scholarly journals Recommendations for the treatment of children with radiotherapy in low- and middle-income countries (LMIC): A position paper from the Pediatric Radiation Oncology Society (PROS-LMIC) and Pediatric Oncology in Developing Countries (PODC) working groups of

2017 ◽  
Vol 64 ◽  
pp. e26903 ◽  
Author(s):  
Jeannette Parkes ◽  
Clayton Hess ◽  
Hester Burger ◽  
Yavuz Anacak ◽  
Verity Ahern ◽  
...  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
George Lameck Chimatiro ◽  
Anthea J. Rhoda

Abstract Background Stroke is a major public health concern, affecting millions of people worldwide. Care of the condition however, remain inconsistent in developing countries. The purpose of this scoping review was to document evidence of stroke care and service delivery in low and middle-income countries to better inform development of a context-fit stroke model of care. Methods An interpretative scoping literature review based on Arksey and O’Malley’s five-stage-process was executed. The following databases searched for literature published between 2010 and 2017; Cochrane Library, Credo Reference, Health Source: Nursing/Academic Edition, Science Direct, BioMed Central, Cumulative Index to Nursing and Allied Health Literature (CINNAHL), Academic Search Complete, and Google Scholar. Single combined search terms included acute stroke, stroke care, stroke rehabilitation, developing countries, low and middle-income countries. Results A total of 177 references were identified. Twenty of them, published between 2010 and 2017, were included in the review. Applying the Donebedian Model of quality of care, seven dimensions of stroke-care structure, six dimensions of stroke care processes, and six dimensions of stroke care outcomes were identified. Structure of stroke care included availability of a stroke unit, an accident and emergency department, a multidisciplinary team, stroke specialists, neuroimaging, medication, and health care policies. Stroke care processes that emerged were assessment and diagnosis, referrals, intravenous thrombolysis, rehabilitation, and primary and secondary prevention strategies. Stroke-care outcomes included quality of stroke-care practice, functional independence level, length of stay, mortality, living at home, and institutionalization. Conclusions There is lack of uniformity in the way stroke care is advanced in low and middle-income countries. This is reflected in the unsatisfactory stroke care structure, processes, and outcomes. There is a need for stroke care settings to adopt quality improvement strategies. Health ministry and governments need to decisively face stroke burden by setting policies that advance improved care of patients with stroke. Stroke Units and Recombinant Tissue Plasminogen Activator (rtPA) administration could be considered as both a structural and process necessity towards improvement of outcomes of patients with stroke in the LMICs.


2016 ◽  
Vol 8 (9) ◽  
pp. 183 ◽  
Author(s):  
Kathryn Hurt ◽  
Rebekah J. Walker ◽  
Jennifer A. Campbell ◽  
Leonard E. Egede

<p>The purpose of this review was to determine whether mHealth interventions were effective in low- and middle-income countries in order to create a baseline for the evidence to support mHealth in developing countries. Studies were identified by searching Medline on 02 October 2014 for articles published in the English language between January 2000 and September 2014. Inclusion criteria were: 1) written in English, 2) completion of an mHealth intervention in a low or middle-income country, 3) measurement of patient outcomes, and 4) participants 18 years of age or older. 7,920 titles were reviewed and 7 were determined eligible based on inclusion criteria. Interventions included a cluster randomized trial, mixed methods study, retrospective comparison of an opt-in text message program, a two-arm proof of concept, single arm trial, a randomized trial, and a single subject design. Five out of seven of the studies showed significant difference between the control and intervention. Currently there is little evidence on mHealth interventions in developing countries, and existing studies are very diverse; however initial studies show changes in clinical outcomes, adherence, and health communication, including improved communication with providers, decrease in travel time, ability to receive expert advice, changes in clinical outcomes, and new forms of cost-effective education.<em> </em>While this initial review is promising, more evidence is needed to support and direct system-level resource investment.</p>


2020 ◽  
pp. 104345422091970
Author(s):  
Sara W. Day ◽  
Courtney E. Sullivan ◽  
Lisa Morrissey ◽  
Linda Abramovitz ◽  
Lorena Segovia ◽  
...  

The Nursing Working Group of the International Society of Pediatric Oncology developed baseline standards for pediatric oncology nursing care in low- and middle-income countries. The standards represent the foundational support required to provide quality nursing care and address barriers such as inadequate staffing, lack of support, limited access to education, and unsafe nursing environments. The purpose of the current study was to develop and validate an instrument to accurately measure the standards. Content validity was assessed by a panel of expert pediatric oncology nurses from all geographical regions of the World Health Organization. The experts were informed about the study’s purpose and provided the publications used to develop the instrument. The experts rated how well each criterion measured the corresponding standard by using a 4-point scale. A content validity index (CVI) was computed by using the percentage of total standards given a score of 3 or 4 by the experts. A CVI of .98 was obtained from the panel’s evaluation. A CVI of more than .80 is recommended for a newly developed instrument. On the basis of the panel’s recommendations, minor modifications were made to the instrument. We developed and validated the content of an instrument to accurately measure baseline standards for pediatric oncology nursing care. This instrument will aid future research on the effect of nursing standards on clinical outcomes, including mortality and abandonment of treatment, with the potential to influence health policy decisions and improve nursing support in low- and middle-income countries.


Author(s):  
Suji Lee ◽  
Kavyasree Chintalapudi ◽  
Abraham K. Badu-Tawiah

Early disease diagnosis is necessary to enable timely interventions. Implementation of this vital task in the developing world is challenging owing to limited resources. Diagnostic approaches developed for resource-limited settings have often involved colorimetric tests (based on immunoassays) due to their low cost. Unfortunately, the performance/sensitivity of such simplistic tests are often limited and significantly hinder opportunities for early disease detection. A new criterion for selecting diagnostic tests in low- and middle-income countries is proposed here that is based on performance-to-cost ratio. For example, modern mass spectrometry (MS) now involves analysis of the native sample in the open laboratory environment, enabling applications in many fields, including clinical research, forensic science, environmental analysis, and agriculture. In this critical review, we summarize recent developments in chemistry that enable MS to be applied effectively in developing countries. In particular, we argue that closed automated analytical systems may not offer the analytical flexibility needed in resource-limited settings. Alternative strategies proposed here have potential to be widely accepted in low- and middle-income countries through the utilization of the open-source ambient MS platform that enables microsampling techniques such as dried blood spot to be coupled with miniature mass spectrometers in a centralized analytical platform. Consequently, costs associated with sample handling and maintenance can be reduced by >50% of the total ownership cost, permitting analytical measurements to be operated at high performance-to-cost ratios in the developing world. Expected final online publication date for the Annual Review of Analytical Chemistry, Volume 14 is August 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.


2014 ◽  
Vol 37 (4) ◽  
pp. E36-E47 ◽  
Author(s):  
Julia M. Challinor ◽  
Rachel Hollis ◽  
Carola Freidank ◽  
Cathérine Verhoeven

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