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https://www.readbyqxmd.com/read/28329208/differentiated-hiv-rna-viral-load-monitoring-in-resource-limited-settings-an-economic-analysis
#1
Diana M Negoescu, Zhenhuan Zhang, Heiner C Bucher, Eran Bendavid
Background: Viral load (VL) monitoring for patients receiving antiretroviral therapy (ART) is recommended worldwide. However, the costs of frequent monitoring are a barrier to implementation in resource-limited settings. The extent to which personalized monitoring frequencies may be cost-effective is unknown. Methods: We created a simulation model parameterized using person-level longitudinal data to assess the benefits of flexible monitoring frequencies. Our data-driven model tracked HIV+ individuals for 10 years following ART initiation...
March 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28328688/prioritizing-the-care-of-critically-ill-children-in-south-africa-how-does-screen-perform-against-other-triage-tools
#2
Bhakti Hansoti, Peter Hodkinson, Lee Wallis
OBJECTIVE: Childhood mortality remains unacceptably high. In low-resource settings, children with critical illness often present for care. Current triage strategies are time consuming and require trained health care workers. To address this limitation, our team developed a simple subjective tool, SCREEN (Sick Children Require Emergency Evaluation Now), which is easy to administer, to identify critically ill children. This article presents the development of the SCREEN program and evaluates its performance when compared with other commonly implemented triage tools in low-resource settings...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28327483/mobile-health-mhealth-in-mental-health-scope-and-applications-in-low-resource-settings
#3
Mamta Sood, Rakesh Kumar Chadda, Pushpendra Singh
No abstract text is available yet for this article.
November 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/28327185/economic-evaluation-of-interventions-delivered-by-primary-care-providers-to-improve-neurodevelopment-in-children-aged-under-5%C3%A2-years-protocol-for-a-scoping-review
#4
Karen M Edmond, Natalie A Strobel, Kimberley McAuley, Elizabeth Geelhoed, Lisa Hurt
BACKGROUND: Frequently cited benefit-cost ratios suggest that interventions to improve neurodevelopment have high economic returns when implemented during pregnancy and early childhood. However, there are many challenges when primary care providers implement these interventions at scale, and it is unclear how many research studies or programmes have examined cost-effectiveness and which methods were used. There are no current scoping or systematic reviews which have assessed economic evaluations of interventions delivered by primary care providers to improve child neurodevelopment...
March 21, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28326868/a-longitudinal-study-assessing-the-maintenance-condition-of-cadres-of-four-types-of-wheelchairs-provided-in-low-resource-areas
#5
Karen Rispin, Kristofer Riseling, Joy Wee
Wheelchair breakdowns increase the risk of injury and limit the mobility of wheelchair users. In the endeavour to meet the enormous global need for wheelchairs, manufacturers of wheelchairs for low-resource settings face a cost-benefit tension between affordability and durability. Field studies are needed to provide feedback on durability. Four manufacturers provided cadres of wheelchairs to the organization providing rehabilitation to students at a boarding school for children with disabilities in a low-resource area...
March 22, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28325945/surveillance-of-dialysis-events-one-year-experience-at-33-outpatient-hemodialysis-centers-in-china
#6
Hui Zhang, Liuyi Li, Huixue Jia, Yunxi Liu, Jianguo Wen, Anhua Wu, Qun Lu, Tieying Hou, Yun Yang, Huai Yang, Weiguang Li, Zhiyong Zong
A multicenter prospective surveillance on dialysis events was carried in 33 dialysis centers in China. Maintenance hemodialysis (HD) outpatients who were dialyzed on the first two days of each month during 2014 were monitored for dialysis events and other infections. During the one-year period, 52,680 patient-months were monitored. Fistula and tunneled or non-tunneled central line were used for 73.70%, 15.70% and 8.85% of vascular access, respectively. There were 773 dialysis events occurred in 671 patients including 589 IV antimicrobial starts, 74 positive blood cultures and 110 local access site infections (LASI)...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28325238/radiation-oncology-quality-and-safety-considerations-in-low-resource-settings-a-medical-physics-perspective
#7
REVIEW
Jacob Van Dyk, Ahmed Meghzifene
The past few years have seen a significant growth of interest in the global radiation therapy (RT) crisis. Various organizations have quantified the need and are providing aid in support of addressing the shortfalls existing in many low-to-middle income countries. With the tremendous demand for new facilities, equipment, and personnel, it is very important to recognize the quality and safety challenges and to address them directly. An examination of publications on quality and safety in RT indicates a consistency in a number of the recommendations; however, these authoritative reports were generally based on input from high-resourced contexts...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28325236/improving-quality-and-access-to-radiation-therapy-an-iaea-perspective
#8
REVIEW
May Abdel-Wahab, Eduardo Zubizarreta, Alfredo Polo, Ahmed Meghzifene
The International Atomic Energy Agency (IAEA) has been involved in radiation therapy since soon after its creation in 1957. In response to the demands of Member States, the IAEA׳s activities relating to radiation therapy have focused on supporting low- and middle-income countries to set up radiation therapy facilities, expand the scope of treatments, or gradually transition to new technologies. In addition, the IAEA has been very active in providing internationally harmonized guidelines on clinical, dosimetry, medical physics, and safety aspects of radiation therapy...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28325084/application-of-a-contextual-instructional-framework-in-a-continuing-professional-development-training-program-for-physiotherapists-in-rwanda
#9
Kim Dunleavy, Julia Chevan, Antoinette P Sander, Jean Damascene Gasherebuka, Monika Mann
BACKGROUND: Continuing professional development is an important component of capacity building in low resource countries. The purpose of this case study is to describe the use of a contextual instructional framework to guide the processes and instructional design choices for a series of continuing professional development courses for physiotherapists in Rwanda. METHODS: Four phases of the project are described: (1) program proposal, needs assessment and planning, (2) organization of the program and instructional design, (3) instructional delivery and (4) evaluation...
March 22, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28324468/ascariasis-and-hyperosmolar-hyperglycemic-state-a-surprising-ultrasound-finding-in-the-emergency-department
#10
Giles N Cattermole, Jean-Paul Nzabandora
BACKGROUND: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS. CASE PRESENTATION: A 26-year-old Rwandan man was admitted to the emergency department in coma, with a glycemia of 600 mg/dl. He was resuscitated with fluids, intubated and ventilated, and treated with insulin and antibiotics...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28323868/-waiting-for-daas-a-retrospective-chart-review-of-patients-with-untreated-hepatitis-c-in-rwanda
#11
Neil Gupta, Jules Kabahizi, Constance Mukabatsinda, Timothy David Walker, Emmanuel Musabeyezu, Athanase Kiromera, Jennifer Ilo Van Nuil, Kevin Steiner, Joia Mukherjee, Sabin Nsanzimana, Aimable Mbituyumuremyi
BACKGROUND: Access to treatment for hepatitis C virus (HCV) in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs), highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs. METHODS AND FINDINGS: We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda...
2017: PloS One
https://www.readbyqxmd.com/read/28323374/characteristics-of-short-stay-critical-care-admissions-from-emergency-departments-in-maryland
#12
Obiora O Chidi, Sarah M Perman, Adit A Ginde
OBJECTIVES: Critical care is an expensive and limited resource, and short stay critical care admissions may be treated in alternate, less costly settings. This study objective was to determine the proportion of critical care admissions with a short critical care length of stay and identify the clinical characteristics and diagnoses associated with high and low rates of short stay critical care admissions. METHODS: Secondary analysis of the 2011 Maryland State Inpatient Database...
March 21, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28321847/antenatal-corticosteroids-for-accelerating-fetal-lung-maturation-for-women-at-risk-of-preterm-birth
#13
REVIEW
Devender Roberts, Julie Brown, Nancy Medley, Stuart R Dalziel
BACKGROUND: Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. While researching the effects of the steroid dexamethasone on premature parturition in fetal sheep in 1969, Liggins found that there was some inflation of the lungs of lambs born at gestations at which the lungs would be expected to be airless. Liggins and Howie published the first randomised controlled trial in humans in 1972 and many others followed...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28321296/improving-surgical-and-anaesthesia-practice-review-of-the-use-of-the-who-safe-surgery-checklist-in-felege-hiwot-referral-hospital-ethiopia
#14
Ryan Ellis, Ahmad Izzuddin Mohamad Nor, Iona Pimentil, Zebenaye Bitew, Jolene Moore
Development of surgical and anaesthetic care globally has been consistently reported as being inadequate. The Lancet Commission on Global Surgery highlights the need for action to address this deficit. One such action to improve global surgical safety is the introduction of the WHO Surgical Checklist to Operating Rooms (OR) around the world. The checklist has a growing body of evidence supporting its ability to assist in the delivery of safe anaesthesia and surgical care. Here we report the introduction of the Checklist to a major Ethiopian referral hospital and low-resource setting and highlight the success and challenges of its implementation over a one year period...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28320495/parent-infant-skin-to-skin-contact-following-birth-history-benefits-and-challenges
#15
Jessie Marie Hubbard, Kindsey Rae Gattman
It is a practice with strong roots in nature and has a significant influence on health outcomes, particularly for at-risk newborns in low-resource settings. In this comprehensive review, benefits of SSC for newborns, mothers, and fathers after vaginal and cesarean births are discussed as well as the benefits of SSC observed for infants in the NICU. Barriers to SSC practice implementation are discussed, and proposed solutions and recommendations are offered. By understanding the many benefits of SSC and strategies for implementation, health care providers can best support and promote this high-quality, evidence-based practice with mothers, newborns, and their families...
March 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28320374/using-a-multimethod-approach-to-develop-implementation-strategies-for-a-cervical-self-sampling-program-in-kenya
#16
Irene Podolak, Caroline Kisia, Gloria Omosa-Manyonyi, Jarold Cosby
BACKGROUND: Numerous health policy makers/researchers are concerned about the limitations of research being applied to support informed decision/policy making and the implementation of practical solutions. The aim of the Chaguo Letu project (which means our choice in Swahili) was to determine how local decision makers could apply a multimethod approach to make strategic decisions to effectively implement a Cervical Self-Sampling Program in Kenya. METHODS: A multimethod approach, involving participatory action research, scenario based planning, and phenomenology, was applied in conjunction with two tools to identify relevant factors (negative or positive) that could impact Cervical Self-Sampling Program implementation...
March 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28319491/breaking-down-the-objective-structured-clinical-examination-an-evaluation-of-the-helping-babies-breathe-osces
#17
Teresa L Seto, Meredith E Tabangin, Kathryn K Taylor, Srirama Josyula, Juan Carlos Vasquez, Beena D Kamath-Rayne
INTRODUCTION: Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation curriculum designed for low-resource settings. At the completion of the workshop, learners complete the following four assessments: a multiple-choice question (MCQ) test, bag-mask ventilation (BMV) checklist, and two objective structured clinical examinations (OSCEs). Objective structured clinical examinations are clinical performance assessments that evaluate learners' skills in simulated scenarios...
March 18, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28314501/legal-and-regulatory-barriers-to-reverse-innovation
#18
Virginia Rowthorn, Alexander J Plum, John Zervos
BACKGROUND: Reverse innovation, or the importation of new, affordable, and efficacious models to high-income countries from the developing world, has emerged as a way to improve the health care system in the United States. Reverse innovation has been identified as a key emerging trend in global health systems in part because low-resourced settings are particularly good laboratories for low-cost/high-impact innovations that are developed out of necessity. A difficult question receiving scant attention is that of legal and regulatory barriers...
November 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28306597/diagnosis-of-viral-hepatitis
#19
Philippa J Easterbrook, Teri Roberts, Anita Sands, Rosanna Peeling
PURPOSE OF REVIEW: Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and HIV-HBV and HCV coinfection are major causes of chronic liver disease worldwide. Testing and diagnosis is the gateway for access to both treatment and prevention services, but there remains a large burden of undiagnosed infection globally. We review the global epidemiology, key challenges in the current hepatitis testing response, new tools to support the hepatitis global response (2016-2020 Global Hepatitis Health Sector strategy, and 2017 WHO guidelines on hepatitis testing and their key recommendations) and future directions and innovations in hepatitis diagnostics...
March 16, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28302547/feasibility-of-using-mobile-ecg-recording-technology-to-detect-atrial-fibrillation-in-low-resource-settings
#20
Grahame F Evans, Arianna Shirk, Peter Muturi, Elsayed Z Soliman
BACKGROUND: Screening for atrial fibrillation (AF), a major risk factor for stroke that is on the rise in Africa, is becoming increasingly critical. OBJECTIVES: This study sought to examine the feasibility of using mobile electrocardiogram (ECG) recording technology to detect AF. METHODS: In this prospective observational study, we used the Kardia Mobile ECG Recorder (AliveCor, Mountain View, California) to screen 50 African adults (66% women; mean age 54...
March 13, 2017: Global Heart
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