Decision-Making in the Prescription of Orthotics and Prosthetics for Partial-Foot Amputees

2019 ◽  
Author(s):  
Pratima Saravanan ◽  
Charity Hipple ◽  
Jingxin Wang ◽  
Christopher McComb ◽  
Jessica Menold
Keyword(s):  
Decision Making ◽  
Low Income ◽  
Low Income Countries ◽  
Extensive Literature ◽  
Proposed Model ◽  
Decision Making Model ◽  
Future Work ◽  
Automated Methods

Abstract Prosthetists face a daunting number of decisions that directly affect an amputee’s ability to walk and indirectly affect the overall quality of life of that amputee. In addition, the lack of resources in low-income countries provides a barrier to receive care after an amputation, and approximately 80% of amputees in low-income countries lack appropriate prosthetic care. In this research, we are motivated to understand what factors affect the decision-making strategies of prosthetists and podiatrists when prescribing prosthetics and orthotics to partial foot amputees. This work establishes a decision-making framework as a step towards automated methods that may reduce the complexities and decision-making burden of prosthetic prescription, ultimately increasing the efficiency of prosthetic prescription in low-resourced areas. A decision-making model is proposed based on an extensive literature review of over 100 papers. The proposed model is compared to qualitative data regarding decision-making strategies during prosthetic or orthotic prescription collected from nine prosthetists, surgeons, and other healthcare professionals directly involved in amputee care. Changes to the proposed model are described and future work exploring the role of automated methods to support decision-making in the context of prosthetics is discussed.

The House of Love and the Mental Hospital

2021 ◽  
Author(s):  
Murphy Halliburton
Keyword(s):  
Family Support ◽  
Family Involvement ◽  
Low Income ◽  
Global Mental Health ◽  
Developed Countries ◽  
Epidemiological Studies ◽  
Low Income Countries ◽  
Rehabilitation Centre

The Movement for Global Mental Health has defined the person suffering psychopathology in low-income countries as an abused and suffering subject in need of saving by biomedical psychiatry. Based on fieldwork in Kerala, South India, carried out at psychiatric clinics and a psychosocial rehabilitation centre, this paper examines patients’ experiences of illness, the degree and quality of family support, and attributions made to the role of ‘sneham’, or love, in recovery. The role of love and family involvement may help explain the provocative finding by WHO epidemiological studies that ‘developing’ countries – and India in particular – showed better rates of recovery from severe mental illness when compared to developed countries.

Sustaining Long-Run Growth and Macroeconomic Stability in Low-Income Countries—The Role of Structural Transformation and Diversification

Policy Papers ◽  
2014 ◽  
Vol 2014 (38) ◽  
Author(s):  
Keyword(s):  
Structural Transformation ◽  
Low Income ◽  
Low Income Countries ◽  
Macroeconomic Performance ◽  
Export Structure ◽  
Long Run ◽  
Trading Partners ◽  
Per Capita

Diversification and structural transformation play important roles in influencing the macroeconomic performance of low-income countries (LICs). Increases in income per capita at early stages of development are typically accompanied by a transformation in a country’s production and export structure. This can include diversification into new products and trading partners as well as increases in the quality of existing products.

scholarly journals A fuzzy-TOPSIS model for maintenance outsourcing considering the quality of submitted tender documents

2021 ◽  
Vol 23 (3) ◽  
pp. 443-453
Author(s):  
Maysa Alshraideh ◽  
Shereen Ababneh ◽  
Elif Elcin Gunay ◽  
Omar Al-Araidah
Keyword(s):  
Decision Making ◽  
Selection Criteria ◽  
Fuzzy Topsis ◽  
Final Decision ◽  
Proposed Model ◽  
Maintenance Outsourcing ◽  
Multiple Experts ◽  
Decision Making Model

The paper provides a multiple-experts Fuzzy-TOPSIS decision-making model for the selection among maintenance contractors based on the quality of tendering documents. The study introduces a set of selection criteria utilizing benefit and cost criteria from literature. The proposed model aggregates subjective linguistic assessments of multiple experts that express their opinions on the degree of importance of criteria and allows multiple decisionmakers to evaluate the compliance of contractors’ documents. For a case study, the model is applied to select among contractors tendering to maintain the heavy-duty cranes of an international steel company from literature. Several decision-making scenarios are investigated, and major changes in the final decision are observed. The changes in obtained results illustrate the need to better address uncertainties in rating and tendering an overqualified contractor at a higher cost.

Decision making to discharge patients from airborne infection isolation rooms: The role of a single GeneXpert MTB/RIF strategy in Brazil

2020 ◽  
Vol 41 (7) ◽  
pp. 784-788
Author(s):  
Lucas José Bazzo Menon ◽  
Cinara Silva Feliciano ◽  
Mateus Rennó de Campos ◽  
Valdes Roberto Bollela
Keyword(s):  
Decision Making ◽  
Low Income ◽  
Positive Impact ◽  
Strong Predictor ◽  
Low Income Countries ◽  
High Complexity ◽  
Healthcare Facilities ◽  
Airborne Infection ◽  
The Impact

AbstractObjective:Tuberculosis (TB) transmission in healthcare facilities is still a concern in low-income countries, where airborne isolation rooms are scarce due to high costs. We evaluated the use of single GeneXpert MTB/RIF, the molecular Mycobacterium tuberculosis (MTB) DNA and resistance to rifampicin (RIF) test, as an accurate and faster alternative to the current criteria of 3 negative acid-fast bacilli (AFB) smears to remove patients from airborne isolation.Methods:In this real-world investigation, we evaluated the impact of a single GeneXpert MTB/RIF on the decision making for discharging patients from respiratory isolation. We enrolled patients with suspected pulmonary TB in a public hospital that provides care for high-complexity patients in Brazil. We studied the performance, costs, and time saved comparing the GeneXpert MTB/RIF with AFB smears.Results:We enrolled 644 patients in 3 groups based on the number of AFB smears performed (1, 2, and 3, respectively) on respiratory specimens. GeneXpert MTB/RIF demonstrated good performance compared to AFB smear to rule out TB in all groups. The negative predictive value for AFB smear was 94% (95% confidence interval [CI], 0.90–0.97) and 98% (95% CIs, 0.94–0.99) for GeneXpert MTB/RIF in G3. The isolation discharge based on 3 AFB smears took 84 hours compared to 24 hours with GeneXpert MTB/RIF, which represents 560 patient-days saved in the isolation rooms.Conclusion:A single GeneXpert MTB/RIF is a fast and strong predictor for TB absence in a high-complexity hospital, which is quite similar to results obtained in recent studies in low-burden settings. This molecular test may also increase patient rotation through isolation rooms, with a positive impact in the emergency room and infectious diseases wards.

Infrastructure Investment and Growth in Developing Countries: Does the Type of Contract Matter?

2012 ◽  
Vol 4 (2) ◽  
pp. 139-152
Author(s):  
Marco Percoco
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Public Investment ◽  
Private Investment ◽  
Public Private Partnerships ◽  
Low Income Countries ◽  
Extensive Literature ◽  
Infrastructure Projects ◽  
Private Participation

The aim of this article is to verify whether public investment in infrastructure is effective in terms of growth. While there is extensive literature analysing the effect of public capital stock on development and growth, comparatively less attention has been devoted to the contractual mechanisms characterising this investment. In this article, we focus on private participation in infrastructure projects through forms of public–private partnerships and verify whether the use of such contracts promotes economic growth. By analysing the performance of 81 developing countries over the period 1991–2008, we found that public–private partnerships are particularly relevant in terms of growth for high-income countries, whereas we could not find significant effect for low-income countries. We interpret this result as evidence of the relevance of better institutions, especially in terms of quality of regulation and rule of law, for attracting private investment in infrastructure projects and then for promoting growth.

Presence through absence? Understanding the role of capital in the African Human Rights Action Plan

2020 ◽  
Vol 58 (4) ◽  
pp. 579-600
Author(s):  
Obiora Chinedu Okafor ◽  
Sanaa Ahmed ◽  
Sylvia Bawa ◽  
Ibironke Odumosu-Ayanu
Keyword(s):  
Human Rights ◽  
Low Income ◽  
Action Plan ◽  
Significant Degree ◽  
Universal Declaration ◽  
Low Income Countries ◽  
Significant Extent ◽  
Global Capital ◽  
Market Practices

AbstractThis study examines the African Human Rights Action Plan (AHRAP) through the lens of Upendra Baxi's germinal theory on the emergence in our time of a ‘trade-related, market-friendly human rights’ (TREMF) thesis that is challenging the specific understandings of ‘people-centric’ human rights that are predicated in the letter and spirit of the Universal Declaration of Human Rights (UDH). Baxi contends, instead, that the dominant strands of the contemporary understandings of human rights are – for the most part – designed to protect the interests of global capital. That said, human rights frameworks in low-income countries need to be studied with a view to what they say and don't say about global capital. Despite its attempt to facilitate a progressive realisation of human rights in Africa, the AHRAP does not rise far enough above the TREMF paradigm to re-locate itself within the UDH one. This is due to the AHRAP not adequately theorising and analysing the role of capital in the (non)realisation of human rights in Africa. By allowing trade and market practices to slip to a significant extent beyond its purview, the AHRAP privileges – to a significant degree – the needs/interests of capital over the human rights of ordinary Africans. That is, the victims of the excesses of capital in Africa are reincarnated in the AHRAP document by the fact of their exclusion from it.

scholarly journals Availability, Accessibility, and Quality of Conservative Kidney Management Worldwide

2020 ◽  
Vol 16 (1) ◽  
pp. 79-87
Author(s):  
Meaghan Lunney ◽  
Aminu K. Bello ◽  
Adeera Levin ◽  
Helen Tam-Tham ◽  
Chandra Thomas ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Low Income ◽  
Kidney Failure ◽  
Low Income Countries ◽  
Multidisciplinary Teams ◽  
Spiritual Support ◽  
Care Providers ◽  
The Status ◽  
Kidney Health

Background and objectivesPeople with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality.Design, setting, participants, & measurementsThe Global Kidney Health Atlas is an ongoing initiative of the International Society of Nephrology that aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 Global Kidney Health Atlas survey, specifically addressing the availability, accessibility, and quality of conservative kidney management.ResultsRespondents from 160 countries completed the survey, and 154 answered questions pertaining to conservative kidney management. Of these, 124 (81%) stated that conservative kidney management was available. Accessibility was low worldwide, particularly in low-income countries. Less than half of countries utilized multidisciplinary teams (46%); utilized shared decision making (32%); or provided psychologic, cultural, or spiritual support (36%). One-quarter provided relevant health care providers with training on conservative kidney management delivery.ConclusionsOverall, conservative kidney management is available in most countries; however, it is not optimally accessible or of the highest quality.

scholarly journals The Role of Strategic Thinking Patterns in the Quality of Administrative Decision Making

2018 ◽  
Vol 2 (2) ◽  
pp. 1-21
Author(s):  
Ahlam Ibrahim Wali ◽  
Muzaffar Hamed Ali ◽  
Ahmed Azan Sharif
Keyword(s):  
Decision Making ◽  
Strategic Thinking ◽  
Managerial Decision ◽  
Holistic Thinking ◽  
Descriptive Approach ◽  
University Leaders ◽  
The University ◽  
Diagnostic Thinking

The aim of the research is to identify the role of strategic thinking patterns (holistic, abstract, diagnostic, schematic) among the university leaders in the faculties of the University of Salahuddin / Erbil. In order to reach this goal, (The type of holistic thinking, the pattern of abstract thinking, the pattern of diagnostic thinking, the pattern of schematic thinking), while the third axis of the dependent variable relates to the quality of administrative decision making. The questionnaire was distributed to 100 respondents Aclasia and the meanings of the deans and heads of scientific departments, has been pursuing the analytical descriptive approach as a way to research was the use of statistical methods SPSS to get to the search results, and research found a set of results 1-There are levels of (types of strategic thinking and quality of administrative decision-making) among the university leaders in faculties of Salahuddin University / Erbil. 2-There is a positive positive relationship between all types of strategic thinking and the quality of administrative decision-making 3- There is a significant impact of the types of strategic thinking in the quality of administrative decision - making. Based on the findings, the researchers recommended that the university leaders at the university be given an interest in strategic thinking as an important factor in the quality of managerial decision making

scholarly journals Refusal to Travel in the National Ambulance Service. A Patient Care Report examination.

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Eamonn Byrne ◽  
Sasha Selby ◽  
Paul Gallen ◽  
Alan Watts
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Shared Decision Making ◽  
Vital Signs ◽  
Ambulance Service ◽  
Guidance Document ◽  
Shared Decision ◽  
Clinical Guidance ◽  
Decision Making Model

<p><strong>Introduction</strong></p><p>Every patient has the right to refuse treatment and, or transport (RTT) to hospital (1). The National Ambulance Service (NAS) has operated under a clinical guidance document that requires an assessment of patient capacity and a baseline amount of data to be gathered on every patient to facilitate the patient making an informed decision (2,3). An increase in the rate of non-conveyance of patients and refusal to travel calls as well as an increasing number of complaints prompted a quality improvement initiative based on improving and facilitating a shared decision-making model.</p><p><strong>Aim</strong></p><p>For patients who RTT, to establish a baseline quality of information collected and recorded on a Patient Care Report.</p><p><strong>Methods</strong></p><p>All NAS incidents closed with a refusal of treatment or transport, from 1<sup>st</sup> Jan 2017 to 9<sup>th</sup> November 2017 were identified from National Emergency Operation Centre (NEOC). A random selection of 75 Patient care reports (52 Paper and 23 Electronic) were identified and reviewed. Compliance with the refusal to travel guidance document was measured.</p><p><strong>Results</strong></p><p>31% of paper PCR’s reviewed were missing a complete set of vital signs. An average of 48.4 % (Median 48.4% Range 36.5% to 61.5%) were missing a complete second set of vital signs. 17.3% of combined forms were missing the patient’s chief complaint and 38.7% had no practitioner clinical impression entered. 24% had no capacity assessment completed.</p><p><strong>Conclusion</strong></p><p>Clinical information recorded by NAS staff did not meet the clinical guidance document requirements. It is impossible to assess what information was given to a patient to facilitate a shared decision-making model. The quality of NAS documentation can be improved for patients who refuse to travel.</p>

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