Novel educational adjuncts for the World Health Organization Basic Emergency Care Course: A prospective cohort study

BACKGROUND Health systems in low- and middle-income countries face considerable challenges in providing high-quality accessible care. eHealth has had mounting interest as a possible solution given the unprecedented growth in mobile phone and internet technologies in these locations; however, few apps or software programs have, as of yet, gone beyond the testing phase, most downloads are never opened, and consistent use is extremely rare. This is believed to be due to a failure to engage and meet local stakeholder needs and the high costs of software development. OBJECTIVE World Health Organization Basic Emergency Care course participants requested a mobile point-of-care adjunct to the primary course material. Our team undertook the task of developing this solution through a community-based participatory model in an effort to meet trainees’ reported needs and avoid some of the abovementioned failings. We aimed to use the well-described Lean software development strategy—given our familiarity with its elements and its ubiquitous use in medicine, global health, and software development—to complete this task efficiently and with maximal stakeholder involvement. METHODS From September 2016 through January 2017, the Basic Emergency Care app was designed and developed at the University of California San Francisco. When a prototype was complete, it was piloted in Cape Town, South Africa and Dar es Salaam, Tanzania—World Health Organization Basic Emergency Care partner sites. Feedback from this pilot shaped continuous amendments to the app before subsequent user testing and study of the effect of use of the app on trainee retention of Basic Emergency Care course material. RESULTS Our user-centered mobile app was developed with an iterative participatory approach with its first version available within 6 months and with high acceptance—95% of Basic Emergency Care Course participants felt that it was useful. Our solution had minimal direct costs and resulted in a robust infrastructure for subsequent assessment and maintenance and allows for efficient feedback and expansion. CONCLUSIONS We believe that utilizing Lean software development strategies may help global health advocates and researchers build eHealth solutions with a process that is familiar and with buy-in across stakeholders that is responsive, rapid to deploy, and sustainable.

Download Full-text

Association between NT-proBNP Level and the Severity of COVID-19 Pneumonia

Cardiology Research and Practice ◽

10.1155/2021/5537275 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Lan Wang ◽

Fei Chen ◽

Lin Bai ◽

Lang Bai ◽

Zhixin Huang ◽

...

Keyword(s):

Cohort Study ◽

Mortality Rate ◽

World Health Organization ◽

Potential Risk ◽

World Health ◽

Single Centre ◽

Radiographic Findings ◽

Natural Logarithm ◽

The World ◽

Health Organization

In this study, we investigated the association between the plasma NT-proBNP level at admission and the severity of COVID-19 pneumonia. For this retrospective, single-centre cohort study, we enrolled consecutive patients from February 9 to March 4, 2020, in a COVID-19 ward of Hubei General Hospital (East Branch) in Wuhan, which is a government-assigned centre for COVID-19 treatment. Diagnosis was confirmed by microbiological and radiographic findings following the interim guidance of the World Health Organization (WHO). A total of 91 (92.9%) patients were finally included in this study. The median age of the patients was 61 years (IQR, 47–69), and 39 (43.0%) of them were male. Two cases of death were reported (2.3%). Twenty-three patients (25.3%) had NT-proBNP levels above 300 pg/ml. Higher NT-proBNP levels were associated with worse PSI and CT scores. The natural logarithm of the NT-proBNP level was positively correlated with the PSI and CT scores (PSI score: rS = 0.396, P = 0.001 ; CT score: rS = 0.440, P < 0.001 ). Patients with NT-proBNP ≥300 pg/ml showed a potential risk for higher mortality than patients with NT-proBNP <300 pg/ml (mortality rate, 8.7% vs. 0%; P = 0.062 ). The plasma NT-proBNP level of COVID-19 patients was significantly related to the severity of pneumonia.

Download Full-text

The impact of the World Health Organization 8-steps in wheelchair service provision in wheelchair users in a less resourced setting: a cohort study in Indonesia

BMC Health Services Research ◽

10.1186/s12913-016-1268-y ◽

2015 ◽

Vol 16 (1) ◽

Cited By ~ 26

Author(s):

Maria L. Toro ◽

Chika Eke ◽

Jonathan Pearlman

Keyword(s):

Cohort Study ◽

World Health Organization ◽

Service Provision ◽

World Health ◽

Wheelchair Users ◽

The World ◽

Health Organization ◽

The Impact

Download Full-text

Nurses responding to the World Health Organization (WHO) priority for emergency care systems for universal health coverage

International Emergency Nursing ◽

10.1016/j.ienj.2020.100876 ◽

2020 ◽

Vol 50 ◽

pp. 100876

Author(s):

Kate Curtis ◽

Petra Brysiewicz ◽

Ramon Z. Shaban ◽

Margaret Fry ◽

Julie Considine ◽

...

Keyword(s):

World Health Organization ◽

Universal Health Coverage ◽

Emergency Care ◽

World Health ◽

Health Coverage ◽

Emergency Care Systems ◽

The World ◽

Care Systems ◽

Health Organization ◽

Universal Health

Download Full-text

Results from a World Health Organization pilot of the Basic Emergency Care Course in Sub Saharan Africa

PLoS ONE ◽

10.1371/journal.pone.0224257 ◽

2019 ◽

Vol 14 (11) ◽

pp. e0224257 ◽

Cited By ~ 2

Author(s):

Andrea G. Tenner ◽

Hendry R. Sawe ◽

Stas Amato ◽

Joseph Kalanzi ◽

Muhumpu Kafwamfwa ◽

...

Keyword(s):

World Health Organization ◽

Emergency Care ◽

Sub Saharan Africa ◽

World Health ◽

Sub Saharan ◽

Health Organization ◽

Care Course

Download Full-text

Breastfeeding among Women with Rheumatoid Arthritis Compared with the General Population: Results from a Nationwide Prospective Cohort Study

The Journal of Rheumatology ◽

10.3899/jrheum.180805 ◽

2019 ◽

Vol 46 (9) ◽

pp. 1067-1074 ◽

Cited By ~ 3

Author(s):

Hilal Ince-Askan ◽

Johanna M.W. Hazes ◽

Radboud J.E.M. Dolhain

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

General Population ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Reference Population ◽

World Health ◽

General Reference ◽

Number Of Patients ◽

Health Organization

Objective.The World Health Organization recommends that infants be exclusively breastfed until the age of 6 months. The first objective was to compare breastfeeding frequencies and time of cessation between women with rheumatoid arthritis (RA) and the general population. The second objective was to identify why patients with RA discontinue breastfeeding.Methods.This study was embedded in the Pregnancy-induced Amelioration of Rheumatoid Arthritis (PARA) study, a nationwide prospective cohort study. From 2002 to 2008, a total of 249 pregnancies were followed from pregnancy until 6 months postpartum. Data on lactation and medication use were collected. Proportion tests were used to compare percentages of breastfeeding between the study population and the general/reference population.Results.At 4–6, 12, and 26 weeks postpartum, 43%, 26%, and 9% of the RA patients breastfed their offspring, respectively, compared with 63%, 46%, and 41% in the general population, respectively (p < 0.001). The main reason for women to discontinue breastfeeding was the restart of medication (n = 129, 57.8%). Nevertheless, more than 40% of these patients restarted medication that was considered compatible with breastfeeding.Conclusion.This large prospective study demonstrates that RA is associated with lower proportions of women breastfeeding their offspring and earlier cessation compared with the general population. A considerable number of patients discontinued breastfeeding so that they could start medication, even though many of the medications are considered safe to use during lactation. Using the results of this study, intervention strategies supporting RA patients who wish to breastfeed may be developed.

Download Full-text