scholarly journals Using smartphone-based virtual patients to assess the quality of primary healthcare in rural China: protocol for a prospective multicentre study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020943 ◽  
Author(s):  
Jing Liao ◽  
Yaolong Chen ◽  
Yiyuan Cai ◽  
Nan Zhan ◽  
Sean Sylvia ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Low Income ◽  
Rural Areas ◽  
Assessment Tool ◽  
Low Cost ◽  
Care Quality ◽  
Assessment Tools ◽  
Face Validity ◽  
Virtual Patients ◽  
Health Centres

IntroductionValid and low-cost quality assessment tools examining care quality are not readily available. The unannounced standardised patient (USP), the gold standard for assessing quality, is costly to implement while the validity of clinical vignettes, as a low-cost alternative, has been challenged. Computerised virtual patients (VPs) create high-fidelity and interactive simulations of doctor-patient encounters which can be easily implemented via smartphone at low marginal cost. Our study aims to develop and validate smartphone-based VP as a quality assessment tool for primary care, compared with USP.Methods and analysisThe study will be implemented in primary health centres (PHCs) in rural areas of seven Chinese provinces, and physicians practicing at township health centres and village clinics will be our study population. The development of VPs involves three steps: (1) identifying 10 VP cases that can best represent rural PHCs’ work, (2) designing each case by a case-specific development team and (3) developing corresponding quality scoring criteria. After being externally reviewed for content validity, these VP cases will be implemented on a smartphone-based platform and will be tested for feasibility and face validity. This smartphone-based VP tool will then be validated for its criterion validity against USP and its reliability (ie, internal consistency and stability), with 1260 VP/USP-clinician encounters across the seven study provinces for all 10 VP cases.Ethics and disseminationSun Yat-sen University: No. 2017-007. Study findings will be published and tools developed will be freely available to low-income and middle-income countries for research purposes.

Complications following volar locking plate fixation for distal radial fractures: a systematic review

2013 ◽  
Vol 39 (7) ◽  
pp. 745-754 ◽  
Author(s):  
A. Bentohami ◽  
K. de Burlet ◽  
N. de Korte ◽  
M. P. J. van den Bekerom ◽  
J. C. Goslings ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Locking Plate ◽  
Assessment Tool ◽  
Plate Fixation ◽  
Assessment Tools ◽  
Volar Locking Plate ◽  
Locking Plate Fixation ◽  
Distal Radial Fractures ◽  
Level Of Evidence

The purpose of this systematic review is to assess the prevalence of complications following volar locking plate fixation of distal radial fractures. A computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Only prospective comparative and prospective cohort studies that presented data concerning complications after treatment of distal radial fractures with a volar locking plate in human adults with a minimal follow-up of 6 months were included. Two quality assessment tools were used to assess the methodological quality of the studies (level of evidence rating according to the Oxford Centre of Evidence Based Medicine and the modified version of the Cochrane Bone, Joint and Muscle Trauma Group’s former quality assessment tool). Thirty three studies were eligible for final assessment. Most complications were problems with nerve and tendon function as well as complex regional pain syndrome. With an overall complication rate of 16.5%, most of which were ‘minor’ complications and low rates of nonunion and malunion, volar locking plate fixation can be considered a reasonably safe treatment option for patients with distal radial fractures.

scholarly journals Kidney Perfusion as an Organ Quality Assessment Tool—Are We Counting Our Chickens Before They Have Hatched?

2020 ◽  
Vol 9 (3) ◽  
pp. 879 ◽  
Author(s):  
Julie De Beule ◽  
Ina Jochmans
Keyword(s):  
Quality Assessment ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Ex Situ ◽  
Risk Scores ◽  
Final Decision ◽  
Kidney Graft ◽  
Viability Assessment ◽  
Organ Quality ◽  
Kidney Perfusion

The final decision to accept an organ for transplantation remains a subjective one. With “poor organ quality” commonly cited as a major reason for kidney discard, accurate, objective, and reliable quality assessment is essential. In an era of increasingly higher-risk deceased donor kidneys, the catch is to accept those where the risk–benefit scale will tip in the right direction. Currently available assessment tools, such as risk-scores predicting outcome and zero-time biopsy, perform unsatisfactory, and assessment options during static cold storage are limited. Kidney perfusion technologies are finding their way into clinical practice, and they bring a new opportunity to assess kidney graft viability and quality, both in hypothermic and normothermic conditions. We give an overview of the current understanding of kidney viability assessment during ex situ kidney perfusion. A pragmatic framework to approach viability assessment is proposed as an interplay of three different compartments: the nephron, the vascular compartment, and the immune compartment. Although many interesting ways to assess kidney injury and function during perfusion have been proposed, none have reached the stage where they can reliably predict posttransplant outcome. Larger well-designed studies and validation cohorts are needed to provide better guidance.

scholarly journals IndoorCare: Low-Cost Elderly Activity Monitoring System through Image Processing

Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 6051
Author(s):  
Daniel Fuentes ◽  
Luís Correia ◽  
Nuno Costa ◽  
Arsénio Reis ◽  
José Ribeiro ◽  
...  
Keyword(s):  
Low Income ◽  
Assisted Living ◽  
Rural Areas ◽  
Low Cost ◽  
Elderly Care ◽  
Ambient Assisted Living ◽  
The Elderly ◽  
Case Scenario ◽  
Care Services ◽  
Socially Excluded

The Portuguese population is aging at an increasing rate, which introduces new problems, particularly in rural areas, where the population is small and widely spread throughout the territory. These people, mostly elderly, have low income and are often isolated and socially excluded. This work researches and proposes an affordable Ambient Assisted Living (AAL)-based solution to monitor the activities of elderly individuals, inside their homes, in a pervasive and non-intrusive way, while preserving their privacy. The solution uses a set of low-cost IoT sensor devices, computer vision algorithms and reasoning rules, to acquire data and recognize the activities performed by a subject inside a home. A conceptual architecture and a functional prototype were developed, the prototype being successfully tested in an environment similar to a real case scenario. The system and the underlying concept can be used as a building block for remote and distributed elderly care services, in which the elderly live autonomously in their homes, but have the attention of a caregiver when needed.

scholarly journals Development of a Multidimensional App-Quality Assessment Tool for Health-Related Apps (AQUA)

2020 ◽  
Vol 1 (2) ◽  
pp. 13-23
Author(s):  
Teresa O'Rourke ◽  
Rüdiger Pryss ◽  
Winfried Schlee ◽  
Thomas Probst
Keyword(s):  
Quality Assessment ◽  
Mobile Applications ◽  
Assessment Tool ◽  
Cognitive Testing ◽  
Assessment Tools ◽  
German Language ◽  
User Engagement ◽  
Quality Assessment Tool ◽  
The Public ◽  
Health Related

Background A multitude of health-related mobile applications is available to the public in app stores. Many of these apps were not developed by health professionals and do not keep what they promise. To facilitate a safe handling and use of such apps, it is important to assess their quality in a standardized way. Some instruments for app quality assessment exist, although they have some limitations, which we want to improve on with this new assessment tool. Objectives The objective of this paper is to introduce a new multidimensional criteria-based tool for the quality assessment of health-related apps. Method Based on existing app-quality assessment tools and guidelines for evaluating health-related app-quality, items were constructed to assess objective and subjective app-quality. A pretest in form of cognitive testing was conducted with six participants and some items were optimized. Results An expert and a user version of AQUA were developed in English and German language. The expert version consists of 31 items in the seven dimensions Usability, User Engagement, Content, Visual Design, Therapeutic Quality, Security and Information. The user version consists of 34 items and additionally includes the dimension Impact. Conclusion AQUA is a brief multidimensional app-quality assessment tool that can be used for the quality assessment of health-related and mental health-related apps by experts and app-users.

scholarly journals Developing indicators of age-friendly neighbourhood environments for urban and rural communities across 20 low-, middle-, and high-income countries

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Emily J. Rugel ◽  
Clara K. Chow ◽  
Daniel J. Corsi ◽  
Perry Hystad ◽  
Sumathy Rangarajan ◽  
...  
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Disease Risk ◽  
High Income ◽  
Community Level ◽  
Assessment Tools ◽  
World Health ◽  
Mixed Data ◽  
Local Context ◽  
Traffic Lights

Abstract Background By 2050, the global population of adults 60 + will reach 2.1 billion, surging fastest in low- and middle-income countries (LMIC). In response, the World Health Organization (WHO) has developed indicators of age-friendly urban environments, but these criteria have been challenging to apply in rural areas and LMIC. This study fills this gap by adapting the WHO indicators to such settings and assessing variation in their availability by community-level urbanness and country-level income. Methods We used data from the Prospective Urban and Rural Epidemiology (PURE) study’s environmental-assessment tools, which integrated systematic social observation and ecometrics to reliably capture community-level environmental features associated with cardiovascular-disease risk factors. The results of a scoping review guided selection of 18 individual indicators across six distinct domains, with data available for 496 communities in 20 countries, including 382 communities (77%) in LMIC. Finally, we used both factor analysis of mixed data (FAMD) and multitrait-multimethod (MTMM) approaches to describe relationships between indicators and domains, as well as detailing the extent to which these relationships held true within groups defined by urbanness and income. Results Together, the results of the FAMD and MTMM approaches indicated substantial variation in the relationship of individual indicators to each other and to broader domains, arguing against the development of an overall score and extending prior evidence demonstrating the need to adapt the WHO framework to the local context. Communities in high-income countries generally ranked higher across the set of indicators, but regular connections to neighbouring towns via bus (95%) and train access (76%) were most common in low-income countries. The greatest amount of variation by urbanness was seen in the number of streetscape-greenery elements (33 such elements in rural areas vs. 55 in urban), presence of traffic lights (18% vs. 67%), and home-internet availability (25% vs. 54%). Conclusions This study indicates the extent to which environmental supports for healthy ageing may be less readily available to older adults residing in rural areas and LMIC and augments calls to tailor WHO’s existing indicators to a broader range of communities in order to achieve a critical aspect of distributional equity in an ageing world.

Serving the low-income consumer in a rich economy: Dollar General racks up sales

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Glyn Atwal ◽  
Douglas Bryson
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Business Strategy ◽  
Cultural Context ◽  
Success Factors ◽  
Low Cost ◽  
Well Being ◽  
Content Type ◽  
The Usa

Purpose The conceptualization of the Base of Pyramid (BOP) proposes that low-income markets can lead to profitable opportunities for businesses. The purpose of this study is to identify key success factors of a BOP business strategy based on a case study of the discount retailer, Dollar General, in the USA. Design/methodology/approach The research design used in this research is an in-depth case study of Dollar General in the USA. Qualitative methods are applied in both the primary and secondary data collection and during the follow-on data analysis of Dollar General. Findings Dollar General’s strategic profile is achieved through the combination of the following four actions which are tailored to compete effectively at the BOP in the USA: creating the neighborhood discounter, raising aspirational appeal, reducing service and eliminating internationalization. Research limitations/implications The case is specific to Dollar General in a US cultural context. Practical implications The case of Dollar General demonstrates how a discounter retailer should not only follow a low-cost strategy to compete at the BOP. Its ability to craft a distinctive strategy is coherent with meeting the logistical, rational and emotional needs of the low-income consumer in the USA. Social implications Many businesses have neglected rural areas of the USA as being unprofitable. The ability for businesses such as Dollar General to serve the BOP segment can foster the socio-economic well-being of communities. Originality/value The overwhelming body of the BOP literature is based on emerging markets. To the best of the authors’ knowledge, this is one of the few studies to investigate BOP business strategy in the USA.

scholarly journals Assessment of cardiovascular risk among adults in a rural area of Kancheepuram district, Tamil Nadu

2018 ◽  
Vol 5 (2) ◽  
pp. 698
Author(s):  
Velavan A. ◽  
Jyothi Vasudevan ◽  
Arun S. ◽  
Anil J. Purty ◽  
Vincent A.
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Low Income ◽  
Rural Areas ◽  
Tamil Nadu ◽  
Low Cost ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Cooking Oils

Background: Increasing longevity of the world’s population has resulted in a shift in the disease patterns prevalent hitherto. The worst affected are the middle and low- income countries including India. The genetic make-up of Indians render them highly susceptible to cardiovascular diseases and diabetes at a much earlier age with resultant higher mortality rates. Thus, low- cost early detection, and innovative, customized preventive strategies are the need of the hour. Methods: In this cross- sectional study, we have used the WHO/ISH risk prediction charts tailor – made for the SEAR D region, to assess the cardiovascular risk of a rural population aged above 40 years. Data regarding multiple cardiovascular risk factors were collected using a pre- defined and pre-tested questionnaire, from 400 participants, including other variables like BP and anthropometric measurements. The data were entered in Microsoft excel and analysed using SPSS- ver16. Results: We found that 14.5% of the population had more than 10% risk of cardiovascular diseases and 41.5% were in stage I or II hypertension. People who belonged to the class II SES, use of oral tobacco, saturated cooking oils and sedentary lifestyle was found to be associated with high CV risk. However the association of CV risk with other risk factors like smoking and BMI was inconsistent. Conclusions: There is an increasing trend of cardiovascular risk in rural areas of Tamil Nadu and risk factors like higher socio economic class, use of oral tobacco, saturated cooking oils and sedentary occupation were found to be associated with high CV risk.

Acceptance of a Smartphone-based Visual Field Screening Platform for Glaucoma: Pre-Post Study (Preprint)

2020 ◽  
Author(s):  
Esmael Kedir Nida ◽  
Sisay Bekele ◽  
Luc Geurts ◽  
Vero Vanden Abeele
Keyword(s):  
Visual Field ◽  
Low Income ◽  
Rural Areas ◽  
Low Cost ◽  
Screening Tests ◽  
Low Income Countries ◽  
Structured Interviews ◽  
Field Screening ◽  
Glaucoma Screening ◽  
Screening Platform

BACKGROUND Glaucoma, the “silent thief of sight”, is a major cause of blindness worldwide. It is a burden for people in low-income countries specifically, where it accounts for 15% of the total blindness. More than half of the people living with glaucoma in low-income countries, are unaware of their disease until it progresses to an advanced stage, resulting in permanent visual impairment. OBJECTIVE To evaluate the acceptability of the Glaucoma Easy Screener (GES), a low-cost and portable visual field screening platform comprising of a smartphone, a stereoscopic VR headset and a gaming joystick. METHODS A mixed-method study was conducted to evaluate the acceptability of GES, including 24 eye care professionals from four hospitals in Southwest Ethiopia. A pre-post design was employed to collect perspectives before and after using GES, using questionnaires and semi-structured interviews. The questionnaire and interview questions were guided by the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS Positive results were obtained both pre-use and post-use, suggesting acceptance of mHealth solutions for glaucoma screening, using a low-cost headset through a smartphone and a game controller. Ophthalmic professionals perceived GES as easy-to-use, enabling the screening of glaucoma screening tests, especially during outreach to rural areas. However, positive evaluations are contingent on adequate accuracy of the tool. Moroever, ophtalmic professionals voiced the need to limit the tool to screening only, and not for diagnosis. CONCLUSIONS The study supports the feasibility of using a mobile device in combination with a low-cost VR headset and classic controller for glaucoma screening in rural areas. GES has the potential to reduce the burden of irreversible blindness due to glaucoma. Yet, a further assessment of its sensitivity and specificity is needed.

The development of environmental assessment tools to support the creation of dementia friendly care environments: Innovative practice

Dementia ◽  
2016 ◽  
Vol 16 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Sarah Waller ◽  
Abigail Masterson ◽  
Simon C Evans
Keyword(s):  
Patient Outcomes ◽  
Environmental Assessment ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Care Homes ◽  
Staff Morale ◽  
Department Of Health ◽  
Health Centres ◽  
Hospital Wards ◽  
Positive Effect

The need for more dementia friendly design in hospitals and other care settings is now widely acknowledged. Working with 26 NHS Trusts in England as part of a Department of Health commissioned programme, The King’s Fund developed a set of overarching design principles and an environmental assessment tool for hospital wards in 2012. Following requests from other sectors, additional tools were developed for hospitals, care homes, health centres and housing with care. The tools have proven to be effective in both disseminating the principles of dementia friendly design and in enabling the case to be made for improvements that have a positive effect on patient outcomes and staff morale. This paper reports on the development, use and review of the environmental assessment tools, including further work that is now being taken forward by The Association for Dementia Studies, University of Worcester.

scholarly journals Manual Borehole Drilling as a Cost-Effective Solution for Drinking Water Access in Low-Income Contexts

Water ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1981
Author(s):  
Pedro Martínez-Santos ◽  
Miguel Martín-Loeches ◽  
Silvia Díaz-Alcaide ◽  
Kerstin Danert
Keyword(s):  
Drinking Water ◽  
Low Income ◽  
Rural Areas ◽  
Low Cost ◽  
Cost Effective ◽  
Unconsolidated Sediments ◽  
Low Income Countries ◽  
Water Access ◽  
Middle Income ◽  
Advantages And Disadvantages

Water access remains a challenge in rural areas of low-income countries. Manual drilling technologies have the potential to enhance water access by providing a low cost drinking water alternative for communities in low and middle income countries. This paper provides an overview of the main successes and challenges experienced by manual boreholes in the last two decades. A review of the existing methods is provided, discussing their advantages and disadvantages and comparing their potential against alternatives such as excavated wells and mechanized boreholes. Manual boreholes are found to be a competitive solution in relatively soft rocks, such as unconsolidated sediments and weathered materials, as well as and in hydrogeological settings characterized by moderately shallow water tables. Ensuring professional workmanship, the development of regulatory frameworks, protection against groundwater pollution and standards for quality assurance rank among the main challenges for the future.

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