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Van Niekerk, Antoinette, and Wilma Viviers. "Promoting sustainable economic growth in South Africa through the production and export of low-carbon environmental goods." South African Journal of Economic and Management Sciences 17, no. 4 (August 29, 2014): 427–39. http://dx.doi.org/10.4102/sajems.v17i4.607.
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Many countries, particularly those in the developing world, are under increasing pressure to improve their growth rates in order to tackle pressing economic problems at the domestic level. Increasing export volumes can make a positive contribution to a country’s economic growth rate, but it can also endanger the environment. How to reconcile the often conflicting phenomena of increased export activity, stronger economic growth and a lower carbon footprint is the focus of this study. A core outcome of the study was the creation of a single list using a cross-section of international sources, of low-carbon environmental goods, and their ranking according to their inherent ability to reduce greenhouse gas emissions, South Africa’s capacity to produce them, and their economic benefits, as reflected in the export opportunities they present. These export opportunities were revealed through the application of the Decision Support Model (DSM), an export market selection tool that incorporates a systematic filtering and screening system. The results of the analysis should help guide policymakers in their strategic deliberations on which export sectors to incentivise and support with a view to encouraging more ‘green’ growth in South Africa in the years ahead. diffusion of such goods. If the production and export of environmental goods were to increase, it could have a potentially positive effect on economic and environmental objectives, such as raising economic growth rates and lowering greenhouse gas intensity, respectively. For the purpose of this study, an analysis of four existing lists of environmental goods led to the identification of 39 core environmental goods. These 39 goods were ranked according to three criteria: i) the potential environmental benefits of each environmental good, using consensus among role players as a proxy; ii) South Africa’s capacity to produce each environmental good, using the Revealed Comparative Advantage (RCA) of each good as a proxy; and iii) the potential economic benefits of each environmental good, using the potential export value as calculated by Steenkamp (2011) in the Decision Support Model (DSM) as a proxy. It emerged that the top five low-carbon environmental goods are: photosensitive semiconductors (HS-6: 854140); towers and masts (HS-6: 730820); electrical control and distribution boards (HS-6: 853710); gearing and screws (HS-6: 848340); and static converters (HS-6: 850440). In addition, the intensive and extensive product-country export opportunities for these top five low-carbon environmental goods were identified.
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Kawooya, Ronald. "Accomplishments of Tea Research in Uganda in the Year 2019." European Journal of Agriculture and Food Sciences 3, no. 1 (January 23, 2021): 75–78. http://dx.doi.org/10.24018/ejfood.2021.3.1.214.
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Tea is Uganda’s third most important export earner and oscillates between coffee and fish. The current production in the country is 59,000 tonnes of made tea per year, earning 104 million United States Dollars to the Uganda’s economy. Despite its importance to Uganda, the tea sector is faced with a number of constraints that include rising production costs, age of tea bushes, high overhead costs, poor agronomic agricultural practices, pests and diseases, low genetic potential, poor seed system, low labour productivity,and climate change. Since the collapse of Tea Research Institute of East Africa, tea research in Uganda has been dormant for three decades, due to limitations in tea experts, finance, and infrastructure. This review paper highlights the current tea research accomplishments made with the help of government of Uganda Agricultural Technology and Agribusiness Advisory Service (ATAAS) funding. These endeavors include: a) Genetic structure of tea diversity in Uganda has been determined, b) Characterization of tea clones with desirable attributes initiated, c) Soil nutrient up take of tea clones has been determined, d) Screening tea clones for resistance to Xylaria and Armillaria diseases and e) Tea dissemination material accomplished. This paper further spells out the future perspective and strategic intervention of tea research in Uganda.
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Peoples, M., S. Sadeghieh, E. Hwang, S. Chen, G. Hannon, C. Long, and M. Westhusin. "5 INHIBITION OF FOOT AND MOUTH DISEASE VIRUS IN VITRO USING RNA INTERFERENCE." Reproduction, Fertility and Development 21, no. 1 (2009): 103. http://dx.doi.org/10.1071/rdv21n1ab5.
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The use of short-hairpin RNA (shRNA) targeting viral genomes has shown great promise in human medicine and in vitro research in animal agriculture. However, this research has not been extrapolated into livestock applications. Foot and mouth disease virus (FMDV) is a world-wide disease resulting in decreased production and export limitations in countries with endemic FMDV, as well as severe economical impacts if an outbreak occurs in an FMDV-free country. The long-term goal for this project is to produce transgenic cattle that express shRNA targeting the FMDV genome resulting in resistance to infection. As a starting point, five siRNA and one non-targeting control siRNA (Null) were developed targeting different highly conserved regions of a FMDV type-A based replicon. The siRNA were transfected into BHK cells 48 h before viral RNA challenge. Eighteen hours post challenge the cells were lysed and analyzed. Three siRNA targeting the non-structural polymerase protein exhibited severe knockdown of 87, 90, and 92% when compared with the Null siRNA transfected control. The siRNA targeting the VPG3 cap protein reduced activity by 59%, and the siRNA targeting the internal ribosomal entry site had a minimal effect of 15% reduction. Based upon these results, we produced recombinant lentiviral particles designed to deliver the shRNA sequence targeting the FMDV genome and the fluorescent marker, dsRed, into a bovine fetal fibroblast cell line. This transgenic cell line expressing the most effective shRNA (based on initial siRNA screening) was used for somatic cell nuclear transfer to create bovine embryos. One hundred and sixty oocytes were enucleated, of which 149 had successful fusion resulting in 35 blastocysts after in vitro culture. Two embryos per recipient were transferred into five recipients. At Day 40 of pregnancy three of the five recipients had a fetus, but no heart beat could be detected. We are currently in the process of creating another cell line and repeating this experiment. If successful, transgenic calves will be visually and genetically analyzed for expression of dsRed and shRNA targeting FMDV. Transgenic and control animals/tissues will then be analyzed for resistance to infection with FMDV.
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Ardiansyah, M., Ibnu Qizam, and Abdul Qoyum. "Telaah kritis model screening saham syariah menuju pasar tunggal ASEAN." IJTIHAD Jurnal Wacana Hukum Islam dan Kemanusiaan 16, no. 2 (January 24, 2017): 197. http://dx.doi.org/10.18326/ijtihad.v16i2.197-216.
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Shariah stocks is one of the financial sectors that experienced with most significant growth in recentyears. the most important issue in Shariah stock is Stock screening mechanism. The aim of this study isto examine the screening models of Shariah stocks in ASEAN countries. This study is very crucialespecially in the era of ASEAN economic community (AEC). In addition, this study aims to examinesome of the factors that contribute to the differences in screening models applied in five ASEANcountries. By using descriptive method and literature studies approach, this study found a few things.Firstly, there are various models of Shariah stock screening in Indonesia, Malaysia, Singapore, Thailandand Philippines. In this context, the model screening in ASEAN countries have two tendencies, namely;for the country in the majority of the population is Muslim whereby there are many Sharia expert, thenthey will use the specific screening model and applied only in the country, while for the country that themajority is not Muslim, then they will tend to use models of screening that has been used globally forexample DJIM, FTSE, etc. This second pattern has been applied by Singapore, Thailand and Philippines.Secondly, differences in shariah screening models influenced by several factors, namely; differencesin social structure of a country where the Islamic stock market is located; the difference in the financialindustry that exist in the country will affect on the difference of screening models; and differences sectembraced by most scholars in a country is one of the fundamental factors in determining stock screeningmodel of sharia in 5 ASEAN Countries.
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Smith, Paul Julian. "Screenings." Film Quarterly 71, no. 1 (2017): 73–79. http://dx.doi.org/10.1525/fq.2017.71.1.73.
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By happy coincidence, Mexico in 2016 yielded two expert and moving documentaries on women, sex, and aging: María José Cuevas's Bellas de noche (Beauties of the Night) and Maya Goded's Plaza de la Soledad (Solitude Square). Both are first-time features by female directors. And both are attempts to reclaim previously neglected subjects: showgirls of the 1970s and sex workers in their seventies, respectively. Moreover, lengthy production processes in which the filmmakers cohabitated with their subjects have resulted in films that are clearly love letters to their protagonists. Widely shown at festivals and beyond, Bellas de noche won best documentary at Morelia, Mexico's key festival for the genre, and was picked up by Netflix in the United States and other territories. Plaza de la Soledad, meanwhile, earned plaudits at Sundance and a theatrical release in its home country in May 2017, a rare opportunity for a documentary. Complex and contradictory, these twin films celebrate women whose lives may be limited by circumstances cruelly beyond their control but who are vital, still, in their quest for friendship and freedom.
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Yusuf, Careema, Marci K. Sontag, Joshua Miller, Yvonne Kellar-Guenther, Sarah McKasson, Scott Shone, Sikha Singh, and Jelili Ojodu. "Development of National Newborn Screening Quality Indicators in the United States." International Journal of Neonatal Screening 5, no. 3 (September 12, 2019): 34. http://dx.doi.org/10.3390/ijns5030034.
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Newborn screening is a public health program facilitated by state public health departments with the goal of improving the health of affected newborns throughout the country. Experts in the newborn screening community established a panel of eight quality indicators (QIs) to track quality practices within and across the United States newborn screening system. The indicators were developed following iterative refinement, consensus building, and evaluation. The Newborn Screening Technical assistance and Evaluation Program (NewSTEPs) implemented a national data repository in 2013 that captures the quality improvement metrics from each state. The QIs span the newborn screening process from collection of a dried blood spot through medical intervention for a screened condition. These data are collected and analyzed to support data-driven outcome assessments and tracking performance to improve the quality of the newborn screening system.
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Hariprasad, R., R. Babu, S. Arora, and R. Mehrotra. "Capacity Building in Cancer Screening Using ECHO (Extension for Community Healthcare Outcomes): Innovative and Cost-Effective Model." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 160s. http://dx.doi.org/10.1200/jgo.18.17500.
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Background and context: Three most common cancers in India are breast, uterine cervix and oral cavity, together accounting for approximately 34% of all cancers. Ministry of Health and Family Welfare, India has released an operational guidelines for cancer screening last year and has urged all the states to roll out population based cancer screening at various health care levels. As per these guidelines, the existing health care providers (HCPs) at various facilities would be rolling out the population based cancer screening in the country. However, the existing HCPs lack the skills and are not trained in cancer screening. Considering the size of the country, it is neither a feasible nor economically viable to provide in-person training for all cadres of HCPs. The limitation is comprehensively overcome by ECHO (Extension for Community Healthcare Outcomes) model provides a cost effective way to exponentially expand the capacity to mentor and train these HCPs in cancer screening best practices. ECHO as per the motto to “move knowledge rather than patients or doctors”, uses widely available one to many video-conferencing technology, didactic presentations and case based learning techniques to mentor and support HCPs to implement best practices in the field. In teleECHO clinics expert teams at an academic “hub” partner with willing participants to participate in knowledge networks in which all teach and all learn. Aim: To train the health care providers in cancer screening through technology assisted learning. Strategy/Tactics: A structured training program was designed using ECHO platform for all HCPs in separate batches that included, gynecologists, dentists and community health workers (CHWs), by virtual training to address all issues while they roll out cancer screening in their communities. Program/Policy process: A structured course of 20 week-sessions' virtual (online) cancer screening training program for various cadres of health care providers was undertaken. A typical one hour of ECHO session consisted of 25-30 minutes of didactics by the expert followed by 2 case presentations by the spokes. A “Beginner´s program” was well received by the participants who requested us to take it ahead with “Advanced training program” for specialists. Outcomes: 58 participants completed the course in cancer screening. The pre- and posttraining knowledge evaluation demonstrated a significant increase in the knowledge gained by participants. What was learned: In a resource constrained environment it is feasible to develop a basic curriculum in cancer screening program and train and support, all cadres of HCPs. Rolling out a technology enabled model such as ECHO for teaching and training can enable the development of a population based cancer screening program.
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Hariprasad, Roopa, and Ravi Mehrotra. "Cancer Screening Program Using Technology Assisted Learning." Journal of Global Oncology 2, no. 3_suppl (June 2016): 23s. http://dx.doi.org/10.1200/jgo.2016.004036.
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Abstract 29 There is an estimated burden of over 1 million individuals who were diagnosed with cancer in India in 2012. The three most commonly occurring cancers in India are breast, uterine cervix and oral cancers, together accounting for one third of India’s cancer burden. All three are usually detectable at early stages, and malignancies of the oral cavity and cervix have precancerous stages that are amenable to secondary prevention. Therefore, screening and early detection of these three cancers will help to markedly reduce the cancer burden in India. The technology used in this project is the ECHO (Extension for Community Health Outcomes) model of the University of New Mexico. ECHO clinics are supported by basic, widely available teleconferencing technology. It links expert specialist teams at an academic ‘hub’ with primary care clinicians in local communities – the ‘spokes’ of the model. This pilot project is being conducted at the primary health centre (PHC) Gumballi, a tribal village in Karnataka. We are incorporating cancer screening program in the existing infrastructure and manpower in-country, using the ECHO model. The Institute of Cytology and Preventive Oncology (ICPO) helps in empowering the community health workers (CHWs) at the PHC to conduct cancer screening of the population covered by the PHC. We have used two modes of training health care providers: Initial face-to-face training on cancer screening tests, allowing for hands-on training and practice of skills. ICPO staff visited Gumballi and provided 4 days of intensive training to the community health workers in screening of oral, breast and cervical cancer. Subsequently, fortnightly, ECHO clinics are being conducted to include reiteration of the training, discussing patient cases, resource sharing and expert presentations. To date, the CHWs have screened 11,342 individuals for oral, breast and cervical cancer, out of the 16,042 eligible population. The screen positives and suspicious cases are being evaluated and treated by a team of specialists from the Kidwai Memorial Institute of Oncology, Bangalore, which is a tertiary care centre for cancer treatment in that region. This pilot study proves that the cancer screening is feasible at the primary health network with the existing resources which can be replicated to the larger masses and subsequently to the whole country. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from either author.
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Winston, Randi. "Introducing the Newborn Hearing Screening Training Curriculum." Perspectives on Hearing and Hearing Disorders in Childhood 18, no. 2 (October 2008): 39–43. http://dx.doi.org/10.1044/hhdc18.2.39.
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Abstract Although hospital based universal newborn hearing screening programs have been implemented in the majority of hospitals in the country, state Early Hearing Detection and Intervention (EHDI) programs and hospitals face the ongoing challenge of ensuring that all screening staff are properly trained and competent. Inadequately trained screening staff jeopardizes the integrity and efficiency of the early identification and intervention process. Over the past 2 ½ years, a team of experts dedicated to newborn hearing screening, represented by The EAR Foundation of Arizona (EFAZ) and the National Center for Hearing Assessment and Management at Utah State University (NCHAM), collaborated on a project to develop a competency based, multi-media training curriculum to meet hospitals’ training needs. The goal was to provide a consistent and comprehensive training solution to help hospitals achieve an improved standard of care to babies and families through efficient screening practices. A draft version was piloted and evaluated in 10 EHDI state programs. Feedback from 70 hospitals was incorporated. This document will discuss considerations and methods used for development and an overview of the curriculum content.
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Sattar, Wasim. "Cost effectiveness of treatment-free remission in chronic myeloid leukemia patients: A report from a developing country." Journal of Global Oncology 5, suppl (October 7, 2019): 131. http://dx.doi.org/10.1200/jgo.2019.5.suppl.131.
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131 Background: Current recommendations for first line therapy in chronic phase chronic myeloid leukemia (CP-CML) is life-time use of tyrosine kinase inhibitors (TKI's). Unfortunately, the financial burden of continuous TKI therapy is unsustainable especially in developing countries. In Pakistan, an access-program for Imatinib (IM) and Nilotinib is available; the cost of therapy is subsidized with the Government paying for 3 months and Novartis for 9 months. Updated results from several trials support continued long term durability of treatment free remission (TFR). We attempted TFR in our patients in an attempt to reduce financial burden and improve quality of life for the patients. We aimed to evaluate the economic impact of discontinuing imatinib versus continuous use of imatinib in patients taking IM 400mg. Methods: 57 patients of CP-CML taking Imatinib 400 mg for the last 10 years who were negative by FISH for at least 3 years or in MR 4.5 at least once in 12 months were evaluated. Of these 30 were screening failures, 4 patients refused consent prior to screening and 25 were eligible for the trial. Two consecutive RQ-PCR were performed 3 months apart prior to enrollment. Patients were eligible if they achieved MR 4.5 for at least 3 months prior to entering the study. Molecular response was assessed by Quantitative BCR-ABL RQ-PCR every 4 weeks after discontinuation for year 1 and 8 weeks at year 2. Cost of Imatinib 400 mg per month was calculated as well as the cost of BCR-ABL RQ-PCR by gene expert for the trial. Results: Of the enrolled 25 patients, 10 lost their deep molecular response and were restarted on therapy, 5 withdrew consent after screening.10 patients are currently on trial at varying time intervals (10-14 months) of cessation of imatinib. The cost of one month of imatinib is US $ 800 and the cost of RT PCR is $ 67. TFR translated into approximately US 1.2 million saved. Conclusions: The discontinuation of TKI in this small subset of patients has resulted in remarkably large savings with significant impact on the meager health budget in our resource limited setting.
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Arora, N., F. Arinde, E. Lang, S. McDonald, S. Manji, L. McCracken, and L. McLeod. "P007: Development of provincial recommendations for domestic violence screening in emergency departments and urgent care settings in Alberta." CJEM 21, S1 (May 2019): S65. http://dx.doi.org/10.1017/cem.2019.198.
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Introduction: Alberta has one of the highest rates of domestic violence (DV) in the country. Emergency departments (EDs) and urgent care centres (UCCs) are significant points of opportunity to screen for DV and intervene. In Alberta, the Calgary Zone began a universal education and direct inquiry program for DV in EDs and UCCs for patients > = 14 years in 2003. The Calgary model is unique in that (a) it provides universal education in addition to screening and (b) screening is truly universal as it includes all age groups and genders. While considering expanding this model provincially, we engaged in the GRADE Adolopment process, to achieve multi-stakeholder consensus on a provincial approach to DV screening, as herewith described. Methods: Using GRADE, we synthesized and rated the quality of evidence on DV screening and presented it to an expert panel of stakeholders from the community, EDs, and Alberta Health Services. There was moderate certainty evidence that screening improved DV identification in antenatal clinics, maternal health services and EDs. There was no evidence of harm and low certainty evidence of improvement in patient-important outcomes. As per Adolopment, the expert panel reviewed the evidence in the context of: a) values and preferences b) benefits and harms, and c) acceptability, feasibility, and resource implications. Results: The panel came to a unanimous decision to conditionally recommend universal screening, i.e., screening all adults above 14 years of age in EDs and UCCs. By conditional, the panel noted that EDs and UCCs must have support resources in place for patients who screen positive to realize the full benefit of screening and avoid harm. The panel deemed universal screening to be a logistically easier recommendation, compared to training healthcare professionals to screen certain subpopulations or assess for specific symptoms associated with DV. The panel noted that despite absence of evidence that screening would impact patient-important outcomes, there was evidence that effective interventions following a positive screen could positively impact these outcomes. The panel stressed the importance of evidence creation in the context of absence of evidence. Conclusion: A GRADE Adolopment process achieved consensus on provincial expansion of an ED-based DV screening program. Moving forward, we plan to gather evidence on patient-important outcomes and understudied subpopulations (i.e. men and the elderly).
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Michaud, Pierre-André, Annemieke Visser, Johanna P. M. Vervoort, Paul Kocken, Sijmen A. Reijneveld, and Danielle E. M. C. Jansen. "Availability and accessibility of primary mental health services for adolescents: an overview of national recommendations and services in EU." European Journal of Public Health 30, no. 6 (August 21, 2020): 1127–33. http://dx.doi.org/10.1093/eurpub/ckaa102.
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Abstract Background Mental health problems in adolescence can profoundly jeopardize adolescent current and future health and functioning. We aimed to describe existing recommendations and services regarding the delivery of primary mental health care for adolescents in 31 European countries. Methods Data on the availability and accessibility of primary mental health services were collected, as part of the Horizon 2020-funded project Models of Child Health Appraised. One expert from each country answered a closed items questionnaire during years 2017–18. Results All 31 participating countries had some policy or recommendations regarding the availability and accessibility of primary mental health services for adolescents, but their focus and implementation varied largely between and within countries. Only half of the participating countries had recommendations on screening adolescents for mental health issues and burdens. Merely a quarter of the countries had ambulatory facilities targeting specifically adolescents throughout the whole country. Just over half had some kind of suicide prevention programs. Same-day access to primary care in case of -health emergencies was possible in 21 countries, but often not throughout the whole country. Nineteen countries had strategies securing accessible mental health care for vulnerable adolescents. Conclusions Overall, around half of European countries had strategies securing access to various primary mental health care for adolescents. They frequently did not guarantee care over the whole country and often tackled a limited number of situations. EU countries should widen the range of policies and recommendations governing the delivery of mental health care to adolescents and monitor their implementation.
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Lees-Haggerty, Kristin, Tony Rosen, and Terry Fulmer. "THE NATIONAL COLLABORATORY TO ADDRESS ELDER MISTREATMENT: COORDINATING NETWORKS OF CARE." Innovation in Aging 3, Supplement_1 (November 2019): S74. http://dx.doi.org/10.1093/geroni/igz038.288.
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Abstract Elder mistreatment is a devastating and pervasive issue affecting an estimated one in ten older adults in the US. To effectively address elder mistreatment, it is essential for researchers, health care providers and communities to coordinate efforts and leverage each other’s strengths. The National Collaboratory to Address Elder Mistreatment (NCAEM), funded by The John A. Hartford Foundation and Gordon and Betty Moore Foundation, is a group of elder mistreatment experts from across the country taking a collective impact approach to alleviating the burden of elder mistreatment on survivors, families, communities, and systems. NCAEM’s goals are to provide hospital emergency departments with training and tools to address elder mistreatment and to develop networks of experts, health care, and community-based providers in a coordinated response to this complex problem. This symposium will include four presentations describing the NCAEM’s collective impact approach, intersection with related work, and applicability to other initiatives. We will present our strategy for creating a team, moving beyond typical collaborative efforts through the development of a central infrastructure and streamlined processes to support experts from across the country as we work together toward common goals and shared measurement for addressing elder mistreatment. Following an overview of our approach, presentations will include specific examples of how the NCAEM worked with clinical partners to refine an elder mistreatment screening and response tool, case examples from NCAEM clinical test sites describing efforts to bridge hospital and community-based services, and learnings from NCAEM’s strategic alignment with complimentary initiatives (the Geri-ED Accreditation and Collaborative).
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Mathur, N. N., and R. Dhawan. "An alternative strategy for universal infant hearing screening in tertiary hospitals with a high delivery rate, within a developing country, using transient evoked oto-acoustic emissions and brainstem evoked response audiometry." Journal of Laryngology & Otology 121, no. 7 (November 20, 2006): 639–43. http://dx.doi.org/10.1017/s0022215106004403.
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Objective: To formulate an alternative strategy for universal infants hearing screening in an Indian tertiary referral hospital with a high delivery rate, which could be extended to similar situations in other developing countries. The system should be able to diagnose, in a timely fashion, all infants with severe and profound hearing losses.Methods: One thousand newborn were randomly selected. All underwent testing with transient evoked oto-acoustic emissions (TEOAE) in the first 48 hours of life. All TEOAE failures were followed up and repeat tests were performed at three weeks, three months and six months of age. Infants with acceptable TEOAE results at any of the four ages were discharged from the study. Infants with unacceptable TEOAE results at all the four ages underwent brainstem evoked response audiometry and oto-endoscopy. The ‘pass rate’ for TEOAE testing was calculated for all four ages. The time taken to perform TEOAE and brainstem evoked response audiometry was recorded for all subjects. These recordings were statistically analysed to find the most suitable strategy for universal hearing screening in our hospital.Results: The pass rate for TEOAE was 79.0 per cent at ≤48 hours, 85.0 per cent at three weeks, 97.0 per cent at three months and 98.0 per cent at six months. The average time taken to perform the test was 12 minutes for TEOAE and 27 minutes for brainstem evoked response audiometry. Obstructed and collapsed external auditory canals were the two factors that significantly affected the specificity of TEOAE in infants ≤48 hours old.Conclusion: The concept of screening all neonates within the first 48 hours of life is impractical because the specificity of TEOAE is lowest at that age. Many false positive results are generated, such that a larger number must undergo brainstem evoked response audiometry, wasting time and resources. This can easily be avoided by delaying TEOAE screening until three months of age, when it has a substantially lower false positive outcome. We expect that implementation of this alternative strategy in our hospital will maximise the benefits of such a programme.
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Mungo, Chemtai, Cirilus Ogollah Osongo, Jeniffer Ambaka, Magdalene A. Randa, Benard Samba, Catherine A. Ochieng, Emily Barker, Anagha Guliam, Jackton Omoto, and Craig R. Cohen. "Feasibility and Acceptability of Smartphone-Based Cervical Cancer Screening Among HIV-Positive Women in Western Kenya." JCO Global Oncology, no. 7 (May 2021): 686–93. http://dx.doi.org/10.1200/go.21.00013.
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PURPOSE Adjunct cervical cancer screening methods are under evaluation to improve the diagnostic accuracy of human papillomavirus (HPV)-based screening in low- and middle-income countries. We evaluated the feasibility and acceptability of smartphone-based cervicography among HPV-positive women living with HIV (WLWH) in Western Kenya. METHODS HPV-positive WLWH of 25-49 years of age enrolled in a clinical trial (ClinicalTrials.gov identifier: NCT04191967 ) had digital images of the cervix taken using a smartphone by a nonphysician provider following visual inspection with acetic acid. All participants had colposcopy-directed biopsy before treatment. Cervical images were evaluated by three off-site colposcopists for quality, diagnostic utility, and assigned a presumed diagnosis. We determined the proportion of images rates as low, medium, or high quality, interobserver agreement using Cohen’s Kappa statistic, and the off-site colposcopist’s sensitivity and specificity for diagnosis of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) compared with histopathology. Acceptability was evaluated using a questionnaire. RESULTS One hundred sixty-four HPV-positive WLWH underwent cervicography during the study period. Mean age was 37.3 years. Images from the first 94 participants were evaluated by off-site colposcopists, with a majority (70.9%) rated as high quality. Off-site colposcopists had a sensitivity ranging from 21.4% (95% CI, 0.06 to 0.43) to 35.7% (95% CI, 0.26 to 0.46) and a specificity between 85.5% (95% CI, 0.81 to 0.90) to 94.9% (95% CI, 0.92 to 0.98) for diagnosis of CIN2+ based compared with histopathology. The majority of women, 99.4%, were comfortable having an image of their cervix taken as part of screening. CONCLUSION Cervicography by a nonphysician provider as an adjunct to HPV-based screening among WLWH in a low- and middle-income country setting is feasible and acceptable. However, low sensitivity for diagnosis of CIN2+ by off-site expert colposcopists highlights the limitations of cervicography.
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Colquhoun, Samantha M., Jonathan R. Carapetis, Joseph H. Kado, Benjamin M. Reeves, Boglarka Remenyi, William May, Nigel J. Wilson, and Andrew C. Steer. "Pilot study of nurse-led rheumatic heart disease echocardiography screening in Fiji – a novel approach in a resource-poor setting." Cardiology in the Young 23, no. 4 (October 8, 2012): 546–52. http://dx.doi.org/10.1017/s1047951112001321.
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AbstractWe designed a pilot study of a training module for nurses to perform rheumatic heart disease echocardiography screening in a resource-poor setting. The aim was to determine whether nurses given brief, focused, basic training in echocardiography could follow an algorithm to potentially identify cases of rheumatic heart disease requiring clinical referral, by undertaking basic two-dimensional and colour Doppler scans. Training consisted of a week-long workshop, followed by 2 weeks of supervised field experience. The nurses’ skills were tested on a blinded cohort of 50 children, and the results were compared for sensitivity and specificity against echocardiography undertaken by an expert, using standardised echocardiography definitions for definite and probable rheumatic heart disease. Analysis of the two nurses’ results revealed that when a mitral regurgitant jet length of 1.5 cm was used as the trigger for rheumatic heart disease identification, they had a sensitivity of 100% and 83%, respectively, and a specificity of 67.4% and 79%, respectively. This pilot supports the principle that nurses, given brief focused training and supervised field experience, can follow an algorithm to undertake rheumatic heart disease echocardiography in a developing country setting to facilitate clinical referral with reasonable accuracy. These results warrant further research, with a view to developing a module to guide rheumatic heart disease echocardiographic screening by nurses within the existing public health infrastructure in high-prevalence, resource-poor regions.
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Yeom, Jong Hum, Ji Sun Park, Ock-Hee Oh, Hyun Taek Shin, and Jung Mi Oh. "Identification of Inappropriate Drug Prescribing by Computerized, Retrospective DUR Screening in Korea." Annals of Pharmacotherapy 39, no. 11 (November 2005): 1918–23. http://dx.doi.org/10.1345/aph.1e674.
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BACKGROUND In Korea, the drug use process has changed significantly since the new pharmacy law was implemented in 2000, separating the prescribing and dispensing functions between physicians and pharmacists and mandating prospective drug use review (DUR) practice by pharmacists immediately before dispensing medications. However, a high prevalence of inappropriate prescribing has been suspected by the public, pharmacists, and health insurance managers, possibly due to suboptimal DUR practice by pharmacists. OBJECTIVE To assess overall patterns of drug usage and potential problems of inappropriate use in outpatient settings by analyzing prescription data that were electronically submitted to the national health insurance manager with a computerized DUR system and develop a computerized adjudication system model for drug claims. METHODS The national prescription drug claims data that were submitted electronically by pharmacies located in the northern part of Korea during 15 days in 2002 were retrospectively screened against the predetermined DUR standards of the selected criteria on drug dosage, duration of therapy, and drug interaction using the DUR screening system. The results of all the DUR conflicts were further validated manually by an expert panel and statistically analyzed to determine drug use patterns. RESULTS Of 31 994 260 drugs prescribed, 3 325 760 (10.4%) items showed a conflict with at least one of the DUR standards. The average number of drugs prescribed on each prescription was 4.07, and even more troubling was the high incidence of under-dosing, over-dosing, and contraindicated drug prescribing. CONCLUSIONS It is evident that inappropriate drug prescribing is very common in Korea; thus, a great deal of attention is urgently needed in the country with respect to proper prescribing and supportive interventions.
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Shah, V. T., Geevar Zachariah, S. Lakshmanan, Surendra Babu, K. Suresh, Devanu Ghosh Roy, Bhupesh Shah, et al. "Patient profile based management approach for Optimal Treatment of Angina: a consensus from India cases." International Journal of Advances in Medicine 6, no. 2 (March 25, 2019): 551. http://dx.doi.org/10.18203/2349-3933.ijam20191174.
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Chronic stable angina (CSA) is an incapacitating disorder. The pain can hinder the routine chores of an individual and significantly impact one’s quality of life (QoL). However, the good news is that this can be treated and the QoL can be improved. The key to apt management lies in the accurate early diagnosis of this condition, followed by a detailed evaluation and accordingly planned management, which should be regularly revised and be backed by an adequate follow-up. OPTA-OPtimal Treatment for chronic stable Angina-is an educational initiative to assist the clinicians in India with screening and diagnostic tools, strengthened by updated guideline-directed management to ensure satisfactory patient outcomes. OPTA aims to improve clinical outcomes by providing optimized pharmacotherapy for patients with stable angina. This expert consensus document intends to provide information for better understanding of the condition by clinicians and to ensure an early, accurate diagnosis, followed by optimal management of angina. For better clinical and practical understanding of Indian clinical scenario, the most commonly encountered patient profiles are briefly described here. These inputs and an extensive literature review were blended to develop the recommendations for clinicians across the country. An attempt is made to include clinical recommendations that meet the needs of the majority of patients in most circumstances in the Indian scenario. However, the ultimate judgment regarding individual case management should be based on clinician’s discretion. This expert consensus document is not a substitute for textbooks and/or a clinical judgment.
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Inglis, Chris. "Focus Wales: A showcase festival of music performance and education." Journal of Popular Music Education 5, no. 1 (April 1, 2021): 113–18. http://dx.doi.org/10.1386/jpme_00046_1.
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Since 2011, the town of Wrexham has hosted the annual Focus Wales festival, showcasing local and international talent across a three-day event to an audience of 15,000. What sets this festival aside from many of the other, similar events happening around the country is its emphasis on music education alongside simply performance. On top of the various shows that take place over the course of the bank holiday weekend, Focus Wales also presents interactive events featuring industry experts, film screenings, and art installations; as well as a conference that presents talks from professional musicians, promoters, radio DJs, academics and more. This article looks into the ways in which Focus Wales has approached musicological discourse over its ten-year history, and how it has contributed to popular music education in Wales.
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Muellenbach, Joanne M. "A Landscape Study Highlights the Urgent Need for Evidence Based Strategies to Enable Electronic Health Records Integration in the National Healthcare Systems of Low- and Middle-Income Countries." Evidence Based Library and Information Practice 16, no. 3 (September 15, 2021): 140–42. http://dx.doi.org/10.18438/eblip29981.
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A Review of: Kumar, M., & Mostafa, J. (2020). Electronic health records for better health in lower- and middle-income countries: A landscape study. Library Hi Tech, 38(4), 751–767. https://doi.org/10.1108/LHT-09-2019-0179 Abstract Objective – To identify how low- and middle-income countries (LMICs) approached the development of national and subnational electronic health records (EHRs) and to understand the challenges related to EHR research priorities and sustainability. Design – Landscape study consisting of a review of the scientific literature, country-focused grey literature, and consultation with international experts. Setting – Hospitals and healthcare systems within LMICs. Subjects – The 402 publications retrieved through a systematic search of four scientific electronic databases along with 49 publications found through a country-focused analysis of grey literature and 14 additional publications found through consultation with two international experts. Methods – On 15 May 2019, the authors comprehensively searched four major scientific databases: Global Health, PubMed, Scopus, and Web of Science. They also searched the grey literature and repositories in consultation with country-based international digital health experts. The authors subsequently used Mendeley reference management software to organize and remove duplicate publications. Peer-reviewed publications that focused on developing national EHRs within LMIC healthcare systems were included for the title and abstract screening. Data analysis was mainly qualitative, and the results were organized to highlight stakeholders, health information architecture (HIA), and sustainability. Main Results – The results were presented in three subsections. The first two described critical stakeholders for developing national and subnational EHRs and HIA, including country eHealth foundations, EHRs, and subsystems. The third section presented and discussed pressing challenges related to EHR sustainability. The findings of the three subsections were further explored through the presentation of three LMIC case studies that described stakeholders, HIA, and sustainability challenges. Conclusion – The results of this landscape study highlighted the scant evidence available to develop and sustain national and subnational EHRs within LMICs. The authors noted that there appears to be a gap in understanding how EHRs impact patient-level and population outcomes within the LMICs. The study revealed that EHRs were primarily designed to support monitoring and evaluating health programs focused on a particular disease or group of diseases rather than common health problems. While national governments and international donors focused on the role of EHRs to improve patient care, the authors highlighted the urgent need for further research on the development of EHRs, with a focus on efficiency, evaluation, monitoring, and quality within the national healthcare enterprise.
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Hur, Kyu Yeon, Min Kyong Moon, Jong Suk Park, Soo-Kyung Kim, Seung-Hwan Lee, Jae-Seung Yun, Jong Ha Baek, et al. "2021 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association." Diabetes & Metabolism Journal 45, no. 4 (July 31, 2021): 461–81. http://dx.doi.org/10.4093/dmj.2021.0156.
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The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.
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Mahalati, Taghi, Parvaneh Gelard, Changiz Valmohammadi, and Heidar Toorani. "Identifying and Ranking Implementation Strategies of Human Resources Productivity Improvement Management in IRAN Insurance Company." REICE: Revista Electrónica de Investigación en Ciencias Económicas 8, no. 16 (December 31, 2020): 571–606. http://dx.doi.org/10.5377/reice.v8i16.10724.
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Improving quality of workforce, acquiring new skills, and identifying factors influencing on human resources productivity will help the organization to strive for its improvement. Deploying management strategies for productivity improvement enables productivity to be promoted as a continuous process, identifying productivity paths, and laying necessary groundwork.This study was conducted to identify and rank human resources management improvement strategies in Iran Insurance Company, with effective and impressionable indicators. To do this, two methods of non-probability and snowball sampling were used, opinions of 15 experts of Iran Insurance Company were considered as the largest insurance supply network in the country. Process of this research was consisted of five steps: a) Identifying factors influencing human resources productivity by studying relevant literature, b) Screening of identified factors using Fuzzy Delphi technique in Iran Insurance Company ,c) Determining interactions and prioritizing factors influencing human resources productivity using Fuzzy Demetel; d) Determining deployment strategies for improving productivity through depth interviews with experts; and e) Ranking productivity deployment strategies using Fuzzy Victor method. Results showed that job satisfaction factor is the most effective and also the highest priority among 15 factors influencing human resources productivity in Iran Insurance Company. Results also showed that establishment of productivity research system ranked as the highest among 7 identified research strategies.
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North, Frederick, Sidna M. Tulledge-Scheitel, John C. Matulis, Jennifer L. Pecina, Andrew M. Franqueira, Sarah S. Johnson, and Rajeev Chaudhry. "Population health challenges in primary care: What are the unfinished tasks and who should do them?" SAGE Open Medicine 6 (January 2018): 205031211880020. http://dx.doi.org/10.1177/2050312118800209.
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Background: There are numerous recommendations from expert sources that help guide primary care providers in cancer screening, infectious disease screening, metabolic screening, monitoring of drug levels, and chronic disease management. Little is known about the potential effort needed for a healthcare system to address these recommendations, or the patient effort needed to complete the recommendations. Methods: For 73 recommended population healthcare items, we examined each of 28,742 patients in a primary care internal medicine practice to determine whether they were up-to-date on recommended screening, immunizations, counseling, and chronic disease management goals. We used a rule-based software tool that queries the medical record for diagnoses, dates, laboratory values, pathology reports, and other information used in creating the individualized recommendations. We counted the number of uncompleted recommendations by age groups and examined the healthcare staff needed to address the recommendations and the potential patient effort needed to complete the recommendations. Results: For the 28,742 patients, there were 127,273 uncompleted recommendations identified for population health management (mean recommendations per patient 4.36, standard deviation of 2.65, range of 0–17 recommendations per patient). The age group with the most incomplete recommendations was age of 50–65 years with 5.5 recommendations per patient. The 18–35 years age group had the fewest incomplete recommendations with 2.6 per patient. Across all age groups, initiation of these recommendations required high-level input (physician, nurse practitioner, or physician’s assistant) in 28%. To completely adhere to recommended services, a 1000-patient cross-section cohort would require a total of 464 procedures and 1956 lab tests. Conclusion: Providers and patients face a daunting number of tasks necessary to meet guideline-generated recommendations. We will need new approaches to address the burgeoning numbers of uncompleted recommendations.
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Alsafadi, Danyah, Aly Ezzat, Fatima Altamimi, Marwan ElBagoury, Mohammed Olfat, Mohammed Saleh, Sherif Roushdy, and Yahia Aktham. "Mucopolysaccharidosis Type I Disease Prevalence Among Patients With Idiopathic Short Stature in Saudi Arabia: Protocol for a Multicenter Cross-sectional Study." JMIR Research Protocols 10, no. 8 (August 31, 2021): e28619. http://dx.doi.org/10.2196/28619.
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Background Since the underlying cause of idiopathic short stature can indeed be undiagnosed mucopolysaccharidosis type I, it is critical to identify patients with mucopolysaccharidosis type I among screened patients with idiopathic short stature. Objective The primary objective of this study is to determine the prevalence of mucopolysaccharidosis type I disease in a high-risk group (ie, patients with idiopathic short stature). Methods We plan to perform a multicenter, cross-sectional screening study to primarily assess the prevalence of mucopolysaccharidosis type I disease in patients with idiopathic short stature. All eligible patients will be tested after obtaining written informed consent from their parents and guardians. Eligible patients will be recruited over 18 months from specialty care centers for pediatrics and genetics. Results This protocol was approved by the Institutional Review Board of King Fahd Medical City and funded by Sanofi Genzyme Saudi Arabia. We expect to collect data from ≥800 patients, as determined by our sample size calculation. Conclusions Saudi Arabia is the largest country in the Arabian Peninsula; it has a population of more than 28 million people. To date, there are no reliable data regarding the incidence and prevalence of mucopolysaccharidosis type I in Saudi Arabia; therefore, future multicenter studies will be needed. Further, the prevalence of an attenuated form of mucopolysaccharidosis type I is largely underestimated in Saudi Arabia due to the absence of an effective newborn screening program. Therefore, the implementation of a nationwide newborn screening program is essential for the accurate estimation of the burden of mucopolysaccharidosis and the early diagnosis of patients. International Registered Report Identifier (IRRID) PRR1-10.2196/28619
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Vijayan, Madhusudan, Rajalakshmi Ravi, Georgi Abraham, Rama Ravi, and Milli Mathew. "Chronic Kidney Disease, A Herculean Task: Are There Effective Means Of Engagement In Alleviating The Burden?" Open Urology & Nephrology Journal 7, no. 1 (July 11, 2014): 56–59. http://dx.doi.org/10.2174/1874303x01407010056.
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Non-communicable diseases are on the rise in India, of which chronic kidney disease (CKD) forms a considerable part. Little is known about CKD in India. The CKD registry of India submitted its first report in 2012 attempting to decipher the load of CKD. Only the tip of the iceberg has been explored, because this registry is the data collection from 200 odd nephrologists to whom these patients were referred, which is hospital based. The burden of CKD is felt to be immense and presumed to catapult in the forthcoming years. The available facilities for renal replacement therapy are sparse, confined to urban areas and certain regions of the country. There is an imminent need for focusing on preventive aspect including screening practices and educational measures to alleviate the burden of CKD. Screening of high risk groups with urine dipstick test and serum creatinine estimation and estimated glomerular filtration rate (eGFR) based on this, is currently recommended by international experts, although debate exists as to whether to screen the entire population or only susceptible and older individuals. Educational interventions aimed at creating awareness are warranted owing to the current circumstances. The Government has to put in place decisive measures to control and monitor the disease. Public private partnerships could play a major role in the future. For the control of CKD as a whole in India, participation from professionals industry, philanthropic organizations with active involvement of Government is necessary.
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Collin, Simon M., Fatima Wurie, Morris C. Muzyamba, Gerard de Vries, Knut Lönnroth, Giovanni Battista Migliori, Ibrahim Abubakar, Sarah R. Anderson, and Dominik Zenner. "Effectiveness of interventions for reducing TB incidence in countries with low TB incidence: a systematic review of reviews." European Respiratory Review 28, no. 152 (May 29, 2019): 180107. http://dx.doi.org/10.1183/16000617.0107-2018.
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AimsWhat is the evidence base for the effectiveness of interventions to reduce tuberculosis (TB) incidence in countries which have low TB incidence?MethodsWe conducted a systematic review of interventions for TB control and prevention relevant to low TB incidence settings (<10 cases per 100 000 population). Our analysis was stratified according to “direct” or “indirect” effects on TB incidence. Review quality was assessed using AMSTAR2 criteria. We summarised the strength of review level evidence for interventions as “sufficient”, “tentative”, “insufficient” or “no” using a framework based on the consistency of evidence within and between reviews.ResultsWe found sufficient review level evidence for direct effects on TB incidence/case prevention of vaccination and treatment of latent TB infection. We also found sufficient evidence of beneficial indirect effects attributable to drug susceptibility testing and adverse indirect effects (measured as sub-optimal treatment outcomes) in relation to use of standardised first-line drug regimens for isoniazid-resistant TB and intermittent dosing regimens. We found insufficient review level evidence for direct or indirect effects of interventions in other areas, including screening, adherence, multidrug-resistant TB, and healthcare-associated infection.DiscussionOur review has shown a need for stronger evidence to support expert opinion and country experience when formulating TB control policy.
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Ceornodolea, Andreea D., Roland Bal, and Johan L. Severens. "Epidemiology and Management of Atrial Fibrillation and Stroke: Review of Data from Four European Countries." Stroke Research and Treatment 2017 (2017): 1–12. http://dx.doi.org/10.1155/2017/8593207.
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In Europe, 1–3% of the population suffers from atrial fibrillation (AF) and has increased stroke risk. By 2060 a doubling in number of cases and great burden in managing this medical condition are expected. This paper offers an overview of data on epidemiology and management of AF and stroke in four European countries as well as the interconnection between these dimensions. A search index was developed to access multiple scientific and “grey” literatures. Information was prioritised based on strength of evidence and date. Information on country reports was double-checked with national experts. The overall prevalence of AF is consistent across countries. France has the lowest stroke incidence and mortality, followed by Netherland and UK, while Romania has higher rates. GPs or medical specialists are responsible for AF treatment; exception are the special thrombosis services in the Netherlands. Prevention measurements are only present in UK through screening programs. Although international and national guidelines are available, undertreatment is present in all countries. Despite differences in healthcare systems and management of AF, epidemiology is comparable between three of the countries. Romania is an outlier, by being limited in data accessibility. This knowledge can contribute to improved AF care in Europe.
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Yap, M. L., A. Oar, F. Y. Moraes, and A. Ilbawi. "An Evidence-Based National Cancer Control Program (NCCP) Quality Assessment Checklist." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 77s. http://dx.doi.org/10.1200/jgo.18.66800.
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Background: The 2017 World Health Assembly resolution on cancer (WHA70.12) defined a key action for governments to be the implementation of a national cancer control plan (NCCP) with a focus on equity and access. A survey of member states performed in 2015 by WHO found that 87% of countries have NCCPs but only 68% are operational. There are limited data analyzing the quality of NCCPs and an evidence-based 'best practice' appraisal tool is lacking. Aim: We formulated an evidence-based comprehensive checklist for the critical appraisal of an NCCP, for potential application for countries across all continents and income classifications. Methods: An extensive literature review was performed to identify previous publications used to advise on or assess NCCPs. Each article was reviewed by three investigators and potential quality items were created to form the preliminary checklist. Items were ranked according to the frequency of appearance in the identified publications, then further refined by an expert panel of global cancer partners including NCCP researchers, civil society, NGOs and technical content experts. Checklist items were categorized to ensure comprehensiveness across both the cancer continuum and health systems building blocks. Multiple choice answers for checklist items were created to allow ease of use and reproducibility. Concordance between multiple reviewers was assessed to confirm precision of the appraisal. Results: Twelve publications/documents which advise on NCCP design were identified in the literature. From these, 65 checklist items were identified and included in the tool; each item was present in a median of 2 publications (range 1-8). An additional 13 items which were absent from the twelve documents were added, as the authors and the expert panel viewed these to be important in appraising an NCCP. This gave a total of 78 check list items for quality assessment, grouped in the following categories: (1) General overview; (2) Prevention; (3) Diagnosis, staging and screening; (4) Treatment (5) Service delivery (6) Governance; (7) Health workforce; (8) Health information systems; (9) Research; (10) Finance and (11) Overall summary. The checklist was refined for clarification of language and content after trialing the draft tool for current NCCPs from ten countries. A final validation was performed on six additional countries that demonstrated strong concordance between reviewers, no further changes were made. The final checklist also allows for non-communicable disease (NCD) plans to be appraised as part of cancer policy review in each country. Conclusion: We have developed a comprehensive tool for the quality assessment of NCCPs. An appraisal of all available NCCPs globally is currently underway using this recently-formed check-list. This tool can also potentially be used by governments, policy makers and stakeholders as a 'best practice' guide when formulating and/or updating their country's NCCP.
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Herrick, T., S. Gannon, B. Gowda, C. Harner-Jay, R. Cummings, and V. Tsu. "Cervical Precancer Treatment Planning Tool." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 159s. http://dx.doi.org/10.1200/jgo.18.10500.
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Background and context: Cervical cancer is a largely preventable disease, yet kills about 260,000 women each year, mostly in low- and middle-income countries (LMIC). Cervical screening is a proven technique for reducing the incidence of cervical cancer, but only if screen-positive women receive timely, effective precancer treatment. As planning efforts to scale up cervical precancer treatment programs to reach more women are occurring in many high-burden countries, tools to determine what and how much equipment to procure and how to deploy it could help decision-makers make better use of scarce resources. Aim: To assist decision-makers, PATH developed the Cervical Precancer Treatment Planning Tool, with the aim of increasing access to lifesaving treatment while optimizing the use of scarce resources. This tool contains a scenario-based Excel model and Tableau data visualization mapping tool, which enable users to examine various strategies for deployment of ablative cervical precancer treatment equipment. The tool evaluates the number of women treated, the number of treatment devices needed, associated start-up costs, and cost of gas across five different scenarios. Strategy/Tactics: The model contains baseline data, gathered from a literature review and PATH fieldwork, for nine countries in sub-Saharan Africa, but it can be adapted to generate data for any LMIC. Users can also adjust baseline values to reflect the most current local data. The Tableau data visualization, which uses Uganda as an illustrative example, provides results at a district level. The tool's parameters, baseline inputs, and outputs were vetted with cervical precancer experts from eight African countries in 2017. Program/Policy process: The tool is available to country decision-makers who want to weigh the tradeoffs when trying to balance patient convenience and access with efficient utilization of equipment, skilled personnel, and financial resources. Results from the tool can inform national precancer treatment program strategies and decisions about device procurement and deployment. Outcomes: The country-level tool is publicly available ( https://sites.path.org/marketdynamics/ ) for decision-makers to make informed strategic decisions about their country's cervical precancer treatment programs. What was learned: The single-visit approach (SVA) for screening and treatment leads to treatment of the most women, but the financial costs for this scenario are on average more than 7 times greater than the next most costly scenario. In addition, treatment devices are underutilized in the SVA. While reducing the number of devices in each country reduces costs and improves equipment utilization, many women would require a second visit for treatment. Depending on the equipment deployment scenario (e.g., one treatment device per hospital), some women may need to travel long distances for this follow-up visit, potentially reducing treatment completion rates for those in need.
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Win, Khin Yadanar, Noppadol Maneerat, Kazuhiko Hamamoto, and Syna Sreng. "Hybrid Learning of Hand-Crafted and Deep-Activated Features Using Particle Swarm Optimization and Optimized Support Vector Machine for Tuberculosis Screening." Applied Sciences 10, no. 17 (August 20, 2020): 5749. http://dx.doi.org/10.3390/app10175749.
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Tuberculosis (TB) is a leading infectious killer, especially for people with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). Early diagnosis of TB is crucial for disease treatment and control. Radiology is a fundamental diagnostic tool used to screen or triage TB. Automated chest x-rays analysis can facilitate and expedite TB screening with fast and accurate reports of radiological findings and can rapidly screen large populations and alleviate a shortage of skilled experts in remote areas. We describe a hybrid feature-learning algorithm for automatic screening of TB in chest x-rays: it first segmented the lung regions using the DeepLabv3+ model. Then, six sets of hand-crafted features from statistical textures, local binary pattern, GIST, histogram of oriented gradients (HOG), pyramid histogram of oriented gradients and bags of visual words (BoVW), and nine sets of deep-activated features from AlexNet, GoogLeNet, InceptionV3, XceptionNet, ResNet-50, SqueezeNet, ShuffleNet, MobileNet, and DenseNet, were extracted. The dominant features of each feature set were selected using particle swarm optimization, and then separately input to an optimized support vector machine classifier to label ‘normal’ and ‘TB’ x-rays. GIST, HOG, BoVW from hand-crafted features, and MobileNet and DenseNet from deep-activated features performed better than the others. Finally, we combined these five best-performing feature sets to build a hybrid-learning algorithm. Using the Montgomery County (MC) and Shenzen datasets, we found that the hybrid features of GIST, HOG, BoVW, MobileNet and DenseNet, performed best, achieving an accuracy of 92.5% for the MC dataset and 95.5% for the Shenzen dataset.
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Sotande, Emmanuel. "Impediments affecting the curbing of illicit financial flows of organised crime in developing economies." Journal of Financial Crime 26, no. 1 (January 7, 2019): 5–21. http://dx.doi.org/10.1108/jfc-11-2017-0108.
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Purpose The purpose of this paper is to examine the treats hindering war against illicit financial flows of organised crime in developing economies and Nigeria in particular. The examination shows that the impediments facing the fight against money laundering and organised crime financial flows vary from one country to another. It may be lesser in developed economies where most instruments, treaties and best practice recommendations to curb serious crime originated from. However, the impediments against the proceeds of organised crime in developing economies are overwhelming. Design/methodology/approach The research methodology adopted was qualitative analysis. This was applied through the use and analysis of documents and expert interviews. Findings The impediments jeopardising the success against organised crime and other related serious crime financial flows in developing economies are devastating. Consequently, the study offered some policy implications to help mitigate these impediments in developing countries. The dynamics and the phenomena of organised crime business model are operated with ingenious strategies within the global states. Therefore, staying in control of the menace and the threats originated from the organised criminal activities would require periodic review of the global initiatives, standards and strategies deployed by the standard setters to combat organised crime and its financial flows in developing and evolving economies. Additionally, the implementing countries should be carried along and allow to make inputs when such initiatives and standards are being developed. Social implications In Nigeria, there is a clear evidence of “collateral damage” in terms of social justice as result of financial exclusion of many bankable adults of the country that do not possess unique identities for account opening documentation and customer due diligence of the Financial Action Task Force recommendation 10. Originality/value There have been quite a number of studies on organised crime and still fewer have recognised the need to explore the success or failure of combating the proceeds of crime in developing economies. This study provides answer to these gaps by screening associated risks of fighting the proceeds of organised crime in developing countries and Nigeria in particular.
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Baranov, A. A., L. S. Namazova- Baranova, R. N. Terletskaya, and E. V. Antonova. "PROBLEMS OF CHILDREN'S DISABILITY IN MODERN RUSSIA." Annals of the Russian academy of medical sciences 72, no. 4 (September 6, 2017): 305–12. http://dx.doi.org/10.15690/vramn823.
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Creation of system of early prophylaxis of children disability and support of the families bringing up disabled children and children with limited opportunities are among the main priorities of the Russian Federation state social policy. There are a number of problems requiring immediate solutions. Dynamics of children’s disability in our country is characterized by process stagnation. The age and gender structure of children’s disability practically doesn’t change. The analysis of its nosological structure shows that alienations and disorders of behavior, illness of a nervous system and congenital anomalies of development steadily occupy more than 60% among the illnesses which caused disability of children of all age groups. There was a decrease in the prevalence of total disability in most classes of diseases, such as injuries, diseases of the genitourinary system, respiratory system, musculoskeletal system, digestive system and growth of disability caused by neoplasms and diseases of the endocrine system. The underestimation of children’s disability bound to various reasons is supposed: social motivation of a family, complexity of legal veneering, strict requirements of service of medico-social examination, insufficient medical experts awareness on criteria of disability. Among disability formations risk factors the most discussed are the achievements of perinatology leading to improvement of nursing of prematurely born and small newborns, and wide uses of auxiliary genesial technologies. An important part of all preventive measures aimed at reducing the genetic load of population is prenatal and preimplantation diagnosis. It seems appropriate to extend the screening to congenital and hereditary metabolic diseases in neonatal period, including the most common nosological forms of infrequent illnesses. In solving problems of childhood disability prevention a priority should be given to development of services of family planning; improving antenatal and perinatal care; preventive work with healthy but having deviations in development children; development of medical genetic services; implementation of programs of different types of pathology screening.
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Hart, Ashleigh Chanel, Emalie Rosewarne, Wendy Spencer, Ruth McCausland, Greg Leslie, Janani Shanthosh, Christine Corby, Keziah Bennett-Brook, and Jacqui Webster. "Indigenous Community-Led Programs to Address Food and Water Security: Protocol for a Systematic Review." International Journal of Environmental Research and Public Health 18, no. 12 (June 11, 2021): 6366. http://dx.doi.org/10.3390/ijerph18126366.
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The connection between indigenous peoples and Country (a multidimensional concept including land and water) enabled communities to thrive and survive over millennia. This has been eroded by colonisation, dispossession and increasing food and water insecurity due to climate change and supply constraints. Globally, indigenous peoples experience a disproportionate burden of chronic disease and poor nutrition is a major risk factor. Indigenous leaders have been advocating for community-led solutions. The primary aim of this systematic review is to determine what community-led programs have been undertaken to address food and/or water security globally. A comprehensive search of peer-reviewed literature will be performed in EMBASE, CINAHL, PsycINFO, PubMed, Scopus, LILACs, Informit and Business Source Premier. The grey literature search will include grey literature databases, customised Google search engines, targeted websites, and consultation with experts. The search strategy will consist of four concepts, combined as follows: (1) indigenous peoples AND (2) community program AND (3) food security OR (4) water security. Covidence will be used for study screening and data extraction by two authors. A deductive thematic analysis using indigenous-informed methodologies will be used to synthesise data. This review seeks to provide insight on models and mechanisms to encourage action and metrics for quantifying success of indigenous community-led programs to improve food and water security.
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Mahajan, Prashant, Chong Shu-Ling, Camilo Gutierrez, Emily White, Benjamin Cher, Elizabeth Freiheit, Apoorva Belle, et al. "A Global Survey of Emergency Department Responses to the COVID-19 Pandemic." Western Journal of Emergency Medicine 22, no. 5 (August 21, 2021): 1037–44. http://dx.doi.org/10.5811/westjem.2021.3.50358.
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Introduction: Emergency departments (ED) globally are addressing the coronavirus disease 2019 (COVID-19) pandemic with varying degrees of success. We leveraged the 17-country, Emergency Medicine Education & Research by Global Experts (EMERGE) network and non-EMERGE ED contacts to understand ED emergency preparedness and practices globally when combating the COVID-19 pandemic. Methods: We electronically surveyed EMERGE and non-EMERGE EDs from April 3–June 1, 2020 on ED capacity, pandemic preparedness plans, triage methods, staffing, supplies, and communication practices. The survey was available in English, Mandarin Chinese, and Spanish to optimize participation. We analyzed survey responses using descriptive statistics. Results: 74/129 (57%) EDs from 28 countries in all six World Health Organization global regions responded. Most EDs were in Asia (49%), followed by North America (28%), and Europe (14%). Nearly all EDs (97%) developed and implemented protocols for screening, testing, and treating patients with suspected COVID-19 infections. Sixty percent responded that provider staffing/back-up plans were ineffective. Many sites (47/74, 64%) reported staff missing work due to possible illness with the highest provider proportion of COVID-19 exposures and infections among nurses. Conclusion: Despite having disaster plans in place, ED pandemic preparedness and response continue to be a challenge. Global emergency research networks are vital for generating and disseminating large-scale event data, which is particularly important during a pandemic.
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Borzì, V. "Approach toward diabetic nephropathy and its management in patients with type 2 diabetes: results of a web-based italian survey." Journal of AMD 24, no. 1 (April 2021): 64. http://dx.doi.org/10.36171/jamd21.24.1.3.
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AIM The purpose of this survey was to investigate the attitudes and clinical approach of Italian diabetologists toward diabetic nephropathy (DN). METHODS A 28-item web survey was distributed to Italian diabetologists by the Associazione Medici Diabetologi. The first part of the questionnaire was aimed at describing the sample of clinicians involved (age, gender, practice setting, etc.). The second part analyzed more deeply the clinical approach to DN. RESULTS Two hundred and thirty-five clinicians, expert in the field (over 44% have been working as diabetologists for more than 20 years) and well distributed across the country, participated in the survey. The lack of medical care provided from a team remains a main concern, since only in a minority of diabetes centers diabetologists can collaborate with health professionals with expertise and a special interest in diabetes. Screening of DN is performed at first visit by 95% of participants. Urinary albumin creatinine ratio and estimated glomerular filtration rate by CKD-EPI are two approaches used. The relevance of intensive glycemic treatment respect to the onset and progression of DN is mostly considered in patients with microalbuminuria, less frequently in patients with more advanced kidney disease. Almost the totality of participants prescribes renin angiotensin system blocking drugs for the treatment of hypertension, mainly in presence of albuminuria. This class of drugs is less frequently recommended in normotensive patients with microalbuminuria. Regarding the new anti-hyperglycemic drugs, more attention is paid for SGLT2 inhibitors or GLP-1 receptor agonist. CONCLUSIONS The present survey highlights the clinical relevance of DN and the high attention for this diabetic complication by Italian diabetologists. Although the lack of medical care provided from a team remains a main concern, the diabetologists are engaged in promoting educational and screening programs. They are also in keeping with guidelines in choosing antihypertensive treatment or new antihyperglycemic drugs showing to protect kidney function. Finally, participants to the survey declare that they are willing to collaborate with nephrologists, mainly in the more advanced stage of DN. KEY WORDS diabetes mellitus; chronic kidney disease; SGLT2 inhibitors; GLP-1 receptor agonist; diabetic nephropathy.
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Hopkins, Melissa, and Raphael Mkuzi. "Clinical Breast Examination and Navigation for Early Cancer Detection in Remote Communities Without an Imaging Screening Option." Journal of Global Oncology 4, Supplement 3 (October 2018): 17s. http://dx.doi.org/10.1200/jgo.18.10190.
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Purpose According to Gazette Review report 2018, Malawi is reportedly the lowest-income country in southeastern Africa. It has a population of 19 million people, of which 70% are women and children. A powerful women’s organization was established to support the increased care and status of the women in the community. Methods Malawi’s Catholic Women’s Organization (CWO), with the Diocese of Mangochi, submitted approval for comprehensive breast examination (CBE) and basic patient navigation training, which was completed in May 2018, that targeted remote communities without resources for early breast cancer detection. The rural population-based data are incomplete, though it is commonly held that the high mortality rate from breast cancer is a result of a lack of education and transportation, cultural stigmas, a lack of support, and other barriers to care. Breast cancer is the most common cause of cancer death in women in Mangochi. The CWO routinely brings outside medical experts to address health care disparity and invited a breast care and cancer registered nurse to address these barriers and provide training in viable and sustainable solutions to overcome these obstacles. Results Trusted community members of an existing women’s organization were trained in breast physiology, anomalies, simplified medical reporting, and navigation to existing facilities for diagnostics and treatment. The following challenges were addressed: remote locations of communities without available imaging, early detection of anomalies without the benefit of local mammography or ultrasound, a poor to nonexistent belief that breast cancer can be cured with early diagnosis, poor to nonexistent communication and transportation means, and late presentation of breast cancer once diagnosed. With training, the following was achieved: education of CWO women of Mangochi in breast exams, reporting, and navigation pathways for diagnosis; breast molds (eight), PowerPoint presentations, and reporting tools were developed as educational tools; PowerPoints were created for breast education, breast anomaly education, CBE, self-breast examination, reporting, data collection, workshop start-up, and patient education; and ongoing support for breast cancer program development. Conclusion Collaborative and multidisciplinary work to mitigate the effects of breast cancer will greatly increase survivability among the women of Mangochi. Targeting the communities through the trusted women who live in the same villages allows for a unique outreach for ongoing, routine education through workshops, CBE, and supported efforts to overcome barriers through planned patient flow pathways to diagnostics and treatment as needed. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
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Vinekar, Anand. "IT‐enabled innovation to prevent infant blindness in rural India: the KIDROP experience." Journal of Indian Business Research 3, no. 2 (June 7, 2011): 98–102. http://dx.doi.org/10.1108/17554191111132215.
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PurposeThe purpose of this paper is to share the IT‐based experience of the first tele‐ophthalmology initiative in infant blindness prevention set up to serve rural India.Design/methodology/approachThe paper describes the two‐plus years of experience of the “Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) initiative” pioneered by one of the leading private tertiary eye care providers in India, Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore. KIDROP was the first tele‐ophthalmology initiative in the world to use trained non‐physicians (“trained technicians”) to capture images of the retinas of infants a few weeks old for a potentially blinding condition called retinopathy of prematurity (ROP) and validated them to store, process and analyze those images at the rural centre itself. In addition, these images were uploaded to a specially customized software‐hardware platform that allowed remotely situated experts to view these images and report real time either on a PC or on their smart phones. The success of this private initiative paved the way for the first public‐private partnership in infant blindness prevention in India which is poised for a statewide and subsequent nationwide expansion.FindingsIn a country like India, where experts are few and far between and found mostly in the big cities, the human ability of “image processing” allows non‐physicians to quickly gain the expertise to screen seemingly difficult cases by using the medium of digital images and a logical algorithm of triage. With an increasing caseload of these conditions, the standard of care can be delivered to the most underserved of areas with this little IT‐based innovation served with dollops of passion.Practical implicationsThe experience of KIDROP is being used as a cornerstone for similar tele‐ophthalmology programs in India and other developing countries with similar demographics. A case for propagating the innovation as an example of “reverse innovation” for more developed economies to emulate has also been made.Originality/valueThe project described in the paper was the first that used non‐physicians to report images of infants for ROP screening, the first ROP network to cater to rural India and is currently the world's largest single hospital‐managed tele‐ROP network.
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Velhner, Maja, Dubravka Potkonjak, Igor Stojanov, Dragica Stojanović, Jelena Petrović, and Gordana Kozoderović. "SALMONELLA CONTROL IN POULTRY PRODUCTION AND RESISTANCE MONITORING IN SERBIA." Archives of Veterinary Medicine 4, no. 2 (September 12, 2019): 11–22. http://dx.doi.org/10.46784/e-avm.v4i2.182.
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A new regulation on Salmonella control in Serbia has been implemented recently. The main goal is to eliminate two most common serovars, Salmonella Enteritidis (SE) and Salmonella Typhimurium (ST) from the poultry farms and to keep the infections caused by these bacteria under control. Experimental work conducted in the past decade in our Institute provided evidence that Salmonella is transmitted easily in a flock and is hard to be eliminated from the farms and hatcheries. This is in good agreement with the published research work by other authors. It is also evident that good management practice and vaccination strategy must be implemented in poultry production. Therefore a simple questionnaire for poultry producers and hatchery experts to provide a quick overview of the management practice was designed in order to find out shortcomings. Salmonella monitoring must be conducted by applying bacteriological examination while serology control is efficient more during exploitation and less during rearing. However, it was found out that bacteriology and serology can be successfully combined in order to estimate the infection status. Although regular bacteriological screening for salmonella is compulsory, some farmers in the country do not pursue this type of analysis at the recommended frequency. Subsequently, those who send the samples for bacteriological examination more often seem to have more salmonella related problems. The most frequent finding of salmonella was in the chickens that died during transportation and the first three days of life and from paper pads. Extremely rare finding of salmonella was in breeding eggs and even rarer in table eggs. If environmental samples from commercial layers are positive, serology testing is recommended. Salmonella isolated from chickens and farm premises in Serbia were susceptible to most antimicrobials tested. Multiple resistances was quite seldom but approximately 20% of the isolates were quinolone resistant. The resistance to fluoroquinolones was not detected. However, Salmonella highly resistant to nalidixic acid with MIC (minimal inhibitory concentration) to NAL > 512 mg/ml were less susceptible to ciprofloxacin, although MICs to CIP were still below the CLSI recommended breakpoint (R > 4 mg/ml). Similar reports were obtained in investigation of salmonella isolated from human stool and the research indicates that the most frequent serovar in the country in humans, food and poultry include Salmonella Enteritidis, Salmonella Typhimurium and Salmonella Infantis.
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Rana, Manish, Rashmi Kundapur, Amir Maroof, Vipul Chaudhari, Amiruddin Kadri, Pradeep Kumar, Sanjay Zodpey, Suneela Garg, Arun Agrawal, and Nirav Bapat. "Way ahead - Post Covid-19 Lockdown in India." Indian Journal of Community Health 32, no. 2 (Supp) (April 20, 2020): 175–83. http://dx.doi.org/10.47203/ijch.2020.v32i02supp.002.
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COVID 19 pandemic is a global health emergency which every country is grappling with since beginning of this year. Countries have their own strategies to cope with the cases and there have been no universal guidelines or recommendations for same. We commend the Hon. Prime Minister for taking pre-emptive timely measures to contain the pandemic at very beginning of infection in India as sustaining containment measures. Even the World Health Organisation (WHO) has acknowledged India’s efforts.
According to experts for effective herd immunity about 60% of population needs to be infected, after which the infection will slow down and cases will continue to occur at low levels. For that we need good data coming from the system and government shall ensure that good data is provided for monitoring and surveillance.
If all the susceptible population is exposed (without any restrictions) then we have an exponential rise in cases and our health system will be overwhelmed probably resulting in large number of deaths. Great Britain went ahead with strategy of developing herd immunity in its population and safeguarding the elderly but after projections from Imperial College COVID 19 team, reversed their strategy to social distancing and saving lives as their health system will be overwhelmed.
COVID 19 is a mild disease for people in the younger age group while in people above the age of 60 years, the mortality is high. So staggered exposure of younger population to infection while safeguarding the elderly population at home will prevent the surge of cases and facilitate gradual development of immunity in population.
Government should also focus on developing a robust health care system for screening and management of cases coupled with gradual relaxation of restriction so that health system is not overwhelmed with management of COVID 19.
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Tacconelli, Evelina, Michael Buhl, Hilary Humphreys, Veronika Malek, Elisabeth Presterl, Jesús Rodriguez-Baño, Margreet C. Vos, Walter Zingg, and Nico T. Mutters. "Analysis of the challenges in implementing guidelines to prevent the spread of multidrug-resistant gram-negatives in Europe." BMJ Open 9, no. 5 (May 17, 2019): e027683. http://dx.doi.org/10.1136/bmjopen-2018-027683.
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ObjectiveThe main objective of the study was to investigate major differences among European countries in implementing infection prevention and control (IPC) measures and reasons for reduced compliance.DesignAn online survey including experts in IPC and a gap analysis were conducted to identify major limitations in implementing IPC guidelines.SettingEurope.Main outcome measuresFour areas were targeted: (1) healthcare structure, (2) finances, (3) culture and (4) education and awareness. Perceived compliance to IPC measures was classified as low (<50%), medium (50% to 80%) and high (>80%). Countries were classified in three regions: North-Western Europe (NWE), Eastern Europe (EE) and Southern Europe (SE).ResultsIn total, 482 respondents from 34 out of 44 (77.3%) European countries participated. Respondents reported availability of national guidelines to control multidrug-resistant Gram-negatives (MDR-GN) in 20 countries (58.0%). According to participants, compliance with IPC measures ranged from 17.8% (screening at discharge) to 96.0% (contact precautions). Overall, three areas were identified as critical for the compliance rate: (1) number of infection control staff, (2) IPC dedicated educational programmes and (3) number of clinical staff. Analysis of reasons for low compliance showed high heterogeneity among countries: participants from NWE and SE deemed the lack of educational programmes as the most important, while those from EE considered structural reasons, such as insufficient single bed rooms or lacking materials for isolation, as main contributors to the low compliance.ConclusionsAlthough national guidelines to reduce the spread of MDR-GN are reported in the majority of the European countries, low compliance with IPC measures was commonly reported. Reasons for the low compliance are multifactorial and vary from region to region. Cross-country actions to reduce the spread of MDR-GN have to consider structural and cultural differences in countries. Locally calibrated interventions may be fruitful in the future.
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Islam, Md Mazharul, Elmoubashar Farag, Ahmad Mahmoudi, Mohammad Mahmudul Hassan, Ehsan Mostafavi, Khalid A. Enan, Hamad Al-Romaihi, Muzzamil Atta, Abdel Rahim M. El Hussein, and Zilungile Mkhize-Kwitshana. "Rodent-Related Zoonotic Pathogens at the Human–Animal–Environment Interface in Qatar: A Systematic Review and Meta-Analysis." International Journal of Environmental Research and Public Health 18, no. 11 (May 31, 2021): 5928. http://dx.doi.org/10.3390/ijerph18115928.
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Rodents are one of the most diversified terrestrial mammals, and they perform several beneficial activities in nature. These animals are also important as carriers of many pathogens with public health importance. The current systematic review was conducted to formulate a true depiction of rodent-related zoonoses in Qatar. Following systematic searches on PubMed, Scopus, Science Direct, and Web of Science and a screening process, a total of 94 published articles were selected and studied. The studied articles reported 23 rodent-related zoonotic pathogens that include nine bacterial, eleven parasitic, and three viral pathogens, from which the frequently reported pathogens were Mycobacterium tuberculosis (32 reports), Escherichia coli (23), and Salmonella spp. (16). The possible pathway of entry of the rodent-borne pathogens can be the land port, seaports, and airport of Qatar through carrier humans and animals, contaminated food, and agricultural products. The pathogens can be conserved internally by rodents, pets, and livestock; by agricultural production systems; and by food marketing chains. The overall estimated pooled prevalence of the pathogens among the human population was 4.27% (95%CI: 4.03–4.51%; p < 0.001) with significant heterogeneity (I2 = 99.50%). The top three highest prevalent pathogens were M.tuberculosis (30.90%; 22.75–39.04%; p < 0.001; I2 = 99.70%) followed by Toxoplasma gondii (21.93%; 6.23–37.61%; p < 0.001; I2 = 99.30%) and hepatitis E virus (18.29%; 11.72–24.86%; p < 0.001; I2 = 96.70%). However, there is a knowledge gap about the listed pathogens regarding the occurrence, transmission pathways, and rodent role in transmission dynamics at the human–animal–environment interface in Qatar. Further studies are required to explore the role of rodents in spreading zoonotic pathogens through the One Health framework, consisting of zoologists, ecologists, microbiologists, entomologists, veterinarians, and public health experts in this country.
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Cook, Nigel S., Konstantinos Kostikas, Beyza Oezel, Sophi Tatlock, Katie Mycock, Tom Gardner, Gerard J. Criner, Pierre-Régis Burgel, and Florian S. Gutzwiller. "PP128 Quantifying The Relative Importance Of Chronic Obstructive Pulmonary Disease Symptoms To Patients." International Journal of Technology Assessment in Health Care 35, S1 (2019): 61. http://dx.doi.org/10.1017/s0266462319002460.
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IntroductionPrevious qualitative research analyzing social media and online community discussions highlighted the symptomatic burden of cough and mucus (sputum), alongside shortness of breath, in patients with chronic obstructive pulmonary disease (COPD). The objective of this study was to determine the relative importance of these symptoms and their consequences (for example, disturbed sleep) to COPD patients, compared with conventional COPD endpoints (lung function and exacerbations).MethodsA total of 1,050 patients (at least 40 years of age) with moderate to severe COPD or chronic bronchitis, and regular symptoms of cough and excess mucus production, are to be recruited through patient advocacy groups (PAGs) from five countries (Australia, France, Japan, the United Kingdom, and the United States; 150 to 400 patients per country). A discrete choice experiment was designed with input from clinical experts and the PAGs, plus scientific advice from the National Institute for Health and Care Excellence (NICE) in the United Kingdom. Patients’ preferences for the conditional relative importance of symptoms and impact of COPD will be quantified based on trade-offs they are willing to make among hypothetical COPD disease state profiles, described by differing attributes and levels. Hierarchical Bayesian analysis with effect-coding parameterization will be undertaken on the choice data to estimate (using Gibbs sampling) the relative value each respondent places on an attribute level.ResultsThe feedback from NICE informed the selection of screening criteria and the statistical analysis plan, as well as the inclusion of a health status measure, the EQ-5D-3L. Qualitative patient interviews and pilot testing of the attributes and levels grid have been completed, informing finalization of the online survey design.ConclusionsPatient preference studies evaluating the relative importance of symptom burden through assessment of disease state preference values are an important new form of patient-based evidence for informing value-based decision making in HTA. The present study should facilitate a more patient-centered approach to developing new treatments for and improving the care of patients with COPD.
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Nwagbara, Ugochinyere Ijeoma, Emmanuella Chinonso Osual, Rumbidzai Chireshe, Obasanjo Afolabi Bolarinwa, Balsam Qubais Saeed, Nelisiwe Khuzwayo, and Khumbulani W. Hlongwana. "Knowledge, attitude, perception, and preventative practices towards COVID-19 in sub-Saharan Africa: A scoping review." PLOS ONE 16, no. 4 (April 19, 2021): e0249853. http://dx.doi.org/10.1371/journal.pone.0249853.
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Background Knowledge, attitudes, perception, and preventative practices regarding coronavirus- 2019 (COVID-19) are crucial in its prevention and control. Several studies have noted that the majority of people in sub-Saharan African are noncompliant with proposed health and safety measures recommended by the World Health Organization (WHO) and respective country health departments. In most sub-Saharan African countries, noncompliance is attributable to ignorance and misinformation, thereby raising questions about people’s knowledge, attitudes, perception, and practices towards COVID-19 in these settings. This situation is particularly of concern for governments and public health experts. Thus, this scoping review is aimed at mapping evidence on the knowledge, attitudes, perceptions, and preventive practices (KAP) towards COVID-19 in sub-Saharan Africa (SSA). Methods Systematic searches of relevant articles were performed using databases such as the EBSCOhost, PubMed, Science Direct, Google Scholar, the WHO library and grey literature. Arksey and O’Malley’s framework guided the study. The risk of bias for included primary studies was assessed using the Mixed Method Appraisal Tool (MMAT). NVIVO version 10 was used to analyse the data and a thematic content analysis was used to present the review’s narrative account. Results A total of 3037 eligible studies were identified after the database search. Only 28 studies met the inclusion criteria after full article screening and were included for data extraction. Studies included populations from the following SSA countries: Ethiopia, Nigeria, Cameroon, Uganda, Rwanda, Ghana, Democratic Republic of Congo, Sudan, and Sierra Leone. All the included studies showed evidence of knowledge related to COVID-19. Eleven studies showed that participants had a positive attitude towards COVID-19, and fifteen studies showed that participants had good practices towards COVID-19. Conclusions Most of the participants had adequate knowledge related to COVID-19. Despite adequate knowledge, the attitude was not always positive, thereby necessitating further education to convey the importance of forming a positive attitude and continuous preventive practice towards reducing contraction and transmission of COVID‐19.
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Goscé, Lara, Gerard J. Abou Jaoude, David J. Kedziora, Clemens Benedikt, Azfar Hussain, Sarah Jarvis, Alena Skrahina, et al. "Optima TB: A tool to help optimally allocate tuberculosis spending." PLOS Computational Biology 17, no. 9 (September 27, 2021): e1009255. http://dx.doi.org/10.1371/journal.pcbi.1009255.
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Approximately 85% of tuberculosis (TB) related deaths occur in low- and middle-income countries where health resources are scarce. Effective priority setting is required to maximise the impact of limited budgets. The Optima TB tool has been developed to support analytical capacity and inform evidence-based priority setting processes for TB health benefits package design. This paper outlines the Optima TB framework and how it was applied in Belarus, an upper-middle income country in Eastern Europe with a relatively high burden of TB. Optima TB is a population-based disease transmission model, with programmatic cost functions and an optimisation algorithm. Modelled populations include age-differentiated general populations and higher-risk populations such as people living with HIV. Populations and prospective interventions are defined in consultation with local stakeholders. In partnership with the latter, demographic, epidemiological, programmatic, as well as cost and spending data for these populations and interventions are then collated. An optimisation analysis of TB spending was conducted in Belarus, using program objectives and constraints defined in collaboration with local stakeholders, which included experts, decision makers, funders and organisations involved in service delivery, support and technical assistance. These analyses show that it is possible to improve health impact by redistributing current TB spending in Belarus. Specifically, shifting funding from inpatient- to outpatient-focused care models, and from mass screening to active case finding strategies, could reduce TB prevalence and mortality by up to 45% and 50%, respectively, by 2035. In addition, an optimised allocation of TB spending could lead to a reduction in drug-resistant TB infections by 40% over this period. This would support progress towards national TB targets without additional financial resources. The case study in Belarus demonstrates how reallocations of spending across existing and new interventions could have a substantial impact on TB outcomes. This highlights the potential for Optima TB and similar modelling tools to support evidence-based priority setting.
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Sotoudehfar, Masoud, Zahra Mazloum Khorasani, Zahra Ebnehoseini, Kobra Etminani, Mahmoud Tara, and Robab bigom Aboutorabi. "DETERMINING THE MINIMUM DATA SET FOR DIABETES REGISTRY." Medical Technologies Journal 1, no. 4 (November 29, 2017): 115–16. http://dx.doi.org/10.26415/2572-004x-vol1iss4p115-116.
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Introduction:
The number of people with diabetes's increasing. More than 220 million people have diabetes, more than 70% of whom live in middle and lower-income countries. already exist many innovations around the world on improving the managed care of diabetes .diabetes registries are one of them. in Iran, development and evaluation of diabetes information systems is one of the most research priorities. since defining health regulations and evaluation of diabetes prevention programs depend on the powerful information system, but in Iran don't exist complete information about incidence and prevalence of diabetes. determine standard data elements (Des) and design diabetes registry is one the most important country requirements. the main purpose of this study is investigating to this subject.
Methods:
This is a descriptive- analytic study. Resource related to diabetes DEs collected from selective minimum data sets. Then diabetes DEs set derived from selective minimum data sets were investigated in focus group sessions with endocrine specialists, health informatics, and health information management. Duplicate DEs were removed and similar DEs were combined. Then seven endocrine specialists evaluated diabetes DEs set. They determine the value of each DEs using the Delphi technique (scores range from 0 to 5). The DEs that received more than 75% of grade 4 and 5 remained in the study. Following the expert opinion, the final version of the diabetes DEs set was designed.
Results:
According to literature review 455 DEs included studying, after Delphi sessions, 293 data element remained to study. Main categories of DEs are:1-patient demographic characterizes (12 DEs), 2-patient referral (5 DEs), 3-diabetes care follow up (15 DEs), 4-physical exam, chief complaint and assessment (40 DEs), 5-history (such as: individual, grow up, family, drug abuse) (10 DEs), 6-pregnancy management (13 DEs), 7-screening (10 DEs), 8-specialty evolutions ( such as: cardiovascular (18 DEs), neuropathy (16 DEs), nephropathy (7 DEs), teeth and mouse (3 DEs), eyes (14 DEs), psychology situation (2 DEs), sexual ability (1 DEs)), 9-laboratory exams (33 DEs), 10-drugs (oral antidiabetics drugs (14 DEs), injectable antidiabetics (7 DEs), lipid (11 DEs), hypertension (20 DEs), anti placates (2 DEs)), cardiac (3 DEs), preparing insulin method (5 DEs)), 11-physical activity (4 DEs),12- diet (12 DEs), 13-education and self care (13 DEs).
Conclusion:
In the study diabetes, DEs set were determined that provide appropriate yield for data gathering and record all required information for diabetes care. Hence diabetes is a chronic disease and Patients suffer from it for years, implementation diabetes DEs can improve documentation and improve diabetes care.
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Liu, Yang, Terry Erwin, and Xingke Yang. "Mordellidae (Coleoptera) Research: A Review Based on the Zoological Record from 1864 through 2013." Insects 9, no. 3 (September 3, 2018): 113. http://dx.doi.org/10.3390/insects9030113.
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Mordellidae (tumbling flower beetles) is a globally distributed family of Coleoptera; it is among the most species-rich families (containing 115 genera and 2308 species described). It is important because of its agroforestry significance and its ecosystem-sustaining attributes. However, the past and current status of Mordellidae research remains unclear. A comprehensive literature review of Mordellidae articles published over the period of 1864–2013 based on the Zoological Record was conducted for the first time. A total of 863 articles were used for analysis after a strict literature search using screening protocols. These articles were then assigned to four categories based on the year of publication, topics/themes, primary authors, and frequently utilized journals for publication of Mordellidae-related articles. The results reveal that: (1) there are three prosperous research periods (1876–1898, 1922–1957, and 1977–2012) for Mordellidae during 1864–2013 that are associated with the active period of three generations of the main taxonomists. However, it is unfortunate that it also demonstrates there is a lack of upcoming researchers to continue the work after the retirement of the current generation, thus action should be taken immediately to promote research on Mordellidae; (2) on average, each primary author published 3.1 papers, but ~35% of the Mordellidae articles were published by less than 3% of the primary authors; (3) researchers tended to mostly publish their articles in local journals of their home countries; (4) more than 90% of the articles pertain to traditional taxonomy, with those of early times generally containing only simple descriptions of the species and the holotypes chosen are sparsely deposited with the researchers or amateurs around the world, thus making them difficult to be checked; (5) nearly half of the studies described Mordellidae species from Palaearctic realm, about one-third of the studies described species in other areas rather than in the fauna in which the authors lived, and about two-fifths of the studies described species from countries outside of the authors’ country of origin. Therefore, the in-depth systematic study of worldwide Mordellidae is required to reconstruct Mordellidae phylogeny and a revision of its classification system with modern methods of comparative morphology, molecular biology, zoogeography, and cladistics. In order to better understand the life stages and biology of Mordellidae insects, more work on Mordellidae ecology should be undertaken to develop strategies for pest control. We hope that this review will provide information to the novice and expert alike in Mordellidae research pertaining to its past and current status, possible future research areas, and attract more attention from the scientific world and renew an interest in Mordellidae research.
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Nash, P., A. Kerschbaumer, D. Van der Heijde, and J. S. Smolen. "AB0352 CONSENSUS STATEMENT: USE OF JAKINIB THERAPY IN IMMUNE MEDIATED INFLAMMATORY DISEASES." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1475–76. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2790.
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Background:Janus kinase inhibitor therapy is approved for use in a variety of Immune mediated inflammatory diseases.Objectives:With 4 agents approved & 1 in development, it is timely to undertake a systematic literature review (SLR) of evidence across indications for efficacy, safety & management issues.Methods:Existing data was evaluated by a steering committee & subsequently by a 25 person expert committee leading to a consensus statement to assist the clinician once the decision had been made to commence a Jakinib. The Committee included patients, rheumatologists, gastroenterologist, haematologist, dermatologist & infectious disease specialists. SLR of Medline, Embase, Cochrane, abstracts from 2018 EULAR & ACR congresses & Epistemonikos identified 1,178 RA & PsA, 128 SLE, & 1339 “other indications” unique references meeting criteria that included randomized & open label clinical trials, registries, phase 4 trials, & meta-analyses. Warnings from regulators issued after the end of the SLR search date were taken into consideration. Cochrane risk of bias tool was used.Results:General principles included (1) shared decision making, (2) adherence to T2T principles, (3) reference to disease specific product information & (4) reference to country/region specific treatment algorithms. Mode of action & indications are discussed & consensus was reached on pre-treatment screening, contra-indications, monitoring, treatment dose, co-medications & adverse effects (see Table 1.), with 80-100% agreement. A research agenda was formulated to update the review as new information becomes available.Table 1.Baseline characteristics of the patients1. Patient history, examination2. Routine Laboratory testing: FBC diff LFTs Renal function, lipids at wk 123. Hepatitis Bs Ag & Ab, core Ab & Hep C ab, & HIV in high risk individuals.4.TB screening as per national guidelines5.Assess & update vaccination status6.Consider VTE risk factors – prior history, familial VTE, use of Cox2 inhibitorsB. Monitoring1. FBC diff LFTs mth 1, & mth 3 with lipids, repeat periodically2. Annual skin examination3. Evaluated response using validated disease specific measures of disease activity – be aware ESR/CRP may be reduced independently of reduction in disease activity or infectionC. Contra-indications (consult label & warnings)1. Severe active (or chronic) infection, including tuberculosis and opportunist infections2. Current malignancies3.Pregnancy & lactation4. Severe organ dysfunction eg severe hepatic disease (Child-Pugh C) or severe renal disease5. Allergy to Jak ihibitor6. History of VTE (relative contra-indication, careful consideration +/_ anticoagulation)Table.Peripheral blood cell counts for each week.D. Adverse Effects.1. Serious infections including opportunist infections, TB, Herpes Zoster, are increased. The risk is lowered with reduction or elimination of concomitant corticosteroid2.Rates of malignancy do not appear elevated although the risk of NMSC may be elevated3. Lymphopenia, neutropenia, elevated liver transaminases, & lipid changes have been noted4. An increased risk of VTE has been reported in a safety trial of tofacitinib & in the placebo-controlled trial period of baricitinib in RA patients5. Elevations of CPK noted but have been rarely associated with clinical events6. Elevations of creatinine noted but not associated with renal failure or hypertensionConclusion:The consensus provides an assessment of evidence for efficacy & safety of an important therapeutic class with guidance on practical management issues.Acknowledgments:Unrestricted grants were provided by Abbvie & Lilly with no input into the planning & development of the recommendations, nor influence or attendance at the meeting nor review of the abstract, with full disclosures from participants & the opportunity to declare any feelings of conflict of interest.Disclosure of Interests:Peter Nash Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, MSD, Novartis, Pfizer Inc, Roche, Sanofi, UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, MSD, Novartis, Pfizer Inc, Roche, Sanofi, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, MSD, Novartis, Pfizer Inc, Roche, Sanofi, UCB, Andreas Kerschbaumer Paid instructor for: Celgene, Speakers bureau: Andreas Kerschbaumer has received lecture fees from Bristol-Myers Squibb, Gilead, Merck Sharp and Dohme and Pfizer., Désirée van der Heijde Consultant of: AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead Sciences, Inc., Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma; Director of Imaging Rheumatology BV, Josef S. Smolen Grant/research support from: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi, Consultant of: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi
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Singh, Reshmi, Heather Scott, Kem Krueger, and Erin J. Bush. "Healthcare Engagement and Encounters in a Rural State: A Focus Group Study." INNOVATIONS in pharmacy 9, no. 1 (January 24, 2018): 5. http://dx.doi.org/10.24926/iip.v9i1.944.
Full textAbstract:
Introduction: Rural populations have many barriers to quality health care including lack of access to primary care and specialty care and a greater likelihood to be underinsured or uninsured. They are also less likely to use preventive screening, or to participate in self-care and engage in their health when compared to urban residents. The purpose of this paper was to describe patients’ healthcare experiences in a rural western state focusing on their healthcare expectations and engagement.
Methods: This qualitative study was conducted using a focus group protocol to elicit rural patients’ healthcare experiences. A purposeful sample of English speaking adult residents from a single county who were willing to discuss their healthcare experiences was included. Patients and community members (21 years and older) were recruited through a local hospital as well as via flyers posted throughout the community. Each audio-recorded group took about two hours. A total of 15 focus groups were conducted to obtain sufficient text for theoretical saturation and thematic analysis. Each group had a range of 3-8 participants. A $25 visa gift card and lunch were provided for each participant as an incentive.
Results: ‘Encounters with Healthcare Professionals’ and ‘Engagement in Health’ were the two dominant dimensions with two themes each. Themes centered around what characterized the best or worst encounters. Trust and Communication - both were based on time spent with the provider and establishment of rapport with the providers. The best encounters were those with health care providers or pharmacists who had sufficient time, adequately explained a diagnosis and new medications did not dismiss patient concerns, and treated individuals with respect. Typical responses describing the worst encounters included examples of misdiagnosis, dismissing patient’s symptoms, healthcare professionals whose attention was not focused on the patient, pushing too many medications, rushed encounters, and providers with poor bedside manner. ‘Engagement in Health’ dimension included the theme of Self-management Process such as taking things one day at a time, taking medication daily, and good stress management. The second theme was Barriers to Engagement and included issues regarding inclement weather, lack of sidewalks, stress, lack of time and the financial constraints for eating healthy, going to a gym, and/or problems with payer source. Participants also described a number of technological tools they utilized to engage with their healthcare including appointment reminders, health-based websites, symptom trackers, online portal systems for health care records, and online bill pay. Many used apps on smart phones to track calories and exercise as well as online community groups to encourage fitness.
Conclusions: The results from this study highlighted some of the gaps in healthcare for rural areas. A large number of participants indicated a lack of trust of their providers and only a few had any communicative interaction with their pharmacist. Future studies could evaluate training designed to teach healthcare providers and pharmacists how to engage patients in their own care. Use of technology by healthcare providers might be another way to improve healthcare engagement.
Conflict of Interest "We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties".
Acknowledgements: This study was funded by the University of Wyoming College of Health Sciences (UW CHS) Faculty Seed Grant awarded to first author Dr. Singh in April 2015. Interim results of this study have been presented at the Health Literacy Research Conference (HARC) in November 2015.
Treatment of Human Subjects: IRB review/approval required and obtained
Type: Original Research
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Warren, Robert, and Donald Kerwin. "The 2,000 Mile Wall in Search of a Purpose: Since 2007 Visa Overstays have Outnumbered Undocumented Border Crossers by a Half Million." Journal on Migration and Human Security 5, no. 1 (March 2017): 124–36. http://dx.doi.org/10.1177/233150241700500107.
Full textAbstract:
The Trump administration has made the construction of an “impregnable” 2,000-mile wall across the length of the US-Mexico border a centerpiece of its executive orders on immigration and its broader immigration enforcement strategy. This initiative has been broadly criticized based on: • Escalating cost projections: an internal Department of Homeland Security (DHS) study recently set the cost at $21.6 billion over three and a half years; • Its necessity given the many other enforcement tools — video surveillance, drones, ground sensors, and radar technologies — and Border Patrol personnel, that cover the US-Mexico border: former DHS Secretary Michael Chertoff and other experts have argued that a wall does not add enforcement value except in heavy crossing areas near towns, highways, or other “vanishing points” (Kerwin 2016); • Its cost-effectiveness given diminished Border Patrol apprehensions (to roughly one-fourth the level of historic highs) and reduced illegal entries (to roughly one-tenth the 2005 level according to an internal DHS study) (Martinez 2016); • Its efficacy as an enforcement tool: between FY 2010 and FY 2015, the current 654-mile pedestrian wall was breached 9,287 times (GAO 2017, 22); • Its inability to meet the administration's goal of securing “operational control” of the border, defined as “the prevention of all unlawful entries to the United States” (White House 2017); • Its deleterious impact on bi-national border communities, the environment, and property rights (Heyman 2013); and • Opportunity costs in the form of foregone investments in addressing the conditions that drive large-scale migration, as well as in more effective national security and immigration enforcement strategies. The Center for Migration Studies (CMS) has reported on the dramatic decline in the US undocumented population between 2008 and 2014 (Warren 2016). In addition, a growing percentage of border crossers in recent years have originated in the Northern Triangle states of Central America (CBP 2016). These migrants are fleeing pervasive violence, persecution, and poverty, and a large number do not seek to evade arrest, but present themselves to border officials and request political asylum. Many are de facto refugees, not illegal border crossers. This report speaks to another reason to question the necessity and value of a 2,000-mile wall: It does not reflect the reality of how the large majority of persons now become undocumented. It finds that two-thirds of those who arrived in 2014 did not illegally cross a border, but were admitted (after screening) on non-immigrant (temporary) visas, and then overstayed their period of admission or otherwise violated the terms of their visas. Moreover, this trend in increasing percentages of visa overstays will likely continue into the foreseeable future. The report presents information about the mode of arrival of the undocumented population that resided in the United States in 2014. To simplify the presentation, it divides the 2014 population into two groups: overstays and entries without inspection (EWIs). The term overstay, as used in this paper, refers to undocumented residents who entered the United States with valid temporary visas and subsequently established residence without authorization. The term EWI refers to undocumented residents who entered without proper immigration documents across the southern border. The estimates are based primarily on detailed estimates of the undocumented population in 2014 compiled by CMS and estimates of overstays for 2015 derived by DHS. Major findings include the following: • In 2014, about 4.5 million US residents, or 42 percent of the total undocumented population, were overstays. • Overstays accounted for about two-thirds (66 percent) of those who arrived (i.e., joined the undocumented population) in 2014. • Overstays have exceeded EWIs every year since 2007, and 600,000 more overstays than EWIs have arrived since 2007. • Mexico is the leading country for both overstays and EWIs; about one-third of undocumented arrivals from Mexico in 2014 were overstays. • California has the largest number of overstays (890,000), followed by New York (520,000), Texas (475,000), and Florida (435,000). • Two states had 47 percent of the 6.4 million EWIs in 2014: California (1.7 million) and Texas (1.3 million). • The percentage of overstays varies widely by state: more than two-thirds of the undocumented who live in Hawaii, Massachusetts, Connecticut, and Pennsylvania are overstays. By contrast, the undocumented population in Kansas, Arkansas, and New Mexico consists of fewer than 25 percent overstays.
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"The significance of Environmental Agencies in the Environmental Impact Assessment process." Earth & Environmental Science Research & Reviews 3, no. 4 (November 11, 2020). http://dx.doi.org/10.33140/eesrr.03.04.05.
Full textAbstract:
Currently, every country is striving to realize development for its people. Thus, to achieve this the construction of various projects are necessary for the realization of socioeconomic and political development of any country. However, the development of the projects is associated with various environmental challenges that may affect the entire society and the environment. Thus, to cater that there is the need for conducting Environmental Impact Assessment (EIA) that is a tool used to identify the environmental, social and economic impacts of a project before decision-making. To achieve the EIA process, there are Environmental Agencies (EAs) that are designed for dealing with all environment-related issues in the relevant country. Thus, this paper aims at providing the key significances provided by the EAs in the EIA process. The following significances are discussed in this paper: formulation of policies, laws and regulations related to EIA; authorization and certification of the experts or firms of expert for EIA process; registration and screening of the projects for EIA; reviewing Environmental Impacts Statements or reports; preparation of the EIA certificates for approval or disapproval of the projects; conducting environmental monitoring and auditing; and monitoring of the implementation of the decommissioning.