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PubMed2006

Diffusion of the D.A.R.E and syringe exchange programs.

We examined the diffusion of the D.A.R.E program to reduce use of illicit drugs among school-aged children and youths and the diffusion of syringe exchange programs to reduce HIV transmission among injection drug users. The D.A.R.E program was diffused widely in the United States despite a lack of evidence for its effectiveness; there has been limited diffusion of syringe exchange in the United States, despite extensive scientific evidence for its effectiveness. Multiple possible associations between diffusion and evidence of effectiveness exist, from widespread diffusion without evidence of effectiveness to limited diffusion with strong evidence of effectiveness. The decision theory concepts of framing and loss aversion may be useful for further research on the diffusion of public health innovations.

Adolescent↗
PubMed1996

[Strategies for productive collaboration between science and general practice].

My contribution is a systematic account of strategies for cooperation and feedback between public health sciences and research. A feature both areas have in common is their commitment to empirically based knowledge. "Rational" models of cooperation (or rather, models based on belief in rationality) presume simple linear links between research and its application. Diffusion models, however, seem to be far more adequate for translating public health research into reality. The best model is the "Discourse Model" based on continuous communication and feedback between science and practice. It seems to promote the diffusion of public health innovations most effectively. In the second part I give examples of how to translate the Discourse Model into practical reality. Summing up, its strategic elements are: 1. responsive project shaping, 2. interactive running of projects, 3. shared processing of results, 4. active diffusion of results.

Diffusion of Innovation↗
PubMed2004

[Treatment of pemphigus with intravenous immunoglobulin].

INTRODUCTION: The interest of intravenous immunoglobulins (Igi.v.) in the treatment of pemphigus is discussed. Pemphigus is not a recognized indication for this treatment by the CEDIT (French Committee for the assessment and diffusion of technological innovations). The aim of this study was to assess the efficacy of Igi.v. in the treatment of severe corticosteroid-dependent or resistant pemphigus. MATERIAL AND METHODS: A retrospective study using a standardized questionnaire was conducted in the various departments of dermatology among the "Groupe Bulles" of the French Society of Dermatology. The study collected the following information from 12 patients suffering from pemphigus and treated with Igi.v.: 1) general demographical data; 2) characteristics of the pemphigus; 3) different treatments applied, and 4) efficacy and side effects of treatments. RESULTS: Among the 12 patients studied at the end of treatment with Igi.v., 8 were in complete remission (1 fleetingly for 2 months and 1 preceding initiation of Igi.v.), and 2 were improved (1 temporarily for 4 months). A reduction in corticosteroid therapy was possible in 75 p. 100 of cases (9 patients). During treatment with Igi.v., immunosuppressors were combined with oral corticosteroids in 3 cases. It was possible to reduce their dose 1 one case and to stop them in another case. No major side effect related to treatment with Igi.v. was observed. Six months and one year after the treatment, complete remission rates were respectively 6/10 and 5/8. One patient relapsed more than one year after the end of Igi.v. treatment. CONCLUSIONS: Although very expensive, treatment with Igi.v. appears of interest in the treatment of severe corticosteroid-dependent or resistant pemphigus. Moreover tolerance is excellent. The results of our study warrant confirmation in a prospective study.

Adrenal Cortex Hormones↗
PubMedDate not supplied

The development and adaptation of the Semmes-Weinstein monofilaments in Brazil.

The purpose of this article is to demonstrate the complexities of adapting technology and developing the sensory testing technique of the Semmes-Weinstein (S-W) monofilaments in Brazil to enable early detection and monitoring of peripheral nerve function in Hansen's disease (Hd). This history of the adoption and implementation of the use of the S-W monofilaments in Brazil follows the sequence described in adoption and diffusion theory of innovations. As a result, the availability of the S-W monofilaments produced in Brazil facilitated the utilization of this sensory testing technique in Brazil. In addition, the Brazilian model proved to be more accessible, durable, portable, and practical in meeting local needs. It improved health care worker awareness of and desire to use better sensory testing technology, making it possible to prevent disability.

Brazil↗
PubMed2000

Diffusion of the concept of patient advocacy.

PURPOSE: To examine the growth and diffusion through the USA and UK literature of nurses claims to patient advocacy. DESIGN: A bibliometric analysis of articles cited under the key descriptor "patient advocacy" in the International Nursing Index (INI) was undertaken. Analysis included output in 5-year accumulations from 1976 to 1995, and was focused on quantity of output and exposition of concerns through interpretation of the titles. Citation mapping was undertaken to trace dominant influences in the diffusion process. METHODS: Titles and countries of origin of the journal along with year of publication were organized into a database to provide quantitative material on comparative output from the USA and the UK. Citation profiles of key influencing authors were examined. FINDINGS: A role in patient advocacy was proposed in the American nursing literature in the late 1970s and in the British literature a decade later. Support for the role was evident in its use in professional organizations and schools. The pattern of dissemination illustrates the influence of American nursing on the professional role of nurses in the UK. CONCLUSIONS: On the basis of a stages model for diffusion of an innovation, patient advocacy has reached only preliminary stages of acceptance as an innovation in nursing.

Humans↗