Clinical Field Testing of Polyurethane Feet for Trans-Tibial Amputees in Tropical Low-Income Countries

2006 ◽  
Vol 30 (2) ◽  
pp. 182-194 ◽  
Author(s):  
J. Steen Jensen ◽  
R. Nilsen ◽  
N. H. Thanh ◽  
A. Saldana ◽  
C. Hartz
Keyword(s):  
Failure Rate ◽  
Low Income ◽  
Developing World ◽  
Compliance Rate ◽  
Field Testing ◽  
Low Income Countries ◽  
Controlled Study ◽  
Tropical Areas ◽  
Prospective Controlled Study ◽  
Better Than

In a prospective controlled study, 172 polyurethane feet of different designs were fitted to 155 amputees with trans-tibial prostheses. These were followed in respect of their durability. The amputee compliance was in general good, and 87% were satisfied with their device. After 18 months the failure rate of 20% with the CIREC spring-blade foot was significantly better than the others, but poorer craftsmanship, higher complaint rate and lower compliance rate cast some doubt on the results. The results with the conventional SACH foot constructions with polyurethane as filling and covering materials were so poor after 18 months that their use cannot be recommended in tropical areas of the developing world.

scholarly journals Clinical Field Testing of Vulcanized Rubber Feet for Trans-Tibial Amputees in Tropical Low-Income Countries

2006 ◽  
Vol 30 (2) ◽  
pp. 195-212 ◽  
Author(s):  
J. Steen Jensen ◽  
R. Nilsen ◽  
J. Zeffer ◽  
J. Fisk ◽  
C. Hartz
Keyword(s):  
Failure Rate ◽  
Low Income ◽  
Field Testing ◽  
Low Income Countries ◽  
Controlled Study ◽  
Sandwich Construction ◽  
Vulcanized Rubber ◽  
Prospective Controlled Study ◽  
Better Than

In a prospective, controlled study, 186 prosthetic rubber feet of different designs were fitted to amputees with trans-tibial prostheses. There were 158 amputees available for follow-up. The amputee compliance was good and 89% were satisfied with their device. After 18 months of use one VI-Solid rubber foot from VVAF in Cambodia had failed, as compared to 11% failures with the same foot with a heel cavity, 3% with the EB-1 sandwich construction from POF in Vietnam, all performing significantly better than the 62% encountered with the vulcanized rubber foot from ICRC in Cambodia; the latter representing half of the feet failing in amputees walking bare-footed. Nearly all failures were located at the foot-sole or the keel. The failure rate was 20% for the HI-Cambodia foot after 12 months. After 24 months of use, still only one VI-Solid rubber foot had failed and this foot design was found superior to the others in regard of durability.

scholarly journals Clinical Field Testing of Vulcanized Jaipur Rubber Feet for Trans-Tibial Amputees in Low-Income Countries

2006 ◽  
Vol 30 (3) ◽  
pp. 225-236 ◽  
Author(s):  
J. Steen Jensen ◽  
Wilfried Raab
Keyword(s):  
Low Income ◽  
Developing World ◽  
Field Testing ◽  
Low Income Countries ◽  
Prosthetic Foot ◽  
Tropical Areas ◽  
User Compliance

The purpose of this study was to check out the performance and durability of vulcanized Jaipur rubber feet in tropical areas of the developing world. Forty-one MUKTI and 40 NISHA feet were followed for 16 (8 – 17) months. The user compliance was high and nearly all were satisfied. Failure of the prosthetic foot with the need for exchange at the end of the study amounted to 27% (22/81), which is equivalent to a mixed series of rubber feet previously reported (Jensen et al. 2006b ). Failures were mostly related to skin fracture and gliding between sponge rubber layers of the heel block.

scholarly journals P.028 Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions

2017 ◽  
Vol 44 (S2) ◽  
pp. S20-S20
Author(s):  
S Wang ◽  
RT Muir ◽  
BC Warf
Keyword(s):  
Low Income ◽  
Developing World ◽  
Pediatric Neurosurgery ◽  
Cost Effective ◽  
Global Surgery ◽  
Low Income Countries ◽  
Global Burden ◽  
Pediatric Hydrocephalus ◽  
Cost Effective Treatment ◽  
Education Gaps

Background: Pediatric hydrocephalus is one of the most common neurosurgical conditions and is a major contributor to the global burden of surgically treatable diseases. Methods: The authors conducted a literature review around the topic of pediatric hydrocephalus in the context of global surgery, the unique challenges to creating access to care in low-income countries, and current international efforts to address the problem. Results: Developing countries face the greatest burden of pediatric hydrocephalus due to high birth rates and greater risk of neonatal infections. This burden is related to more general global health challenges, including malnutrition, infectious diseases, maternal and perinatal risk factors, and education gaps. Unique challenges pertaining to the treatment of hydrocephalus in the developing world include a preponderance of postinfectious hydrocephalus, limited resources, and restricted access to neurosurgical care. In the 21st century, several organizations have established programs that provide hydrocephalus treatment and neurosurgical training in Africa, Central and South America, Haiti, and Southeast Asia. These international efforts have employed various models to achieve the goals of providing safe, sustainable, and cost-effective treatment. Conclusions: Broader commitment from the pediatric neurosurgery community, increased funding, public education, surgeon training, and ongoing surgical innovation will be needed to meaningfully address the global burden of untreated hydrocephalus.

scholarly journals Clinical field-testing of ATLAS prosthetic system for trans-tibial amputees

2002 ◽  
Vol 26 (2) ◽  
pp. 86-92 ◽  
Author(s):  
J. S. Jensen ◽  
W. Raab
Keyword(s):  
Patient Safety ◽  
Failure Rate ◽  
Field Testing ◽  
Tropical Areas ◽  
In Trans

The ATLAS prosthetic system was tested on 81 trans-tibial amputees in two tropical areas and followed for about two years. At the conclusion 19% (15/81) had given up its use; mostly because of unsatisfactory socket fit, but in 7% (6/81) system related failures were the cause of non-compliance; mostly because of a shrieking noise from the shin-foot piece during use. System related failures were encountered in 62% (41/66) of users; the most serious threat to patient safety was fractures of the shank in 39% (26/66) and badly worn feet in 12% (8/66). With a failure rate of about 41% after one and a half years the ATLAS system is considered unacceptable for general use in trans-tibial amputees.

scholarly journals Clinical Field Testing of Vulcanized Jaipur Rubber Feet for Trans-Tibial Amputees in Low-Income Countries

2007 ◽  
Vol 31 (1) ◽  
pp. 105-115 ◽  
Author(s):  
J. Steen Jensen ◽  
Wilfried Raab
Keyword(s):  
Low Income ◽  
Field Testing ◽  
Low Income Countries

The publishers would like to apologise for an error that occured in the order of figures in the above mentioned paper in Volume 30, Issue 3 of Prosthetics and Orthotics International. The paper should appear as follows.

Developing Training Tools for Clinicians in LICs: Using Hidden Markov Modeling to Study the Decision-Making Strategies of Expert and Novice Prosthetists

2020 ◽  
Author(s):  
Pratima Saravanan ◽  
Michael Walker ◽  
Jessica Menold
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Low Income ◽  
Decision Support Tool ◽  
Low Income Countries ◽  
Controlled Study ◽  
Clear Understanding ◽  
Care Providers ◽  
Support Tool ◽  
Expert And Novice

Abstract Approximately, 40 million amputees reside in the rural parts of Low-Income Countries (LICs), and 95% of this population do not have proper access to prosthetic devices and rehabilitation services. A proper prosthetic prescription requires a clear understanding of the patient’s ambulation, goals, cultural and societal norms, locally available prosthetic materials, etc., which can be accomplished only by a local prosthetist. However, due to the lack of prosthetic schools and training centers in LICs, the rural parts lack well-trained amputee care providers. Hence there is a need to educate the prosthetists and prosthetic technicians in the LIC, specifically in the rural regions. To accomplish this, the current research proposes a decision-support tool to aid decision-making during prescription and educate prosthetists. A controlled study was conducted with expert and novice prosthetists to compare effective decision-making strategies. Results suggest that experts leverage distinct decision-making strategies when prescribing prosthetic and orthotic devices; in comparison, novices exhibited less consistent patterns of decision-making tendencies. By modeling the decision-making strategies of expert prosthetists, this work lays the foundation to develop an automated decision support tool to support decision-making for prosthetists in LICs, improving overall amputee care.

Addressing Supply Side Barriers to Introduction of New Vaccines to the Developing World

2009 ◽  
Vol 35 (2-3) ◽  
pp. 415-441 ◽  
Author(s):  
Sean McElligott
Keyword(s):  
Low Income ◽  
Developing World ◽  
Low Income Countries ◽  
Supply Side ◽  
Significant Morbidity ◽  
Product Availability ◽  
Life Saving ◽  
Potential Adaptation ◽  
Vaccine Availability ◽  
New Vaccines

AbstractLow-income countries experience significant morbidity and mortality from avoidable infectious diseases, but all too often life-saving innovative vaccines are only available in high-income markets. The Generic Open (GO) license proposal posits that an increase in generic entry will lower prices through greater competition and increase vaccine availability in low-income markets. However, the GO proposal, as currently structured, is unlikely to function as envisioned in the vaccine market. Innovator vaccine firms will be unlikely to participate in the program because the payments in the GO license do not adequately compensate firms for all lost profits. Additionally, the price reductions from competitive entry are unlikely because the vaccine market is already characterized by low, and in some cases unsustainable, prices. I propose a potential adaptation where developing world vaccine manufacturers serve as contract suppliers to innovator firms for a given period of time. Donors could also share in the initial costs of capacity with the developing world manufacturers. Sales of developing world manufactured vaccines would be sold solely to UN procurement agencies under a confidential pricing or rebate system. This would increase overall product availability, maintain market separation, and decrease costs to UN agencies.

Formal assessment of teamwork among cancer health care professionals in 3 large tertiary centers in Nigeria.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18126-e18126 ◽  
Author(s):  
Abiola Falilat Ibraheem ◽  
Olutosin Alaba Awolude ◽  
Myhammad-yaqub Murtazha Habeebu ◽  
Anthonia Chima Sowunmi ◽  
Popoola Abiodun Olaniyi ◽  
...  
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Professionals ◽  
Cancer Care ◽  
Developing World ◽  
Low Income Countries ◽  
Major Barrier ◽  
Optimal Outcomes ◽  
Quality Cancer Care ◽  
Key Stakeholders

e18126 Background: Cancer is fast becoming a common cause of death in developing world. Over the last decade, there have been strategies to bring quality cancer care to underserved patients around the world. In low-income countries, poor utilization of principles of teamwork is a major barrier to achieving quality services. The intent of this study is to assess teamwork as perceived by the health care workers caring for cancer patients Methods: We conducted a survey among health care professionals involved in cancer care in 3 tertiary centers in the southwestern part of Nigeria from July to November 2016. Respondents rated teamwork using the previously validated ÒSafety Attitudes QuestionnaireÓ. For this analysis we focused on the teamwork climate subscale. This subscale is scored on a scale of 0-100 with mean (SD) values,in US ambulatory population of 69.7 (17). We compared ratings by professionals using analysis of variance Results: Overall 373 professionals completed the survey: Physicians (47%), nurses (14%), pharmacists (6%) and others (33%). Some results are shown in table Conclusions: Cancer care is complex and depends on teamwork amongst health care professionals to achieve optimal outcomes. While overall teamwork scores was consistent with US ambulatory studies , there are important variations that provide targets for intervention. Physicians rated teamwork poorly both intra and inter professionally. Pharmacists rated inter professional teamwork with nurses particularly poorly. Further data on additional subscales of the instrument and by individual centers will be presented. Efforts to transform cancer care need to focus on building trust among the key stakeholders. This is true in developing world where there is a need to maximize the use of limited resources to improve patient outcomes. [Table: see text]

scholarly journals Quality benchmark for trans-tibial prostheses in low-income countries

2005 ◽  
Vol 29 (1) ◽  
pp. 53-58 ◽  
Author(s):  
J. Steen Jensen ◽  
Rune Nilsen ◽  
John Zeffer
Keyword(s):  
Patient Satisfaction ◽  
Patient Compliance ◽  
Low Income ◽  
Historical Data ◽  
Field Testing ◽  
International Committee ◽  
Low Income Countries ◽  
Red Cross ◽  
Assembly System ◽  
Technical Performance

Based on four series of patients (N = 141) participating in clinical field testing of prosthetic feet and all provided with trans-tibial prostheses in accordance with the polypropylene component and assembly system developed by the International Committee of the Red Cross (ICRC) a series of quality benchmarks was developed and tested against historical data. The patient compliance demands were set for walking > 1km at 90 ± 10%, non-users at 5 ± 5%, discomfort at 10 ± 10%, pain at 10 ± 10%, and patient satisfaction at 90 ± 10%. The technical performance demands were set for good socket fit at 60 ± 10%, misalignment at 15 ± 10%, insufficient craftsmanship at 10 ± 10%, and requirements for socket change at 10 ± 10%.

SSA’s IPP Policy Dilemma

2020 ◽  
pp. 175-201
Author(s):  
James Leigland
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Developing World ◽  
Public Private Partnership ◽  
Low Income Countries ◽  
Multilateral Development Banks ◽  
Private Partnership ◽  
Development Finance ◽  
Generating Capacity ◽  
Development Banks

This chapter focuses on independent power producer (IPP) projects, by far the most successful kind of public–private partnership (PPP) in the developing world. These projects generate more investment in developing countries than all other forms of PPP combined. However, the development community exhibits ambivalence towards independent power producer (IPP) projects. They are supposed to work best in power sectors that are being reformed, where user tariffs are cost reflective and off-taker utilities are creditworthy. Yet, in practice, many influential multilateral development banks (MDBs), development finance institutions (DFIs), and donors are encouraging the use of IPP projects virtually everywhere in the developing world, whether or not sector reforms are taking place. This reflects a policy dilemma: most low-income countries desperately need more generating capacity, but should the development of IPP projects be delayed until progress is made on broader sector reforms? How can these policy dilemmas be resolved? Who can make that happen?

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