Publications by authors named "Paul Elish"
Background: Pediatric Early Warning Systems (PEWS) assist early detection of clinical deterioration in hospitalized children with cancer. Relevant to successful PEWS implementation, the "stages of change" model characterizes stakeholder support for PEWS based on willingness and effort to adopt the new practice.
Methods: At five resource-limited pediatric oncology centers in Latin America, semi-structured interviews were conducted with 71 hospital staff involved in PEWS implementation.
Background: Pediatric Early Warning Systems (PEWS) aid in identification of deterioration in hospitalized children with cancer but are underutilized in resource-limited settings. Proyecto EVAT is a multicenter quality improvement (QI) collaborative in Latin America to implement PEWS. This study investigates the relationship between hospital characteristics and time required for PEWS implementation.
View Article and Find Full Text PDFBackground/objectives: Childhood overweight and obesity have a well-established negative impact on children's health. Overweight and obesity might also negatively impact children's academic performance, but existing literature on this association is inconclusive. This study uses a longitudinal design in a large, diverse elementary school sample to rigorously test the association between longitudinal weight status and academic achievement.
View Article and Find Full Text PDFBackground: The COVID-19 pandemic impacted healthcare delivery worldwide, including pediatric cancer care, with a disproportionate effect in resource-limited settings. This study evaluates its impact on existing quality improvement (QI) programs.
Methods: We conducted 71 semi-structured interviews of key stakeholders at five resource-limited pediatric oncology centers participating in a collaborative to implement Pediatric Early Warning System (PEWS).
Background: Sustainability, or continued use of evidence-based interventions for long-term patient benefit, is the least studied aspect of implementation science. In this study, we evaluate sustainability of a Pediatric Early Warning System (PEWS), an evidence-based intervention to improve early identification of clinical deterioration in hospitalized children, in low-resource settings using the Clinical Capacity for Sustainability Framework (CCS).
Methods: We conducted a secondary analysis of a qualitative study to identify barriers and enablers to PEWS implementation.
Background: Pediatric Early Warning Systems (PEWS) reduce clinical deterioration, improve interdisciplinary communication, and provide cost savings; however, little is known about how these impacts are achieved or related. This study evaluates the multi-level impacts of PEWS in resource-limited pediatric oncology centers.
Methods: We conducted 71 semi-structured interviews including physicians (45%), nurses (45%), and administrators (10%) from 5 resource-limited pediatric oncology centers in 4 Latin American countries.
Background: Many children do not engage in sufficient physical activity, and schools provide a unique venue for children to reach their recommended 60 daily minutes of moderate-to-vigorous physical activity (MVPA). Prior research examining effects of MVPA on academic achievement is inconclusive, and few studies have investigated potential moderators of this relationship. This study examined whether student-level characteristics (gender, race/ethnicity, free/reduced-price lunch status) and school-level characteristics (proportion of students qualifying for free/reduced-price lunch, physical activity environment and opportunities) moderate the relationship between MVPA and academic achievement.
View Article and Find Full Text PDFBackground: It is recommended that school-aged children accrue 30 minutes of daily moderate-to-vigorous physical activity (MVPA) in school. Current literature is inconclusive about the long-term associations between school-based physical activity and academic achievement. In this study, we use a large sample and longitudinal design to rigorously evaluate whether school-day MVPA is associated with academic achievement.
View Article and Find Full Text PDFImportance: Pediatric early warning systems (PEWS) aid with early identification of clinical deterioration and improve outcomes in children with cancer hospitalized in resource-limited settings; however, there may be barriers to implementation.
Objective: To evaluate stakeholder-reported barriers and enablers to PEWS implementation in resource-limited hospitals.
Design, Setting, And Participants: In this qualitative study, semistructured stakeholder interviews were conducted at 5 resource-limited pediatric oncology centers in 4 countries in Latin America.
Article Synopsis
- Transgender women in Peru face significant health challenges, particularly high rates of HIV, STIs, and substance use issues, prompting a focused study on HIV-positive individuals in this group.
- The study, conducted between June 2015 and August 2016, found that out of 50 participants, 85% achieved viral suppression, yet many engaged in risky sexual behaviors and had a high prevalence of alcohol and drug use.
- The results suggest that addressing substance use disorders in HIV treatment could improve viral suppression rates among transgender women in Lima, emphasizing the necessity for integrated healthcare approaches.
Article Synopsis
- In Peru, a study involving 591 HIV-positive men who have sex with men (MSM) and transgender women (TGW) found that a high percentage, 82.4%, achieved viral suppression (VS), while 73.6% reached maximal viral suppression (MVS) during the period from June 2015 to August 2016.
- The study indicated that barriers such as transportation difficulties significantly hindered the likelihood of achieving VS and MVS, especially for those with alcohol use disorders.
- Moreover, older participants were more likely to reach MVS, highlighting the need for more accessible HIV care and integrated behavioral health services in Lima to improve outcomes.