Feasibility of a Symptom Management Intervention for Honduran Adults Undergoing Chemotherapy

2019 ◽  
Vol 41 (10) ◽  
pp. 1517-1539 ◽  
Author(s):  
Suyapa Bejarano ◽  
Meghan E. Freed ◽  
Darwin Zeron ◽  
Rennie Medina ◽  
Julio Cesar Zuniga-Moya ◽  
...  
Keyword(s):  
Symptom Management ◽  
Quantitative Data ◽  
Treatment Manual ◽  
Evidence Based ◽  
Middle Income ◽  
Qualitative And Quantitative ◽  
Management Intervention ◽  
Middle Income Countries ◽  
Different Types ◽  
Nurse Time

Evidence-based interventions often need to be adapted to maximize their implementation potential in low-to middle-income countries. A single-arm feasibility study was conducted to determine the feasibility and acceptability of a telephone-delivered, nurse-led, symptom management intervention for adults undergoing chemotherapy in Honduras. Over the course of 6 months, nurses engaged 25 patients undergoing chemotherapy in the intervention. Each participant received an average of 16.2 attempts to contact them for telephone sessions ( SD = 8.0, range = 2-28). Collectively, the participants discussed 24 different types of symptoms. The most commonly discussed symptoms were pain (12%), nausea (7%), and constipation (5%). Qualitative and quantitative data were used to identify treatment manual modifications (i.e., adding content about different symptoms and addressing scheduling of treatment) and workplace modifications (i.e., dedicated nurse time and space) that are needed to optimize implementation of the intervention.

Health research capacity in Nepal: Analysis of the trend and the role of local researchers

2021 ◽  
pp. 004947552098277
Author(s):  
Madhu Kharel ◽  
Alpha Pokharel ◽  
Krishna P Sapkota ◽  
Prasant V Shahi ◽  
Pratisha Shakya ◽  
...  
Keyword(s):  
Health Research ◽  
Fold Increase ◽  
Research Capacity ◽  
Rapid Review ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Evidence Based Decision Making

Evidence-based decision-making is less common in low- and middle-income countries where the research capacity remains low. Nepal, a lower-middle-income country in Asia, is not an exception. We conducted a rapid review to identify the trend of health research in Nepal and found more than seven-fold increase in the number of published health-related articles between 2000 and 2018. The proportion of articles with Nepalese researchers as the first authors has also risen over the years, though they are still only in two-thirds of the articles in 2018.

scholarly journals Evidence-Based Guidelines for Mental, Neurological, and Substance Use Disorders in Low- and Middle-Income Countries: Summary of WHO Recommendations

PLoS Medicine ◽  
2011 ◽  
Vol 8 (11) ◽  
pp. e1001122 ◽  
Author(s):  
Tarun Dua ◽  
Corrado Barbui ◽  
Nicolas Clark ◽  
Alexandra Fleischmann ◽  
Vladimir Poznyak ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Evidence Based Guidelines ◽  
Low And Middle Income

scholarly journals Evidence-based interventions to reduce mortality among preterm and low-birthweight neonates in low-income and middle-income countries: a systematic review and meta-analysis

2021 ◽  
Vol 6 (2) ◽  
pp. e003618
Author(s):  
Mirjam Y Kleinhout ◽  
Merel M Stevens ◽  
Kwabena Aqyapong Osman ◽  
Kwame Adu-Bonsaffoh ◽  
Floris Groenendaal ◽  
...  
Keyword(s):  
Low Income ◽  
Low Birthweight ◽  
Meta Analysis ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Evidence Based ◽  
Antenatal Corticosteroids ◽  
Essential Newborn Care ◽  
Middle Income ◽  
Middle Income Countries

BackgroundPreterm birth is the leading cause of under-five-mortality worldwide, with the highest burden in low-income and middle-income countries (LMICs). The aim of this study was to synthesise evidence-based interventions for preterm and low birthweight (LBW) neonates in LMICs, their associated neonatal mortality rate (NMR), and barriers and facilitators to their implementation. This study updates all existing evidence on this topic and reviews evidence on interventions that have not been previously considered in current WHO recommendations.MethodsSix electronic databases were searched until 3 March 2020 for randomised controlled trials reporting NMR of preterm and/or LBW newborns following any intervention in LMICs. Risk ratios for mortality outcomes were pooled where appropriate using a random effects model (PROSPERO registration number: CRD42019139267).Results1236 studies were identified, of which 49 were narratively synthesised and 9 contributed to the meta-analysis. The studies included 39 interventions in 21 countries with 46 993 participants. High-quality evidence suggested significant reduction of NMR following antenatal corticosteroids (Pakistan risk ratio (RR) 0.89; 95% CI 0.80 to 0.99|Guatemala 0.74; 0.68 to 0.81), single cord (0.65; 0.50 to 0.86) and skin cleansing with chlorhexidine (0.72; 0.55 to 0.95), early BCG vaccine (0.64; 0.48 to 0.86; I2 0%), community kangaroo mother care (OR 0.73; 0.55 to 0.97; I2 0%) and home-based newborn care (preterm 0.25; 0.14 to 0.48|LBW 0.42; 0.27 to 0.65). No effects on perinatal (essential newborn care 1.02; 0.91 to 1.14|neonatal resuscitation 0.95; 0.84 to 1.07) or 7-day NMR (essential newborn care 1.03; 0.83 to 1.27|neonatal resuscitation 0.92; 0.77 to 1.09) were observed after training birth attendants.ConclusionThe findings of this study encourage the implementation of additional, evidence-based interventions in the current (WHO) guidelines and to be selective in usage of antenatal corticosteroids, to reduce mortality among preterm and LBW neonates in LMICs. Given the global commitment to end all preventable neonatal deaths by 2030, continuous evaluation and improvement of the current guidelines should be a priority on the agenda.

Abstract WP418: A Systematic Comparison of Key Features of Ischaemic Stroke Prevention Guidelines in Low- and Middle-income vs High-income Countries

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hernan O Bayona ◽  
Mayowa Owolabi ◽  
Wayne Feng ◽  
James R Sawers ◽  
Paul Olowoyo ◽  
...  
Keyword(s):  
Stroke Prevention ◽  
High Income ◽  
Evidence Based ◽  
Vascular Risk ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Prevention Guideline ◽  
Prevention Guidelines ◽  
Low And Middle Income

Introduction: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low- and Middle-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. Focus therefore, should be on approaches enabling healthcare systems to improve control of vascular risk factors. Objective: We aimed to compare important features of stroke prevention guidelines between LMICs and High Income Countries (HICs). Methods: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: “Stroke” and “Guidelines”. We critically appraised the articles for evidence level, issuance frequency and implementation aspects to clinical practice. Results: Among 45 stroke prevention guidelines published, 28 (62%) met eligibility criteria: 7 from LMICs (25%) and 21 from HICs (75%). LMIC-issued guidelines were less likely to have conflict of interest declarations (57% vs. 100%, p=0.01), involve high quality systematic reviews (57% vs. 95%, p= 0.03), had good dissemination channels (14% vs 71%, p=0.02). The patient views and preferences were the most significant stakeholder considerations in HICs (43%, p=0.04) compared with LMICs. Conclusion: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.

Abstract P681: Implementation of Stroke Prevention Interventions in Low- and Middle-Income Countries: A Scoping Review

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Nessa Ryan ◽  
Vida Rebello ◽  
Desiree Gutierrez ◽  
Kameko Washburn ◽  
Alvaro Zevallos Barboza ◽  
...  
Keyword(s):  
Scoping Review ◽  
Stroke Prevention ◽  
Health Workers ◽  
Evidence Based ◽  
Community Based Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Implementation Outcomes ◽  
Prevention Interventions ◽  
Low And Middle Income

Background: Stroke is the second leading cause of death globally and an increasing concern in low- and middle-income countries (LMIC) where, due to limited capacity to treat stroke, preventative efforts are critically important. Although some research on evidence-based interventions for stroke prevention in LMIC exists, there remains a significant gap in understanding of their implementation across various contexts in LMIC. Objectives: In this scoping review, our objective was to identify and synthesize the implementation outcomes (using Proctor et al.’s taxonomy, 2011) for stroke prevention interventions, as well as to describe the diverse interventions employed. Methods: Eligible studies were empirical, focused on implementation of stroke prevention programs or policies, and occurred in at least one LMIC. Five databases were searched, including PubMed, PsycINFO, CINAHL, EMBASE, and Web of Science. Two reviewers independently assessed studies for selection and charted data; discrepancies were resolved through discussion with a third reviewer until consensus was reached. Narrative synthesis was used to analyze and interpret the findings. Results: Studies were predominantly focused in Asia, targeting primary or secondary prevention, and facility-based. Interventions were conducted at the level of individual (n=11), system (n=12), or both (n=4). Various implementation outcomes were reported, most commonly cost (n=10), acceptability (n=7), fidelity (n=7), and feasibility (n=6), but also adoption (n=4), penetration (n=3), appropriateness (n=1), and sustainability (n=1). Conclusions: Findings highlight the breadth of evidence-based interventions for stroke prevention available to implement in LMIC settings, including culturally acceptable education interventions, cost-effective medications, and community-based interventions implemented by community health workers. Implementation outcomes remain under-reported, and more rigorous research is needed to better plan and evaluate the implementation of these interventions to prevent stroke.

scholarly journals Feasibility of an Intervention for Patients with Cognitive Impairment Using an Interactive Digital Calendar with Mobile Phone Reminders (RemindMe) to Improve the Performance of Activities in Everyday Life

2020 ◽  
Vol 17 (7) ◽  
pp. 2222
Author(s):  
Maria Andreassen ◽  
Helena Hemmingsson ◽  
Inga-Lill Boman ◽  
Henrik Danielsson ◽  
Tiny Jaarsma
Keyword(s):  
Mobile Phone ◽  
Everyday Life ◽  
Quantitative Data ◽  
Occupational Therapists ◽  
Successful Implementation ◽  
Evidence Based ◽  
Intention To Use ◽  
Qualitative And Quantitative

The aim of this study is to increase evidence-based interventions by investigating the feasibility of an intervention using an interactive digital calendar with mobile phone reminders (RemindMe) as support in everyday life. Qualitative and quantitative data were collected from participating patients (n = 8) and occupational therapists (n = 7) from three rehabilitation clinics in Sweden. The intervention consisted of delivering the interactive digital calendar RemindMe, receiving an individualized introduction, a written manual, and individual weekly conversations for two months with follow-up assessments after two and four months. Feasibility areas of acceptability, demand, implementation, practicality, and integration were examined. Patients expressed their interest and intention to use RemindMe and reported a need for reminders and individualized support. By using reminders in activities in everyday life their autonomy was supported. The study also demonstrated the importance of confirming reminders and the possible role of habit-forming. Occupational therapists perceived the intervention to be useful at the rehabilitation clinics and the weekly support conversations enabled successful implementation. This study confirmed the importance of basing and tailoring the intervention to patients’ needs and thus being person-centered.

PP124 Health Technology Assessment And Feedback For Healthy Workplace Culture In Malaria Care In Low And Middle Income Countries

2018 ◽  
Vol 34 (S1) ◽  
pp. 114-114
Author(s):  
Patrick Okwen ◽  
Raphael Cheabum ◽  
Etienne Che ◽  
Joy Ngwemsi Mbunu ◽  
Miriam Nkangu
Keyword(s):  
Workplace Culture ◽  
Evidence Based ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Children Under Five ◽  
Under Five ◽  
Middle Income Countries ◽  
Percent Improvement ◽  
Evidence Based Care ◽  
Low And Middle Income

Introduction:Malaria is a leading cause of mortality and morbidity in children under five in low and middle income countries (LMICs). Management of malaria in children under five years of age is challenging. One challenge faced by clinical practice in LMICs is lack of evidence to guide practice. This challenge is further compounded by different training backgrounds of team members. In the management of malaria in Cameroon, conflicts usually arise between clinicians, lab technicians and pharmacists resulting in over diagnosis and treatment of malaria. The patient's view is usually not considered. This leads to over diagnosis and over prescriptions for malaria in children under five years of age.Methods:We used the Joanna Briggs Institute (JBI) approach of getting research into practice to organize stakeholder meetings, assess existing evidence in malaria care, develop evidence criteria for management based on levels of evidence, assess the gamut of care for malaria, provide feedback to clinicians and re-assess practice. We used the JBI practical application of clinical evidence system (PACES) and getting research into practice (GRiP) evidence implementation tools in the process to facilitate teamwork, collaboration on evidence and provide feedback.Results:A collaborative approach to assessments and feedback including all healthcare stakeholders significantly improved workplace culture of evidence-based care and staff-to-staff relationships as well as staff-to-patient relationships. Over a period of twelve months, we reported eighty-four percent fewer conflicts between staff and ninety-eight percent fewer conflicts between staff and patients. For malaria management, overall criteria showed a thirty-one percent improvement in compliance with best practice recommendations with evidence levels of Grade 1.Conclusions:The project demonstrated that local leadership and evidence-based care can significantly improve practice in resource limited settings.

scholarly journals A New Decision-Making Method for Stock Portfolio Selection Based on Computing with Linguistic Assessment

2009 ◽  
Vol 2009 ◽  
pp. 1-20 ◽  
Author(s):  
Chen-Tung Chen ◽  
Wei-Zhan Hung
Keyword(s):  
Decision Making ◽  
Portfolio Selection ◽  
Quantitative Data ◽  
Decision Makers ◽  
Stock Selection ◽  
Qualitative And Quantitative ◽  
Selection Problems ◽  
Different Types ◽  
Linguistic Assessment ◽  
Stock Portfolio

The purpose of stock portfolio selection is how to allocate the capital to a large number of stocks in order to bring a most profitable return for investors. In most of past literatures, experts considered the portfolio of selection problem only based on past crisp or quantitative data. However, many qualitative and quantitative factors will influence the stock portfolio selection in real investment situation. It is very important for experts or decision-makers to use their experience or knowledge to predict the performance of each stock and make a stock portfolio. Because of the knowledge, experience, and background of each expert are different and vague, different types of 2-tuple linguistic variable are suitable used to express experts' opinions for the performance evaluation of each stock with respect to criteria. According to the linguistic evaluations of experts, the linguistic TOPSIS and linguistic ELECTRE methods are combined to present a new decision-making method for dealing with stock selection problems in this paper. Once the investment set has been determined, the risk preferences of investor are considered to calculate the investment ratio of each stock in the investment set. Finally, an example is implemented to demonstrate the practicability of the proposed method.

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