scholarly journals A qualitative study comparing experiences of the surgical safety checklist in hospitals in high-income and low-income countries

BMJ Open ◽  
2013 ◽  
Vol 3 (8) ◽  
pp. e003039 ◽  
Author(s):  
Emma-Louise Aveling ◽  
Peter McCulloch ◽  
Mary Dixon-Woods
EMJ Radiology ◽  
2020 ◽  

Retained foreign bodies have become very rare in countries where the safety rules in the operating theatre are very rigorous and follow precise guidelines. There are low-income countries where hospital structures are precarious, in which the implementation of surgical safety rules has only been effective recently. Surgical teams in these countries are not yet well trained in the observance of the guidelines concerning swab count, meaning that textilomas are not uncommon. Abdominal textiloma may be asymptomatic, or present serious gastrointestinal complications such as bowel obstruction, perforation, or fistula formation because of misdiagnosis. It may mimic abscess formation in the early stage or soft tissue masses in the chronic stage. This case report presents a 27-year-old female who underwent an emergency laparotomy in a rural surgical centre for an ectopic pregnancy. Two months later, a swelling had appeared on the left side of her abdomen, gradually increasing in size, which was not very painful but caused digestive discomfort and asthenia. Intermittent fever was described and treated with antibiotics. The patient was referred to a better equipped centre to benefit from a CT scan. A textiloma was strongly suspected on the CT but a left colic mass was not excluded. Laparotomy confirmed the diagnosis of textiloma and the postoperative course was uneventful. Prevention rules must be strengthened in these countries where patients can hardly bear the costs of iterative surgeries for complications that are avoidable.


2018 ◽  
Vol 45 (4) ◽  
pp. E13 ◽  
Author(s):  
Michael C. Dewan ◽  
Ronnie E. Baticulon ◽  
Abbas Rattani ◽  
James M. Johnston ◽  
Benjamin C. Warf ◽  
...  

OBJECTIVEThe presence and capability of existing pediatric neurosurgical care worldwide is unknown. The objective of this study was to solicit the expertise of specialists to quantify the geographic representation of pediatric neurosurgeons, access to specialist care, and equipment and training needs globally.METHODSA mixed-question survey was sent to surgeon members of several international neurosurgical and general pediatric surgical societies via a web-based platform. Respondents answered questions on 5 categories: surgeon demographics and training, hospital and practice details, surgical workforce and access to neurosurgical care, training and equipment needs, and desire for international collaboration. Responses were anonymized and analyzed using Stata software.RESULTSA total of 459 surgeons from 76 countries responded. Pediatric neurosurgeons in high-income and upper-middle-income countries underwent formal pediatric training at a greater rate than surgeons in low- and lower-middle-income countries (89.5% vs 54.4%). There are an estimated 2297 pediatric neurosurgeons in practice globally, with 85.6% operating in high-income and upper-middle-income countries. In low- and lower-middle-income countries, roughly 330 pediatric neurosurgeons care for a total child population of 1.2 billion. In low-income countries in Africa, the density of pediatric neurosurgeons is roughly 1 per 30 million children. A higher proportion of patients in low- and lower-middle-income countries must travel > 2 hours to seek emergency neurosurgical care, relative to high-income countries (75.6% vs 33.6%, p < 0.001). Vast basic and essential training and equipment needs exist, particularly low- and lower-middle-income countries within Africa, South America, the Eastern Mediterranean, and South-East Asia. Eighty-nine percent of respondents demonstrated an interest in international collaboration for the purposes of pediatric neurosurgical capacity building.CONCLUSIONSWide disparity in the access to pediatric neurosurgical care exists globally. In low- and lower-middle-income countries, wherein there exists the greatest burden of pediatric neurosurgical disease, there is a grossly insufficient presence of capable providers and equipped facilities. Neurosurgeons across income groups and geographic regions share a desire for collaboration and partnership.


The Lancet ◽  
2017 ◽  
Vol 390 (10113) ◽  
pp. 2643-2654 ◽  
Author(s):  
Scott A Lear ◽  
Weihong Hu ◽  
Sumathy Rangarajan ◽  
Danijela Gasevic ◽  
Darryl Leong ◽  
...  

2021 ◽  
Author(s):  
Wilson Mupfururirwa ◽  
Victoria Nembaware ◽  
Jack Morrice ◽  
Khuthala Mnika ◽  
Gaston Kuzamunu Mazandu ◽  
...  

BACKGROUND The impact of mobile phones and their applications in healthcare (mobile health) is well established for a range of diseases and cross-cutting complications, such as pain. While numerous mobile health (mHealth) pain interventions have been established, an evaluation of their prevalence, adequacy and distribution remains limited. OBJECTIVE This study aims at reviewing and comparing current pain management mHealth tools in high- versus low-income countries. METHODS A literature and application (app) store search was conducted in May 2021 using combinations of the following keywords: “pain management”, “pain”, “mobile health”, “telemedicine”, and “app”. Literature searches were conducted in PubMed, Scopus, Cochrane Review Library, and Google scholar. App store searches were conducted in Google Play and Apple App Store. Data characteristics descriptive analysis was performed using R software to summarize different datasets and compute p-values (P) for testing the significance of different hypotheses with the significance level set to 0.05. RESULTS The search identified 40 publications (literature search) and 230 mHealth applications (app store search), revealing a non uniform distribution of search categories (χ2= 133.7, P < 0.004) with a ratio approximating 1:6 (OR = 5.730, 95%CI:3.745-8.909, P < 0.004). About 86.7% of these 270 applications (apps) are from high-income countries, showing a statistically significant non uniform distribution of country categories: high- and low-income (χ2= 145.2, P < 0.004) approximating the theoretical distribution of a 7:1 ratio (OR = 6.476, 95%CI:4.180-10.222, P < 0.004). Moreover, there is no significant difference in the proportion of search categories between country categories ( χ2= 0.113, P = 0.737) and the difference in pain app prevalence in high- versus low-income countries is not statistically significant. Finally, we have observed that pain-tracking apps are significantly more prevalent in developed countries in comparison to low-income countries. CONCLUSIONS As expected, pain management app prevalence is higher in high-income countries. However, more research is required to readily comprehend the effectiveness of these apps.


Author(s):  
Josue Mbonigaba

The unsustainable food consumption across high-income countries (HICs) and low-income countries (LICs) is expected to differ in nature and extent, although no formal evidence in this respect has been documented. Documenting this evidence is the aim of this chapter. Specifically, the chapter seeks to answer the following questions: 1) Do the contexts in less developed countries (LDCs) and developed countries (DCs) make the nature and extent of unsustainability in food consumption different? 2) Do the mechanisms of the linkage between unsustainability of food consumption and health outcomes independent of countries' contexts? 3) Are current policies against unsustainable food consumption equally effective in DCs and LDCs? These questions are answered by means of a systematic review of the literature for the period 2000-2017. The findings are that the nature and extent of unsustainability is quite different across contexts of LICs and HICs.


2018 ◽  
Vol 09 (03) ◽  
pp. 1850010 ◽  
Author(s):  
Sudeshna Ghosh

This paper explores the causal association between globalization and carbon dioxide emanations in a panel set of 17 low- and low-middle-income countries and 12 upper-middle and high-income countries of Asia, respectively. The time series of observations run from 1974 to 2014. The Westerlund (2007) panel cointegration test reveals that there exists a long-run cointegrating relationship in both the panel set of observations between globalization and CO2 emissions. For the panel of upper-middle and high-income countries of Asia the long-run panel (heterogeneous elasticities) shows that globalization does not cause environmental damage, contrary to the observation based on lower- and lower-middle-income countries. The study is in conformity with the Environmental Kuznets Curve Hypothesis. The Granger causality between the variables is explored by utilizing the Dumitrescu and Hurlin (2012) Granger Causality tests. The empirical observation shows that globalization-led environmental causality is valid for lower- and lower-middle-income countries of Asia. So proper sustainable green and clean technology must be adopted for the low-income countries to stop the negation of the growth process in the near future.


2019 ◽  
Vol 4 (6) ◽  
pp. e001830 ◽  
Author(s):  
Ladson Hinton ◽  
Duyen Tran ◽  
Thuc-Nhi Nguyen ◽  
Janis Ho ◽  
Laura Gitlin

IntroductionDespite increasing numbers of persons living with Alzheimer’s disease and Alzheimer’s-related dementias (AD/ADRD) in Asia, particularly in low-income countries (LIC) and middle-income countries (MIC), surprisingly little is known about the current state of the evidence for family caregiver interventions. The objectives of this scoping review were to: (1) describe the evidence for efficacy of family dementia-caregiver psychosocial interventions in Asian countries, (2) compare evidence across LIC, MIC, and high-income countries (HIC), and (3) characterise cultural adaptions to interventions developed outside Asia.MethodsThe inclusion criteria included: (1) conducted in Asia (2) included an intervention delivered to a family caregiver of a person living with AD/ADRD, (3) reported quantitative outcomes for the family caregiver and (4) published in a peer-reviewed journal with full text available in English.ResultsThirty intervention trials were identified meeting inclusion criteria and all reported statistically significant (p<0.05) improvement in one or more caregiver outcomes. Interventions usually included multiple components. The most frequently reported outcomes (ie, by ≥20% of studies) were caregiver depression, burden, quality of life and self-efficacy. Overall, 26 (87%) of the studies were conducted in HIC in Asia, primarily in Hong Kong SAR—China and Taiwan, and only 4 (13%) in LIC and MIC in Asia. Seven studies (23%) used interventions developed in USA and several described cultural adaptations.ConclusionThis scoping review found substantial evidence, particularly from high-income Asian countries, that a wide range of interventions improve AD/ADRD family caregiver outcomes. However, critical knowledge gaps exist, particularly for LIC and MIC in Asia, where the number of persons with dementia is numerically largest and projected to increase dramatically in coming decades. The field could also benefit from more detailed descriptions of the process and types of cultural adaptations to interventions.


SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 41
Author(s):  
Simon Matthew Graham ◽  
Ciaran Brennan ◽  
Maritz Laubscher ◽  
Sithombo Maqungo ◽  
David G. Lalloo ◽  
...  

Background: To perform a bibliometric analysis and quantify the amount of orthopaedic and trauma literature published from low-income countries (LICs). Methods and methods: The Web of Science database was utilised to identify all indexed orthopaedic journals. All articles published in the 76 orthopaedics journals over the last 10 years were reviewed, to determine their geographic origin. Results: A total of 131 454 articles were published across 76 orthopaedic journals over the last 10 years. Of these, 132 (0.1%) were published from LICs and 3515 (2.7%) were published from lower middle-income countries (LMICs); 85.7% (n = 112 716) of published orthopaedic research was undertaken in a high-income setting. The majority of the studies (n = 90, 74.4%) presented level IV evidence. Only 7.4% (n = 9) were high-quality evidence (level I or II). Additionally, the majority of research (74 articles, 56%) was published in partnership with high-income countries (HICs). Conclusions: There is a stark mismatch between the publication of scientific reports on orthopaedic research and the geographical areas of greatest clinical need. We believe there is an urgent need for orthopaedic research to be carried out in low-income settings to guide treatment and improve outcomes, rather than assuming that evidence from high-income settings will translate into this environment. Level of evidence: IV


2018 ◽  
Vol 3 (6) ◽  
pp. e000912 ◽  
Author(s):  
Alison M Devlin ◽  
Daniel Wight ◽  
Candida Fenton

IntroductionThere is increasing interest in the transferability of parenting interventions from high-income countries (HICs) to low-income countries (LICs) in order to improve child development and health outcomes. This is based on the premise that associations between parenting practices and child outcomes are similar in both settings. Many parenting interventions in HICs are evidence-based, but less evidence exists on associations of parenting practices with child outcomes in LICs, in particular, sub-Saharan African (SSA) countries. This review synthesises evidence on the association of parenting practices with child outcomes in SSA in order to compare findings with those from HICs.MethodsWe searched electronic databases—Web of Science, ASSIA, Embase, IBSS and PsycINFO—to identify studies from SSA that reported quantitative associations between parenting practices and child health or psychosocial outcomes (eg, sexual and reproductive health (SRH), mental health, conduct disorders). Due to inconsistent conceptual framing of parenting across studies, we used a modified version of the international WHO classification of parenting dimensions to guide synthesis of the results.ResultsForty-four studies met our inclusion criteria. They were conducted in 13 SSA countries and included cross-sectional and longitudinal studies, and were predominantly descriptive studies rather than intervention research. Synthesis of results showed that associations between patterns of parenting (‘positive’/‘harsh’) and child outcomes (including SRH, mental health and conduct disorders) in studies from SSA were broadly similar to those found in HICs.ConclusionsThese findings suggest that the impacts of parenting practices on child outcomes are similar across contrasting global regions and, therefore, parenting interventions from HICs might be successfully transferred to SSA, subject to appropriate adaptation. However, this review also highlights the paucity of evidence in this area and the urgent need for higher quality studies to confirm these findings to help develop effective parenting interventions in SSA.


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