SummaryBackgroundRheumatic heart disease (RHD) is a major public health problem in low– and middle–income countries (LMICs), with a paucity of high–quality trial data to improve patient outcomes. Investigators felt that involvement in a recent large, observational RHD study impacted positively on their practice, but this was poorly defined.AimThe purpose of this study was to document the experience of investigators and research team members from LMICs who participated in a prospective, multi–centre study, the global Rheumatic Heart Disease Registry (REMEDY), conducted in 25 centres in 14 countries from 2010 to 2012. MethodsWe conducted an online survey of site personnel to identify and quantify their experiences. Telephone interviews were conducted with a subset of respondents to gather additional qualitative data. We asked about their experiences, positive and negative, and about any changes in RHD management practices resulting from their participation in REMEDY as a registry site.ResultsThe majority of respondents in both the survey and telephone interviews indicated that participation as a registry site improved their management of RHD patients. Administrative changes included increased attention to follow–up appointments and details in patient records. Clinical changes included increased use of penicillin prophylaxis, and more frequent INR monitoring and contraceptive counselling.ConclusionsOur study demonstrates that participation in clinical research on RHD can have a positive impact on patient management. Furthermore, REMEDY has led to increased patient awareness and improved healthcare workers’ knowledge and efficiency in caring for RHD patients.
In 2014, the Institute of Medicine (IOM) 1 held the second annual District of Columbia (DC) Public Health Case Challenge. 2 The IOM collaborated with faculty and students from Georgetown University to develop this competition, which had its inaugural year in 2013 and was both inspired by and modeled on the Emory University Global Health Case Competition. 3 The DC Case Challenge aims to promote interdisciplinary, problem-based learning in public health and to foster engagement with local universities and the local community. The Case Challenge engages graduate and undergraduate students from multiple schools, disciplines, and universities to come together to promote awareness of and develop innovative solutions for 21st century public health issues, grounded in a challenge faced by the local DC community. Each year the organizers and a student case-writing team develop a case based on a topic that is not only relevant in the DC area, but also has broader domestic and global resonance. Content experts are then recruited as volunteer reviewers to assist the student case-writing team. Universities located in the Washington, DC, area are invited to form teams of three to six students enrolled in undergraduate or graduate degree programs. In an effort to promote public health dialogue among a variety of disciplines, each team is required to include representation from at least three different schools, programs, or majors of study. Two weeks before the Case Challenge event, the teams are charged to employ critical analysis, thoughtful action, and interdisciplinary collaboration to develop a solution to the problem presented in the case. On the day of the Case Challenge, teams present their proposed solution to a panel of judges composed of representatives from local DC organizations as well as other subject matter experts from disciplines relevant to the case. 2014 CASE: SUPPORTING ADULT INVOLVEMENT IN ADOLESCENT HEALTH AND EDUCATION The 2014 case focused on how to support the adults in the lives of adolescents in Washington, DC, to improve health and education outcomes. The case asked the student groups to develop a program for less than $1 million over 4 years that would fill a void in interventions intended to change adult behavior by increasing the time, quality, and effectiveness of adult involvement in early adolescent 1 On July 1, 2015, the National Academy of Medicine (NAM) joined the National Academy of Sciences and the National Academy of Engineering as the third academy overseeing the program units of the newly formed National Academies of Sciences, Engineering, and Medicine ("the Academies"). The NAM has assumed the membership and honorific functions previously held by the Institute of Medicine (IOM), as well as the administration of fellowships, Perspectives, the Rosenthal Symposium, and other activities and initiatives. The IOM has been incorporated as a program unit of the Academies, in which form it continues its traditional consensus study and convening activities. Beginning in 2015, the DC Public Healt...
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