Stroke services in Africa: What is there and what is needed

2022 ◽  
pp. 174749302110664
Author(s):  
Tamer Roushdy ◽  
Hany Aref ◽  
Selma Kesraoui ◽  
Michael Temgoua ◽  
Kiatoko Ponte Nono ◽  
...  
Keyword(s):  
Online Survey ◽  
A Priori ◽  
Stroke Care ◽  
Diagnostic Tools ◽  
African Countries ◽  
Related Services ◽  
The Past ◽  
Care Services ◽  
Stroke Services ◽  
Corrective Procedures

Background: Over the past few years, the incidence and prevalence of stroke has been rising in most African countries and has been reported as one of the leading causes of morbidity and mortality. To study this problem, we need to realize the quality and availability of stroke care services as a priori to improve them. Methods and Results: In this study, we investigated the availability of different stroke-related services in 17 countries from different African regions. An online survey was conducted and fulfilled by stroke specialists and included primary prevention, acute management, diagnostic tools, medications, postdischarge services, and stroke registries. The results showed that although medications for secondary prevention are available, yet many other services are lacking in various countries. Conclusion: This study displays the deficient aspects of stroke services in African countries as a preliminary step toward active corrective procedures for the improvement of stroke-related health services.

Stroke Care Services in Africa: A Systematic Review

2018 ◽  
Vol 1 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Rufus O. Akinyemi ◽  
Olaleye A. Adeniji
Keyword(s):  
Large Scale ◽  
Systems Of Care ◽  
Care Delivery ◽  
Stroke Care ◽  
Developed Countries ◽  
High Morbidity ◽  
New Paradigm ◽  
African Countries ◽  
Care Services ◽  
Stroke Services

Background: Stroke is the second leading cause of death and adult-onset disability globally. Although its incidence is reducing in developed countries, low- and middle-income countries, especially African countries, are witnessing an increase in cases of stroke, leading to high morbidity and mortality. Evidently, a new paradigm is needed on the continent to tackle this growing burden of stroke in its preventative and treatment aspects. Aims and Objectives: The aim of this study was to determine the scope of stroke care services, where they exist, and their relationship with currently existing health systems. Methods: A detailed literature search was undertaken referring to PubMed and Google Scholar for articles from January 1960 to March 2018, using a range of search terms. Of 93 publications, 45 papers were shortlisted, and 21 reviewed articles on existing stroke services were included. Results: The literature on models of stroke services in Africa is sparse. We identified focused systems of care delivery in the hyperacute, acute, and rehabilitative phases of stroke in a few African countries. There is a continent-wide paucity of data on the organization of prehospital stroke services. Only 3 African countries (South Africa, Egypt, and Morocco) reported experiences on thrombolysis. Also, the uptake of dedicated stroke units appears limited across the continent. Encouragingly, there are large-scale secondary prevention models on the continent, mostly within the context of experimental research projects, albeit with promising results. We found only 1 article on the interventional aspects of stroke care in our review, and this was a single-center report. Conclusions: The literature on the organization of stroke services is sparse in Africa. Dedicated action at policy, population, community, and hospital-based levels is urgently needed toward the organization of stroke services to tame the burgeoning burden of stroke on the African continent.

scholarly journals Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

2017 ◽  
Vol 49 (1-2) ◽  
pp. 45-61 ◽  
Author(s):  
Jeyaraj Durai Pandian ◽  
Akanksha G. William ◽  
Mahesh P. Kate ◽  
Bo Norrving ◽  
George A. Mensah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care Services ◽  
Cost Effective ◽  
Stroke Care ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
Stroke Services ◽  
Low And Middle Income

Background: The burden of stroke in low- and middle-income countries (LMICs) is large and increasing, challenging the already stretched health-care services. Aims and Objectives: To determine the quality of existing stroke-care services in LMICs and to highlight indigenous, inexpensive, evidence-based implementable strategies being used in stroke-care. Methods: A detailed literature search was undertaken using PubMed and Google scholar from January 1966 to October 2015 using a range of search terms. Of 921 publications, 373 papers were shortlisted and 31 articles on existing stroke-services were included. Results: We identified efficient models of ambulance transport and pre-notification. Stroke Units (SU) are available in some countries, but are relatively sparse and mostly provided by the private sector. Very few patients were thrombolysed; this could be increased with telemedicine and governmental subsidies. Adherence to secondary preventive drugs is affected by limited availability and affordability, emphasizing the importance of primary prevention. Training of paramedics, care-givers and nurses in post-stroke care is feasible. Conclusion: In this systematic review, we found several reports on evidence-based implementable stroke services in LMICs. Some strategies are economic, feasible and reproducible but remain untested. Data on their outcomes and sustainability is limited. Further research on implementation of locally and regionally adapted stroke-services and cost-effective secondary prevention programs should be a priority.

scholarly journals Immunodiagnostic Methods: What Is Their Role in Areas of Low Endemicity?

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Rafaella Fortini Queiroz Grenfell ◽  
Vanessa Silva-Moraes ◽  
Diana Taboada ◽  
Ana Carolina Alves de Mattos ◽  
Ana Karine Sarvel de Castro ◽  
...  
Keyword(s):  
Public Health Problem ◽  
Parasite Load ◽  
Current Status ◽  
Diagnostic Tools ◽  
African Countries ◽  
Diagnostic Assays ◽  
The Past ◽  
Control Programmes ◽  
Core Areas ◽  
Remarkable Progress

WorldwideSchistosomiasis mansonicontinues to be a serious public health problem. Over the past decades, control programmes have made remarkable progress in reducingS. mansoniinfections to a relatively low level in Brazil and African countries. Endemic regions are currently circumscribed in certain core areas where reinfection and repeated chemotherapy are frequent and, consequently, are related to residents with low parasite load. At present, diagnosis is predominately a key step for final disease control although low endemicity area residents are hardly detected by most of the available assays. In this paper, we review the current status and efforts made aiming at the improvement of diagnostic tools forS. mansoniin low endemicity infections. The establishment of diagnostic assays—simple, affordable, sensitive, and specific for field diagnosis ofS. mansoni—is essential and should be given high priority.

The Impact of War on Population Health

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Turkan Ahmet
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Care Services ◽  
Negative Effects ◽  
The Past ◽  
Care Services ◽  
Physical Environments ◽  
The Social ◽  
Personal Experiences ◽  
The Impact

The past few decades of ongoing war in Iraq has had a dramatic impact on the health of Iraq’s population. Wars are known to have negative effects on the social and physical environments of individuals, as well as limit their access to the available health care services. This paper explores the personal experiences of my family members, who were exposed to war, as well as includes information that has been reviewed form many academic sources. The data aided in providing recommendations and developing strategies, on both local and international levels, to improve the health status of the populations exposed to war.

Weiterentwicklung der «Waldpolitik 2020» aus Sicht der Schweizer Waldstakeholder

2016 ◽  
Vol 167 (4) ◽  
pp. 221-228 ◽  
Author(s):  
Astrid Zabel ◽  
Eva Lieberherr
Keyword(s):  
Policy Process ◽  
Online Survey ◽  
Development Process ◽  
Sustainable Forest Management ◽  
Forest Policy ◽  
Legislative Process ◽  
Expert Interviews ◽  
The Past ◽  
Conflicting Interests ◽  
Forest Act

Advancement of the Swiss Forest Policy 2020 from stakeholders' perspectives In light of the ending of the Swiss “ Forest Policy 2020”, this article assesses the goals, challenges and concerns of Swiss forest stakeholders in relation to forest policy post 2020. The data were collected through expert interviews and an online survey. The results show that securing an economically sustainable forest management and economically viable silvicultural businesses are key concerns for many stakeholders. Apart from these issues, several further and sometimes conflicting interests were mentioned. The study concludes that a debate on an adjustment of the weights given to goals in the Swiss Forest Policy 2020 may be commendable. However, there does not appear to be need for a complete change of course in order to address the stakeholders' needs and concerns. In terms of policy process, most stakeholders positively evaluated the past planning and development process of the Swiss Forest Policy 2020, but also provided suggestions for improvements. Finally, a network analysis revealed that the Swiss Federal Agency for the Environment, the Swiss Forest Owners Association and the Conference of Cantonal Foresters played a central role in the amendment of the Swiss Federal Forest Act. The analysis also showed that more stakeholders find each other as important than actually work together in a legislative process.

Australian Orthodontists Utilization and Attitude Toward a Government Funded Cleft Scheme

2021 ◽  
pp. 105566562198912
Author(s):  
Morgan Wishney ◽  
Aziz Sahu-Khan ◽  
Peter Petocz ◽  
M. Ali Darendeliler ◽  
Alexandra K. Papadopoulou
Keyword(s):  
Cleft Palate ◽  
Online Survey ◽  
Cleft Lip ◽  
Training Programs ◽  
Capital City ◽  
Australian Society ◽  
Capital Cities ◽  
The Past ◽  
Orthodontic Training ◽  
University Training

Objectives: To (1) survey Australian orthodontists about their involvement with a government-funded scheme for patients with clefts, the Medicare Cleft Lip and Cleft Palate Scheme (MCLCPS) and (2) investigate their attitude toward treating patients with clefts and their training in this respect. Design: A 13-question online survey was distributed to members of the Australian Society of Orthodontists. The survey gathered information regarding respondent demographics, the number of MCLCPS-eligible patients seen in the past 12 months and usual billing practices. Results: A total of 96 complete responses were obtained. About 70% of respondents had treated MCLCPS-eligible patients in the past 12 months and 55% saw between 2 and 5 patients during this time. The likelihood of treating patients with clefts increased by a factor of 4.8 (95% CI: 1.2-18.9) if practicing outside of a capital city and 1.5 times for each decade increase in orthodontist’s age (95% CI: 1.0-2.2). The MCLCPS was utilized by 81% of orthodontists with 26% of these respondents accepting rebate only. Most orthodontists felt their university training could have better prepared them to treat patients with clefts. A minority of orthodontists felt that a rebate increase would make them more likely to treat these patients. Conclusions: Australian orthodontists who treat patients with clefts tend to be older and work outside of capital cities. The decision to treat these patients tends to not be financially motived. Specialty orthodontic training programs could improve the preparedness of their graduates to treat patients with clefts.

scholarly journals Morphological Characteristics, Classifications and Difficulties in the Use of Diagnostic Criteria for Serrated Lesions of the Large Intestine

2021 ◽  
Author(s):  
Cesar de Souza Bastos Junior ◽  
Vera Lucia Nunes Pannain ◽  
Adriana Caroli-Bottino
Keyword(s):  
Diagnostic Criteria ◽  
Morphological Characteristics ◽  
World Health ◽  
Diagnostic Tools ◽  
Serrated Adenoma ◽  
The Past ◽  
The World ◽  
Serrated Lesions ◽  
Health Organization

Abstract Introduction Colorectal carcinoma (CRC) is the most common gastrointestinal neoplasm in the world, accounting for 15% of cancer-related deaths. This condition is related to different molecular pathways, among them the recently described serrated pathway, whose characteristic entities, serrated lesions, have undergone important changes in their names and diagnostic criteria in the past thirty years. The multiplicity of denominations and criteria over the last years may be responsible for the low interobserver concordance (IOC) described in the literature. Objectives The present study aims to describe the evolution in classification of serrated lesions, based on the last three publications of the World Health Organization (WHO) and the reproducibility of these criteria by pathologists, based on the evaluation of the IOC. Methods A search was conducted in the PubMed, ResearchGate and Portal Capes databases, with the following terms: sessile serrated lesion; serrated lesions; serrated adenoma; interobserver concordance; and reproducibility. Articles published since 1990 were researched. Results and Discussion The classification of serrated lesions in the past thirty years showed different denominations and diagnostic criteria. The reproducibility and IOC of these criteria in the literature, based on the kappa coefficient, varied in most studies, from very poor to moderate. Conclusions Interobserver concordance and the reproducibility of microscopic criteria may represent a limitation for the diagnosis and appropriate management of these lesions. It is necessary to investigate diagnostic tools to improve the performance of the pathologist's evaluation, for better concordance, and, consequently, adequate diagnosis and treatment.

scholarly journals Heterogeneity of SARS-CoV-2 virus produced in cell culture revealed by shotgun proteomics and supported by genome sequencing

2021 ◽  
Author(s):  
Fabrice Gallais ◽  
Olivier Pible ◽  
Jean-Charles Gaillard ◽  
Stéphanie Debroas ◽  
Hélène Batina ◽  
...  
Keyword(s):  
Molecular Structure ◽  
Cell Culture ◽  
Shotgun Proteomics ◽  
Rapid Analysis ◽  
Diagnostic Tools ◽  
Tandem Mass ◽  
The Past ◽  
Viral Particles ◽  
Depth Analysis ◽  
The Subject

AbstractCOVID-19 is the most disturbing pandemic of the past hundred years. Its causative agent, the SARS-CoV-2 virus, has been the subject of an unprecedented investigation to characterize its molecular structure and intimate functioning. While markers for its detection have been proposed and several diagnostic methodologies developed, its propensity to evolve and evade diagnostic tools and the immune response is of great concern. The recent spread of new variants with increased infectivity requires even more attention. Here, we document how shotgun proteomics can be useful for rapidly monitoring the evolution of the SARS-CoV-2 virus. We evaluated the heterogeneity of purified SARS-CoV-2 virus obtained after culturing in the Vero E6 cell line. We found that cell culture induces significant changes that are translated at the protein level, such changes being detectable by tandem mass spectrometry. Production of viral particles requires careful quality control which can be easily performed by shotgun proteomics. Although considered relatively stable so far, the SARS-CoV-2 genome turns out to be prone to frequent variations. Therefore, the sequencing of SARS-CoV-2 variants from patients reporting only the consensus genome after its amplification would deserve more attention and could benefit from more in-depth analysis of low level but crystal-clear signals, as well as complementary and rapid analysis by shotgun proteomics. Graphical abstract

scholarly journals Evaluating Metrics Applied to the Medical Science Liaison (MSL) Role: A Survey-Based Study of Canadian MSL Leaders

2021 ◽  
Author(s):  
Munaza Saleem ◽  
Lisa Cesario ◽  
Lisa Wilcox ◽  
Marsha Haynes ◽  
Simon Collin ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professional ◽  
Online Survey ◽  
Medical Science ◽  
Specialty Care ◽  
Product Lifecycle ◽  
The Past ◽  
Data Analyses ◽  
Quantitative Metrics ◽  
Frequency Of Use

Abstract Introduction Metrics utilized within the Medical Science Liaison (MSL) role are plentiful and traditionally quantitative. We sought to understand the current use and value of metrics applied to the MSL role, including the use of qualitative metrics. Methods We developed a list of 70 MSL leaders working in Canada, spanning 29 companies. Invitations were emailed Jun 16, 2020 and the 25-question online survey was open for 3 weeks. Questions were designed to assess demographics as well as how and why metrics are applied to the MSL role. Data analyses were descriptive. Results Responses were received from 44 leaders (63%). Of the 42 eligible, 45% had ≤ 2 years of experience as MSL leaders and 86% supported specialty care products over many phases of the product lifecycle. A majority (69%) agreed or strongly agreed that metrics are critical to understanding whether an MSL is delivering value, and 98% had used metrics in the past year. The most common reason to use metrics was ‘to show value/impact of MSLs to leadership’ (66%). The most frequently used metric was ‘number of health-care professional (HCP) interactions’, despite this being seen as having moderate value. Quantitative metrics were used more often than qualitative, although qualitative were more often highly valued. Conclusion The data collected show a lack of agreement between the frequency of use for some metrics and their value in demonstrating the contribution of an MSL. Overall, MSL leaders in our study felt qualitative metrics were a better means of showing the true impact of MSLs.

Workplace mental health: Current practice and support needs of Ontario occupational therapists

2018 ◽  
Vol 85 (5) ◽  
pp. 408-417
Author(s):  
Sandra E. Moll ◽  
Caitlin M. Heino ◽  
Alison H. LeBlanc ◽  
Lydia B. Beck ◽  
Laura M. Kalef
Keyword(s):  
Mental Health ◽  
Occupational Therapy ◽  
Online Survey ◽  
Occupational Therapists ◽  
Cross Sectional Study ◽  
Support Needs ◽  
Cross Sectional ◽  
Related Services ◽  
Work Related ◽  
Workplace Mental Health

Background. Workplace mental health (WMH) is an important and expanding practice area for occupational therapists. Purpose. This cross-sectional study explores the current practices and support needs of Ontario-based occupational therapists in WMH. Method. Registrants from the provincial association who provide mental health and/or work-related services were invited to participate. Ninety-three therapists completed an online survey; 10 participated in follow-up focus groups. Analysis involved descriptive statistics of the survey data and content analysis of the focus group data. Findings. Return to work, reactivation, and functional cognitive assessment were the most commonly reported services. Key challenges were limited funding and training and lack of awareness of the occupational therapy role. Therapists emphasized the importance of raising the competence, credibility, and profile of occupational therapy in WMH. Implications. Defining the role of occupational therapy, developing training and resources, and advocacy are needed to advance occupational therapy practice within this rapidly changing field.

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