The administration of spike monoclonal antibody treatment to patients with mild to moderate COVID-19 is very challenging. This article summarizes essential components and processes in establishing an effective spike monoclonal antibody infusion program. Rapid identification of a dedicated physical infrastructure was essential to circumvent the logistical challenges of caring for infectious patients, while maintaining compliance with regulations and ensuring the safety of our personnel and other patients. Our partnerships and collaborations among multiple different specialties and disciplines enabled contributions from personnel with specific expertise in medicine, nursing, pharmacy, infection prevention and control, EHR informatics, compliance, legal, medical ethics, engineering, administration and other critical areas. Clear communication and a culture where all roles are welcomed at the planning and operational tables are critical to the rapid development and refinement needed to adapt and thrive in providing this time-sensitive beneficial therapy. Our partnerships with leaders and providers outside our institutions, including those who care for underserved populations, have promoted equity in the access of monoclonal antibodies in our regions. Strong support from institutional leadership facilitated expedited action when needed, from a physical, personnel, and system infrastructure standpoint. Our ongoing real-time assessment and monitoring of our clinical program allowed us to improve and optimize our processes to ensure that the needs of our COVID-19 patients in the outpatient setting are met.
The World Health Organization estimates a global deficit of about 12.9 million skilled health professionals (midwives, nurses, and physicians) by 2035. These shortages limit the ability of countries, particularly resource-constrained countries, to deliver basic health care, to respond to emerging and more complex needs, and to teach, graduate, and retain their future health professionals—a vicious cycle that is perpetuated and has profound implications for health security. The Global Health Service Partnership (GHSP) is a unique collaboration between the Peace Corps, President’s Emergency Plan for AIDS Relief, Seed and host-country institutions, which aims to strengthen the breadth and quality of medical and nursing education and care delivery in places with dire shortages of health professionals. Nurse and physician educators are seconded to host institutions to serve as visiting faculty alongside their local colleagues. They serve for 1 year with many staying longer. Educational and clinical best practices are shared, emphasis is placed on integration of theory and practice across the academic–clinical domains and the teaching and learning environment is expanded to include implementation science and dissemination of locally tailored and sustainable practice innovations. In the first 3 years (2013–2016) GHSP placed 97 nurse and physician educators in three countries (Malawi, Tanzania, and Uganda). These educators have taught 454 courses and workshops to 8,321 trainees, faculty members, and practicing health professionals across the curriculum and in myriad specialties. Mixed-methods evaluation included key stakeholder interviews with host institution faculty and students who indicate that the addition of GHSP enhanced clinical teaching (quality and breadth) resulting in improved clinical skills, confidence, and ability to connect theory to practice and critical thinking. The outputs and outcomes from four exemplars which focus on the translation of evidence to practice through implementation science are included. Findings from the first 3 years of GHSP suggest that an innovative, locally tailored and culturally appropriate multi-country academic–clinical partnership program that addresses national health priorities is feasible and generated new knowledge and best practices relevant to capacity building for nursing and medical education. This in turn has implications for improving the health of populations who suffer a disproportionate burden of global disease.
This article focuses on how economically advantaged families hire independent educational consultants (IECs) to help them navigate the college application process. We argue that the help provided by IECs embodies the marketization of emotional and relational mediation that many privileged families pursue during times of great anxiety. We offer the concept of “family mediator” to illustrate the relationship between parents, children, and the IECs whom these families employ. First, this article will chronicle why many advantaged parents feel apprehensive about their children's application to college and how they decide to turn to IECs for help. Furthermore, we will demonstrate how privileged parents, especially mothers, rely on IECs to assuage their feelings and emotions. Finally, we will examine how IECs enable parents and children to avoid conflicts and sustain connections to each other. Nevertheless, we find that resorting to IECs as emotional and intergenerational mediators may not always work. Some parents and children occasionally resist the mediation provided by these IECs, just as a few IECs are unwilling to work as the bridge persons in these privileged families in order to protect their professional reputation and boundaries.
This article uses privileged families who hire Independent Educational Consultants (IECs) as an instance to examine how privileged parents collaborate with individuals whom they consider educational experts to support their children in the college race. We argue that advantaged parents' anxieties about their children have created a market for IECs who provide expert advice in order to mitigate the uncertainties that these parents experience and to manage various goals that they want to achieve at an important turning point in their children's lives. Drawing primarily on interviews with parents who work with IECs, we introduce the concept of "collaborative cultivation" to analyze the processes whereby advantaged parents rely on the expertise and expert status of private counselors to cope with their and their children's vulnerability in the college race while at the same time preparing their children for the unknown future. The parental method of "concerted cultivation" reveals how elite parents rely on individuals they perceive as experts to establish "bridges" between their own social worlds and the academic worlds that appear to beyond their control. This bridging labor points to the myriad cultural beliefs enacted to justify the child-rearing goals that privileged parents wish to accomplish by working with IECs.
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