Evaluation

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  • 文章类型: Journal Article
    现场流行病学培训计划(FETPs)是基于能力的培训计划,在加强全球卫生安全和提高公共卫生专业人员的流行病学能力方面发挥着关键作用。本范围审查审查了有关全球FETPs评估的现有已发表文献。
    进行了文献综述,以评估全球FETPs。使用特定于FETPs评估的关键词来搜索PubMed,Scopus,和Web科学数据库。在应用纳入和排除标准后,该研究包括来自60个初始池的12个相关研究。数据提取包括关键细节,定性综合使用叙事方法组织不同的发现,以得出适当的结论并提出建议。
    审查涵盖了12项研究的结果,这些研究涵盖了所有三个FETP模式,并涵盖了各个地区的国家。评估探索获得的技能,参与FETP活动,以及现场流行病学功能的改善。获得了技能和知识,参与FETP活动,现场流行病学功能的改善是显而易见的,对每个FETP层都有具体的期望。所有研究的积极结果是一致的,揭示监测活动的改善,爆发响应,数据管理,和其他系统功能。
    这项审查证实了FETPs对学员和毕业生的积极影响,强调跨不同模式的能力增强。建议采用各种策略来改善对FETPs的评估。为了有效评估,有必要开发强大的评估工具,并建立标准化的指标,以比较不同地区或国家的FETP。
    UNASSIGNED: Field Epidemiology Training Programs (FETPs) are competency-based training programs that play a critical role in strengthening global health security and enhancing the epidemiological capabilities of public health professionals. This scoping review examined available published literature on the evaluations of FETPs globally.
    UNASSIGNED: A literature review was conducted to evaluate FETPs globally. Keywords specific to the evaluation of FETPs were utilized to search the PubMed, Scopus, and Web Science databases. After applying the inclusion and exclusion criteria, 12 relevant studies from an initial pool of 60 were included in this study. Data extraction included key details, and a qualitative synthesis organized diverse findings using a narrative approach to draw appropriate conclusions and generate recommendations.
    UNASSIGNED: The review covered findings from 12 studies covering all three FETP modalities and spanning countries in various regions. Evaluations explored gained skills, engagement in FETP activities, and improvements in field epidemiological functions. Gained skills and knowledge, engagement in FETP activities, and improvements in field epidemiological functions were evident, with specific expectations for each FETP tier. Positive outcomes were consistent across studies, revealing improvements in surveillance activities, outbreak response, data management, and other system functions.
    UNASSIGNED: This review confirmed the positive impact of FETPs on trainees and graduates, which emphasized competency enhancements across different modalities. Various strategies are recommended to improve the evaluation of FETPs. For effective evaluation, it is necessary to develop robust evaluation tools and establish standardized metrics to compare FETPs across regions or countries.
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  • 文章类型: Journal Article
    癌症基因组服务(CGS)可以支持遗传风险分层的癌症预防和治疗。与非西班牙裔白人相比,种族/少数民族群体不太可能获得和利用CGS。很少有研究描述了针对拉丁裔CGS的干预措施的特征。此范围审查旨在(1)描述促进美国和拉丁美洲拉丁美洲人吸收CGS的干预措施,(2)描述拉丁裔参与者的干预适应,(3)总结影响因素,有效性,收养,实施,和维护(RE-AIM)框架。我们在PubMed和拉丁美洲和加勒比健康科学文献数据库中搜索了2005年至2022年之间发表的英文和西班牙文文献。2344篇论文中有16篇符合分析的纳入标准。在拉丁美洲社区中推广CGS的努力在美国受到限制,而在拉丁美洲则较低。这篇综述强调了对文化适应知情干预措施进行深入探索的必要性,并更好地报告实施因素,以增强其在不同环境中的可扩展性。
    Cancer genomic services (CGS) can support genetic risk-stratified cancer prevention and treatment. Racial/ethnic minority groups are less likely to access and utilize CGS compared with non-Hispanic Whites. Little research has described characteristics of interventions targeted at CGS among Latinos. This scoping review aimed to (1) describe interventions promoting uptake of CGS among Latinos in the United States and Latin America, (2) describe intervention adaptations for Latino participants, and (3) summarize intervention implementation factors suggested by reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. We conducted a search in English and Spanish of literature published between 2005 and 2022 across PubMed and Latin American and Caribbean Health Sciences Literature databases. Sixteen of 2344 papers met the inclusion criteria of the analysis. Efforts to promote CGS among Latino communities were limited in the US and lower in Latin America. This review highlights the need for in-depth exploration of acculturation-informed interventions and better reporting on implementation factors to enhance their scalability across diverse settings.
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  • 文章类型: Journal Article
    冠状动脉斑块性质和组成的准确评估涉及临床随访和预后。冠状动脉CT血管造影是最常用的无创性斑块评价方法,然而,基于CT值对斑块的定性和定量评价是不准确的,由于管腔衰减的影响,管电压,参数设置和主观性。
    Accurate evaluation of the nature and composition of coronary plaque involves clinical follow-up and prognosis. Coronary CT angiography is the most commonly non-invasive method for plaque evaluation, however, the qualitative and quantitative evaluation of plaque based on CT value is inaccurate, due to the influence of luminal attenuation, tube voltage, parameter setting and the subjectivity.
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  • 文章类型: Journal Article
    本研究描述了适应行为评估系统(ABAS-3)对巴西葡萄牙语的跨文化适应,它评估了三个主要自适应领域内的11个技能领域:概念,社会,实用。翻译是由两名独立的翻译人员完成的,随后由两名专家对翻译进行综合,然后由来自健康和教育领域的33名专家(每个子量表3名)对综合进行分析,这些专家是ABAS-3评估的领域的专家。在五个ABAS-3表格的1121个项目中,82(7.31%)需要修订。专家们在大多数项目上都有很好的共识,只需要进行微小的调整。有很好的证据表明内容的有效性和适应性在概念上,惯用的,以及乐器项目的语义方面。这种跨文化适应的初始过程是必要的,因为适应行为受到社会经济地位和文化等环境因素的强烈影响。
    This study describes the cross-cultural adaptation to Brazilian Portuguese of the Adaptive Behavior Assessment System (ABAS-3), which assesses 11 skills areas within three major adaptive domains: the conceptual, social, and practical. The translation was performed by two independent translators, which was followed by the synthesis of the translations by two experts and then an analysis of the synthesis by 33 specialists from the areas of health and education (three per subscale) who were experts in the domains evaluated by ABAS-3. Of the 1121 items of the five ABAS-3 forms, 82 (7.31%) needed revision. There was good agreement between the specialists in respect of most items, with only minor adjustments being required. There was good evidence of content validity and the adequacy of the adaptation in respect of the conceptual, idiomatic, and semantic aspects of the items of the instrument. This initial process of cross-cultural adaptation was necessary because adaptive behavior is strongly influenced by environmental factors such as socioeconomic status and culture.
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  • 文章类型: Journal Article
    军事人员在外国行动时面临的最困难挑战之一是与当地居民进行清晰和成功的沟通。为了解决这个问题,国防高级研究计划局(DARPA)正在通过战术用口语交流和翻译系统(TRANSTAC)计划资助学术机构和工业组织,以开发实用的机器翻译系统。TRANSTAC计划的目标是展示快速开发和现场自由形式的能力,双向,语音到语音翻译系统,使不同语言的人能够在现实世界的战术情况下相互交流,而无需口译员。对这些技术的评估是该计划的重要组成部分,DARPA已要求国家标准与技术研究所(NIST)领导这项工作。本文介绍了TRANSTAC评估的实验设计和度量标准,定量和定性,用于全面评估系统性能。
    One of the most difficult challenges that military personnel face when operating in foreign countries is clear and successful communication with the local population. To address this issue, the Defense Advanced Research Projects Agency (DARPA) is funding academic institutions and industrial organizations through the Spoken Language Communication and Translation System for Tactical Use (TRANSTAC) program to develop practical machine translation systems. The goal of the TRANSTAC program is to demonstrate capabilities to rapidly develop and field free-form, two-way, speech-to-speech translation systems that enable speakers of different languages to communicate with one another in real-world tactical situations without an interpreter. Evaluations of these technologies are a significant part of the program and DARPA has asked the National Institute of Standards and Technology (NIST) to lead this effort. This article presents the experimental design of the TRANSTAC evaluations and the metrics, both quantitative and qualitative, that were used to comprehensively assess the systems\' performance.
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  • 文章类型: Journal Article
    背景:医疗保健系统正在转变为使用数据驱动和研究知情方法来实现持续改进的学习型卫生系统。这些方法之一是使用临床路径,这些工具可以使特定人群的护理标准化并提高医疗质量。评估临床路径的成熟度是必要的,以告知路径开发团队和卫生系统决策者所需的路径修订或实施支持。为了改善发展,实施,以及省级临床路径的可持续性,我们建立了临床路径成熟度评估矩阵.探索矩阵的初始内容和面形效度,我们用它来评估萨斯喀彻温省卫生部门的一个病例路径,加拿大。
    方法:通过使用迭代的基于共识的流程,我们收集了包括患者和家庭伙伴在内的利益相关者的反馈,政策制定者,临床医生,和质量改进专家,排名,保留,或删除草案矩阵的启用符和子启用符。我们在当地试点地区的初级保健慢性疼痛路径(CPP)上测试了矩阵,并根据CPP开发团队负责人的反馈修改了矩阵。
    结果:最终矩阵包含五个使能者(即,设计,所有权和执行者,基础设施,绩效管理,和文化),20个子推动者,和每个子启用器的三个轨迹定义。为六个子启用者创建了补充文件。CPP在40个可能的成熟点中得到15分。尽管该途径在设计推动者中得分最高(10/12),这需要在几个方面给予更多关注,特别是所有权和执行者以及绩效管理推动者,每个得分为零。此外,基础设施和文化推动者得了2/4和3/8分,分别。CPP的这些领域需要改进,以提高CPP的整体成熟度。
    结论:我们开发了临床路径成熟度矩阵来评估临床路径的开发和实施的各个维度。这项初步工作的目标是开发和验证一种工具,以评估新的或现有途径的成熟度和准备情况,并跟踪途径的修订和改进。
    BACKGROUND: Healthcare systems are transforming into learning health systems that use data-driven and research-informed approaches to achieve continuous improvement. One of these approaches is the use of clinical pathways, which are tools to standardize care for a specific population and improve healthcare quality. Evaluating the maturity of clinical pathways is necessary to inform pathway development teams and health system decision makers about required pathway revisions or implementation supports. In an effort to improve the development, implementation, and sustainability of provincial clinical pathways, we developed a clinical pathways maturity evaluation matrix. To explore the initial content and face validity of the matrix, we used it to evaluate a case pathway within a provincial health authority in Saskatchewan, Canada.
    METHODS: By using iterative consensus-based processes, we gathered feedback from stakeholders including patient and family partners, policy makers, clinicians, and quality improvement specialists, to rank, retain, or remove enablers and sub-enablers of the draft matrix. We tested the matrix on the Chronic Pain Pathway (CPP) for primary care in a local pilot area and revised the matrix based on feedback from the CPP development team leader.
    RESULTS: The final matrix contains five enablers (i.e., Design, Ownership and Performer, Infrastructure, Performance Management, and Culture), 20 sub-enablers, and three trajectory definitions for each sub-enabler. Supplemental documents were created for six sub-enablers. The CPP scored 15 out of 40 possible points of maturity. Although the pathway scored highest in the Design enabler (10/12), it requires more attention in several areas, specifically the Ownership and Performer and the Performance Management enablers, each of which scored zero. Additionally, the Infrastructure and Culture enablers scored 2/4 and 3/8 points, respectively. These areas of the CPP are in need of improvement in order to enhance the overall maturity of the CPP.
    CONCLUSIONS: We developed a clinical pathways maturity matrix to evaluate the various dimensions of clinical pathways\' development and implementation. The goals of this initial work were to develop and validate a tool to assess the maturity and readiness of new or existing pathways and to track pathways\' revisions and improvements.
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  • 文章类型: Journal Article
    背景:乌干达在七个高风险地点设有哨点监测系统,以监测黄热病(YF)模式并检测暴发。我们评估了该系统从2017年到2022年的性能。
    方法:我们评估了选定的属性,包括及时性(不同关键时间点之间的滞后),外部完整性(系统中每年报告≥1例疑似病例的预期哨点比例),和内部完整性(填写了最低要求数据元素的报告比例),使用2017年1月至2022年7月YF监测数据库中的次要数据。我们对医疗机构和国家层面的利益相关者进行了重要的线人访谈,以评估有用性,灵活性,简单,以及监控系统的可接受性。
    结果:总计,报告了3,073例疑似YF病例和15例确诊YF病例。从样品收集到实验室装运的中位时滞为37天(IQR:21-54)。外部完整性为76%;内部完整性为65%。利益相关者认为监控系统简单且可以接受,但不确定灵活性。以前爆发的大多数(71%)YF病例是通过哨点监测系统发现的;数据用于告知干预措施,例如加强YF疫苗接种。
    结论:YF哨点监测系统可用于检测暴发和告知公共卫生行动。案件确认的延迟和不完整的数据损害了其整体有效性和效率。
    BACKGROUND: Uganda has a sentinel surveillance system in seven high-risk sites to monitor yellow fever (YF) patterns and detect outbreaks. We evaluated the performance of this system from 2017 to 2022.
    METHODS: We evaluated selected attributes, including timeliness (lags between different critical time points), external completeness (proportion of expected sentinel sites reporting ≥ 1 suspect case in the system annually), and internal completeness (proportion of reports with the minimum required data elements filled), using secondary data in the YF surveillance database from January 2017-July 2022. We conducted key informant interviews with stakeholders at health facility and national level to assess usefulness, flexibility, simplicity, and acceptability of the surveillance system.
    RESULTS: In total, 3,073 suspected and 15 confirmed YF cases were reported. The median time lag from sample collection to laboratory shipment was 37 days (IQR:21-54). External completeness was 76%; internal completeness was 65%. Stakeholders felt that the surveillance system was simple and acceptable, but were uncertain about flexibility. Most (71%) YF cases in previous outbreaks were detected through the sentinel surveillance system; data were used to inform interventions such as intensified YF vaccination.
    CONCLUSIONS: The YF sentinel surveillance system was useful in detecting outbreaks and informing public health action. Delays in case confirmation and incomplete data compromised its overall effectiveness and efficiency.
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  • 文章类型: Journal Article
    背景:需要对助产士进行预防性筛查和有效干预的教育策略,以改善受虐待妇女及其家庭的临床实践和结局。此范围审查旨在描述助产士/学生助产士怀孕期间亲密伴侣暴力(IPV)的可用教育培训计划。
    方法:对文献进行范围审查,它于2010年1月至2023年3月在PUBMED以英文出版,EBSCO,和CINAHAL数据库,已应用。搜索中使用了以下关键字:\'evaluation\',\'教育培训\',\'课程\',\'助产士\',\'学生助产士\',\'亲密伴侣暴力\',\'怀孕\',结合AND和OR布尔运算符。纳入的研究侧重于助产士/学生助产士关于亲密伴侣暴力的培训计划/课程。
    结果:共有9项研究符合纳入条件,描述了六个助产士计划和三个学生助产士计划。教育干预措施的长度各不相同(例如几个小时到几周)和多学科课程等教育方法,讲座,理论,角色扮演,在筛选中的实践,小组活动,观看视频,和病例报告讨论。这些节目有类似的内容,包括提高人们对暴力的认识,定义它,讨论性别角色,IPV对女性健康的影响,转介机构,以及每个国家关于暴力的法律。
    结论:这项范围审查强调了缺乏关于怀孕期间亲密伴侣暴力的教育计划,建议需要根据当代临床实践和助产教育建议开发新的计划。
    BACKGROUND: Educational strategies for preventive screening and effective interventions in midwives are needed to improve clinical practice and outcomes for abused women and their families. This scoping review aimed to describe available educational training programs on intimate partner violence (IPV) in pregnancy for midwives/student midwives.
    METHODS: A scoping review of the literature, which was published in English from January 2010 to March 2023, in PUBMED, EBSCO, and CINAHAL databases, was applied. The following keywords were used in the search: \'evaluation\', \'educational training\', \'course\', \'midwives\', \'student midwife\', \'intimate partner violence\', \'pregnancy\', combined with AND and OR Boolean operators. The included studies focused on training programs/courses for midwives/student midwives regarding intimate partner violence.
    RESULTS: A total of 9 studies were eligible for inclusion, describing six programs for midwives and 3 for student midwives. Educational interventions varied in length (e.g. a few hours to weeks) and educational approaches such as multidisciplinary sessions, lectures, theory, role-playing, practice in screening, group activities, watching videos, and case reports discussion. The programs had similar content, including raising awareness of violence, defining it, discussing gender roles, the impact of IPV on women\'s health, referral agencies, and the laws regarding violence in each country.
    CONCLUSIONS: This scoping review highlighted a lack of educational programs on intimate partner violence during pregnancy, suggesting that new programs need to be developed based on contemporary clinical practices and recommendations for midwifery education.
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  • 文章类型: Journal Article
    背景:疫苗数量的增加和免疫程序的复杂性,随着传染病流行病学的不断变化,需要一种系统的方法来评估疫苗有效性(VE)。本研究提出了一项初步调查,以建立韩国的VE评估框架,重点是国家免疫计划。
    方法:专家意见是通过针对关键利益相关者的两轮在线调查收集的。第一轮由两个多项选择题和两个开放式问题组成。第二轮是定量调查,通过分析第一轮调查的结果得出了基于五个领域的17份问卷。
    结果:结果强调了政府主导的VE评估系统以及建立多学科评估组织的必要性和紧迫性。关键考虑因素包括人员,预算,数据集成,法律标准,和监控系统增强。
    结论:这些发现为政策制定者提供了有价值的见解,强调合作的必要性,财政支持,和强有力的数据管理,以制定循证疫苗接种政策。
    BACKGROUND: The increasing number of vaccines and the complexity of immunization programs, along with continuous changes in the epidemiology of infectious diseases, necessitate a systematic approach to vaccine effectiveness (VE) evaluation. This study presents a preliminary survey to establish a VE evaluation framework in Korea, focusing on the National Immunization Program.
    METHODS: Experts\' opinions were collected through a two-round online survey targeting key stakeholders. The first round consisted of two multiple-choice questions and two open-ended questions. The second round was a quantitative survey with 17 questionnaires based on five domains derived by analyzing the results of the first-round survey.
    RESULTS: The results emphasize the necessity and urgency of a government-led VE evaluation system and the establishment of a multidisciplinary evaluation organization. Key considerations include personnel, budget, data integration, legal standards, and surveillance system enhancements.
    CONCLUSIONS: These findings provide valuable insights for policymakers, emphasizing the need for collaboration, financial support, and robust data management in developing evidence-based vaccination policies.
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  • 文章类型: Journal Article
    背景:教师发展计划对于促进持续学习至关重要,提高教学效果,并鼓励医学教育工作者的专业成长。2007年,基于问题的学习被引入我们医学院的教学策略。此后,进行了几轮教师发展计划,以帮助教师认识到他们作为促进者的角色并评估需要改进的领域。
    方法:我们进行了一项混合方法研究,其中284名三年级医学生回答问卷,21名教职员工参与焦点小组。使用经过验证的13项问卷来调查学生对其导师的评估在基于问题的学习中的表现。然后与参与基于问题的学习的教职员工进行了三场会议,以深入了解他们的经验和观点。
    结果:学生授予的导师的平均成绩排名超过一半。有一个显著的正相关之间的导师表现排名和所有五个的学习方法在这里检查:建设性/主动学习,自主学习,情境学习,协作学习,和个人内部行为(p<0.05)。焦点小组的数据在五个广泛的主题下进行了分析:导师对他们的优势和劣势的见解,进行基于问题的学习的挑战,导师为基于问题的学习做准备的方法,反馈,以及改进基于问题的学习研讨会的建议。
    结论:本研究为高级项目评估提供了改进和未来方向。教师发展计划可以量身定制,以有效地满足学生和教职员工的目标和需求,这可以有利于教学和学习过程,并培养持续改进和专业成长的文化。
    BACKGROUND: Faculty development programs are crucial for promoting continuous learning, enhancing teaching effectiveness, and encouraging professional growth among medical educators. Problem-based learning was introduced as a teaching strategy in our Faculty of Medicine in 2007. Thereafter, several rounds of a faculty development program were conducted to help teachers recognize their role as facilitators and assess areas for improvement.
    METHODS: We conducted a mixed-methods study with a sample of 284 third-year medical students answering a questionnaire and 21 faculty members participating in focus groups. A validated 13-item questionnaire was used to investigate the students\' evaluation of their tutors\' performance in problem-based learning. Three sessions were then conducted with faculty members involved in problem-based learning to gain in-depth insights into their experiences and perspectives.
    RESULTS: The mean performance ranking for tutors awarded by the students was above halfway. There was a significant positive correlation between tutors\' performance ranking and all five of the learning approaches examined herein: constructive/active learning, self-directed learning, contextual learning, collaborative learning, and intra-personal behavior (p < 0.05). The data from the focus groups were analyzed under five broad themes: tutors\' insights into their strengths and weaknesses, challenges in conducting problem-based learning, tutors\' ways of preparing for problem-based learning, feedback, and suggestions for improving problem-based learning workshops.
    CONCLUSIONS: This study recommends improvements and future directions for advanced program evaluation. Faculty development programs can be tailored to effectively address students and faculty members\' goals and needs, which can benefit the teaching and learning process and foster a culture of continuous improvement and professional growth.
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