Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Soto-Gomez E [original query] |
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Assessment of COVID-19 vaccination practices for 16 vaccination providers in Puerto Rico, 2021
Sánchez-González L , Wong JM , Conde A , Alicea M , Soto-Gomez E , Feliciano C , Rivera Á , Martínez M , Paz-Bailey G , Cardona I . P R Health Sci J 2021 40 (4) 185-187 OBJECTIVE: To assess COVID-19 vaccine providers' adherence to best practices and identify knowledge and practice gaps to guide corrective actions and retraining activities in Puerto Rico. METHODS: A CDC supportive evaluation tool was modified to collect information on vaccine storage, handling, preparation, administration, and post-vaccination care. Assessment visits to COVID-19 vaccine providers in Puerto Rico were conducted a month after the availability of COVID-19 vaccines in the island. RESULTS: A total 16 vaccine providers were visited, 12 (75%) administering Pfizer-BioNTech vaccine and 4 (25%) administering Moderna vaccine. All providers adhered to correct handling practices after vaccine thawing. Required resources for managing anaphylaxis on site were available in all sites. Few instances of incorrect use of retractable-needle syringes, unapproved temperature monitoring devices, and lack of recorded temperature data were observed. Corrective actions were taken during the evaluation visit. CONCLUSION: No major deficiencies that could jeopardize vaccine viability or patient safety were found. The use of a supportive evaluation tool during assessment visits is helpful to determine needs for vaccine providers retraining and to continue the safe administration of COVID-19 vaccines in Puerto Rico. |
Effect of a dengue clinical case management course on physician practices in Puerto Rico
Han GS , Gregory CJ , Biggerstaff BJ , Horiuchi K , Perez C , Soto-Gomez E , Matos D , Margolis HS , Tomashek KM . Clin Infect Dis 2016 63 (10) 1297-1303 BACKGROUND: Prior to 2010, the clinical management of dengue in Puerto Rico was shown to be inconsistent with World Health Organization guidelines. A four-hour classroom-style course on dengue clinical management was developed in 2009 and mandated in 2010 for Puerto Rico medical licensure. Fifty physicians were trained as 'master trainers' and gave this course to 7,638 physicians. This study evaluated the effect of the course on the clinical management of hospitalized dengue patients. METHODS: Pre- and post-course test responses were analyzed. Changes in physician practices were assessed by reviewing the medical records of 430 adult and 1075 pediatric dengue patients at the 12 hospitals in Puerto Rico that reported the most cases during 2008-2009 (pre-intervention) and 2011 (post-intervention). Mixed-effects logistic regression was used to compare key indicators of dengue management. RESULTS: Physician test scores increased from 48% correct to 72% after the course. Medical record review showed that the percentage of adult patients who did not receive corticosteroids increased from 30% to 68% (OR 5.9, 95% CI 3.7-9.5) and from 91% to 96% in pediatric patients (OR 2.7, 95% CI 1.5-4.9). Usage of isotonic intravenous saline solutions during the critical period increased from 57% to 90% in adult patients (OR 6.2, 95% CI 1.9-20.4) and from 25% to 44% in pediatric patients (OR 3.4, 95% CI 2.2-5.3). CONCLUSIONS: The management of hospitalized dengue patients improved significantly following implementation of a classroom-style physician training course taught by master trainers. An online version of the course was launched in 2014 to expand its reach and sustainability. |
Assessing the interest to participate in a dengue vaccine efficacy trial among residents of Puerto Rico
Guerra CL , Rodriguez-Acosta R , Soto-Gomez E , Zielinski-Gutierrez E , Pena-Orellana M , Santiago L , Rivera R , Cruz RR , Ramirez V , Tomashek K , Dayan G . Hum Vaccin Immunother 2012 8 (7) 905-15 Dengue, endemic in Puerto Rico, is a major public health problem. Vaccines are thought the best means to prevent dengue because vector control alone has been largely ineffective. We implemented qualitative studies in 2006 and 2010 to determine the acceptability of conducting placebo-controlled dengue vaccine efficacy trials in Puerto Rican children. Key informant interviews and focus groups with parents and children were conducted in municipalities with high dengue incidence. We used structured open-ended questions to determine motivators and attitudes regarding vaccine trial participation. Knowledge about dengue risk and prevention, and knowledge, attitudes, and beliefs regarding vaccines and vaccine trials were assessed. Using grounded theory, we conducted content analysis and established categories and sub-categories of participant responses. All participants were knowledgeable about dengue prevention and perceived children as most affected age groups. Participants were aware of vaccines benefits and they thought a vaccine could prevent dengue. However, most would not allow their children to participate in a placebo-controlled vaccine trial. Barriers included lack of trust in new vaccines and vaccine trial procedures; fear of developing dengue or side effects from the vaccine and lack of information about candidate dengue vaccines. Participants thought information, including results of previous trials might overcome barriers to participation. Motivators for participation were altruism, protection from dengue, free medical attention, and compensation for transportation and participation. Parents would consider children participation if accurate vaccine trial information is provided. |
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