scholarly journals Asia Pacific Sepsis Alliance; Critical Care Resources and Disaster Preparedness Survey 2020 Results (March 2021)

2021 ◽  
Author(s):  
Brett John Abbenbroek ◽  
Simon Finfer ◽  
Naomi Hammond ◽  
Bharath Kumar Tirupakuzhi Vijayaraghavan ◽  
Lowell Ling ◽  
...  
Keyword(s):  
Critical Care ◽  
Health Services ◽  
Life Support ◽  
High Income ◽  
Asia Pacific ◽  
Organ Support ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Middle Income ◽  
Middle Income Countries

Aim: To investigate critical care resourcing and the clinical management of sepsis in lower-middle income, upper-middle income and high income countries across the Asia Pacific region. Background: Sepsis is a time-critical complex condition that requires evidence-based care delivered by appropriate levels of well trained, qualified and experienced staff supported by proactive organisational and quality processes, sophisticated technologies and reliable infrastructure. In 2017, the estimated sepsis incidence in the Asia Pacific region ranged from 120 to 200 per 100,000 population in Australia and New Zealand to 2500 to 3400 per 100,000 population in India. Currently, there is limited information on the organisational structures, human resources, clinical standards, laboratory support and the therapeutic options available in the Asia Pacific region to treat sepsis. Method: Prospective electronic survey. Results: Representatives of 59 hospitals from 15 countries responded. Provision of critical care and the management of sepsis varied considerably between lower-middle income, upper-middle income and high income countries. Specific differences include nurse to patient ratios and availability of allied health services. Conventional organ support modalities such as mechanical ventilation and non-invasive ventilation were commonly available. Even advanced life support like extracorporeal membrane oxygenation was available in at least 60% of surveyed ICUs. However, in contrast, essential monitoring devices including EtCO2 were not universally available. Lower-middle income countries had considerably lower provisions for isolation and surge capacity to support pandemic and disaster management, though basic personal protective equipment was widely available. A majority of ICUs used the Surviving Sepsis Campaign guidelines or the adapted version for lower-middle income countries, though only 21% of ICUs in lower-middle income countries used the adapted version. While essential antimicrobials were accessible across most ICUs, availability of reserve antibiotics was limited. Conclusion: The disparities identified in this survey inform healthcare workers and health services, policy makers and governments on the priorities for action to improve the delivery of critical care and sepsis outcomes in this region. Keywords: critical care, disaster, resources, sepsis

scholarly journals Organisation of primary health care systems in low- and middle-income countries: review of evidence on what works and why in the Asia-Pacific region

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001487 ◽  
Author(s):  
Rebecca Dodd ◽  
Anna Palagyi ◽  
Stephen Jan ◽  
Marwa Abdel-All ◽  
Devaki Nambiar ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Engagement ◽  
Asia Pacific ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Middle Income ◽  
Middle Income Countries ◽  
What Works ◽  
Primary Health

IntroductionThis paper synthesises evidence on the organisation of primary health care (PHC) service delivery in low-income and middle-income countries (LMICs) in the Asia Pacific and identifies evidence of effective approaches and pathways of impact in this region.MethodsWe developed a conceptual framework describing key inputs and outcomes of PHC as the basis of a systematic review. We searched exclusively for intervention studies from LMICs of the Asia-Pacific region in an effort to identify ‘what works’ to improve the coverage, quality, efficiency, equity and responsiveness of PHC. We conducted a narrative synthesis to identify key characteristics of successful interventions.ResultsFrom an initial list of 3001 articles, we selected 153 for full-text review and included 111. We found evidence on the impact of non-physician health workers (NPHWs) on coverage and quality of care, though better integration with other PHC services is needed. Community-based services are most effective when well integrated through functional referral systems and supportive supervision arrangements, and have a reliable supply of medicines. Many studies point to the importance of community engagement in improving service demand. Few studies adopted a ‘systems’ lens or adequately considered long-term costs or implementation challenges.ConclusionBased on our findings, we suggest five areas where more practical knowledge and guidance is needed to support PHC systems strengthening: (1) NPHW workforce development; (2) integrating non-communicable disease prevention and control into the basic package of care; (3) building managerial capacity; (4) institutionalising community engagement; (5) modernising PHC information systems.

Trauma Quality Improvement in Low and Middle Income Countries of the Asia–Pacific Region: A Mixed Methods Study

2012 ◽  
Vol 36 (8) ◽  
pp. 1978-1992 ◽  
Author(s):  
Henry Thomas Stelfox ◽  
Manjul Joshipura ◽  
Witaya Chadbunchachai ◽  
Ranjith N. Ellawala ◽  
Gerard O’Reilly ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Asia Pacific ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Methodologies of Stigma-Related Research Amongst Men Who Have Sex With Men (MSM) and Transgender People in Asia and the Pacific Low/Middle Income Countries (LMICs): A Scoping Review

2021 ◽  
Vol 3 ◽  
Author(s):  
Ni Wayan Septarini ◽  
Jacqueline Hendriks ◽  
Bruce Maycock ◽  
Sharyn Burns
Keyword(s):  
Scoping Review ◽  
Asia Pacific ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Transgender People ◽  
Middle Income ◽  
Related Research ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Sex With Men

Much stigma-related research focuses on marginalized populations, including men who have sex with men (MSM) and transgender people. The importance of research in this area is widely recognized, however methodologies and measures vary between studies. This scoping review will collate existing information about how stigma-related research has been conducted in low/middle income countries (LMICs) within the Asia Pacific region, and will compare research designs, sampling frameworks, and measures. Strengths and limitations of these studies will inform recommendations for future stigma-related health research. A methodological framework for scoping studies was applied. Searches of Psych INFO, Scopus, ProQuest, Global Health and PubMed were used to identify articles. Stigma-related research amongst MSM and transgender communities, published between 2010 and 2019 in LMICs within the Asia Pacific region were included. A total of 129 articles based on 123 different studies were included. Of the 129 articles 51.19% (n = 66) were quantitative; 44.96% (n = 57) were qualitative and 3.88% (n = 5) were mixed methods studies. The majority of studies (n = 57; 86.36%) implemented a cross sectional survey. In-depth interviews (n = 20, 34.48%) were also common. Only 3.88% of studies utilized mixed-methods design. Non-probabilistic and probabilistic sampling methods were employed in 99.22 and 0.78% of studies respectively. The most common measures used in quantitative studies were the Center for Epidemiological Study on Depression (CES-D) (n = 18) and the Self Stigma Scale (SSS) (n = 6). Strengths and limitations proposed by researchers included in this review are summarized as lesson learnt and best practices in stigma-related research.

scholarly journals Investigating the Energy-Environmental Kuznets Curve Hypothesis for the Asia-Pacific Region

2019 ◽  
Vol 11 (8) ◽  
pp. 2395 ◽  
Author(s):  
Kentaka Aruga
Keyword(s):  
Energy Consumption ◽  
Environmental Kuznets Curve ◽  
Developed Countries ◽  
High Income ◽  
Asia Pacific ◽  
Kuznets Curve ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Income Groups ◽  
The Developed Countries

As mitigating the effects of energy consumption on the environment is a crucial issue for the Asia-Pacific region, this study investigates the energy-environmental Kuznets curve (EEKC) hypothesis among the 19 Asia-Pacific countries. The study also tests the EEKC hypothesis for the low-, middle-, and high-income groups of the region. The panel regression and cointegration models are used for this purpose. Our test results of both models suggest that the EEKC hypothesis holds for the whole Asia-Pacific region. However, the test performed on the three different income groups revealed that the hypothesis only holds for the high-income group. The hypothesis was not apparent for the low- and middle-income groups. This indicates that the transition in the energy consumption along the EEKC is only occurring in the developed countries of the Asia-Pacific region and the developed countries need to support the developing countries to achieve economic growth along the EEKC.

Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries

2021 ◽  
pp. bjsports-2020-103640
Author(s):  
Peter T Katzmarzyk ◽  
Christine Friedenreich ◽  
Eric J Shiroma ◽  
I-Min Lee
Keyword(s):  
Cardiovascular Disease ◽  
Low Income ◽  
Physical Inactivity ◽  
Communicable Diseases ◽  
High Income ◽  
Asia Pacific ◽  
Global Burden ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries

ObjectivesPhysical inactivity is a risk factor for premature mortality and several non-communicable diseases. The purpose of this study was to estimate the global burden associated with physical inactivity, and to examine differences by country income and region.MethodsPopulation-level, prevalence-based population attributable risks (PAR) were calculated for 168 countries to estimate how much disease could be averted if physical inactivity were eliminated. We calculated PARs (percentage of cases attributable to inactivity) for all-cause mortality, cardiovascular disease mortality and non-communicable diseases including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers of the bladder, breast, colon, endometrium, oesophagus, stomach and kidney.ResultsGlobally, 7.2% and 7.6% of all-cause and cardiovascular disease deaths, respectively, are attributable to physical inactivity. The proportions of non-communicable diseases attributable to physical inactivity range from 1.6% for hypertension to 8.1% for dementia. There was an increasing gradient across income groups; PARs were more than double in high-income compared with low-income countries. However, 69% of total deaths and 74% of cardiovascular disease deaths associated with physical inactivity are occurring in middle-income countries, given their population size. Regional differences were also observed, with the PARs occurring in Latin America/Caribbean and high-income Western and Asia-Pacific countries, and the lowest burden occurring in Oceania and East/Southeast Asia.ConclusionThe global burden associated with physical inactivity is substantial. The relative burden is greatest in high-income countries; however, the greatest number of people (absolute burden) affected by physical inactivity are living in middle-income countries given the size of their populations.

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