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Programmatic assessment

Margriet den Boer, Asish Kumar Das, Fatima Akhter, Sakib Burza, V Ramesh, Be-Nazir Ahmed, Eduard E Zijlstra, Koert Ritmeijer
Background: A safe and effective short-course treatment regimen for Post Kala Azar Dermal Leishmaniasis (PKDL) is considered essential for achieving and sustaining elimination of visceral leishmaniasis (VL) in the Indian subcontinent.(1, 2) Here, single dose liposomal amphotericin B (AmBisome) has been adopted as a first line regimen for VL; however the effectiveness and safety of AmBisome for PKDL has not been formally evaluated. Methods: The safety and effectiveness of AmBisome 15 mg/kg, given over 15 days in 5 biweekly infusions of 3mg/kg on an outpatient basis, was evaluated between April and November 2014 in clinically diagnosed PKDL patients of 12 years and older residing in a highly VL endemic area in Bangladesh...
March 15, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Anatole Manzi, Jean Claude Mugunga, Hari S Iyer, Hema Magge, Fulgence Nkikabahizi, Lisa R Hirschhorn
BACKGROUND: Integrated management of childhood illness (IMCI) can reduce under-5 morbidity and mortality in low-income settings. A program to strengthen IMCI practices through Mentorship and Enhanced Supervision at Health centers (MESH) was implemented in two rural districts in eastern Rwanda in 2010. METHODS: We estimated cost per improvement in quality of care as measured by the difference in correct diagnosis and correct treatment at baseline and 12 months of MESH...
2018: PloS One
Qi Jiang, Liping Lu, Jie Wu, Chongguang Yang, Ravi Prakash, Tianyu Zuo, Qingyun Liu, Jianjun Hong, Xiaoqin Guo, Qian Gao
BACKGROUND: Tuberculosis (TB) contact investigation has been observed as a useful programmatic tool in active case finding. We collected data of contact cases to evaluate the effectiveness of TB contact investigation programme in Shanghai, China. METHODS: Since 2009, we screened and followed up the close contacts of bacteria-positive TB cases in Songjiang, Shanghai and calculated the incidence of TB in close contacts and confirmed the transmission by genotyping and sequencing...
January 2018: Tuberculosis
Kimberly Y Won, Keri Robinson, Katy L Hamlin, Joseph Tufa, Margaret Seespesara, Ryan E Wiegand, Katherine Gass, Joseph Kubofcik, Thomas B Nutman, Patrick J Lammie, Saipale Fuimaono
BACKGROUND: Current WHO recommendations for lymphatic filariasis (LF) surveillance advise programs to implement activities to monitor for new foci of transmission after stopping mass drug administration (MDA). A current need in the global effort to eliminate LF is to standardize diagnostic tools and surveillance activities beyond the recommended transmission assessment survey (TAS). METHODOLOGY: TAS was first conducted in American Samoa in 2011 (TAS 1) and a repeat TAS was carried out in 2015 (TAS 2)...
March 9, 2018: PLoS Neglected Tropical Diseases
Phan Vuong Khac Thai, Dang Thi Minh Ha, Nguyen Thi Hanh, Jeremy Day, Sarah Dunstan, Nguyen Thi Quynh Nhu, Vo Sy Kiet, Nguyen Huu Lan, Nguyen Huy Dung, Nguyen Thi Ngoc Lan, Nguyen Thuong Thuong, Nguyen Ngoc Lan, Phạm Thị Thúy Liễu, Nguyễn Thị Hồng, Đào Công Điệp, Nguyễn Thị Kim Thanh, Nguyễn Văn Hội, Nguyễn Văn Nghĩa, Trương Ngọc Đại, Hoàng Quang Minh, Nguyễn Văn Thơm, Jeremy Farrar, Maxine Caws
BACKGROUND: Drug resistant tuberculosis (TB) is increasing in prevalence worldwide. Treatment failure and relapse is known to be high for patients with isoniazid resistant TB treated with standard first line regimens. However, risk factors for unfavourable outcomes and the optimal treatment regimen for isoniazid resistant TB are unknown. This cohort study was conducted when Vietnam used the eight month first line treatment regimen and examined risk factors for failure/relapse among patients with isoniazid resistant TB...
March 6, 2018: BMC Infectious Diseases
Katharine Footman, Katherine Keenan, Kate Reiss, Barbara Reichwein, Pritha Biswas, Kathryn Church
We undertook a systematic review to assess 1) the level and quality of pharmacy and drug shop provision of medical abortion (MA) in low- and middle-income countries (LMICs) and 2) interventions to improve quality of provision. We used standardized terms to search six databases for peer-reviewed and grey literature. We double-extracted data using a standardized template, and double-graded studies for methodological quality. We identified 22 studies from 16 countries reporting on level and quality of MA provision through pharmacies and drug sellers, and three intervention studies...
March 2018: Studies in Family Planning
Tsegahun Manyazewal, Mokgadi C Matlakala
Background: Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. Methods: A facility-based, cross-sectional study was carried out in five public hospitals with different operational characteristics that have been implementing health care reform in central Ethiopia...
June 2018: Journal of Global Health
Kulamakan Kulasegaram, Maria Mylopoulos, Paul Tonin, Stacey Bernstein, Pier Bryden, Marcus Law, Jana Lazor, Richard Pittini, Sanjeev Sockalingam, Glendon R Tait, Patricia Houston
RATIONALE: There are perennial calls for MD curricula to reform in order to meet the changing needs of students, patients, and society. And yet, efforts at renewal have also been suggested to have minimal impact on the pedagogy and outcomes of medical education. One reason may be misalignment between the components of the curriculum during design and implementation. The University of Toronto MD program recently renewed its undergraduate preclinical Foundations curriculum. Mindful of the pitfalls of misalignment, the renewal process focused deliberately on alignment between the various components of the curriculum: instructional methods, student assessment, faculty development, and the larger purpose of serving students and society...
February 28, 2018: Medical Teacher
George C Mejicano, Tracy N Bumsted
Oregon Health & Science University School of Medicine launched a completely new undergraduate medical education curriculum in 2014. This initiative dramatically transformed the MD degree program, changing the instructional content taught, the pedagogical methods used by the faculty, and the methods of assessment, and it added new elements such as academic coaching and programmatic entrustment to the program. One of the most exciting and impactful aspects to date of this curricular transformation has been the deliberate implementation of a competency-based framework that incorporates frequent assessment, tracking of student progression using an electronic portfolio, and academic coaching to optimize learning and customize curricular elements for each student...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Sally-Ann Ohene, Frank Bonsu, Nii Nortey Hanson-Nortey, Adelaide Sackey, Samuel Danso, Felix Afutu, Paul Klatser, Mirjam Bakker
BACKGROUND: The End TB Strategy calls for systematic screening of selected high-risk groups including contacts of tuberculosis (TB) cases to facilitate early TB case detection. Contact investigation is not usually routinely practiced in low TB burden countries, such as Ghana, with consequent paucity of data on the yield of TB case detection from such interventions. This study's objective was to document the outcomes and feasibility of implementing contact investigation activities under programmatic conditions in Ghana...
February 27, 2018: Infectious Diseases of Poverty
Maria P Rebollo, Honorat Zoure, Kisito Ogoussan, Yao Sodahlon, Eric A Ottesen, Paul T Cantey
The meaning of 'mapping' in relation to onchocerciasis has changed at least three times over the past 50 years as the programmatic goals and the assessment tools have changed. With the current goal being global elimination of Onchocerca volvulus (OV), all areas where OV might currently be transmitted and where mass drug administration (MDA) with ivermectin treatment has not been delivered previously must now be identified by careful, detailed 'elimination mapping' as either OV endemic or not, so that appropriate programmatic targets can be established...
March 1, 2018: International Health
Rachel Bacon, Jane Kellett, Janeane Dart, Cathy Knight-Agarwal, Rebecca Mete, Susan Ash, Claire Palermo
AIM: The aim of this research was to evaluate a Consensus Model for competency-based assessment. METHODS: An evaluative case study was used to allow a holistic examination of a constructivist-interpretivist programmatic model of assessment. Using a modified Delphi process, the competence of all 29 students enrolled in their final year of a Master of Nutrition and Dietetics course was assessed by a panel (with expertise in competency-based assessment; industry and academic representation) from a course e-portfolio (that included the judgements of student performance made by worksite educators) and a panel interview...
February 21, 2018: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
Marcia Perry, Andrew Linn, Brendan W Munzer, Laura Hopson, Ambrosya Amlong, Michael Cole, Sally A Santen
Background : Programmatic assessment is the intentional collection of key data from multiple sources for both assessment of learning and assessment for learning . Objective : We developed a system of programmatic assessment (PA) to identify competency progression (summative) and assessment for learning to assist residents in their formative development. Methods : The programmatic assessment was designed iteratively from 2014 through 2016...
February 2018: Journal of Graduate Medical Education
Heather L Yeo, Jonathan S Abelson, Matthew M Symer, Jialin Mao, Fabrizio Michelassi, Richard Bell, Art Sedrakyan, Julie A Sosa
Importance: Attrition in general surgery residency remains high, and attrition that occurs in the later years is the most worrisome. Although several studies have retrospectively investigated the timing of attrition, no study to date has prospectively evaluated a national cohort of residents to understand which residents are at risk for attrition and at what point during residency. Objective: To prospectively evaluate individual resident and programmatic factors associated with the timing of attrition during general surgery residency...
February 21, 2018: JAMA Surgery
Allison R Dahlke, Julie K Johnson, Caprice C Greenberg, Remi Love, Lindsey Kreutzer, Daniel B Hewitt, Christopher M Quinn, Kathryn E Engelhardt, Karl Y Bilimoria
OBJECTIVE: The aim of the study was to (1) assess differences in how male and female general surgery residents utilize duty-hour regulations and experience aspects of burnout and psychological well-being, and (2) to explore reasons why these differing experiences exist. BACKGROUND: There may be differences in how women and men enter, experience, and leave residency programs. METHODS: A total of 7395 residents completed a survey (response rate = 99%)...
February 16, 2018: Annals of Surgery
Teralynn Ludwick, Eleanor Turyakira, Teddy Kyomuhangi, Kimberly Manalili, Sheila Robinson, Jennifer L Brenner
BACKGROUND: While evidence supports community health worker (CHW) capacity to improve maternal and newborn health in less-resourced countries, key implementation gaps remain. Tools for assessing CHW performance and evidence on what programmatic components affect performance are lacking. This study developed and tested a qualitative evaluative framework and tool to assess CHW team performance in a district program in rural Uganda. METHODS: A new assessment framework was developed to collect and analyze qualitative evidence based on CHW perspectives on seven program components associated with effectiveness (selection; training; community embeddedness; peer support; supportive supervision; relationship with other healthcare workers; retention and incentive structures)...
February 13, 2018: Human Resources for Health
Nicole A Haberland, Katharine J McCarthy, Martha Brady
Increasing attention to adolescent girls has generated an abundance of programs and a growing body of research on adolescent girls in low- and middle-income countries. Despite this, questions remain about what implementation approaches in program design are most effective, hindering efficient resource allocation, program scale-up, and replication across settings. To address these questions, we conducted a systematic review to identify lessons learned and gaps in the evidence base. We searched four electronic databases to identify studies published between 1990 and 2014 that evaluated health, social, and/or economic development programs targeting adolescent girls in low- and middle-income countries...
February 9, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Lela Sulaberidze, Stuart Green, Ivdity Chikovani, Maia Uchaneishvili, George Gotsadze
BACKGROUND: Whilst there is recognition that the global burden of disease associated with mental health disorders is significant, the economic resources available, especially in Low and Middle Income Countries, are particularly scarce. Identifying the economic (system) and financial (individual) barriers to delivering mental health services and assessing the opportunities for reform can support the development of strategies for change. METHODS: A mixed methods study was developed, which engaged with a range of stakeholders from mental health services, including key informants, service managers, healthcare professional and patients and their care-takers...
February 13, 2018: BMC Health Services Research
Mark Stenger, Heidi Bauer, Ellen Klingler, Teal Bell, Jennifer Donnelly, Margaret Eaglin, Megan Jespersen, Robbie Madera, Melanie Mattson, Elizabeth Torrone
BACKGROUND: Lacking information on men who have sex with men (MSM) for most reported cases, sexually transmitted disease (STD) programs in the United States have used crude measures such as male-to-female case ratios (MFCR) as a rule of thumb to gauge MSM involvement at the local level, primarily with respect to syphilis cases in the past. Suitability of this measure for gonorrhea incidence has not previously been investigated. METHODS: A random sample of gonorrhea cases reported from January 2010 through June 2013 were interviewed in selected counties participating in the STD Surveillance Network to obtain gender of sex partners and history of transactional sex...
March 2018: Sexually Transmitted Diseases
Jamie O Creed, Julianne M Cyr, Hillary Owino, Shannen E Box, Mia Ives-Rublee, Brian B Sheitman, Beat D Steiner, Jefferson G Williams, Michael W Bachman, Jose G Cabanas, J Brent Myers, Seth W Glickman
OBJECTIVE: Emergency Departments (ED) are overburdened with patients experiencing acute mental health crises. Pre-hospital transport by Emergency Medical Services (EMS) to community mental health and substance abuse treatment facilities could reduce ED utilization and costs. Our objective was to describe characteristics, treatment, and outcomes of acute mental health crises patients who were transported by EMS to an acute crisis unit at WakeBrook, a North Carolina community mental health center...
February 7, 2018: Prehospital Emergency Care
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