50 CEnR consultations each year, which have resulted in development of new partnerships, grant submissions, and research projects that utilize CEnR principles and address community-identified health priorities. DISCUSSION/SIGNIFICANCE OF IMPACT: This presentation will describe the evolution of MICHR’s CEnR consultation process and highlight successful outcomes and lessons learned over its 12-year history. CONFLICT OF INTEREST DESCRIPTION: NA

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Creating Academic and Health Care Partnerships that Impact Public Health

Kinesiology Review ◽

10.1123/kr.2015-0037 ◽

2015 ◽

Vol 4 (4) ◽

pp. 378-384

Author(s):

Peter W. Grandjean ◽

Burritt W. Hess ◽

Nicholas Schwedock ◽

Jackson O. Griggs ◽

Paul M. Gordon

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Providers ◽

Professional Training ◽

Local Health ◽

Care Providers ◽

Research Partnerships ◽

Local Health Care ◽

Training Community ◽

The University

Kinesiology programs are well positioned to create and develop partnerships within the university, with local health care providers, and with the community to integrate and enhance the activities of professional training, community service, public health outreach, and collaborative research. Partnerships with medical and health care organizations may be structured to fulfill accreditation standards and the objectives of the “Exercise is Medicine®” initiative to improve public health through primary prevention. Barriers of scale, location, time, human resources, and funding can be overcome so all stakeholder benefits are much greater than the costs.

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Generating Evidence From Contextual Clinical Research in Low- to Middle Income Countries: A Roadmap Based on Theory of Change

Frontiers in Pediatrics ◽

10.3389/fped.2021.764239 ◽

2021 ◽

Vol 9 ◽

Author(s):

Babar S. Hasan ◽

Muneera A. Rasheed ◽

Asra Wahid ◽

Raman Krishna Kumar ◽

Liesl Zuhlke

Keyword(s):

Health Care ◽

Health Care Providers ◽

Theory Of Change ◽

Health Priorities ◽

Global Health Research ◽

Local Health ◽

Care Providers ◽

Middle Income ◽

Middle Income Countries ◽

Health Ministries

Along with inadequate access to high-quality care, competing health priorities, fragile health systems, and conflicts, there is an associated delay in evidence generation and research from LMICs. Lack of basic epidemiologic understanding of the disease burden in these regions poses a significant knowledge gap as solutions can only be developed and sustained if the scope of the problem is accurately defined. Congenital heart disease (CHD), for example, is the most common birth defect in children. The prevalence of CHD from 1990 to 2017 has progressively increased by 18.7% and more than 90% of children with CHD are born in Low and Middle-Income Countries (LMICs). If diagnosed and managed in a timely manner, as in high-income countries (HICs), most children lead a healthy life and achieve adulthood. However, children with CHD in LMICs have limited care available with subsequent impact on survival. The large disparity in global health research focus on this complex disease makes it a solid paradigm to shape the debate. Despite many challenges, an essential aspect of improving research in LMICs is the realization and ownership of the problem around paucity of local evidence by patients, health care providers, academic centers, and governments in these countries. We have created a theory of change model to address these challenges at a micro- (individual patient or physician or institutions delivering health care) and a macro- (government and health ministries) level, presenting suggested solutions for these complex problems. All stakeholders in the society, from government bodies, health ministries, and systems, to frontline healthcare workers and patients, need to be invested in addressing the local health problems and significantly increase data to define and improve the gaps in care in LMICs. Moreover, interventions can be designed for a more collaborative and effective HIC-LMIC and LMIC-LMIC partnership to increase resources, capacity building, and representation for long-term productivity.

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Are we missing an epidemic of HIV-associated nephropathy?

Journal of the American Society of Nephrology ◽

10.1681/asn.v711 ◽

1996 ◽

Vol 7 (1) ◽

pp. 1-7

Author(s):

J A Winston ◽

P E Klotman

Keyword(s):

Health Care Providers ◽

Diagnostic Category ◽

National Registry ◽

National Institutes Of Health ◽

Care Providers ◽

Serological Screening ◽

Common Cause ◽

The Third ◽

Aids Epidemic ◽

Changing Demographics

HIV-associated nephropathy is infrequently cited as a common cause of ESRD. It is likely, however, that by the end of the decade, HIV-associated nephropathy will be the third leading cause of ESRD in African Americans between the ages of 20 and 64. Underreporting for reasons of confidentiality and a failure to track this specific diagnostic category nationally may account for the nephrology community's inattention. As a result of this community's failure to define this issue, national agencies are poorly prepared to recognize and anticipate the changing demographics of the AIDS epidemic as it affects the practice of nephrology. The study presented here concluded: that a national registry should be created to track the incidence of HIV-associated nephropathy as a cause of ESRD; that renal biopsies should be routinely performed to confirm the clinical diagnosis of HIV-associated nephropathy; that anonymous serological screening of all patients and health care providers in dialysis units be reconsidered in order to maintain vigilance for potential unit outbreaks; that the National Institutes of Health and the Office of AIDS Research be better appraised of the importance of this issue by the nephrology community; and that special attention be directed toward the underlying cause(s) of HIV-associated nephropathy and the cofactor(s) that determine the predilection of this disease in blacks.

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Protecting frontline workers and their patients from infection

British Journal of Nursing ◽

10.12968/bjon.2020.29.12.714 ◽

2020 ◽

Vol 29 (12) ◽

pp. 714-715

Author(s):

Alan Glasper

Keyword(s):

Health Care ◽

Health Care Providers ◽

Care Providers ◽

Emeritus Professor ◽

Frontline Workers ◽

The University

Emeritus Professor Alan Glasper, from the University of Southampton, discusses the strategies used by health care providers to protect frontline workers and their patients from infection

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Management of Hereditary Spherocytosis in a Public Health Care Provider in a Developing Country.

Blood ◽

10.1182/blood.v106.11.3752.3752 ◽

2005 ◽

Vol 106 (11) ◽

pp. 3752-3752

Author(s):

Leonardo Feldman ◽

Guillermo Drelichman ◽

Nora Basack ◽

Ernesto Rodriguez ◽

Daniel Freigeiro ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Hereditary Spherocytosis ◽

Public Health Care ◽

Health Priorities ◽

European Ancestry ◽

Care Providers ◽

Immune Hemolytic Anemia ◽

Hemolytic Crisis ◽

Total Splenectomy

Abstract Hereditary Spherocytosis (HS) is the most common cause of non-immune hemolytic anemia in Argentine people of European ancestry, it is characterized by chronic hemolysis, which is reduced or abrogated by splenectomy.. Because of the risk of postsplenectomy sepsis, especially among children under 5 years old, partial splenectomy has been advocated as an alternative. This procedure seems to ensure prolonged reduction but not complete elimination of hemolysis and it is possible some regrowth of the splenic remnant and a secondary total splenectomy must be performed in some patients (pts). This problem is worse especially when pts. live in rural areas and a close observation is necessary. We analyzed retrospectively the evolution of 83 pediatric pts with HS with low resources, other health priorities and in some cases an underling nutritional deficit. Diagnostics was made in a public hospital between October 1971 and December 2002 and the last control was in December 2004. The pts. Median age at diagnostic was 4.7 years (14 days to 14 years). Severe forms were observed in 18%, mild in 20% and moderate in 62%. Twenty four pts were phenotypically sporadic. Biochemical analysis (SDS-PAGE) were performed in 30 pts and/or family members, combined spectrin- ankirin deficiency were observed in most of them. Sixty-nine hemolytic crisis was observed in 30 pts (37.5%). and 17.5% developed an aplastic crisis. Fifty-two pts. (65%) received 249 Red Blood Cell Transfusions (Trs), 36% between 1 and 2, 22.5% 3 to10, and 6% between 10 to 34 Trs. Gallstones were observed in 4 PTs (5%). Total splenectomy was performed in 46 of 83 pts (55%), median age: 7 years (4–15) 42 pts had conventional and 4 have undergone laparoscopyc procedure. Ninety six per cent of pts were splenectomized after age of 5. The median time from diagnostic to splenectomy was 1 year (0.2–8.9). All pts were immunized against Pneumococcus, Haemophilus, and Meningococus and received prophylactic antibiotics. With a median follow up of 18.5 years (3–30 y) after splenectomy all pts showed a significant clinical improvement and no further transfusion requirement. In all cases the hemoglobin increased (median pre and post splenectomy 8.6/13gr/dl) and reticulocyte counts decreased (8 / 1.4%). We do not observe procedure relate mortality, sepsis, thrombosis, and aplastic or hemolytic crisis post-splenectomy. On the basis of our experience we favor the total splenectomy performed by a training team in countries with low resources and in pts with deficient hygienic and housing conditions that inhabit in places with long distances from centers to ensure wider access to training health care providers.

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The Use of Medical Records in Research: What Do Patients Want?

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2003.tb00105.x ◽

2003 ◽

Vol 31 (3) ◽

pp. 429-433 ◽

Cited By ~ 53

Author(s):

Nancy E. Kass ◽

Marvin R. Natowicz ◽

Sara Chandros Hull ◽

Ruth R. Faden ◽

Laura Plantinga ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Medical Records ◽

Medical Information ◽

Personal Information ◽

National Institutes Of Health ◽

Care Providers ◽

Electronic Information ◽

The Past ◽

Growing Body

In the past ten years, there has been growing interest in and concern about protecting the privacy of personal medical information. Insofar as medical records increasingly are stored electronically, and electronic information can be shared easily and widely, there have been legislative efforts as well as scholarly analyses calling for greater privacy protections to ensure that patients can feel safe disclosing personal information to their health-care providers. At the same time, the volume of biomedical research conducted in this country continues to grow. The budget of the National Institutes of Health, for example, was $20,298 million in 2001, having more than doubled from a budget of $9,218 million 10 years before. This growing body of research includes increased efforts to use stored medical records as a source of data for health services, epidemiologic, and clinical studies.

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One Institution - 2 Podcasts - Our experience

10.36811/grjp.2019.110001 ◽

2019 ◽

pp. 01-09

Author(s):

Tony R Tarchichi ◽

Jessica Garrison ◽

Kishore Vellody

Keyword(s):

Health Care ◽

Down Syndrome ◽

Health Care Providers ◽

Health Care Professionals ◽

Hospital Medicine ◽

Care Providers ◽

Pediatric Hospital ◽

University Of Pittsburgh ◽

The Subject ◽

The University

Objectives: Podcasts have increased in popularity since the early 2000s. The number of medical podcasts created by physicians for patients and/or health care providers is increasing. With the increase in podcasts' popularity and their convenience, podcasts have significant potential for use as an educational tool. Methods: Faculty at the Children's Hospital of Pittsburgh of UPMC have created two podcasts, the Pediatric Hospital Medicine (PHM) podcast and the Down Syndrome Center (DSC) of Western Pennsylvania Podcast. This paper is a descriptive review of both podcasts. The PHM podcast was created for health care providers who care for hospitalized children. The DSC podcast was started as a source of reliable information for parents of children with Down syndrome. Results: The PHM podcast has over seventeen thousand downloads in over sixty-seven countries. The DSC podcast has over twenty-three thousand downloads in over sixty-nine countries. The PHM podcast has an option for listeners to get CME credit after they listen to the podcast if they click on a link at the University of Pittsburgh website and answer a few questions. Data from responses to these questions demonstrates that 83% of the respondents reported that the podcast either highly or very highly enhanced their knowledge of the subject matter, and 86.8% reported that the content of the podcast was highly or very highly relevant to their work. Conclusion: These results suggest podcasts are a popular and useful tool for disseminating information to families and health care professionals.

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Content Analysis of Media Coverage of Childhood Obesity Topics in UAE Newspapers and Popular Social Media Platforms, 2014-2017

International Journal of Health Policy and Management ◽

10.15171/ijhpm.2018.100 ◽

2018 ◽

Vol 8 (2) ◽

pp. 81-89 ◽

Cited By ~ 1

Author(s):

Niyi Awofeso ◽

Sara Al Imam ◽

Arwa Ahmed

Keyword(s):

Social Media ◽

Childhood Obesity ◽

United Arab Emirates ◽

Health Care Providers ◽

Media Coverage ◽

Health Priorities ◽

Obesity Prevalence ◽

Care Providers ◽

Eligibility Criteria ◽

Food And Beverage

The 2017 prevalence of obesity among children (age 5–17 years) in the United Arab Emirates (UAE) is 13.68%. Childhood obesity is one of the 10 top health priorities in the UAE. This study examines the quality, frequency, sources, scope and framing of childhood obesity in popular social media and three leading UAE newspapers from 2014 to 2017. During the review period, 152 newspaper articles from three leading national newspapers – Gulf News, The National and Al Ittihad – met the eligibility criteria for this study. There were 57 Facebook posts, 50 Twitter posts, 14 posted YouTube videos, and 13 Media releases on related to childhood obesity between 2014 and 2017. Childhood obesity was consistently problematized, primarily in health terms, but was not strongly linked to socio-economic and geographical factors. Childhood obesity was framed as being predominantly influenced by individual and parental behaviours more frequently (n = 76) compared with structural or environmental factors such as the roles of the food and beverage industry (n = 22). Unlike findings from studies with adult obesity, articles advocating individual behavior changes to address childhood obesity were relatively few (n = 29). Social media may be an effective way to help children overcome obesity, in part through online interaction with health care providers and health conscious obese peers. Areas for improvement in social media use to reduce childhood obesity prevalence in UAE include enhancing public engagement with social media posts on childhood obesity, as reflected in the numbers of Likes and Retweets or Shares.

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Physician Deaths from Corona Virus Disease (COVID-19)

10.1101/2020.04.05.20054494 ◽

2020 ◽

Cited By ~ 7

Author(s):

Edsel B. Ing ◽

Alis (Qinyuan) Xu ◽

Ali Salimi ◽

Nurhan Torun

Keyword(s):

Internal Medicine ◽

Health Care Providers ◽

Virus Disease ◽

Protective Equipment ◽

Care Providers ◽

Front Line ◽

Common Cause ◽

Future Events ◽

Infectious Disease Specialists ◽

Line Work

ABSTRACTOBJECTIVEThe COVID-19 pandemic has caused much morbidity and mortality to patients but also health care providers. We tabulated the cases of physician deaths from COVID-19 associated with front-line work in hopes of mitigating future events.METHODOn April 5, 2020, Google internet search was performed using the keywords “doctor” “physician” “death” “COVID” “COVID-19” and “coronavirus” in English and Farsi, and in Chinese using the Baidu search engine.RESULTSWe found 198 physician deaths from COVID-19, but complete details were missing for 49 individuals. The average age of the physicians that died was 63.4 years (range 28 to 90 years) and the median age was 66 years of age. Ninety percent of the deceased physicians were male (175/194). General practitioners and emergency room doctors (78/192), respirologists (5/192), internal medicine specialists (11/192) and anesthesiologists (6/192) comprised 52% of those dying. Two percent of the deceased were epidemiologists (4/192), 2% were infectious disease specialists (4/192), 5% were dentists (9/192), 4% were ENT (8/192), and 4% were ophthalmologists (7/192). The countries with the most reported physician deaths were Italy (79/198), Iran (43/198), China (16/198), Philippines (14/198), United States (9/192) and Indonesia (7/192).CONCLUSIONPhysicians from all specialties may die from COVID, and these deaths will likely increase as the pandemic progresses. Lack of personal protective equipment was cited as a common cause of death. Consideration should be made to exclude older physicians from front-line work.

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