Suchergebnisse

Intro -- Contents -- Editors and Contributors -- About the Editors -- Contributors -- Abbreviations -- 1: Introduction -- References -- 2: Telebehavioral Health: The Basics -- TBH Services -- The Evolution of Telebehavioral Health in the United States -- The Pioneering Experiments -- The "Coming-of-Age" Period -- The Resurgence of TBH in the 1990s -- The 2000s and Beyond -- The Evolving Role of TBH -- References -- 3: The Originating Site -- Geographic Location -- Type of Originating Sites -- Physical Setup -- Accessibility -- Privacy -- Atmosphere -- Communication -- Safety -- Teleclinician -- Site Staff -- Workflows and Protocols -- Information and Communication Technologies -- Documentation -- Prescribing -- Testing -- Crisis Management -- After-Hours Coverage -- Training -- References -- 4: The Patient Population -- Patient Population -- Child and Adolescent Populations -- Geriatric Populations -- Rural Populations -- LGBTQ Communities -- Populations with Substance Use Disorders -- Patients with Communication Needs -- Informed Consent and Patient Information -- Referring Patients to In-person BHS -- References -- 5: The Teleclinician -- Prior to Sessions -- Build an Online Profile -- Appropriateness for TBH -- Scheduling -- Informed Consent and Patient Information -- Technological Preparedness -- Crisis Planning -- Teleclinician Setup -- During Sessions -- The Basics -- Rapport and Therapeutic Alliance -- Clinical Considerations -- Technological Issues -- Crisis Management -- Prescribing -- Ending the Session -- After Sessions -- Documentation -- Clinical Collaboration -- Coding and Billing -- Beyond Sessions -- Ethical Considerations -- Teleclinician Well-Being -- References -- 6: Information and Communication Technologies -- Software -- Hardware -- Connectivity -- Contingency Planning -- References -- 7: Cultural and Regulatory Context.

Abstract
Introduction
For those with severe conflict-associated wounds which are affected by antimicrobial resistant (AMR) organisms, health systems during protracted conflict are often ill-equipped to respond to their needs. In this study, our aim is to explore the experiences of those with conflict-associated wounds whose wounds have been infected with AMR bacteria and who reside in northwest Syria (NWS). This is with a view to understanding the challenges they face and how the health and humanitarian system can better respond to their needs.


Methods
A qualitative research methodology where in-depth interviews were conducted with patients who are known to have AMR organisms infecting conflict-associated wounds was used. Patients were recruited from Bab Al-Hawa hospital in NWS based on pre-set inclusion criteria. They were invited to participate in remote interviews due to the ongoing COVID-19 pandemic. Interviews were conducted during January and February 2021 and transcribed in Arabic before thematic analysis was undertaken to identify key themes and subthemes.

Results
14 in-depth interviews were conducted of which 12 were with men. The age range was 20–49 years. We categorised the findings into 6 themes: i. those related to the mechanism of injury, ii, the impact of the conflict on health system accessibility, iii. experiences of immediate inpatient management, iv. the experience of outpatient and home management, v. the current impact of the injury on participants, and vi. participant perspectives around improving healthcare access for those with conflict-related wounds affected by AMR organisms. Important findings relate to the quality and capacity for both immediate and longer-term care and the psychosocial and socioeconomic impacts of the injuries which many of the participants continue to grapple with.

Conclusion
This is the first exploration through qualitative research of the experiences of those with conflict-affected wounds which are infected with AMR organisms in NWS. Emerging themes as told by participants can help stakeholders, including policy makers, humanitarian organisations and those involved with health system planning in NWS consider gaps in current and future care needs (including livelihood opportunities) for this vulnerable group.

AbstractBackgroundGiven the magnitude and frequency of conflicts in the MENA region along with their devastating impact on health responses and outcomes, there exists a strong need to invest in contextualized, innovative, and accessible capacity building approaches to enhance leadership and skills in global health. The MENA region suffers from limited (1) continued educational and career progression opportunities, (2) gender balance, and (3) skill-mix among its health workforce, which require significant attention.Main textThe Global Health Institute at the American University of Beirut incepted the Academy division to develop and implement various global health capacity building (GHCB) initiatives to address those challenges in fragile settings across low-and middle-income countries in the MENA region. These initiatives play a strategic role in this context, especially given their focus on being accessible through employing innovative learning modalities. However, there exists a dearth of evidence-based knowledge on best practices and recommendations to optimize the design, implementation, and evaluation of GHCB in fragile settings in the MENA region. The present paper describes the development of the evaluation of capacity building program (eCAP), implemented under the Academy division, to assess the effectiveness of its initiatives. eCAP is composed of 3 phases: (1) a situational assessment, followed by (2) production of multiple case studies, and finally (3) a meta-assessment leading to model development. The goal of eCAP is not only to inform the Academy's operations, but also to synthesize produced knowledge into the formation of an evidence-based, scalable, and replicable model for GHCB in fragile settings.ConclusioneCAP is an important initiative for researchers, educators, and practitioners interested in GHCB in fragile settings. Several lessons can be learned from the outcomes it has yielded so far in its first two phases of implementation, ranging from the situational assessment to the production of evaluation case studies, which are expanded on in the manuscript along with pertinent challenges.

AbstractBackgroundThe Middle East and North Africa (MENA) region is consistently plagued with humanitarian crises while having little response capacity. Despite their obvious growing need, there exist limited educational opportunities for humanitarian workers to develop their capacity in humanitarian topics. The present study evaluates an online training program, the Humanitarian Leadership Diploma (HLD), which targeted humanitarian workers across the MENA region.MethodsA mixed-methods design was used, comprising short and long-term quantitative and qualitative data, targeting individual and organizational-level outcomes. A total of 28 humanitarian workers across the MENA region enrolled in the program starting September 2019 until October 2020, 18 of which completed the full diploma. Short-term quantitative data such as knowledge assessments, course evaluations, and reflective commentaries were collected from all learners, whereas long-term qualitative data was collected only from those who completed the full diploma and from peers at their organizations, 6 months after completion. Data was triangulated, analyzed using qualitative content analysis, and reported as themes.ResultsThe program was overall successful given multiple factors reported by participants such as enhanced knowledge, high satisfaction, and improved practice, with some important challenges being identified. Themes under the strengths category related to (1) online learning, (2) significance of diploma, (3) course content, (4) instructors, (5) transfer of learning into practice, and (6) personal development. Themes under the challenges category related to (1) barriers to applying changes in behavior and performance, (2) engagement and interaction, and (3) pedagogical approach.ConclusionThis is one of very few evaluations of locally developed and delivered online learning programs for humanitarian actors in the MENA region. The findings are especially important as they may inform researchers and humanitarian actors looking to design and deliver similar programs in the MENA region or other fragile settings. Key recommendations are discussed in the manuscript, and include to combine synchronous and asynchronous approaches, design concise course materials, limit theoretical pedagogical approaches, ensure topics are contextualized to the region, and consider continuous engagement strategies for learners.