scholarly journals Situational Analysis of the impact of COVID-19 pandemic on digital health research initiatives in South Asia

Author(s):  
Akash Gajanan Prabhune ◽  
Aishwarya Mallawaram ◽  
Sachin Bhat ◽  
Ayesha Mehar Shagufta

Abstract The objective of this paper was to evaluate and compare the quantity, and sustainability of digital health initiatives in the South Asia region pre-pandemic and during the COVID-19 pandemic. The study used a two-step methodology of a) Descriptive analysis of digital health research articles published from 2016-21 from South Asia in terms of stratification of research articles based on diseases and conditions they were developed, geography, tasks wherein the initiative was applied. b) A simple and replicable tool was developed by authors to assess the sustainability of digital health initiatives using Experimental or Observational study designs. The results from descriptive analysis highlight; a) 40% increase in the number of studies report in 2020 when compared to 2019, b) The three most common diseases and conditions wherein substantive digital health research has been focused are Health Systems Strengthening, Ophthalmic Disorders, and COVID-19, c) Remote Consultation, Health Information delivery and Clinical Decision support systems are the top three commonly developed tools. We developed and estimated the inter-rater operability of the sustainability assessment tool was ascertained with a Kappa value of 0.806 (± 0.088). We conclude that the COVID-19 pandemic had a positive impact on digital health research with improvement in the number of digital health initiatives and improvement in sustainability score of studies published during COVID-19.

Sains Insani ◽  
2018 ◽  
Vol 2 (1) ◽  
pp. 12-16
Author(s):  
Mohammad Tawfik Yaakub ◽  
Osman Md Rasip

This article discusses impact of UMNO-PAS political cooperation towards Islamic development in Malaysia from 1973 until 1978. The success of political cooperation in 1973 was the result of both UMNO’s leader, Tun Abdul Razak and PAS’s leader, Asri Muda willingness to explore a new political approach compared to what was being practiced at that time. Both leaders then started the development of a government known as the ‘Cooperation Government’ with the combination of UMNO and PAS in 1973 and later on, the development of the National Front’s (BN) Coalition Government in 1974. The Islamic religion benefits the most from the development of the Coalition Government which is a favourable gain for the Malays in Malaysia. Henceforth, this article will discuss in detail on the impact of the political cooperation between UMNO and PAS within the cooperation period. The methods used for this research is by interview and also by referring to secondary sources which are analyzed in a historical descriptive manner that is normally practiced in historical research. At the end of this research it is established that there are profound impacts to the Islamic religion within the UMNO-PAS cooperation period within 1973 to 1978 for example, the television and radio station beginning starting their programmes with the recitation from Quranic verses, the promulgation of ‘Adhan, alcohols are no longer served in official government’s function, lottery companies are not allowed to promote and announce the lottery results in official government’s media, the establishment of Islamic institution, the strengthening of Islamic education and the appropriate change in the relevant ministry’s symbols. This article can be utilized by subsequent researchers who wish to study the impact of political cooperation between UMNO and PAS. Keywords: political cooperation, UMNO-PAS, cooperation government ABTRAK:Makalah ini membincangkan mengenai impak kerjasama politik UMNO-PAS terhadap perkembangan Islam di Malaysia dari tahun 1973 hingga 1978. Kerjasama politik yang berjaya dibentuk bermula pada tahun 1973 adalah hasil daripada kesediaan Tun Abdul Razak dengan Mohd Asri Muda yang menerajui UMNO dan PAS pada ketika itu mencetuskan perubahan corak berpolitik yang berbeza berbanding sebelumnya. Maka, kedua-dua pemimpin ini kemudiannya merintis pembentukan sebuah kerajaan yang menggabungkan UMNO dengan PAS menerusi Kerajaan Campuran pada tahun 1973 dan Kerajaan Gabungan Barisan Nasional (BN) pada tahun 1974. Hasil daripada kejayaan penubuhan kedua-dua kerajaan ini, perkembangan Islam di negara ini bertambah pesat dan dapat dimanfaatkan oleh keseluruhan orang Melayu di Malaysia. Justeru, artikel ini membincangkan secara terperinci impak kerjasama politik antara UMNO dengan PAS dalam tempoh kerjasama politik berkenaan. Penyelidikan ini menggunapakai kaedah temubual dan menyorot sejumlah sumber sekunder yang kemudiannya dianalisis secara deskriptif sejarah (historical descriptive analysis) yang lazimnya dipraktikkan dalam kajian sejarah. Hasil kajian ini mendapati terdapat impak-impak jelas terhadap perkembangan Islam di negara ini sepanjang tempoh kerjasama politik antara UMNO dengan PAS dari tahun 1973 hingga 1978. Antara impak-impak tersebut ialah permulaan siaran televisyen dan radio dengan bacaan ayat-ayat suci Al-Quran, mengumandangkan suara azan, penghapusan arak dalam majlis-majlis kerajaan, penghapusan promosi dan keputusan judi di media kerajaan, penubuhan institusi Islam, pemerkasaan pendidikan Islam dan penukaran simbol institisu kerajaan. Akhirnya, artikel ini dapat dimanfaatkan oleh penyelidik-penyelidik berikutnya untuk menilai impak kerjasama politik antara UMNO dengan PAS.Kata kunci: kerjasama politik, UMNO-PAS, kerajaan campuran


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Xing-Yu Hu ◽  
Guang-Ying Gao

Abstract Background PTB is an infectious disease, which not only seriously affects people’s health, but also causes a heavier disease economic burden on patients. At present, reform of the medical insurance payment can be an effective method to control medical expenses. Therefore, our study is to explore the compensation mechanism for pulmonary tuberculosis (PTB) patients with a full period of treatment, to alleviate the financial burden of PTB patients and provide a reference and basis for the reform of PTB payment methods in other regions and countries. Methods The quantitative data of PTB patients was collected from the first half of 2015 to the first half of 2018 in Dehui Tuberculosis Hospital in Jilin Province, and medical records of PTB patients registered in the first half of 2018 (n = 100) from the hospital was randomly selected. Descriptive analysis of these quantitative data summarized the number, cost, medication and compliance. Semi-structured in depth interviews with policymakers and physicians were conducted to understand the impact of interventions and its causes. Results After implementation of the compensation mechanism, the number of PTB patient visits in 2018 was increased by 14.2%, average medical costs for outpatients and inpatients were significantly reduced by 31.8% and 47.0%, respectively, and the auxiliary medication costs was reduced by 36.5%. Moreover, the hospital carried out standardized management of tuberculosis, and the patient compliance was very high, reaching almost 90%. Conclusions The capitation compensation mechanism with a full period of treatment was a suitable payment method for PTB, and it is worthy of promotion and experimentation. In addition, the model improved patient compliance and reduced the possibility of drug-resistant PTB. However, due to the short implementation time of the model in the pilot areas, the effect remains to be further observed and demonstrated.


2021 ◽  
Vol 13 (8) ◽  
pp. 195
Author(s):  
Akash Gupta ◽  
Adnan Al-Anbuky

Hip fracture incidence is life-threatening and has an impact on the person’s physical functionality and their ability to live independently. Proper rehabilitation with a set program can play a significant role in recovering the person’s physical mobility, boosting their quality of life, reducing adverse clinical outcomes, and shortening hospital stays. The Internet of Things (IoT), with advancements in digital health, could be leveraged to enhance the backup intelligence used in the rehabilitation process and provide transparent coordination and information about movement during activities among relevant parties. This paper presents a post-operative hip fracture rehabilitation model that clarifies the involved rehabilitation process, its associated events, and the main physical movements of interest across all stages of care. To support this model, the paper proposes an IoT-enabled movement monitoring system architecture. The architecture reflects the key operational functionalities required to monitor patients in real time and throughout the rehabilitation process. The approach was tested incrementally on ten healthy subjects, particularly for factors relevant to the recognition and tracking of movements of interest. The analysis reflects the significance of personalization and the significance of a one-minute history of data in monitoring the real-time behavior. This paper also looks at the impact of edge computing at the gateway and a wearable sensor edge on system performance. The approach provides a solution for an architecture that balances system performance with remote monitoring functional requirements.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Estupiñán-Romero ◽  
J Gonzalez-García ◽  
E Bernal-Delgado

Abstract Issue/problem Interoperability is paramount when reusing health data from multiple data sources and becomes vital when the scope is cross-national. We aimed at piloting interoperability solutions building on three case studies relevant to population health research. Interoperability lies on four pillars; so: a) Legal frame (i.e., compliance with the GDPR, privacy- and security-by-design, and ethical standards); b) Organizational structure (e.g., availability and access to digital health data and governance of health information systems); c) Semantic developments (e.g., existence of metadata, availability of standards, data quality issues, coherence between data models and research purposes); and, d) Technical environment (e.g., how well documented are data processes, which are the dependencies linked to software components or alignment to standards). Results We have developed a federated research network architecture with 10 hubs each from a different country. This architecture has implied: a) the design of the data model that address the research questions; b) developing, distributing and deploying scripts for data extraction, transformation and analysis; and, c) retrieving the shared results for comparison or pooled meta-analysis. Lessons The development of a federated architecture for population health research is a technical solution that allows full compliance with interoperability pillars. The deployment of this type of solution where data remain in house under the governance and legal requirements of the data owners, and scripts for data extraction and analysis are shared across hubs, requires the implementation of capacity building measures. Key messages Population health research will benefit from the development of federated architectures that provide solutions to interoperability challenges. Case studies conducted within InfAct are providing valuable lessons to advance the design of a future pan-European research infrastructure.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040749
Author(s):  
Shanthi Ann Ramanathan ◽  
Sarah Larkins ◽  
Karen Carlisle ◽  
Nalita Turner ◽  
Ross Stewart Bailie ◽  
...  

ObjectivesTo (1) apply the Framework to Assess the Impact from Translational health research (FAIT) to Lessons from the Best to Better the Rest (LFTB), (2) report on impacts from LFTB and (3) assess the feasibility and outcomes from a retrospective application of FAIT.SettingThree Indigenous primary healthcare (PHC) centres in the Northern Territory, Australia; project coordinating centre distributed between Townsville, Darwin and Cairns and the broader LFTB learning community across Australia.ParticipantsLFTB research team and one representative from each PHC centre.Primary and secondary outcome measuresImpact reported as (1) quantitative metrics within domains of benefit using a modified Payback Framework, (2) a cost-consequence analysis given a return on investment was not appropriate and (3) a narrative incorporating qualitative evidence of impact. Data were gathered through in-depth stakeholder interviews and a review of project documentation, outputs and relevant websites.ResultsLFTB contributed to knowledge advancement in Indigenous PHC service delivery; enhanced existing capacity of health centre staff, researchers and health service users; enhanced supportive networks for quality improvement; and used a strengths-based approach highly valued by health centres. LFTB also leveraged between $A1.4 and $A1.6 million for the subsequent Leveraging Effective Ambulatory Practice (LEAP) Project to apply LFTB learnings to resource development and creation of a learning community to empower striving PHC centres.ConclusionRetrospective application of FAIT to LFTB, although not ideal, was feasible. Prospective application would have allowed Indigenous community perspectives to be included. Greater appreciation of the full benefit of LFTB including a measure of return on investment will be possible when LEAP is complete. Future assessments of impact need to account for the limitations of fully capturing impact when intermediate/final impacts have not yet been realised and captured.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sanju Gautam ◽  
Nipun Shrestha ◽  
Sweta Mahato ◽  
Tuan P. A. Nguyen ◽  
Shiva Raj Mishra ◽  
...  

AbstractThe escalating burden of diabetes is increasing the risk of contracting tuberculosis (TB) and has a pervasive impact on TB treatment outcomes. Therefore, we conducted this systematic review and meta-analysis to examine the burden of diabetes among TB patients and assess its impact on TB treatment in South Asia (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka). PubMed, Excerpta Medica Database (EMBASE), and CINAHL databases were systematically searched for observational (cross-sectional, case–control and cohort) studies that reported prevalence of diabetes in TB patients and published between 1 January 1980 and 30 July 2020. A random-effect model for computing the pooled prevalence of diabetes and a fixed-effect model for assessing its impact on TB treatment were used. The review was registered with PROSPERO number CRD42020167896. Of the 3463 identified studies, a total of 74 studies (47 studies from India, 10 from Pakistan, four from Nepal and two from both Bangladesh and Sri-Lanka) were included in this systematic review: 65 studies for the prevalence of diabetes among TB patients and nine studies for the impact of diabetes on TB treatment outcomes. The pooled prevalence of diabetes in TB patients was 21% (95% CI 18.0, 23.0; I2 98.3%), varying from 11% in Bangladesh to 24% in Sri-Lanka. The prevalence was higher in studies having a sample size less than 300 (23%, 95% CI 18.0, 27.0), studies conducted in adults (21%, 95% CI 18.0, 23.0) and countries with high TB burden (21%, 95% CI 19.0, 24.0). Publication bias was detected based on the graphic asymmetry of the funnel plot and Egger’s test (p < 0.001). Compared with non-diabetic TB patients, patients with TB and diabetes were associated with higher odds of mortality (Odds Ratio (OR) 1.7; 95% CI 1.2, 2.51; I2 19.4%) and treatment failure (OR 1.7; 95% CI 1.1, 2.4; I2 49.6%), but not associated with Multi-drug resistant TB (OR 1.0; 95% CI 0.6, 1.7; I2 40.7%). This study found a high burden of diabetes among TB patients in South Asia. Patients with TB-diabetes were at higher risk of treatment failure and mortality compared to TB alone. Screening for diabetes among TB patients along with planning and implementation of preventive and curative strategies for both TB and diabetes are urgently needed.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S501-S502
Author(s):  
Humberto R Jimenez ◽  
Naana Boachie ◽  
Sangwon Park ◽  
Jin Suh

Abstract Background As people with HIV (PWH) have experienced reductions in antiretroviral pill burden, there has been an increase in medications to manage non-AIDS-related co-morbidities. Previous studies have linked virologic failure to an increased pill burden. This study assessed whether polypharmacy and other variables affect success of HIV management in our population. Methods A retrospective, cross-sectional analysis of PWH receiving care at a Ryan White-funded clinic in New Jersey was performed. Eligible patients were ≥18 years old, had ≥2 visits in 2019 and were receiving antiretroviral therapy (ART). The primary endpoints were to determine the effect polypharmacy (defined as 5 or more non-ART pills per day) on virologic response rates (HIV RNA &lt; 200 copies/mL). Secondary endpoints accounted for the impact of age, gender, race/ethnicity, HIV transmission risk factor, and AIDS diagnosis on virologic response. A descriptive analysis of comorbidities and medication classes was also completed. Logistic regression, chi square and student’s t test were used for statistical analysis. Results 964 patients were included in the analysis, with 355 (37%) meeting the criteria for polypharmacy. Most patients were male (60%) and the mean age was 49 years of age. The racial/ethnic breakdown was 46% Hispanic, 45% Black and 8% White. Polypharmacy was associated with higher rates of virologic success compared to those with a lower pill burden: 94% vs 86% had an HIV RNA &lt; 200 copies/mL (P=0.0003), respectively. ART pill burden was statistically, but not clinically higher among those with polypharmacy (1.34 vs 1.45, P=0.025). Virologic response was found to be higher among Hispanics and Whites in comparison to Black patients (OR 2.2, CI 1.4-3.5 and 3.0, CI 1.1-8.2). Patients with an AIDS diagnosis were less likely to achieve virologic response (OR 0.64, CI 0.42-0.99). Conclusion Patients with polypharmacy were more likely to achieve virologic success than paitents with a low pill burden in our population. Disclosures Humberto R. Jimenez, PharmD, BCPS, AAHIVP, Gilead (Speaker’s Bureau)


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Piper ◽  
Tracey A. Davenport ◽  
Haley LaMonica ◽  
Antonia Ottavio ◽  
Frank Iorfino ◽  
...  

Abstract Background The World Economic Forum has recently highlighted substantial problems in mental health service provision and called for the rapid deployment of smarter, digitally-enhanced health services as a means to facilitate effective care coordination and address issues of demand. In mental health, the biggest enabler of digital solutions is the implementation of an effective model of care that is facilitated by integrated health information technologies (HITs); the latter ensuring the solution is easily accessible, scalable and sustainable. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution – delivered through the Youth Mental Health and Technology Program – which incorporates two components: 1) a highly personalised and measurement-based (data-driven) model of youth mental health care; and 2) an industrial grade HIT registered on the Australian Register of Therapeutic Goods. This paper describes a research protocol to evaluate the impact of implementing the BMC’s digital health solution into youth mental health services (i.e. headspace - a highly accessible, youth-friendly integrated service that responds to the mental health, physical health, alcohol or other substance use, and vocational concerns of young people aged 12 to 25 years) within urban and regional areas of Australia. Methods The digital health solution will be implemented into participating headspace centres using a naturalistic research design. Quantitative and qualitative data will be collected from headspace health professionals, service managers and administrators, as well as from lead agency and local Primary Health Network (PHN) staff, via service audits, Implementation Officer logs, online surveys, and semi-structured interviews, at baseline and then three-monthly intervals over the course of 12 months. Discussion At the time of publication, six headspace centres had been recruited to this study and had commenced implementation and impact evaluation. The first results are expected to be submitted for publication in 2021. This study will focus on the impact of implementing a digital health solution at both a service and staff level, and will evaluate digital readiness of service and staff adoption; quality, usability and acceptability of the solution by staff; staff self-reported clinical competency; overall impact on headspace centres as well as their lead agencies and local PHNs; and social return on investment.


2021 ◽  
Vol 13 (6) ◽  
pp. 3320
Author(s):  
Amy R. Villarosa ◽  
Lucie M. Ramjan ◽  
Della Maneze ◽  
Ajesh George

The COVID-19 pandemic has resulted in many changes, including restrictions on indoor gatherings and visitation to residential aged care facilities, hospitals and certain communities. Coupled with potential restrictions imposed by health services and academic institutions, these changes may significantly impact the conduct of population health research. However, the continuance of population health research is beneficial for the provision of health services and sometimes imperative. This paper discusses the impact of COVID-19 restrictions on the conduct of population health research. This discussion unveils important ethical considerations, as well as potential impacts on recruitment methods, face-to-face data collection, data quality and validity. In addition, this paper explores potential recruitment and data collection methods that could replace face-to-face methods. The discussion is accompanied by reflections on the challenges experienced by the authors in their own research at an oral health service during the COVID-19 pandemic and alternative methods that were utilised in place of face-to-face methods. This paper concludes that, although COVID-19 presents challenges to the conduct of population health research, there is a range of alternative methods to face-to-face recruitment and data collection. These alternative methods should be considered in light of project aims to ensure data quality is not compromised.


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