scholarly journals Remote monitoring of marginalised populations affected by COVID-19: a retrospective review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042647
Author(s):  
Stephanie Q Ko ◽  
Benjamin M Y Hooi ◽  
Chieh-Yang Koo ◽  
Daniel W P Chor ◽  
Zheng Jye Ling ◽  
...  
Keyword(s):  
Low Income ◽  
Retrospective Review ◽  
Emergency Services ◽  
Migrant Worker ◽  
Low Cost ◽  
Vital Signs ◽  
Primary Outcome Measure ◽  
Primary Objective ◽  
Self Report ◽  
Secondary Outcome

ObjectivesThe COVID-19 outbreak in Singapore has largely centred around migrant worker dormitories, comprising over 90% of all cases in the country. Dormitories are home to a culturally and linguistically distinct, low-income population, without on-site healthcare after-hours. The primary objective of this study was to assess the engagement and utilisation of a simple, low-cost, accessible, mobile health solution for remote self-reporting of vital parameters in dormitory residents with COVID-19.DesignRetrospective review of medical care.SettingTwo large migrant worker dormitories with a combined population of 31 546.ParticipantsAll COVID-19-affected residents housed in dormitories during the study period.InterventionAll residents were taught to use a chat assistant to self-report their temperature, heart rate and oxygen saturations. Results flowed into a dashboard, which alerted clinicians of abnormal results.OutcomesThe primary outcome measure was engagement rate. This was derived from the total number of residents who registered on the platform over the total number of COVID-19-affected residents in the dormitories during the study period. Secondary outcome measures included outcomes of the alerts and subsequent escalations of care.Results800 of the 931 COVID-19-affected residents (85.9%) engaged with the platform to log a total of 12 511 discrete episodes of vital signs. Among 372 abnormal readings, 96 teleconsultations were initiated, of which 7 (1.8%) were escalated to emergency services and 18 (4.9%) were triaged to earlier physical medical review on-site.ConclusionsA chat-assistant-based self-reporting platform is an effective and safe community-based intervention to monitor marginalised populations with distinct cultural and linguistic backgrounds, living communally and affected by COVID-19. Lessons learnt from this approach may be applied to develop safe and cost-effective telemedicine solutions across similar settings.

scholarly journals Efficacy of a strategy-based intervention on text-level reading comprehension in persons with aphasia: a study protocol for a repeated measures study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048126
Author(s):  
Sarah-Maria Thumbeck ◽  
Philipp Schmid ◽  
Sophie Chesneau ◽  
Frank Domahs
Keyword(s):  
Reading Comprehension ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Primary Objective ◽  
Secondary Outcome ◽  
Waiting Period ◽  
Reading Activities

IntroductionAt least 68% of persons with aphasia (PWA) experience reading difficulties. Even though strategy-based interventions are a promising treatment approach for text level reading comprehension deficits in PWA, empirical evidence for their efficacy remains rare. The primary objective of this study is the analysis of the efficacy of a strategy-based intervention on text-level reading comprehension and on reading activities in PWA.Methods and analysisIn a repeated measures trial, 24 PWA will first participate in a waiting period and then in a strategy-based intervention (14 face-to-face-sessions, 60 min each). We will apply two combinations of strategies to treat either the microstructure or the macrostructure, respectively. Participants will be randomly allocated to two parallel groups that will receive these combinations in interchanged sequences. Assessments will be implemented before and after each period as well as 3 and 6 months after the intervention. The primary outcome measure is text-level reading comprehension measured with a German version of the Test de Compréhension de Textes (TCT-D) and represented by the score TCT-D Total . A non-blinded and a blinded rater will evaluate the primary outcome measure. Secondary outcome measures will address specific reading functions, reading activities and cognitive functions. The sample size was determined with an a priori power analysis. For statistical analysis, we will use contrast analyses within repeated measures analysis of variance models. We expect significant improvements in primary and secondary outcome measures during the intervention as compared with changes during the waiting period.Ethics and disseminationThis study was approved by the ethics committee of Deutscher Bundesverband für akademische Sprachtherapie und Logopädie (20–10074-KA-MunmErw+Ko). Results and relevant data will be disseminated in peer-reviewed journals, at conferences and on the Open Science Framework.Trial registration numberDRKS00021411 (see Supplementary Table 1).

scholarly journals Research proposal: evaluation of ART in adult patients

2006 ◽  
Vol 14 (spe) ◽  
pp. 25-29 ◽  
Author(s):  
Régia Luzia Zanata
Keyword(s):  
Low Income ◽  
Tooth Extraction ◽  
Clinical Performance ◽  
Low Cost ◽  
Adult Population ◽  
High Viscosity ◽  
Primary Objective ◽  
Atraumatic Restorative Treatment ◽  
Restorative Treatment ◽  
Effect Of Treatment

The primary objective of the Atraumatic RestorativeTreatment (ART) is to reduce the indication of tooth extraction by means of a low-cost technique. Considering the difficulties of Brazilian public services to meet the demand of care of the low-income population, with lack of care to the adult population, which usually receives only emergency care, the aim of this study is to assess the performance of high-viscosity glass ionomer cements accomplished by the modified atraumatic restorative treatment in one- and multiple-surface cavities, compared to the conventional restorative approach. It will be analyzed the clinical performance of the materials; cost (material and human resources); patient satisfaction with the treatment received; and preventive effect of treatment.

scholarly journals Diabetes and associated dietary intake among urban adults: COPEN (Colombian Nutritional Profiles)—a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e042050
Author(s):  
Carlos O Mendivil ◽  
Sebastián A Gutiérrez Romero ◽  
María J Peláez-Jaramillo ◽  
Luz D Nieves-Barreto ◽  
Angélica Montaño-Rodríguez ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Abdominal Obesity ◽  
Low Income ◽  
Plasma Glucose ◽  
Self Report ◽  
Secondary Outcome ◽  
Dietary Recommendations ◽  
Cross Sectional ◽  
Urban Adults ◽  
Nutritional Profiles

ObjectivesDiabetes is increasing rapidly in low-income and middle-income countries. We aimed to estimate the prevalence of diabetes, describe its correlates and its associated dietary intake in urban adults from Colombia.SettingThe Colombian Study of Nutritional Profiles was a population-based, cross-sectional, multi-stage probabilistic sampling survey designed to represent the five main Colombian cities.ParticipantsBetween June and November 2018, we studied 736 non-pregnant participants aged 18 or older. Diabetes was defined as a random plasma glucose ≥200 mg/dL, self-reported prior diagnosis of diabetes or use of any oral or injectable antidiabetic medication(s). Participants also fulfilled a detailed 157-item food-frequency questionnaire.Primary and secondary outcome measuresPrevalence of diabetes, dietary intake of key nutrients, achievement of dietary goals among individuals with diabetes.ResultsThe overall estimated prevalence of diabetes was 10.1%, with no difference by sex (9.6% in women, 10.8% in men, p=0.43). The association between diabetes and education level depended on sex, diabetes was more prevalent among more educated men and less educated women. Abdominal obesity was associated with a 65% increase in diabetes prevalence among men, and a 163% increase in women. Individuals with diabetes reported lower mean consumption of all nutrients, but after adjustment by sex, age, socioeconomic level (SEL) and body mass index, only their lower sodium consumption remained significant (p=0.013). The proportion of non-achievement of dietary intake goals among participants with diabetes was 94.4% for saturated fats, 86.7% for sodium, 84.4% for fibre and 80% for trans fats. In multivariate logistic regression models, age was the strongest independent correlate of diabetes.ConclusionsDiabetes by self-report, random plasma glucose or medication use was highly prevalent among Colombian adults. There were large differences by abdominal obesity status, region of residence, SEL and educational level. The proportion of individuals with diabetes meeting dietary recommendations was alarmingly low.

Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year

2018 ◽  
Vol 103 (5) ◽  
pp. 659-665 ◽  
Author(s):  
Vanita Pathak Ray ◽  
Divya P Rao
Keyword(s):  
Success Rate ◽  
Low Income ◽  
Low Cost ◽  
Primary Outcome Measure ◽  
Glaucoma Drainage Device ◽  
Complication Rates ◽  
Case Review ◽  
Ahmed Glaucoma Valve ◽  
Drainage Device

BackgroundA new low-cost, indigenously manufactured, non-valved glaucoma drainage device (GDD) has been introduced and its design is based on the Baerveldt Glaucoma Device. We aim to demonstrate the efficacy and safety of this GDD (Aurolab aqueous drainage implant, AADI) vis-à-vis the valved device, Ahmed glaucoma valve (AGV), in the management of refractory glaucomas.DesignRetrospective, comparative, interventional.Participants Case review of consecutive patients who underwent GDD surgery by a single fellowship-trained surgeon at a Tertiary Centre between January 2014 and November 2016.Primary outcome measure Intraocular pressure (IOP).SecondaryAntiglaucoma medication (AGM), LogMAR best-corrected visual acuity (BCVA), complications.ResultsA total of 88 eyes of 83 patients were included; 36 eyes received AGV and 52 AADI. Preoperative parameters were similar between groups. Median follow-up was 13 and 12 months for AADI and AGV, respectively. Overall success rate was higher in AADI (92.3%) vs AGV (80.5%) (p<0.001). The median IOP in mm Hg (Quartiles; IQR) (AADI 14 (10,15;5) vs AGV 16 (14,20;6)) and AGM (AADI: 0 (0,1;1) vs AGV 2 (1,2.75;1.75)) was significantly lower in the AADI group at last follow-up (p<0.001). LogMAR BCVA improved in both groups; complication rates (AADI 44.2% vs AGV 52.7%) were comparable (p=0.59).ConclusionsBoth procedures were effective in reduction of IOP and need for AGM. Nevertheless, overall success rate was higher in the AADI group and IOP and number of AGM required was significantly lower in the AADI group; this affordable GDD could have a tremendous impact in the management of refractory glaucomas in low-income to middle-income countries.

scholarly journals Self-Managing Postoperative Pain with the Use of a Novel, Interactive Device: A Proof of Concept Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Luke Mordecai ◽  
Frances H. L. Leung ◽  
Clarissa Y. M. Carvalho ◽  
Danielle Reddi ◽  
Martin Lees ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Controlled Trial ◽  
Primary Objective ◽  
Self Report ◽  
Secondary Outcome ◽  
Pain Scores ◽  
Prospective Randomized Controlled Trial ◽  
Pain Ratings ◽  
The Difference ◽  
Patient Use

Background. Pain is commonly experienced following surgical procedures. Suboptimal management is multifactorial.Objectives. The primary objective was to assess whether patients used a device (Navimed) to self-report pain over and above a normal baseline of observations. Secondary outcome measures included comparison of pain scores and patient use of and feedback on the device.Methods. In a prospective randomized controlled trial, elective gynaecological surgery patients received standard postoperative pain care or standard care plus the Navimed, which allowed them to self-report pain and offered interactive self-help options.Results. 52 female patients, 26 in each of device and standard groups, did not differ in the frequency of nurse-documented pain scores or mean pain scores provided to nurses. The device group additionally reported pain on the device (means 18.50 versus 11.90 pain ratings per day,t(32)=2.75,p<0.001) that was significantly worse than reported to nurses but retrospectively rated significantly less anxiety. 80% of patients found the device useful.Discussion and Conclusion. This study demonstrates that patients used the Navimed to report pain and to help manage it. Further work is required to investigate the difference in pain scores reported and to develop more sophisticated software.

scholarly journals The prevalence of burnout, risk factors and job-related stressors in gastroenterologists: a systematic review

2020 ◽  
Author(s):  
John Ong ◽  
Carla Swift ◽  
Michael Bath ◽  
Sharon Ong ◽  
Wanyen Lim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Female Gender ◽  
Primary Outcome Measure ◽  
Primary Objective ◽  
Personal Accomplishment ◽  
Quality Data ◽  
British Society ◽  
Secondary Outcome ◽  
The Uk ◽  
Meta Analyses

ABSTRACTBackground and aimsClinician burnout is an important occupational hazard and the scale of the problem within gastroenterology remains poorly understood. The primary objective of this study was to identify the prevalence of burnout and its symptoms in gastroenterologists. The secondary objective was to identify risk factors and job-related stressors that commonly contribute to burnout in gastroenterologists.MethodsSystematic searches were conducted in PubMed, Scopus, Cochrane and PsycINFO by two reviewers independently for articles published to 1 September 2020. The primary outcome measure was the reported prevalence of burnout in gastroenterologists. The secondary outcome measures were (i) the prevalence of burnout symptoms (emotional exhaustion, depersonalisation and low personal accomplishment) and (ii) the frequency of risk factors and stressors reported in studies. Data were tabulated and meta-analyses were presented as Funnel and Forest plots.ResultsData were extracted from 11 studies. 54.5% (6/11) of these studies reported the prevalence of burnout in gastroenterologists; this ranged from 18.3% to 64.4%. Similar to burnout prevalence, burnout symptoms showed geographical variation and were common in gastroenterologists (up to 63.9%). Factors associated with work volume, age, and female gender were the three most frequently reported risk factors for increased levels of anxiety, stress or burnout in 72.7% (8/11), 54.5% (6/11), and 45.5% (5/11) of studies respectively. Significant methodological and clinical heterogeneity was observed.ConclusionsBurnout and its symptoms are common in gastroenterologists but the syndrome is understudied within the field. Further research and good quality data are needed to help address the problem.Disclose StatementJO is funded by the British Society of Gastroenterology to conduct burnout research in the UK, and the Journal of Gastroenterology and Hepatology Foundation (Australia) to conduct burnout research in Southeast Asia.

scholarly journals Comparison of longitudinal trends in self-reported symptoms and COVID-19 case activity in Ontario, Canada

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262447
Author(s):  
Arjuna S. Maharaj ◽  
Jennifer Parker ◽  
Jessica P. Hopkins ◽  
Effie Gournis ◽  
Isaac I. Bogoch ◽  
...  
Keyword(s):  
Low Income ◽  
Low Cost ◽  
Virus Transmission ◽  
Population Surveillance ◽  
Primary Objective ◽  
Surveillance Systems ◽  
Digital Surveillance ◽  
Longitudinal Comparison ◽  
Participatory Surveillance ◽  
Positive Correlations

Background Limitations in laboratory diagnostic capacity impact population surveillance of COVID-19. It is currently unknown whether participatory surveillance tools for COVID-19 correspond to government-reported case trends longitudinally and if it can be used as an adjunct to laboratory testing. The primary objective of this study was to determine whether self-reported COVID-19-like illness reflected laboratory-confirmed COVID-19 case trends in Ontario Canada. Methods We retrospectively analyzed longitudinal self-reported symptoms data collected using an online tool–Outbreaks Near Me (ONM)–from April 20th, 2020, to March 7th, 2021 in Ontario, Canada. We measured the correlation between COVID-like illness among respondents and the weekly number of PCR-confirmed COVID-19 cases and provincial test positivity. We explored contemporaneous changes in other respiratory viruses, as well as the demographic characteristics of respondents to provide context for our findings. Results Between 3,849–11,185 individuals responded to the symptom survey each week. No correlations were seen been self-reported CLI and either cases or test positivity. Strong positive correlations were seen between CLI and both cases and test positivity before a previously documented rise in rhinovirus/enterovirus in fall 2020. Compared to participatory surveillance respondents, a higher proportion of COVID-19 cases in Ontario consistently came from low-income, racialized and immigrant areas of the province- these groups were less well represented among survey respondents. Interpretation Although digital surveillance systems are low-cost tools that have been useful to signal the onset of viral outbreaks, in this longitudinal comparison of self-reported COVID-like illness to Ontario COVID-19 case data we did not find this to be the case. Seasonal respiratory virus transmission and population coverage may explain this discrepancy.

IoT based e-Healthcare System to Enable Remote Patient Care based on Cloud Server

2017 ◽  
Vol 7 (7) ◽  
pp. 36
Author(s):  
P.Venu Gopala Rao ◽  
Eslavath Raja ◽  
Ramakrishna Gandi ◽  
G. Ravi Kumar
Keyword(s):  
Low Cost ◽  
Vital Signs ◽  
Smart Phone ◽  
Medical Professional ◽  
Design Parameters ◽  
Cloud Server ◽  
Significant Area ◽  
Efficient Data ◽  
System Data ◽  
Remote Patient

IoT (Internet of Things) has become most significant area of research to design an efficient data enabled services with the help of sensors. In this paper, a low-cost system design for e-healthcare service to process the sensitive health data is presented. Vital signs of the human body are measured from the patient location and shared with a registered medical professional for consultation. Temperature and heart rate are the major signals obtained from a patient for the initial build of the system. Data is sent to a cloud server where processing and analysis is provided for the medical professional to analyze. Secure transmission and dissemination of data through the cloud server is provided with an authentication system and the patient could be able to track his data through a smart phone on connecting to the cloud server. A prototype of the system along with its design parameters has been discussed.

Comparative study of intracranial access in thrombectomy using next generation 0.088 inch guide catheter technology

2021 ◽  
pp. neurintsurg-2021-017341
Author(s):  
Devin V Bageac ◽  
Blake S Gershon ◽  
Jan Vargas ◽  
Maxim Mokin ◽  
Zeguang Ren ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Anterior Circulation ◽  
Guide Catheter ◽  
Catheter Failure ◽  
Catheter Technology ◽  
Intracranial Vasculature

BackgroundMost conventional 0.088 inch guide catheters cannot safely navigate intracranial vasculature. The objective of this study is to evaluate the safety of stroke thrombectomy using a novel 0.088 inch guide catheter designed for intracranial navigation.MethodsThis is a multicenter retrospective study, which included patients over 18 years old who underwent thrombectomy for anterior circulation large vessel occlusions. Technical outcomes for patients treated using the TracStar Large Distal Platform (TracStar LDP) or earlier generation TRX LDP were compared with a matched cohort of patients treated with other commonly used guide catheters. The primary outcome measure was device-related complications. Secondary outcome measures included guide catheter failure and time between groin puncture and clot engagement.ResultsEach study arm included 45 patients. The TracStar group was non-inferior to the control group with regard to device-related complications (6.8% vs 8.9%), and the average time to clot engagement was 8.89 min shorter (14.29 vs 23.18 min; p=0.0017). There were no statistically significant differences with regard to other technical outcomes, including time to recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2B). The TracStar was successfully advanced into the intracranial internal carotid artery in 33 cases (73.33%); in three cases (6.67%), it was swapped for an alternate catheter. Successful reperfusion (mTICI 2B-3) was achieved in 95.56% of cases. Ninety-day follow-up data were available for 86.67% of patients, among whom 46.15% had an modified Rankin Score of 0–2%, and 10.26% were deceased.ConclusionsTracstar LDP is safe for use during stroke thrombectomy and was associated with decreased time to clot engagement. Intracranial access was regularly achieved.

Self-inflicted injuries: The intersection of mental health and traumatic injury in Malawi

2021 ◽  
pp. 004947552110131
Author(s):  
Brittney M Williams ◽  
Linda Kayange ◽  
Laura Purcell ◽  
Jared Gallaher ◽  
Anthony Charles
Keyword(s):  
Mental Health ◽  
Hospital Mortality ◽  
Low Income ◽  
Retrospective Review ◽  
Primary Outcome ◽  
Trauma Registry ◽  
Traumatic Injury ◽  
Low Income Countries ◽  
Intentional Injury ◽  
Fall From Height

Self-inflicted injury, the most common form of intentional injury, disproportionately affects low-income countries, but is poorly described in this setting. This retrospective review of the 2008–2018 trauma registry at a referral hospital in Malawi included all victims of intentional injury ≥10 years. Self-inflicted injuries were compared to assaults. The primary outcome was in-hospital mortality. Common mechanisms of self-inflicted injuries were fall from height, poisoning, and penetrating injury. In-hospital mortality from self-inflicted injury was 8.8% vs. 1.9% for assault. Those who died from self-inflicted injury were more often older (median 34 vs. 26 years, p < 0.001), male (91.9% vs. 67.8%, p < 0.001), unemployed (32.8% vs. 6.4%, p < 0.001), and most commonly died by hanging (60%). The odds of in-hospital mortality after self-inflicted injury was four times assault (OR 4.0 [95% CI 1.4–11.5], p = 0.01). The trauma registry proved useful for describing self-inflicted injury in this setting.

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