scholarly journals Promoting Simulation-Based Learning through Low-Cost Simulators: Development, Skills Targeted and Implementation

2021 ◽  
Author(s):  
Inaaya Fatima Khan ◽  
youness zidoun ◽  
Sharon Mascarenhas ◽  
Nabil Zary
Keyword(s):  
Medical Education ◽  
Low Cost ◽  
Cost Effective ◽  
Learning Approaches ◽  
Skills Acquisition ◽  
Middle Income ◽  
Diverse Range ◽  
Low Middle Income Countries ◽  
Simulation Based ◽  
Invaluable Tool

Background: Simulations have historically aided training programs by providing a realistic and holistic replication of professional scenarios and procedures. Simulations have developed over the past 40 years to include varying fidelities and modalities of simulation. Learning in a simulation-centered environment has benefits, ranging from improved patient care to specific skills acquisition while catering to students’ numerous and varied learning approaches. Simulation is a multifaceted field that benefits all parties, the teachers, the learners, and the patients. The application of simulation to medical education and its amalgamation with other modes and substitutes allows for a more integrated learning and testing curriculum that advances the current trajectory of medical education. Such developments, however, are limited to resource rich areas, leaving behind low-middle income countries to use traditional, less evolved methodologies and practices. This review aimed to explore different aspects of simulation and focus specifically on low-cost task trainers and their accessibility. Method: The purpose of the study was to assess the accessibility of low-cost task trainers in terms of cost-effectiveness, distribution, validation, and frequency within specific specialties. To do so, 84 PubMed publications have been screened, and 39 filtered research studies have collected the necessary data. After analyzing the papers, we classified the following information – process, specialization, validation (y/n), costs, development location, and year of publication. Results: After carefully analyzing the accumulated data from the selected 39 publications, we found that most studies (i.e., 6 out of 39) were published in 2020. Emergency Medicine was the most common specialty for which low-cost trainers were developed (9 out of 39 procedural simulators); Otolaryngology followed this with 8 out of 39 trainers and general surgery with 7/39 of the task-trainers. The price ranges fluctuated and fell within the price bracket of USD 0 to USD 400 collectively. Our review also uncovered the concentration of development of such innovations solely in high income countries (HICs). Conclusion: Simulation is an invaluable tool applicable to a diverse range of phases of medical education. Future conjunction of simulation with low-cost substitutes along with increased encouragement and enthusiasm towards developing cost effective simulation-based learning environments (SBLEs) with the reserves and requirements of these areas in mind may prove to be a reliable option for low and middle resource settings

scholarly journals Neurosurgical digital teaching in low-middle income countries: beyond the frontiers of traditional education

2018 ◽  
Vol 45 (4) ◽  
pp. E17 ◽  
Author(s):  
Federico Nicolosi ◽  
Zefferino Rossini ◽  
Ismail Zaed ◽  
Angelos G. Kolias ◽  
Maurizio Fornari ◽  
...  
Keyword(s):  
Low Cost ◽  
Easy Access ◽  
Scientific Validity ◽  
Middle Income ◽  
Digital Platforms ◽  
Poor Countries ◽  
Middle Income Countries ◽  
Standard Education ◽  
Low Middle Income Countries ◽  
Learning Programs

OBJECTIVENeurosurgical training is usually based on traditional sources of education, such as papers, books, direct surgical experience, and cadaveric hands-on courses. In low-middle income countries, standard education programs are often unavailable, mainly owing to the lack of human and economic resources. Introducing digital platforms in these settings could be an alternative solution for bridging the gap between Western and poor countries in neurosurgical knowledge.METHODSThe authors identified from the Internet the main digital platforms that could easily be adopted in low-middle income countries. They selected free/low-cost mobile content with high educational impact.RESULTSThe platforms that were identified as fulfilling the characteristics described above are WFNS Young Neurosurgeons Forum Stream, Brainbook, NeuroMind, UpSurgeOn, The Neurosurgical Atlas, Touch surgery, The 100 UCLA Subjects in Neurosurgery, Neurosurgery Survival Guide, EANS (European Association of Neurosurgical Societies) Academy, Neurosurgical.TV, 3D Neuroanatomy, The Rhoton Collection, and Hinari. These platforms consist of webinars, 3D interactive neuroanatomy and neurosurgery content, videos, and e-learning programs supported by neurosurgical associations or journals.CONCLUSIONSDigital education is an emerging tool for contributing to the spread of information in the neurosurgical community. The continuous improvement in the quality of content will rapidly increase the scientific validity of digital programs. In conclusion, the fast and easy access to digital resources could contribute to promote neurosurgical education in countries with limited facilities.

scholarly journals A Century of Riverbank Protection and River Training in Bangladesh

Water ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3018 ◽  
Author(s):  
Knut Oberhagemann ◽  
A. M. Aminul Haque ◽  
Angela Thompson
Keyword(s):  
New Technologies ◽  
Low Cost ◽  
Dynamic Environment ◽  
Cost Effective ◽  
Lessons Learned ◽  
New Techniques ◽  
Middle Income ◽  
Knowledge Based ◽  
Protection Technology ◽  
River Training

Protecting against riverbank erosion along the world’s largest rivers is challenging. The Bangladesh Delta, bisected by the Brahmaputra River (also called the Jamuna River), is rife with complexity. Here, an emerging middle-income country with the world’s highest population density coexists with the world’s most unpredictable and largest braided, sand-bed river. Bangladesh has struggled over decades to protect against the onslaught of a continuously widening river corridor. Many of the principles implemented successfully in other parts of the world failed in Bangladesh. To this end, Bangladesh embarked on intensive knowledge-based developments and piloted new technologies. After two decades, successful, sustainable, low-cost riverbank protection technology was developed, suitable for the challenging river conditions. It was necessary to accept that no construction is permanent in this morphologically dynamic environment. What was initially born out of fund shortages became a cost-effective, systematic and adaptive approach to riverbank protection using improved knowledge, new materials, and new techniques, in the form of geobag revetments. This article provides an overview of the challenges faced when attempting to stabilize the riverbanks of the mighty rivers of Bangladesh. An overview of the construction of the major bridge crossings as well as riverbank protection schemes is detailed. Finally, a summary of lessons learned concludes the impressive progress made.

scholarly journals COVID-19: An opportunity to strengthen Public Health Policy and Advocacy Efforts in LMIC (Low- Middle-Income Countries)

2021 ◽  
Author(s):  
Ponn P Mahayosnand ◽  
Saman Essa ◽  
ZM Sabra
Keyword(s):  
Public Health ◽  
Cost Effective ◽  
World Health ◽  
Evidence Based ◽  
Middle Income ◽  
Policy Problem ◽  
Middle Income Countries ◽  
Successful Case ◽  
Low Middle Income Countries ◽  
Public Health Practitioners

Similar to how physicians practice evidence-based medicine to treat individual patients, policymakers should govern the public's health according to evidence-based data. Initiated by the World Health Organization's directive to make COVID-19 research open and freely accessible, (1,2) multidisciplinary studies are still published daily. Collectively, policymakers worldwide have not used available data effectively to make noteworthy reductions in the pandemic that is now over a year old. This brief commentary introduces a policy problem, then shares 3 categories of successful case studies as possible solutions: [1] Low- and Middle-Income Countries (LMIC): Vietnam and Iran, (3,4) [2] public health practitioners: social workers in Africa and pharmacists in Zambia, (5,6) and [3] public health programs: a smoking cessation program and inmate health program. (7,8) Examples from LMIC were selected to demonstrate practical, cost-effective and duplicable methods. A collaborative multidisciplinary approach with community health partners is also proposed. (2,9)

scholarly journals Role of Fibrinolytic Enzymes in Anti-Thrombosis Therapy

2021 ◽  
Vol 8 ◽  
Author(s):  
Farwa Altaf ◽  
Shourong Wu ◽  
Vivi Kasim
Keyword(s):  
Plasminogen Activator ◽  
Thrombus Formation ◽  
Low Cost ◽  
Cost Effective ◽  
Tissue Type ◽  
High Yield ◽  
Efficacy Rate ◽  
Middle Income ◽  
Fibrinolytic Enzymes ◽  
Effective Manner

Thrombosis, a major cause of deaths in this modern era responsible for 31% of all global deaths reported by WHO in 2017, is due to the aggregation of fibrin in blood vessels which leads to myocardial infarction or other cardiovascular diseases (CVDs). Classical agents such as anti-platelet, anti-coagulant drugs or other enzymes used for thrombosis treatment at present could leads to unwanted side effects including bleeding complication, hemorrhage and allergy. Furthermore, their high cost is a burden for patients, especially for those from low and middle-income countries. Hence, there is an urgent need to develop novel and low-cost drugs for thrombosis treatment. Fibrinolytic enzymes, including plasmin like proteins such as proteases, nattokinase, and lumbrokinase, as well as plasminogen activators such as urokinase plasminogen activator, and tissue-type plasminogen activator, could eliminate thrombi with high efficacy rate and do not have significant drawbacks by directly degrading the fibrin. Furthermore, they could be produced with high-yield and in a cost-effective manner from microorganisms as well as other sources. Hence, they have been considered as potential compounds for thrombosis therapy. Herein, we will discuss about natural mechanism of fibrinolysis and thrombus formation, the production of fibrinolytic enzymes from different sources and their application as drugs for thrombosis therapy.

scholarly journals Breakout Session: Leveraging Licensing to Increase Access

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Michelle Polchow
Keyword(s):  
Los Angeles ◽  
Low Cost ◽  
Cost Savings ◽  
Cost Effective ◽  
Convincing Evidence ◽  
Open Educational Resources ◽  
Breakout Session ◽  
Diverse Range ◽  
Course Materials ◽  
Library Resources

The Affordable Course Materials Initiative (ACMI) is a library-driven program established by University of California, Los Angeles (UCLA), designed to leverage existing library resources, encourage open educational resources (OER) content creation, identify cost-effective digital projects and modify existing license agreements in order to create reduced cost course materials for students, as an alternative to rising commercial textbook costs.  The faculty incentivized program encourages instructors to partner with the library to leverage free or low-cost resources, adjusting syllabi and assignments as needed.  ACMI’s two-year pilot resulted in convincing evidence that the service supported a broad and diverse range of campus disciplines, achieved substantial cost savings, served as a catalyst for community building with multiple stakeholders, and gained campus administration recognition with an ongoing commitment of financial support to permanently integrate the initiative as an ongoing component of library services. 

scholarly journals Neonatal innovations in resource-limited settings

2021 ◽  
Vol 36 ◽  
pp. 82-86
Author(s):  
Neha Agarwal ◽  
Rakesh Kumar ◽  
Girish Gupta
Keyword(s):  
Health Care ◽  
Neonatal Mortality ◽  
Low Cost ◽  
Cost Effective ◽  
Middle Income ◽  
Development Goal ◽  
The Sustainable Development ◽  
Resource Limited ◽  
Care Technology ◽  
Year 2000

In the year 2000, Millennium Declaration was signed by the world leaders to reduce the under-5 mortality rate by two-thirds from the baseline figure in 1990. Millennium Development Goal 4 was replaced by the Sustainable Development Goal (SDG) in 2015. Reduction in the neonatal mortality, which accounts for majority of the deaths in children under the age of 5 years, was an imminent goal of SDG. Despite these initiatives, the current trends in neonatal mortality are far away from the expected targets. To curb the rate of neonatal mortality, the neonatal services are expanding in India at a rapid pace. To bridge the gap between the availability and accessibility to the health care technology between the developed and developing countries, the current focus is toward the development of low-cost and effective technological innovations in neonatal care and ensuring their patenting and effective publicity. This should facilitate the translation of innovations into mass production and availability for practice with significant effect in low- and middle-income countries. Generation of evidence will increase the acceptability of these innovations by demonstrating their benefit over the currently available technologies. Fortuitously, India has developed many innovations in the neonatal health care. However, majority of the neonatologists are still unaware of the existing technological solutions, and the ways to optimally utilize them. This review is, therefore, an attempt to recognize such low-cost, effective, and sustainable innovations done in the field of neonatology, over the past few decades.

scholarly journals Low-cost, easy-to-build noninvasive pressure support ventilator for under-resourced regions: open source hardware description, performance and feasibility testing

2020 ◽  
Vol 55 (6) ◽  
pp. 2000846 ◽  
Author(s):  
Onintza Garmendia ◽  
Miguel A. Rodríguez-Lazaro ◽  
Jorge Otero ◽  
Phuong Phan ◽  
Alexandrina Stoyanova ◽  
...  
Keyword(s):  
Open Source ◽  
Low Cost ◽  
Bench Test ◽  
Mechanical Ventilators ◽  
Middle Income ◽  
Low Middle Income Countries ◽  
Number Of Patients ◽  
Hardware Description ◽  
Commercial Device ◽  
Open Source Hardware

AimCurrent pricing of commercial mechanical ventilators in low-/middle-income countries (LMICs) markedly restricts their availability, and consequently a considerable number of patients with acute/chronic respiratory failure cannot be adequately treated. Our aim was to design and test an affordable and easy-to-build noninvasive bilevel pressure ventilator to allow a reduction in the serious shortage of ventilators in LMICs.MethodsThe ventilator was built using off-the-shelf materials available via e-commerce and was based on a high-pressure blower, two pressure transducers and an Arduino Nano controller with a digital display (total retail cost <75 USD), with construction details provided open source for free replication. The ventilator was evaluated, and compared with a commercially available device (Lumis 150 ventilator; Resmed, San Diego, CA, USA): 1) in the bench setting using an actively breathing patient simulator mimicking a range of obstructive/restrictive diseases; and b) in 12 healthy volunteers wearing high airway resistance and thoracic/abdominal bands to mimic obstructive/restrictive patients.ResultsThe designed ventilator provided inspiratory/expiratory pressures up to 20/10 cmH2O, respectively, with no faulty triggering or cycling; both in the bench test and in volunteers. The breathing difficulty score rated (1–10 scale) by the loaded breathing subjects was significantly (p<0.005) decreased from 5.45±1.68 without support to 2.83±1.66 when using the prototype ventilator, which showed no difference with the commercial device (2.80±1.48; p=1.000).ConclusionThe low-cost, easy-to-build noninvasive ventilator performs similarly to a high-quality commercial device, with its open-source hardware description, which will allow for free replication and use in LMICs, facilitating application of this life-saving therapy to patients who otherwise could not be treated.

School Health and Nutrition: Policy and Programs

2005 ◽  
Vol 26 (2_suppl2) ◽  
pp. S186-S192 ◽  
Author(s):  
Donald Bundy
Keyword(s):  
School Health ◽  
Low Cost ◽  
Cost Effective ◽  
School Age Children ◽  
Nutrition Interventions ◽  
Middle Income ◽  
Health And Nutrition ◽  
Nutrition Programs ◽  
The World ◽  
The Impact

This paper argues that there is now reliable evidence that ill health and malnutrition affect education access, participation, completion, and achievement, and that school-based health and nutrition programs can provide a cost-effective and low-cost solution. International coordination around this issue has been helped by a consensus framework to “Focus Resources on Effective School Health (FRESH),” developed jointly by UNESCO, WHO, UNICEF, Education International, and the World Bank, and launched at the World Education Forum in Dakar in April 2000 as part of the global effort to achieve the goal of Education for All (EFA). The need for school health and nutrition programs as part of EFA actions is now recognized by both countries and development partners, and examples of successful practical sector programs that have gone to scale are presented for both low- and middle-income countries. This paper argues that, despite this progress, there are two key unresolved issues related to the targeting of nutrition interventions toward school-age children. The first concerns the role of food as an incentive for participation in education, and the second concerns the appropriate target age group for nutrition interventions. It is suggested that finding clear answers to these key policy questions in nutrition could profoundly influence the impact of future school health and nutrition programs.

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