10 research outputs found
Vergleich der Effizienz intravenöser Antibiotika bei Patienten mit Cystischer Fibrose anhand einer randomisierten prospektiven Studie aus den Jahren 1997 bis 1999 und anhand von Literatur der vergangenen 25 Jahre
Limitations of the Millennium Development Goals: a literature review
With the Millennium Development Goals (MDGs) showing uneven progress, this review identifies possible limitations arising from the MDG framework itself rather than extrinsic issues. A multidisciplinary literature review was conducted with a focus on limitations in the formulation of the MDGs, their structure, content and implementation. Of 1837 MDG-related articles, 90 met criteria for analysis. Articles describe MDGs as being created by only a few stakeholders without adequate involvement by developing countries and overlooking development objectives previously agreed upon. Others claim MDGs are unachievable and simplistic, not adapted to national needs, do not specify accountable parties and reinforce vertical interventions. While MDGs have promoted increased health and well-being in many countries by recognising and deliberating on the possible constraints of the MDG framework, the post-2015 agenda may have even greater impact. Complex problems have simple, easy to understand, wrong answers (Henry Louis Mencken
an analysis of current capacity, needs and barriers
Background In times of increasing global challenges to health, it is crucial
to create a workforce capable of tackling these complex issues. Even though a
lack of GHE in Germany is perceived by multiple stakeholders, no systematic
analysis of the current landscape exists. The aim of this study is to provide
an analysis of the global health education (GHE) capacity in Germany as well
as to identify gaps, barriers and future strategies. Methods An online search
in combination with information provided by student representatives, course
coordinators and lecturers was used to create an overview of the current GHE
landscape in Germany. Additionally, a semi-structured questionnaire was sent
to GHE educators and students engaged in global health (GH) to assess the
capacity of German GHE, its barriers and suggested strategies for the future.
Results A total of 33 GHE activities were identified at 18 German
universities. Even though medical schools are the main provider of GHE (42%),
out of 38 medical schools, only 13 (34%) offer any kind of GHE. Modules
offered for students of other health-related professions constitute 27% of all
activities. Most survey respondents (92%, n = 48) consider current GHE
activities in Germany insufficient. Suggested formats were GHE as part of
medical curricula (82%, n = 45) and dual degree MD/MPH or PhD programs. Most
important barriers mentioned were low priority of GH at faculties and academic
management levels (n = 41, 75%) as well as lack of necessary institutional
structures (n = 33, 60%). Conclusions Despite some innovative academic
approaches, there is clearly a need for more systematic GHE in Germany. GHE
educators and students can take an important role advocating for more
awareness at university management level and suggesting ways to
institutionalize GHE to overcome barriers. This study provides key evidence,
relevant perceptions and suggestions to strengthen GHE in Germany
Innovative package for frontline maternal, newborn and child health workers in South Sudan
Improving maternal, newborn, and child health is a leading priority worldwide. It is a particularly urgent issue in South Sudan, which suffers from the world’s worst maternal mortality and among the worst newborn and child mortalities. A leading barrier to improving these health indices is limited frontline health worker capacity. In partnership with the Ministry of Health, the Division of Global Health and Human Rights (Department of Emergency Medicine, Massachusetts General Hospital, Boston, USA) has developed and is currently implementing its novel Maternal, Newborn, and Child Survival (MNCS) Initiative throughout much of South Sudan. The purpose of MNCS is to build frontline health worker capacity through a training package that includes:1. A participatory training course2. Pictorial checklists to guide prevention, care, and referral3. Re-useable medical equipment and commodities.Program implementation began in November 2010 utilizing a training-of-trainers model. To date, 72 local trainers and 632 frontline health workers have completed the training and received their MNCS checklists and commodities. Initial monitoring and evaluation results are encouraging as further evaluation continues. This innovative training package may also serve as a model for building capacity for maternal, newborn, and child health in other resource limited settings beyond South Sudan
Global health education in Germany: an analysis of current capacity, needs and barriers
Abstract Background In times of increasing global challenges to health, it is crucial to create a workforce capable of tackling these complex issues. Even though a lack of GHE in Germany is perceived by multiple stakeholders, no systematic analysis of the current landscape exists. The aim of this study is to provide an analysis of the global health education (GHE) capacity in Germany as well as to identify gaps, barriers and future strategies. Methods An online search in combination with information provided by student representatives, course coordinators and lecturers was used to create an overview of the current GHE landscape in Germany. Additionally, a semi-structured questionnaire was sent to GHE educators and students engaged in global health (GH) to assess the capacity of German GHE, its barriers and suggested strategies for the future. Results A total of 33 GHE activities were identified at 18 German universities. Even though medical schools are the main provider of GHE (42%), out of 38 medical schools, only 13 (34%) offer any kind of GHE. Modules offered for students of other health-related professions constitute 27% of all activities. Most survey respondents (92%, n = 48) consider current GHE activities in Germany insufficient. Suggested formats were GHE as part of medical curricula (82%, n = 45) and dual degree MD/MPH or PhD programs. Most important barriers mentioned were low priority of GH at faculties and academic management levels (n = 41, 75%) as well as lack of necessary institutional structures (n = 33, 60%). Conclusions Despite some innovative academic approaches, there is clearly a need for more systematic GHE in Germany. GHE educators and students can take an important role advocating for more awareness at university management level and suggesting ways to institutionalize GHE to overcome barriers. This study provides key evidence, relevant perceptions and suggestions to strengthen GHE in Germany
Efficacy and safety of intravenous meropenem and tobramycin versus ceftazidime and tobramycin in cystic fibrosis
BACKGROUND: Cystic fibrosis (CF) is characterized by chronic bacterial broncho-pulmonary infection. Although intravenous (IV) antibiotic therapy is regarded as standard treatment in CF, only few randomised trials comparing different antibiotic compounds exist. METHODS: We report on a prospective multicenter interventional trial of IV meropenem (120 mg/kg/day) or IV ceftazidime (200-400 mg/kg/day), each administered together with IV tobramycin (9-12 mg/kg/day). Outcome measures were changes in lung function, microbiological sputum burden and blood inflammatory marker. Liver and renal function values were measured to assess safety. RESULTS: One hundred eighteen patients (59/59) were included into the study with the following indications: first infection of P. aeruginosa (n=6), acute pulmonary exacerbation (n=34) and suppression therapy of chronic P. aeruginosa colonization (n=78). Both treatments improved lung function measures, bacterial sputum burden and CRP levels with no differences between treatment groups observed. A significant higher elevation for alkaline phosphatase (p<0.0001) was observed for patients in the meropenem/tobramycin group. CONCLUSIONS: IV antibiotic therapy in CF patients with meropenem/tobramycin is as effective as with ceftazidime/tobramycin regarding lung function, microbiological sputum burden and systemic inflammatory status. Hepato-biliary function should be monitored carefully during IV treatment, possibly important in CF patients with pre-existing liver disease
Feasibility Study on Menstrual Cycles With Fitbit Device (FEMFIT): Prospective Observational Cohort Study
BackgroundDespite its importance to women’s reproductive health and its impact on women’s daily lives, the menstrual cycle, its regulation, and its impact on health remain poorly understood. As conventional clinical trials rely on infrequent in-person assessments, digital studies with wearable devices enable the collection of longitudinal subjective and objective measures.
ObjectiveThe study aims to explore the technical feasibility of collecting combined wearable and digital questionnaire data and its potential for gaining biological insights into the menstrual cycle.
MethodsThis prospective observational cohort study was conducted online over 12 weeks. A total of 42 cisgender women were recruited by their local gynecologist in Berlin, Germany, and given a Fitbit Inspire 2 device and access to a study app with digital questionnaires. Statistical analysis included descriptive statistics on user behavior and retention, as well as a comparative analysis of symptoms from the digital questionnaires with metrics from the sensor devices at different phases of the menstrual cycle.
ResultsThe average time spent in the study was 63.3 (SD 33.0) days with 9 of the 42 individuals dropping out within 2 weeks of the start of the study. We collected partial data from 114 ovulatory cycles, encompassing 33 participants, and obtained complete data from a total of 50 cycles. Participants reported a total of 2468 symptoms in the daily questionnaires administered during the luteal phase and menses. Despite difficulties with data completeness, the combined questionnaire and sensor data collection was technically feasible and provided interesting biological insights. We observed an increased heart rate in the mid and end luteal phase compared with menses and participants with severe premenstrual syndrome walked substantially fewer steps (average daily steps 10,283, SD 6277) during the luteal phase and menses compared with participants with no or low premenstrual syndrome (mean 11,694, SD 6458).
ConclusionsWe demonstrate the feasibility of using an app-based approach to collect combined wearable device and questionnaire data on menstrual cycles. Dropouts in the early weeks of the study indicated that engagement efforts would need to be improved for larger studies. Despite the challenges of collecting wearable data on consecutive days, the data collected provided valuable biological insights, suggesting that the use of questionnaires in conjunction with wearable data may provide a more complete understanding of the menstrual cycle and its impact on daily life. The biological findings should motivate further research into understanding the relationship between the menstrual cycle and objective physiological measurements from sensor devices