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Romeyer Dherbey J, Bertels F. The untapped potential of phage model systems as therapeutic agents. Virus Evol 2024; 10:veae007. [PMID: 38361821 PMCID: PMC10868562 DOI: 10.1093/ve/veae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/18/2023] [Accepted: 01/12/2024] [Indexed: 02/17/2024] Open
Abstract
With the emergence of widespread antibiotic resistance, phages are an appealing alternative to antibiotics in the fight against multidrug-resistant bacteria. Over the past few years, many phages have been isolated from various environments to treat bacterial pathogens. While isolating novel phages for treatment has had some success for compassionate use, developing novel phages into a general therapeutic will require considerable time and financial resource investments. These investments may be less significant for well-established phage model systems. The knowledge acquired from decades of research on their structure, life cycle, and evolution ensures safe application and efficient handling. However, one major downside of the established phage model systems is their inability to infect pathogenic bacteria. This problem is not insurmountable; phage host range can be extended through genetic engineering or evolution experiments. In the future, breeding model phages to infect pathogens could provide a new avenue to develop phage therapeutic agents.
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Affiliation(s)
- Jordan Romeyer Dherbey
- Microbial Population Biology, Max Planck Institute for Evolutionary Biology, August-Thienemann-Straße 2, Plön, Schleswig-Holstein 24306, Germany
| | - Frederic Bertels
- Microbial Population Biology, Max Planck Institute for Evolutionary Biology, August-Thienemann-Straße 2, Plön, Schleswig-Holstein 24306, Germany
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Niang M, Alami H, Gagnon MP, Dupéré S. A conceptualisation of scale-up and sustainability of social innovations in global health: a narrative review and integrative framework for action. Glob Health Action 2023; 16:2230813. [PMID: 37459240 DOI: 10.1080/16549716.2023.2230813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The scale-up and sustainability of social innovations for health have received increased interest in global health research in recent years; however, these ambiguous concepts are poorly defined and insufficiently theorised and studied. Researchers, policymakers, and practitioners lack conceptual clarity and integrated frameworks for the scale-up and sustainability of global health innovations. Often, the frameworks developed are conceived in a linear and deterministic or consequentialist vision of the diffusion of innovations. This approach limits the consideration of complexity in scaling up and sustaining innovations. OBJECTIVE By using a systems theory lens and conducting a narrative review, this manuscript aims to produce an evidence-based integrative conceptual framework for the scale-up and sustainability of global health innovations. METHOD We conducted a hermeneutic narrative review to synthetise different definitions of scale-up and sustainability to model an integrative definition of these concepts for global health. We have summarised the literature on the determinants that influence the conditions for innovation success or failure while noting the interconnections between internal and external innovation environments. RESULTS The internal innovation environment includes innovation characteristics (effectiveness and testability, monitoring and evaluation systems, simplification processes, resource requirements) and organisational characteristics (leadership and governance, organisational change, and organisational viability). The external innovation environment refers to receptive and transformative environments; the values, cultures, norms, and practices of individuals, communities, organisations, and systems; and other contextual characteristics relevant to innovation development. CONCLUSION From these syntheses, we proposed an interconnected framework for action to better guide innovation researchers, practitioners, and policymakers in incorporating complexity and systemic interactions between internal and external innovation environments in global health.
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Affiliation(s)
- Marietou Niang
- Department of Social Work and Psychosociology, Université du Québec à Rimouski, Lévis, QC, Canada
| | - Hassane Alami
- Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, QC, Canada
| | | | - Sophie Dupéré
- Faculty of Nursing Science, Université Laval, Québec, QC, Canada
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Wilson KL, Garney WR, Garcia KM, Esquivel CH, Ajayi KV, Flores SA, Curran L. The Development of a Systems-Level Approach to Address Adolescent Access to Health Care: A Novel Confidentiality Policy Intervention. FAMILY & COMMUNITY HEALTH 2023; 46:S66-S73. [PMID: 37696017 DOI: 10.1097/fch.0000000000000380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Most evidence-based interventions in adolescent sexual and reproductive health and mental health remain largely aimed at individual-level outcomes and do not conceptualize adolescent health within a social-ecological model. Interventions to affect policy, systems, and environmental change offer potential for sustained population impact. The current initiative used an innovation framework to develop a novel systems-level approach to address adolescent access to health care. The Framework for Public Health Innovation provided an approach to develop a novel intervention. Confident Teen is a systems-level intervention that creates the opportunity, through organizational policy change, to increase adolescents' access to confidential sexual and reproductive health services through organizational policies. Gaps in adolescents' access to health care services allowed for a systems-level approach to be designed through an adolescent pregnancy prevention innovation initiative. Confidentiality is a right and critical component to their health care; therefore, a policy and conversation between provider and patient is a prioritized component of the novel intervention.
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Affiliation(s)
- Kelly L Wilson
- School of Public Health, Texas A&M University, College Station (Drs Garney, Esquivel, and Ajayi and Mss Garcia, Flores, and Curran); and School of Nursing, Texas A&M University, Bryan (Dr Wilson)
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Reid B, Davis LL, Gordon L. Capturing what and why in healthcare innovation. BMJ LEADER 2023:leader-2022-000642. [PMID: 37192109 DOI: 10.1136/leader-2022-000642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 02/25/2023] [Indexed: 05/18/2023]
Abstract
Understandings of innovation usually encompass multiple overlapping aspects, putting innovation terminology at risk of vagueness and overuse. However, innovation concepts are expected to remain powerful and useful in healthcare beyond the pandemic and into the future, so clarity will be helpful for effective leadership. To disentangle and disambiguate meanings within innovation, we offer a framework that captures and simplifies foundational substance within innovation concepts. Our method is an overview review of innovation literature from the 5 years preceding COVID-19. 51 sources were sampled and analysed for explicit definitions of healthcare innovation. Drawing on broad themes suggested from previous reviews, and gathering specific themes emergent from this literary dataset, we focused on categorising the nature of innovations (the what) and reasons given for them (the why). We identified 4 categories of what (ideas, artefacts, practice/process and structure) and 10 categories of why (economic value, practical value, experience, resource use, equity/accessibility, sustainability, behaviour change, specific-problem solving, self-justifying renewal and improved health). These categories reflect contrasting priorities and values, but do not substantially interfere or occlude each other. They can freely be additively combined to create composite definitions. This conceptual scheme affords insight and clarity for creating precise meanings, and making critical sense of imprecision, around innovation. Improved communication and clear shared understandings around innovative intentions, policies and practices cannot but improve the chances of enhanced outcomes. The all-inclusive character of this scheme leaves space for considering the limits of innovation, and notwithstanding well-established critiques, provides a basis for clarity in ongoing usage.
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Affiliation(s)
- Benet Reid
- Management School, University of St Andrews, St Andrews, UK
| | | | - Lisi Gordon
- Centre for Medical Education, University of Dundee, Dundee, UK
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Harrington C, Bailey A, Delorme E, Hano S, Evans EA. "And Then COVID Hits": A Qualitative Study of How Jails Adapted Services to Treat Opioid Use Disorder During COVID-19. Subst Use Misuse 2023; 58:266-274. [PMID: 36510800 DOI: 10.1080/10826084.2022.2155480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: Jails in Massachusetts are among the first nationwide to provide correctional populations with medications to treat opioid use disorder (MOUD). The COVID-19 pandemic caused jails to pivot and adapt MOUD programming. We aimed to identify adaptations and barriers to MOUD access that COVID-19 exacerbated or created, and document new elements that staff wish to sustain as COVID-19 recedes. Methods: We conducted semi-structured in-depth interviews and focus groups in 2020-2021 with 29 jail staff who implement MOUD programming in two Massachusetts jails. We conducted qualitative data analysis in Atlas.ti 8 using an inductive approach. Results: Participants shared that access to MOUD among correctional populations is understood by jail staff to be an essential health service. Thus, to facilitate continued access to MOUD, both during incarceration and also at community reentry, jail staff quickly implemented changes in MOUD regulations and dosing protocols and established telehealth capacity. Despite these program adaptations, participants identified how COVID-19 increased health and social needs among correctional populations, reduced availability of community-based healthcare and recovery-supportive services, and introduced new factors that could undermine recovery. Innovations that participants wished to sustain as COVID-19 receded included telehealth capacity, smaller-sized therapeutic groups, and application of a public health approach to treat opioid use disorder among correctional populations. Conclusions: During disruptive events, jails can adapt MOUD programming to ensure access for people living in jail and upon release. Findings identify factors for understanding the outcomes of jail-based MOUD programming during COVID-19 and highlight opportunities to improve service delivery after COVID-19.
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Affiliation(s)
- Calla Harrington
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Amelia Bailey
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA.,Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island
| | - Elizabeth Delorme
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Samantha Hano
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Elizabeth A Evans
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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Bergeron DA, Rey L, Murillo Salazar F, Michaud AM, Ccaniahuire Laura F. An ounce of prevention is worth a pound of cure-the arts as a vehicle for knowledge translation and exchange (KTE) in public health during a pandemic: a realist-informed developmental evaluation research protocol. BMJ Open 2022; 12:e058874. [PMID: 36123098 PMCID: PMC9485651 DOI: 10.1136/bmjopen-2021-058874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The COVID-19 crisis has led to the adoption of strict and coercive preventive measures. The implementation of these measures has generated negative impacts for many communities. The situation is especially worrisome for Indigenous communities in Peru. Therefore, it is necessary to recognise the contribution of the experiential knowledge of Indigenous communities and to implement innovative approaches. The use of art can be a promising avenue for working in partnership with Indigenous communities.The goal of this research is to (1) develop an intervention promoting barrier measures and vaccination to limit the transmission of COVID-19 among Indigenous communities using an arts-based and community-based knowledge translation and exchange (ACKTE) model; and (2) understand the contextual elements and mechanisms associated with the process of developing a preventive intervention using the ACKTE model. METHODOLOGY AND ANALYSIS This research will take place in Indigenous communities in Peru and will be based on a developmental evaluation guided by the principles of realist evaluation. Members of two Indigenous communities, local authorities, health professionals and artists will participate in the intervention development process as well as in the developmental evaluation. For data collection, we will conduct modified talking circles and semistructured individual interviews with stakeholders as well as an analysis of documents and artistic works produced. ETHICS AND DISSEMINATION OF RESULTS This research received the approval of the Université du Québec à Rimouski's research ethics board. In addition to scientific articles, the results of this research will be disseminated through videos and during an artistic performance.
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Affiliation(s)
- Dave A Bergeron
- Department of Health Sciences, Université du Québec à Rimouski, Rimouski, Québec, Canada
- Observatoire des administrations publiques autochtones, École nationale d'administration publique, Montréal, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
| | - Lynda Rey
- Department of Health Sciences, Université du Québec à Rimouski, Rimouski, Québec, Canada
- Observatoire des administrations publiques autochtones, École nationale d'administration publique, Montréal, Quebec, Canada
| | - Fernando Murillo Salazar
- Professional School of Dentistry, Facultad de Ciencias de la Salud, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Cusco, Peru
| | - Anne Marie Michaud
- Departmental Unit of Educational Sciences, Université du Québec à Rimouski, Lévis, Québec, Canada
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Vianna Franco MP, Molnár O, Dorninger C, Laciny A, Treven M, Weger J, Albuquerque EDME, Cazzolla Gatti R, Villanueva Hernandez LA, Jakab M, Marizzi C, Menéndez LP, Poliseli L, Rodríguez HB, Caniglia G. Diversity regained: Precautionary approaches to COVID-19 as a phenomenon of the total environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 825:154029. [PMID: 35202694 PMCID: PMC8861146 DOI: 10.1016/j.scitotenv.2022.154029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 05/02/2023]
Abstract
As COVID-19 emerged as a phenomenon of the total environment, and despite the intertwined and complex relationships that make humanity an organic part of the Bio- and Geospheres, the majority of our responses to it have been corrective in character, with few or no consideration for unintended consequences which bring about further vulnerability to unanticipated global events. Tackling COVID-19 entails a systemic and precautionary approach to human-nature relations, which we frame as regaining diversity in the Geo-, Bio-, and Anthropospheres. Its implementation requires nothing short of an overhaul in the way we interact with and build knowledge from natural and social environments. Hence, we discuss the urgency of shifting from current to precautionary approaches to COVID-19 and look, through the lens of diversity, at the anticipated benefits in four systems crucially affecting and affected by the pandemic: health, land, knowledge and innovation. Our reflections offer a glimpse of the sort of changes needed, from pursuing planetary health and creating more harmonious forms of land use to providing a multi-level platform for other ways of knowing/understanding and turning innovation into a source of global public goods. These exemplary initiatives introduce and solidify systemic thinking in policymaking and move priorities from reaction-based strategies to precautionary frameworks.
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Affiliation(s)
- Marco P Vianna Franco
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | - Orsolya Molnár
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria.
| | - Christian Dorninger
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria; Institute of Social Ecology, University of Natural Resources and Life Sciences, Schottenfeldgasse 29, Vienna 1070, Austria
| | - Alice Laciny
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | - Marco Treven
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | - Jacob Weger
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | - Eduardo da Motta E Albuquerque
- Cedeplar, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Roberto Cazzolla Gatti
- Department of Biological, Geological and Environmental Sciences, University of Bologna, Via Zamboni, 33, 40126 Bologna, BO, Italy
| | | | - Manuel Jakab
- Department for Academic Communication, Sigmund Freud University, Freudpl. 1, Vienna 1020, Austria
| | - Christine Marizzi
- BioBus, 1361 Amsterdam Avenue, Ste 340, New York, NY, 10027, United States
| | - Lumila Paula Menéndez
- Department of Anthropology of the Americas, University of Bonn, Regina-Pacis-Weg 3, 53113 Bonn, Germany; Department of Evolutionary Biology, University of Vienna, Universitätsring 1, 1010 Vienna, Austria
| | - Luana Poliseli
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | | | - Guido Caniglia
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
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Yousefi Nooraie R, Shelton RC, Fiscella K, Kwan BM, McMahon JM. The pragmatic, rapid, and iterative dissemination and implementation (PRIDI) cycle: adapting to the dynamic nature of public health emergencies (and beyond). Health Res Policy Syst 2021; 19:110. [PMID: 34348732 PMCID: PMC8335455 DOI: 10.1186/s12961-021-00764-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/21/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Public health emergencies-such as the 2020 COVID-19 pandemic-accelerate the need for both evidence generation and rapid dissemination and implementation (D&I) of evidence where it is most needed. In this paper, we reflect on how D&I frameworks and methods can be pragmatic (i.e., relevant to real-world context) tools for rapid and iterative planning, implementation, evaluation, and dissemination of evidence to address public health emergencies. THE PRAGMATIC, RAPID, AND ITERATIVE D&I (PRIDI) CYCLE The PRIDI cycle is based on a "double-loop" learning process that recognizes the need for responsiveness and iterative adaptation of implementation cycle (inner loop) to the moving landscapes, presented by the outer loops of emerging goals and desired outcomes, emerging interventions and D&I strategies, evolving evidence, and emerging characteristics and needs of individuals and contexts. Stakeholders iteratively evaluate these surrounding landscapes of implementation, and reconsider implementation plans and activities. CONCLUSION Even when the health system priority is provision of the best care to the individuals in need, and scientists are focused on development of effective diagnostic and therapeutic technologies, planning for D&I is critical. Without a flexible and adaptive process of D&I, which is responsive to emerging evidence generation cycles, and closely connected to the needs and priorities of stakeholders and target users through engagement and feedback, the interventions to mitigate public health emergencies (e.g., COVID-19 pandemic), and other emerging issues, will have limited reach and impact on populations that would most benefit. The PRIDI cycle is intended to provide a pragmatic approach to support planning for D&I throughout the evidence generation and usage processes.
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Affiliation(s)
- Reza Yousefi Nooraie
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA.
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | - Kevin Fiscella
- Department of Family Medicine, University of Rochester, Rochester, NY, USA
| | - Bethany M Kwan
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - James M McMahon
- School of Nursing, University of Rochester, Rochester, NY, USA
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