National Partners Research Articles

Engaging frontline workers in policy development to support the implementation of measurement-based care: Lessons learned from a field-based workgroup.

Measurement-Based Care (MBC) is the use of patient-reported outcome measures repeatedly over the course of treatment to track progress and empower both providers and patients to collaboratively set goals and plan treatment. The Measurement-Based Care in Mental Health Initiative within the Department of Veterans Affairs' Office of Mental Health and Suicide Prevention partnered with the Post Traumatic Stress Disorder (PTSD) Mentoring Program to create an interdisciplinary field-based workgroup. The workgroup included psychologists, clinical social workers, and mental health counselors from PTSD Clinical Teams. The task of the workgroup was to create guidelines for best practice in delivery of MBC in PTSD Clinical Teams given anticipated policy requiring MBC to be used in PTSD Clinical Teams. Framed in the Strategic Action Field Framework for Policy Implementation Research, the current paper evaluates this hybrid top-down and bottom-up process of policy development. Major barriers included difficulty with the workgroup as an authentic bottom-up process, inability to reach the entire field (e.g., focus groups not widely attended by providers), and limited diversity in the workgroup. Facilitators included using consensus to make decisions, support provided to workgroup members by national operations partners, and collaboration and mutual respect among workgroup members. Workgroup members noted an equal, respectful partnership between operations partners and the workgroup; they reported feeling empowered and believed the viewpoints of the field were included in the guidelines. Further, due to the COVID-19 pandemic, the workgroup included more guidelines specific to telehealth into the guidelines. This hybrid model provides a process through which frontline workers can inform policy development and implementation.

Taking the initiative to advance precision medicine: a perspective from Norway Immuno-Oncology Insights 2022; 3(7), 349–355

What does the practical implementation of precision medicine in oncology look like, and how can key public and private stakeholders be brought to the table? We spoke to Kjetil Taskén to find out how Norway is driving precision medicine in cancer through three nationwide initiatives, and to discuss his own work on functional precision medicine and tumor immune evasion mechanisms.Kjetil Taskén (born 1965, MD, PhD) was appointed Professor of Medicine at University of Oslo (UiO) in 2001 and has since 2018 served as Head of the Institute for Cancer Research, Oslo University Hospital (OUH) where he is also Group Leader for the Cell Signaling and Immune Regulation Group (approx. 20 people) in the Dept. of Cancer Immunology. He was the Director of the Biotechnology Centre of Oslo, UiO from 2003 to 2016 and the founding Director of Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, UiO where he served from 2008 to 2018. He established and directed the national infrastructure for academic chemical biology and drug screening (Nor-Openscreen, coupled to EU-Openscreen) and was the national director for EATRIS (translational medicine). More recently he has been key in building the national cancer precision medicine initiative for Norway (InPreD molecular diagnostics infrastructure, IMPRESS-Norway national clinical trial and CONNECT public-private partnership) and is Director of the OUH Centre for Precision Cancer Medicine. He is a partner in the K.G. Jebsen Centre for B Cell Malignancies. He has served or serves on a number of evaluation panels, SABs and Editorial Boards, including ERC StG panel LS3 (2014-20), the IMI Scientific Committee (2017-22), and Cancer Research UK New agents committee (2019-). Taskén received the Anders Jahre Medical Prize for younger scientists in 2002 (Nordic award), and won the King Olav V’s Prize for Cancer Research (national life-achievement award) in 2016. He was elected to the Norwegian Academy of Science and Letters in 2005. Taskén is author of >290 publications and inventor > 20 patents (>14,000 citations, h-index =62). Current research is in tumor immune evasion mechanisms and immune regulation and in functional precision medicine and drug screening for different solid and blood cancers.

Lack of Alignment Between WHO Joint External Evaluation and State Party Self-Assessment Scores Undermines Utility as Evaluation Tools for the Department of Defense.

The International Health Regulations 2005 (IHR) set standards for countries to detect and respond to public health threats such as COVID-19. The US Department of Defense engages with partner nations to build IHR-related health security capacities. In this article, we compare 2 elements of the IHR Monitoring and Evaluation Framework to determine if they align in a useful way. The version of the State Party Self-Assessment Annual Reporting (SPAR) tool used for this study is a self-assessment of 13 capacities, while the Joint External Evaluation (JEE) requires collaboration with international subject matter experts to evaluate 19 capacities. The SPAR indicators are scored separately from 0% to 100%, whereas the JEE uses a rank-ordered scale from 1 to 5 for variable numbers of indicators in each capacity. Using 2018-2019 data from the World Health Organization, we quantitatively and qualitatively evaluated the alignment of the SPAR and JEE scoring systems, using paired t tests for related capacities and 3 approaches to matching the scales. Whether using a simple, evenly divided scale for the SPAR or downscaling the SPAR scores to match with lower JEE scores, the paired t tests indicate that the JEE and SPAR scoring systems are not aligned. Many of the capacities in the JEE and SPAR are defined differently, pointing to one of the reasons for the discordance. We discuss implications for revision of the JEE and SPAR assessment tools along with ways in which the scores might be used for planning global health engagement capacity-building activities.

KiESEL – The Children’s Nutrition Survey to Record Food Consumption for the youngest in Germany

BackgroundWith KiESEL, the Children’s Nutrition Survey to Record Food Consumption, the German Federal Institute for Risk Assessment (BfR) collected representative food consumption data for children aged six months up to five years. KiESEL was one of five modules of KiGGS Wave2 (German Health Interview and Examination Survey for Children and Adolescents) conducted by the Robert Koch Institute (RKI). The objective was to update the consumption data for children in Germany and to fill a data gap for the age group of five-year-old children. The study provides an up-to-date and comprehensive database that will be used for exposure assessment, as part of risk assessment of Germany’s youngest consumers.MethodsIn the years 2014 to 2017, 1104 children from all over Germany participated in KiESEL. During home visits, survey staff conducted a questionnaire-based interview including a food propensity questionnaire (FPQ) on seldom eaten foods and questions concerning consumption outside home, dietary habits and diet during first year. The interviewer measured the children’s height and weight. Families and childcare workers filled out a food record, covering three consecutive days and one independent day. Data are based on the FPQ and present consumption frequencies. Depending on the question, socioeconomic status (SES) and migration background were considered.Results1104 participants had an interview and filled out the questionnaire on usual food intake, seldom eaten foods and consumption away from home. They were included in sample1. 1008 of these participants additionally reported food consumption of at least three days (sample2). 91.2% of the children follow no special diet and 0.8% are vegetarians. 7% of the older children consuming soya-drink. For some foods differences in consumption across SES or migration status were noted. Children from families with higher SES consume more often soya-based substitute milk as families with lower SES (p < 0.00005).ConclusionsKiESEL gathered up-to-date consumption data for more than 1000 children living in Germany, aged six month up to including five years. The data will be used for risk assessments of the BfR and provided to national and international partners.

Using Health Economics to Inform Immunization Policy Across All Levels of Government.

Publicly funded immunization programs have grown in both complexity and scope, resulting in increased costs and more complex programmatic decision making. Economic evaluations can provide crucial information to support informed decision making. While very few countries have National Immunization Technical Advisory Groups that analyze economic information, many have started to develop processes for this purpose. Since these guidelines are being developed at the national level, we propose that regional jurisdictions, especially those responsible for healthcare (e.g., provinces, territories, states), need clear processes for incorporating this information into their immunization decision making and program implementation. We interviewed Canadian vaccine experts involved in provincial vaccine policy decision making to identify current practices, perceptions, and recommendations around incorporating economic analysis into that process. Based on these interviews, we make five recommendations: (1) economic evidence should be routinely incorporated into the decision making process; (2) economic experts should sit on, or be available to, regional advisory committees; (3) efforts should be made to build on regional expertise by increasing educational opportunities on economic evaluation; (4) processes should include guidelines for when economic analysis is not required; and (5) clarification on the role of regional advisory groups in economic analysis is needed in relation to national expertise. The information presented here provides a starting point for regional health policy experts and decision makers to work collaboratively with national partners to create transparent and effective approaches to incorporating economic analysis into vaccine decision making.Supplementary InformationThe online version contains supplementary material available at 10.1007/s41669-022-00347-1.

Culturally Tailored and Community-Based Social Media Intervention to Promote Organ Donation Awareness among Asian Americans: “Heart of Gold”

Organ donation disparities among ethnic minorities have persisted for decades, especially among Asian Americans (AAs). AAs represent a substantial proportion of the national transplant waitlist but have historically had the lowest organ donation rate in the United States. Community based and culturally tailored (CBCT) interventions are needed to increase donor designation within AA communities. In collaboration with local AA organizations and representatives and national partners, we developed a culturally and linguistically tailored video using a family appeal to promote donor designation among AAs. The video was distributed on social media platforms in two stages from February 17 to September 17, 2021 and tracked Reaches, Impressions, Views, and Engagements as part of a larger evaluation. The results revealed higher social media activities and engagements on Facebook than on Instagram with and without paid advertisements, although the paid approach yielded 5 to 16 times higher viewer engagement. Over six months, the video reached 36,845 AAs and gained 53,308 Impressions, 20,139 Views, 2,455 Engagements, and 232 visits to the organ donation registration page. The findings indicated Facebook and CBCT approaches as effective communication strategies to potentially raise AAs’ organ donation awareness, especially among AA females over 45 years of age. Implications and limitations are discussed.

A General Perspective about Institutional Rankings, Ranking Framework, Benefits of Rankings and Ranking Methodological Flaws

Ranking scales is an important tool which serves learning outcomes. Accuracy of Ranking depends upon how accurately &amp;amp; honestly the data is submitted according to the ranking methodology, how accurately Peers are giving their responses and how efficiently the ranking agencies are validating and evaluating the submitted data. However, giving more emphasis on pedagogy, teaching &amp;amp; learning environment, periodic curriculum review, strengthening the existing infrastructure resource, graduate outcome in minimum stipulated time, employability including entrepreneurship and higher studies, regular evaluation &amp;amp; assessments, research &amp;amp; outcomes, collaborations and new course offering according to the market demand, Ranking will improve, International outlook will also improve accordingly. Ranking is essential for strategic planning and enhancement of institutional transparency and stimulating the quality culture in education. Rankings also influence national and international partnerships and collaborations. Rankings are a manifestation of global competition and are used as a policy instrument. Rankings are provoking an important debate about the quality and performance of HEIs. We can also say one of the manifestations of Rankings is to build a competitive institutional competence of world class universities. In this paper, I have discussed mainly on general perspective about institutional rankings, ranking framework, benefits of rankings and flaws in the ranking methodology.

The Degree of Social Studies Teachers’ Knowledge of the Dimensions of Citizenship Education at Basic Education Schools in the Sultanate of Oman

Citizenship education is the effective educational tool in building a citizen who is able to participate in building his country. This can only come through the educational efforts that teachers make in the classroom. Such a step requires teachers to have knowledge of citizenship education, its principles, and the foundations for its development. Thus, the study aims to examine the degree of social studies teachers' knowledge of the dimensions of citizenship education at the basic education schools in the Sultanate of Oman. It also aims to examine its relationship with a set of variables. The researchers used the quantitative descriptive approach to achieve the objectives of the study. It further adopted a test tool, which consisted in its final form of five areas: citizenship knowledge, rights and duties, national identity, community partnership, and global and digital citizenship. The test was divided later into (38) multiple-choice questions. After verifying the validity and reliability of this tool, it was applied to a sample of (200) male and female teachers. The results of the study have shown that the degree of knowledge of social studies teachers in citizenship education was average, reaching the arithmetic level of (57.67%). Furthermore, there were no statistically significant differences in the level of knowledge of social studies teachers of citizenship education with respect to the variables of gender and educational qualification in the fields of citizenship education. Accordingly, the researchers have recommended that the citizenship education course should be included in teacher preparation programs at public and private universities in the Sultanate of Oman. Moreover, the concepts and principles of citizenship education should be included in the school curricula.

The State of Public Health Education and Science During and After the Fall of the Soviet Union: Achievements, Remaining Challenges, and Future Priorities.

ObjectivesIn the post–COVID-19 world, when the adequacy of public health workforce education is being critically re-evaluated, this study undertakes a historical analysis of how the educational and scientific field of public health developed during and after the fall of the Soviet Union in 1991. The study intends to historically contextualize public health education and science development in former Soviet Republics. It attempts to document achievements after gaining independence and identify remaining challenges that need to be addressed for advancing public health science and education in Former Soviet Union countries to better prepare them for future pandemics and address current health challenges of the nations.MethodsThe study used a mixed-methods review approach combining both a literature review, information collection from the school's websites, and secondary analysis of the quantitative data available about scientific outputs—peer-reviewed articles.ResultsDuring communist rule and after the fall of the Soviet Union, the main historical events seem to have shaped the public health field of former Soviet countries, which also determined its eventual evolution. The international efforts post-1991 were instrumental in shifting medically oriented conceptualization of public health toward Western approaches, albeit with variable progress. Also, while scientific output has been growing from 1996 to 2019, sub-regional differences remain prominent.ConclusionThe region seems to have matured enough that it might be time to start and facilitate regional cooperation of public health schools to advance the field of public health and research. Regional and country variabilities feature prominently in the volume and quality of scientific output and call for the immediate attention of national governments and international partners.

983 LEARNING FROM THE EXPERIENCES OF NURSES IN CARE HOMES DURING COVID-19 (THRIVE STUDY): STEERING THE SHIP THROUGH THE STORM

Abstract Background Nurses practising in older people’s care homes are often the only trained nurse on shift, undertaking leadership roles while also supporting residents with complex clinical needs. The study aimed to explore Nursing and Midwifery Council (NMC)-registered nurses’ experiences of working in older people’s care homes during the COVID-19 pandemic. Method Recruitment used direct contact with care homes, social media and links provided by national partners, then purposive sampling for age, gender, type of care home and location. Data collected through one-to-one on-line interviews using a topic guide developed collaboratively with care home nurses, focusing on how COVID-19 impacted on nurses’ resilience and mental well-being. Data were analysed thematically. Results 18 nurses interviewed between March–July 2021: female 16, majority aged between 46–55 years; mean time registered with NMC 19 years (range 18 months-45 years); one had not nursed residents with COVID-19. Preliminary findings indicate that nurses developed enhanced clinical skills, which increased their professional standing. Many nurses were in leadership roles responsible for processing and sharing rapidly-changing guidance, making judgements on how to manage infection risk within the home. Nurses reported balancing information-assimilation and reporting with providing direct care due to staff shortages. All nurses provided emotional support to other staff. They sought support from their peers, namely nurses inside and outside their workplace. As leaders, many of the nurses spoke about the emotional impact of having to manage relatives’ expectations and make decisions on whether a relative could be with a dying resident. Conclusion Understanding the types of support that might best increase resilience and well-being for nurses in care homes now and in the future is essential to maintain a healthy, stable workforce. Support for nurses will likely benefit other care workers either directly through wider roll-out, or indirectly through improved well-being of the nurse leaders.

Overcoming Inequality of Access and Participation Through Institutional, International, and Governmental Collaboration: a Case Study

Abstract On October 27, 2021, the U.S. Department of State’s Bureau of Educational and Cultural Affairs (eca) named St. Edward’s University as one of only 35 Fulbright hsi Leaders. On the same day, eca recognized St. Edward’s as a Top Producing Institution during the past 20 years in the Benjamin A. Gilman International Scholarship Program, which funds low-income American students studying abroad. How did this happen at a small, Hispanic-Serving, majority-minority university, with a large percentage of low-income students (44% Federal Pell Grant recipients)? The answer lies in the decision by St. Edward’s to strategically create and foster a network of internal partnerships, and national and international partnerships with other universities and government-sponsored organizations, to significantly improve the quality of the educational experience for all students (especially low-income and students of color) and to multiply opportunities for them to contend and achieve in the most competitive national and international student competitions.

Reflections on ‘Exceptionalism’ and ‘Acceptionalism’

Abstract In 1835, Alexis de Tocqueville introduced the concept of American Exceptionalism in his well known Democracy in America. Its subsequent use has been selective and politically pragmatic, serving a range of pens and purposes, most recently becoming a justification for exclusion and bigotry. This runs counter to the progress higher education has made to internationalize its curricula and to significantly expand the opportunities for students to study abroad over the recent decades at a time when the need for international awareness and understanding is at its greatest. The future success of international programming and institutional partnering will be judged by its ability to prepare students for the real life problems differing peoples are facing, going beyond the most common travel and culture programs which have come to characterize higher education for over 50 years. While the original educational and cultural aspirations for study-abroad, as well as the pragmatic bases for institutional partnerships certainly remain, both the dramatic changes in the delivery of higher education and the significance of the broader challenges societies are facing, call for an expansion and re-examination of the role of national and international partnerships and our expectations for undergraduate study-abroad. Furthermore, it is argued that through a greater application of a more experiential approach to study-abroad, students will develop a richer and more insightful understanding of why all cultures for reasons of their own should be considered exceptional; an understanding that is inclusionary – protagistically replacing exceptionalism with acceptionalism.

Multiplex Serology for Measurement of IgG Antibodies Against Eleven Infectious Diseases in a National Serosurvey: Haiti 2014-2015.

BackgroundIntegrated surveillance for multiple diseases can be an efficient use of resources and advantageous for national public health programs. Detection of IgG antibodies typically indicates previous exposure to a pathogen but can potentially also serve to assess active infection status. Serological multiplex bead assays have recently been developed to simultaneously evaluate exposure to multiple antigenic targets. Haiti is an island nation in the Caribbean region with multiple endemic infectious diseases, many of which have a paucity of data for population-level prevalence or exposure.MethodsA nationwide serosurvey occurred in Haiti from December 2014 to February 2015. Filter paper blood samples (n = 4,438) were collected from participants in 117 locations and assayed for IgG antibodies on a multiplex bead assay containing 15 different antigens from 11 pathogens: Plasmodium falciparum, Toxoplasma gondii, lymphatic filariasis roundworms, Strongyloides stercoralis, chikungunya virus, dengue virus, Chlamydia trachomatis, Treponema pallidum, enterotoxigenic Escherichia coli, Entamoeba histolytica, and Cryptosporidium parvum.ResultsDifferent proportions of the Haiti study population were IgG seropositive to the different targets, with antigens from T. gondii, C. parvum, dengue virus, chikungunya virus, and C. trachomatis showing the highest rates of seroprevalence. Antibody responses to T. pallidum and lymphatic filariasis were the lowest, with <5% of all samples IgG seropositive to antigens from these pathogens. Clear trends of increasing seropositivity and IgG levels with age were seen for all antigens except those from chikungunya virus and E. histolytica. Parametric models were able to estimate the rate of seroconversion and IgG acquisition per year for residents of Haiti.ConclusionsMultiplex serological assays can provide a wealth of information about population exposure to different infectious diseases. This current Haitian study included IgG targets for arboviral, parasitic, and bacterial infectious diseases representing multiple different modes of host transmission. Some of these infectious diseases had a paucity or complete absence of published serological studies in Haiti. Clear trends of disease burden with respect to age and location in Haiti can be used by national programs and partners for follow-up studies, resource allocation, and intervention planning.

The National Partnership to Improve Dementia Care and Hospital Readmission Among Skilled Nursing Facility Residents.

The National Partnership to Improve Dementia Care in Nursing Homes (i.e., the National Partnership) was launched in March 2012. Using national Medicare, Minimum Data Set, and Nursing Home Compare data in CY 2010-2014, we examined changes in hospital readmissions for older post-acute skilled nursing facility (SNF) residents with Alzheimer's disease or related dementias (ADRD) following the National Partnership. Using residents without ADRD as reference group to control for concurrent policy and SNF quality changes, we estimated linear probability models to examine the relationship between readmissions and the National Partnership for residents with ADRD, and also stratified the analysis by quality of SNFs. We found a decreasing trend in hospital readmissions over time. The risk of readmissions in residents with ADRD decreased additional 0.3 percentage-points (p < .01) after the launch of the National Partnership. This relationship varied across SNFs with different quality, as it was stronger in high-quality compared to low-quality SNFs.

Assessing returns to research investments in rice varietal development: Evidence from the Philippines and Bangladesh

•This study estimates economic returns to investments in rice varietal development in the Philippines and Bangladesh.•The net returns to IRRI and national partners' investments remain strongly positive.•However, the returns are decreasing at a faster rate in the Philippines (24%) than in Bangladesh (6%).•IRRI and national partners should continue investing in rice R&D, especially to develop superior rice varieties.

Progress, Persistence, and Hope: Building a System of Services for CYSHCN and Their Families.

Progress, Persistence, and Hope: Building a System of Services for CYSHCN and Their Families.

COVID-19 in the context of pregnancy, infancy and parenting (CoCoPIP) study: protocol for a longitudinal study of parental mental health, social interactions, physical growth and cognitive development of infants during the pandemic

IntroductionWhile the secondary impact of the COVID-19 pandemic on the psychological well-being of pregnant women and parents has become apparent over the past year, the impact of these changes on...

Accomplishing provider status: Getting pharmacists paid for their patient care services

Accomplishing provider status: Getting pharmacists paid for their patient care services

Impact of Nursing Home Factors on Antipsychotic Use in Residents Before and After the Implementation of the Antipsychotic Reduction Initiative: A Facility-level Analysis

The purpose of this study was to identify nursing home (NH) characteristics associated with rates and patterns of change in antipsychotic (AP) use before and after implementation of the Centers for Medicare and Medicaid Services’ (CMS) National Partnership roll-out of the Antipsychotic Reduction Initiative (ARI).

Reprint of: Four dimensions of sustainable governance for National Scenic Trails

Sustainable management of protected areas requires attention to the structures, processes, institutions, and funding mechanisms that support them. When protected areas transcend multiple jurisdictions and landownerships, effective governance requires engagement of multiple institutions. In the United States, 11 National Scenic Trails (NSTs) extend across multiple states, landownerships, and jurisdictions, with regional and national partnerships enhancing management capacity. Trail governance requires a systems approach – coordinating among governmental and nongovernmental partners at multiple scales. We conducted 17 interviews with NST administrators and partners and gathered secondary data about trail characteristics and governance to explore existing trail capacities. Here, we explore NSTs along four dimensions of governance that shape trail management: structural and foundational elements, landownership regimes, trail funding, and partnerships. Understanding these dimensions can inform managers of NSTs and other protected areas crossing multiple jurisdictions, helping them recognize strengths and gaps in institutional form and capacity, and strategies for effective governance.