7 results on '"Chris Paton"'
Search Results
2. Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities.
- Author
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Naomi Muinga, Ibukun-Oluwa Omolade Abejirinde, Lenka Benova, Chris Paton, Mike English, and Marjolein Zweekhorst
- Subjects
Public aspects of medicine ,RA1-1270 - Abstract
Documenting inpatient care is largely paper-based and it facilitates team communication and future care planning. However, studies show that nursing documentation remains suboptimal especially for newborns, necessitating introduction of standardised paper-based charts. We report on a process of implementing a comprehensive newborn monitoring chart and the perceptions of health workers in a network of hospitals in Kenya. The chart was launched virtually in July 2020 followed by learning meetings with nurses and the research team. This is a qualitative study involving document review, individual in-depth interviews with nurses and paediatricians and a focus group discussion with data clerks. The chart was co-designed by the research team and hospital staff then implemented using a trainer of trainers' model where the nurses-in-charge were trained on how to use the chart and they in turn trained their staff. Training at the hospital was delivered by the nurse-in-charge and/or paediatrician through a combined training with all staff or one-on-one training. The chart was well received with health workers reporting reduced writing, consolidated information, and improved communication as benefits. Implementation was facilitated by individual and team factors, complementary projects, and the removal of old charts. However, challenges arose related to the staff and work environment, inadequate supply of charts, alternative places to document, and inadequate equipment. The participants suggested that future implementation should be accompanied by mentorship or close follow-up, peer experience sharing, training at the hospital and in pre-service institutions and wider stakeholder engagement. Findings show that there are opportunities to improve the implementation process by clarifying roles relating to the filing system, improving the chart supply process, staff induction and specifying a newborn patient file. The chart did not meet the need for supporting documentation of long stay patients presenting an opportunity to explore digital solutions that might provide more flexibility and features.
- Published
- 2022
- Full Text
- View/download PDF
3. Mark-release-recapture of male Aedes aegypti (Diptera: Culicidae): Use of rhodamine B to estimate movement, mating and population parameters in preparation for an incompatible male program.
- Author
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Brendan J Trewin, Daniel E Pagendam, Brian J Johnson, Chris Paton, Nigel Snoad, Scott A Ritchie, Kyran M Staunton, Bradley J White, Sara Mitchell, and Nigel W Beebe
- Subjects
Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Rapid advances in biological and digital support systems are revolutionizing the population control of invasive disease vectors such as Aedes aegypti. Methods such as the sterile and incompatible insect techniques (SIT/IIT) rely on modified males to seek out and successfully mate with females, and in doing so outcompete the wild male population for mates. Currently, these interventions most frequently infer mating success through area-wide population surveillance and estimates of mating competitiveness are rare. Furthermore, little is known about male Ae. aegypti behaviour and biology in field settings. In preparation for a large, community scale IIT program, we undertook a series of mark- release-recapture experiments using rhodamine B to mark male Ae. aegypti sperm and measure mating interactions with females. We also developed a Spatial and Temporally Evolving Isotropic Kernel (STEIK) framework to assist researchers to estimate the movement of individuals through space and time. Results showed that ~40% of wild females captured daily were unmated, suggesting interventions will need to release males multiple times per week to be effective at suppressing Ae. aegypti populations. Males moved rapidly through the landscape, particularly when released during the night. Although males moved further than what is typically observed in females of the species, survival was considerably lower. These unique insights improve our understanding of mating interactions in wild Ae. aegypti populations and lay the foundation for robust suppression strategies in the future.
- Published
- 2021
- Full Text
- View/download PDF
4. The indirect impact of COVID-19 pandemic on inpatient admissions in 204 Kenyan hospitals: An interrupted time series analysis.
- Author
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Steven Wambua, Lucas Malla, George Mbevi, Amen-Patrick Nwosu, Timothy Tuti, Chris Paton, Samuel Cheburet, Ayub Manya, Mike English, and Emelda A Okiro
- Subjects
Public aspects of medicine ,RA1-1270 - Abstract
The first case of severe acute respiratory coronavirus 2 (SARS-CoV-2) was identified in March 2020 in Kenya resulting in the implementation of public health measures (PHM) to prevent large-scale epidemics. We aimed to quantify the impact of COVID-19 confinement measures on access to inpatient services using data from 204 Kenyan hospitals. Data on monthly admissions and deliveries from the District Health Information Software version 2 (DHIS 2) were extracted for the period January 2018 to March 2021 stratified by hospital ownership (public or private) and adjusting for missing data using multiple imputation (MI). We used the COVID-19 event as a natural experiment to examine the impact of COVID-19 and associated PHM on use of health services by hospital ownership. We estimated the impact of COVID-19 using two approaches; Statistical process control (SPC) charts to visualize and detect changes and Interrupted time series (ITS) analysis using negative-binomial segmented regression models to quantify the changes after March 2020. Sensitivity analysis was undertaken to test robustness of estimates using Generalised Estimating Equations (GEE) and impact of national health workers strike on observed trends. SPC charts showed reductions in most inpatient services starting April 2020. ITS modelling showed significant drops in April 2020 in monthly volumes of live-births (11%), over-fives admissions for medical (29%) and surgical care (25%) with the greatest declines in the under-five's admissions (59%) in public hospitals. Similar declines were apparent in private hospitals. Health worker strikes had a significant impact on post-COVID-19 trends for total deliveries, live-births and caesarean section rate in private hospitals. COVID-19 has disrupted utilization of inpatient services in Kenyan hospitals. This might have increased avoidable morbidity and mortality due to non-COVID-19-related illnesses. The declines have been sustained. Recent data suggests a reversal in trends with services appearing to be going back to pre- COVID levels.
- Published
- 2021
- Full Text
- View/download PDF
5. Building Learning Health Systems to Accelerate Research and Improve Outcomes of Clinical Care in Low- and Middle-Income Countries.
- Author
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Mike English, Grace Irimu, Ambrose Agweyu, David Gathara, Jacquie Oliwa, Philip Ayieko, Fred Were, Chris Paton, Sean Tunis, and Christopher B Forrest
- Subjects
Medicine - Abstract
Mike English and colleagues argue that as efforts are made towards achieving universal health coverage it is also important to build capacity to develop regionally relevant evidence to improve healthcare.
- Published
- 2016
- Full Text
- View/download PDF
6. The indirect impact of COVID-19 pandemic on inpatient admissions in 204 Kenyan hospitals: an interrupted time series analysis
- Author
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George Mbevi, Chris Paton, Nwosu A-P., Timothy Tuti, E A Okiro, Mike English, S Cheburet, Lucas Malla, A Manya, and S Wambua
- Subjects
Kenya ,medicine.medical_specialty ,Natural experiment ,business.industry ,030503 health policy & services ,medicine.medical_treatment ,Public health ,Missing data ,Gee ,3. Good health ,Interrupted Time Series Analysis ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Pandemic ,medicine ,Caesarean section ,030212 general & internal medicine ,0305 other medical science ,business - Abstract
The first case of severe acute respiratory coronavirus 2 (SARS-CoV-2) was identified in March 2020 in Kenya resulting in the implementation of public health measures (PHM) to prevent large-scale epidemics. We aimed to quantify the impact of COVID-19 confinement measures on access to inpatient services using data from 204 Kenyan hospitals. Data on monthly admissions and deliveries from the District Health Information Software version 2 (DHIS 2) were extracted for the period January 2018 to March 2021 stratified by hospital ownership (public or private) and adjusting for missing data using multiple imputation (MI). We used the COVID-19 event as a natural experiment to examine the impact of COVID-19 and associated PHM on use of health services by hospital ownership. We estimated the impact of COVID-19 using two approaches; Statistical process control (SPC) charts to visualize and detect changes and Interrupted time series (ITS) analysis using negative-binomial segmented regression models to quantify the changes after March 2020. Sensitivity analysis was undertaken to test robustness of estimates using Generalised Estimating Equations (GEE) and impact of national health workers strike on observed trends. SPC charts showed reductions in most inpatient services starting April 2020. ITS modelling showed significant drops in April 2020 in monthly volumes of live-births (11%), over-fives admissions for medical (29%) and surgical care (25%) with the greatest declines in the under-five’s admissions (59%) in public hospitals. Similar declines were apparent in private hospitals. Health worker strikes had a significant impact on post-COVID-19 trends for total deliveries, live-births and caesarean section rate in private hospitals. COVID-19 has disrupted utilization of inpatient services in Kenyan hospitals. This might have increased avoidable morbidity and mortality due to non-COVID-19-related illnesses. The declines have been sustained. Recent data suggests a reversal in trends with services appearing to be going back to pre- COVID levels.
- Published
- 2021
7. Building Learning Health Systems to Accelerate Research and Improve Outcomes of Clinical Care in Low- and Middle-Income Countries
- Author
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Chris Paton, Philip Ayieko, David Gathara, Sean Tunis, Christopher B. Forrest, Fred Were, Mike English, Jacquie Oliwa, Grace Irimu, and Ambrose Agweyu
- Subjects
Comparative Effectiveness Research ,Quality management ,National Health Programs ,Cost-Benefit Analysis ,Health Care Providers ,Social Sciences ,Learning and Memory ,0302 clinical medicine ,Universal Health Insurance ,Patient-Centered Care ,Health care ,Medicine and Health Sciences ,Psychology ,030212 general & internal medicine ,Cooperative Behavior ,Policy Making ,Health Systems Strengthening ,Data Management ,Policy Forum ,Evidence-Based Medicine ,Delivery of Health Care, Integrated ,Health services research ,Capacity building ,Health Care Costs ,General Medicine ,Public relations ,Quality Improvement ,Research Design ,Income ,Medicine ,Science policy ,Health Services Research ,Computer and Information Sciences ,Capacity Building ,Clinical Research Design ,Science Policy ,Comparative effectiveness research ,Developing country ,Research and Analysis Methods ,03 medical and health sciences ,030225 pediatrics ,Humans ,Learning ,Developing Countries ,Insurance, Health ,Health Care Policy ,business.industry ,Cognitive Psychology ,Biology and Life Sciences ,Evidence-based medicine ,Health Care ,Cognitive Science ,Interdisciplinary Communication ,Business ,Neuroscience - Abstract
• Achieving universal coverage that supports high-quality care will require that health systems are designed to integrate the delivery of health services with the generation of new knowledge about the effectiveness of these services. • Achieving universal coverage that supports high-quality care will require that health systems are designed to integrate the delivery of health services with the generation of new knowledge about the effectiveness of these services. • In high-income countries, learning health systems (LHS) are emerging to meet similar needs. The LHS vision aspires to engage policy makers, researchers, service providers, and patients in learning that uses and strengthens routinely collected data to conduct pragmatic, contextually appropriate research, promote rapid adoption of findings to improve quality and outcomes, and promote continuous learning. • In high-income countries, learning health systems (LHS) are emerging to meet similar needs. The LHS vision aspires to engage policy makers, researchers, service providers, and patients in learning that uses and strengthens routinely collected data to conduct pragmatic, contextually appropriate research, promote rapid adoption of findings to improve quality and outcomes, and promote continuous learning./p> • A global coalition on how to build LHS effectively that shares accumulating learning could enable such a strategy.
- Published
- 2016
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