scholarly journals A Novel Mobile Health Tool for Home-Based Identification of Neonatal Illness in Uganda: Formative Usability Study

10.2196/14540 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e14540 ◽  
Author(s):  
Madison Vanosdoll ◽  
Natalie Ng ◽  
Anthony Ho ◽  
Allison Wallingford ◽  
Shicheng Xu ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Health Workers ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Ease Of Use ◽  
World Health ◽  
Severe Illness ◽  
Home Setting ◽  
Danger Signs ◽  
Neonatal Assessment

Background While early identification of neonatal illness can impact neonatal mortality rates and reduce the burden of treatment, identifying subtle clinical signs and symptoms of possible severe illness is especially challenging in neonates. The World Health Organization and the United Nations Children’s Fund developed the Integrated Management of Neonatal Childhood Illness guidelines, an evidence-based tool highlighting seven danger signs to assess neonatal health. Currently, many mothers in low-resource settings rely on home visits from community health workers (CHWs) to determine if their baby is sick. However, CHWs visit infrequently, and illness is often detected too late to impact survival. Thus, delays in illness identification pose a significant barrier to providing expedient and effective care. Neonatal Monitoring (NeMo), a novel neonatal assessment tool, seeks to increase the frequency of neonatal screening by task-shifting identification of neonatal danger signs from CHWs to mothers. Objective This study aimed to explore the usability and acceptability of the NeMo system among target users and volunteer CHWs by assessing ease of use and learnability. Methods Simulated device use and semistructured interviews were conducted with 32 women in the Iganga-Mayuge districts in eastern Uganda to evaluate the usability of the NeMo system, which involves a smartphone app paired with a low cost, wearable band to aid in identification of neonatal illness. Two versions of the app were evaluated using a mixed methods approach, and version II of the app contained modifications based on observations of the first cohort’s use of the system. During the posed scenario simulations, participants were offered limited guidance from the study team in order to probe the intuitiveness of the NeMo system. The ability to complete a set of tasks with the system was tested and recorded for each participant and closed- and open-ended questions were used to elicit user feedback. Additionally, focus groups with 12 CHWs were conducted to lend additional context and insight to the usability and feasibility assessment. Results A total of 13/22 subjects (59%) using app version I and 9/10 subjects (90%) using app version II were able to use the phone and app with no difficulty, despite varying levels of smartphone experience. Following modifications to the app’s audio instructions in version II, participants’ ability to accurately answer qualitative questions concerning neonatal danger signs improved by at least 200% for each qualitative danger sign. All participants agreed they would trust and use the NeMo system to assess the health of their babies. Furthermore, CHWs emphasized the importance of community sensitization towards the system to encourage its adoption and regular use, as well as the decision to seek care based on its recommendations. Conclusions The NeMo system is an intuitive platform for neonatal assessment in a home setting and was found to be acceptable to women in rural Uganda.

scholarly journals Young infant clinical signs study­­, Pakistan: a data note

2021 ◽  
Vol 5 ◽  
pp. 122
Author(s):  
Shahira Shahid ◽  
Shiyam Sunder Tikmani ◽  
Nick Brown ◽  
Anita K.M. Zaidi ◽  
Fyezah Jehan ◽  
...  
Keyword(s):  
Child Death ◽  
Young Infant ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
World Health Organisation ◽  
World Health ◽  
Severe Illness ◽  
Public Health Importance ◽  
Course Of Illness ◽  
Young Infants

Neonatal sepsis is the leading cause of child death globally with most of these deaths occurring in the first week of life.  It is of utmost public health importance that clinical signs predictive of severe illness and need for referral are identified early in the course of illness. From 2002-2005, a multi country trial called the Young Infant Clinical Signs Study (YICSS) was conducted in seven sites across three South-Asian (Bangladesh, India, and Pakistan), two African (Ghana, and South Africa), and one South American (Bolivia) country. The study aimed to develop a simplified algorithm to be used by primary healthcare workers for the identification of sick young infants needing prompt referral and treatment. The main study enrolled 8,889 young infants between the ages of 0-59 days old. This dataset contains observations on 2950 young infants aged 0-59 days from the Pakistan site. The data was collected between 2003-2004 with information on the most prevalent signs and symptoms. The data from this study was used to update the Integrated Management of Childhood Illness guidelines. The World Health Organisation (WHO) seven-sign algorithm has been used in other major community-based trials to study possible serious bacterial infection and its treatment regimens.

scholarly journals Improving Risk Assessments by Sanitary Inspection for Small Drinking-Water Supplies—Qualitative Evidence

Resources ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 71 ◽  
Author(s):  
Katherine Pond ◽  
Richard King ◽  
Jo Herschan ◽  
Rosalind Malcolm ◽  
Rory Moses McKeown ◽  
...  
Keyword(s):  
Drinking Water ◽  
Assessment Tool ◽  
World Health Organisation ◽  
Ease Of Use ◽  
World Health ◽  
Remedial Action ◽  
Water Supplies ◽  
Qualitative Evidence ◽  
Operations And Maintenance

Small drinking-water supplies face particular challenges in terms of their management. Being vulnerable to contamination but often not monitored regularly nor well-maintained, small drinking-water supplies may pose consequences for health of users. Sanitary inspection (SI) is a risk assessment tool to identify and manage observable conditions of the water supply technology or circumstances in the catchment area that may favour certain hazardous events and introduce hazards which may become a risk to health. This qualitative research aimed to identify the strengths and weaknesses of the SI tool as published by the World Health Organisation to inform a review and update of the forms and to improve their robustness. The study identified a number of benefits of the approach, such as its simplicity and ease of use. Challenges were also identified, such as potential for inconsistencies in perception of risk between inspectors, in interpreting questions, and lack of follow-up action. The authors recommend a revision of the existing SI forms to address the identified challenges and development of complementary advice on possible remedial action to address identified risk factors and on basic operations and maintenance.

scholarly journals Phosphodiesterase Inhibitors: Could They Be Beneficial for the Treatment of COVID-19?

2020 ◽  
Vol 21 (15) ◽  
pp. 5338 ◽  
Author(s):  
Mauro Giorgi ◽  
Silvia Cardarelli ◽  
Federica Ragusa ◽  
Michele Saliola ◽  
Stefano Biagioni ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Phosphodiesterase Inhibitors ◽  
Signs And Symptoms ◽  
World Health ◽  
Pde Inhibitors ◽  
Clinical Signs And Symptoms ◽  
Hydrolyzing Enzymes ◽  
Health Organization ◽  
Restrictive Measures

In March 2020, the World Health Organization declared the severe acute respiratory syndrome corona virus 2 (SARS-CoV2) infection to be a pandemic disease. SARS-CoV2 was first identified in China and, despite the restrictive measures adopted, the epidemic has spread globally, becoming a pandemic in a very short time. Though there is growing knowledge of the SARS-CoV2 infection and its clinical manifestations, an effective cure to limit its acute symptoms and its severe complications has not yet been found. Given the worldwide health and economic emergency issues accompanying this pandemic, there is an absolute urgency to identify effective treatments and reduce the post infection outcomes. In this context, phosphodiesterases (PDEs), evolutionarily conserved cyclic nucleotide (cAMP/cGMP) hydrolyzing enzymes, could emerge as new potential targets. Given their extended distribution and modulating role in nearly all organs and cellular environments, a large number of drugs (PDE inhibitors) have been developed to control the specific functions of each PDE family. These PDE inhibitors have already been used in the treatment of pathologies that show clinical signs and symptoms completely or partially overlapping with post-COVID-19 conditions (e.g., thrombosis, inflammation, fibrosis), while new PDE-selective or pan-selective inhibitors are currently under study. This review discusses the state of the art of the different pathologies currently treated with phosphodiesterase inhibitors, highlighting the numerous similarities with the disorders linked to SARS-CoV2 infection, to support the hypothesis that PDE inhibitors, alone or in combination with other drugs, could be beneficial for the treatment of COVID-19.

scholarly journals Clinical characteristics of COVID-19 in children compared with adults in Shandong, China

2020 ◽  
Author(s):  
Wenjun Du ◽  
Jinhong Yu ◽  
Hui Wang ◽  
Xiaoguo Zhang ◽  
Shouwei Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Health Workers ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Case Series ◽  
Signs And Symptoms ◽  
Asymptomatic Patients ◽  
Positive Indicators ◽  
Clinical Signs And Symptoms

Abstract Aims & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.Methods: Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.Results: Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74).Conclusions: The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.

scholarly journals COVID-19–Related Internet Search Patterns Among People in the United States: Exploratory Analysis

10.2196/22407 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e22407
Author(s):  
Tony S Shen ◽  
Aaron Z Chen ◽  
Patawut Bovonratwet ◽  
Carol L Shen ◽  
Edwin P Su
Keyword(s):  
United States ◽  
Web Search ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
The United States ◽  
World Health ◽  
The Internet ◽  
Sources Of Information ◽  
Academic Medical ◽  
Clinical Signs And Symptoms

Background The internet is a well-known source of information that patients use to better inform their opinions and to guide their conversations with physicians during clinic visits. The novelty of the recent COVID-19 outbreak has led patients to turn more frequently to the internet to gather more information and to alleviate their concerns about the virus. Objective The aims of the study were to (1) determine the most commonly searched phrases related to COVID-19 in the United States and (2) identify the sources of information for these web searches. Methods Search terms related to COVID-19 were entered into Google. Questions and websites from Google web search were extracted to a database using customized software. Each question was categorized into one of 6 topics: clinical signs and symptoms, treatment, transmission, cleaning methods, activity modification, and policy. Additionally, the websites were categorized according to source: World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), non-CDC government, academic, news, and other media. Results In total, 200 questions and websites were extracted. The most common question topic was transmission (n=63, 31.5%), followed by clinical signs and symptoms (n=54, 27.0%) and activity modification (n=31, 15.5%). Notably, the clinical signs and symptoms category captured questions about myths associated with the disease, such as whether consuming alcohol stops the coronavirus. The most common websites provided were maintained by the CDC, the WHO, and academic medical organizations. Collectively, these three sources accounted for 84.0% (n=168) of the websites in our sample. Conclusions In the United States, the most commonly searched topics related to COVID-19 were transmission, clinical signs and symptoms, and activity modification. Reassuringly, a sizable majority of internet sources provided were from major health organizations or from academic medical institutions.

scholarly journals COVID-19–Related Internet Search Patterns Among People in the United States: Exploratory Analysis (Preprint)

2020 ◽  
Author(s):  
Tony S Shen ◽  
Aaron Z Chen ◽  
Patawut Bovonratwet ◽  
Carol L Shen ◽  
Edwin P Su
Keyword(s):  
United States ◽  
Web Search ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
The United States ◽  
World Health ◽  
The Internet ◽  
Sources Of Information ◽  
Academic Medical ◽  
Clinical Signs And Symptoms

BACKGROUND The internet is a well-known source of information that patients use to better inform their opinions and to guide their conversations with physicians during clinic visits. The novelty of the recent COVID-19 outbreak has led patients to turn more frequently to the internet to gather more information and to alleviate their concerns about the virus. OBJECTIVE The aims of the study were to (1) determine the most commonly searched phrases related to COVID-19 in the United States and (2) identify the sources of information for these web searches. METHODS Search terms related to COVID-19 were entered into Google. Questions and websites from Google web search were extracted to a database using customized software. Each question was categorized into one of 6 topics: clinical signs and symptoms, treatment, transmission, cleaning methods, activity modification, and policy. Additionally, the websites were categorized according to source: World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), non-CDC government, academic, news, and other media. RESULTS In total, 200 questions and websites were extracted. The most common question topic was transmission (n=63, 31.5%), followed by clinical signs and symptoms (n=54, 27.0%) and activity modification (n=31, 15.5%). Notably, the clinical signs and symptoms category captured questions about myths associated with the disease, such as whether consuming alcohol stops the coronavirus. The most common websites provided were maintained by the CDC, the WHO, and academic medical organizations. Collectively, these three sources accounted for 84.0% (n=168) of the websites in our sample. CONCLUSIONS In the United States, the most commonly searched topics related to COVID-19 were transmission, clinical signs and symptoms, and activity modification. Reassuringly, a sizable majority of internet sources provided were from major health organizations or from academic medical institutions.

scholarly journals Integrated management of childhood illness (IMCI): an innovative vision for child health care

2001 ◽  
Vol 1 (3) ◽  
pp. 223-236 ◽  
Author(s):  
Yehuda Benguigui
Keyword(s):  
Health Promotion ◽  
Health Workers ◽  
Integrated Management ◽  
Health Condition ◽  
Childhood Illness ◽  
Infant Mortality Rate ◽  
World Health ◽  
Danger Signs ◽  
Prevention And Health Promotion ◽  
Health Organization

The Integrated Management of Childhood Illness (IMCI) strategy developed by the World Health Organization (WHO), Panamerican Health Organization (PAHO) and the United Nation Children's Fund (UNICEF), joint experiences of previous frequent diseases programs in children, with prevention and health promotion activities. In this new approach the family, the community and health workers have a leading role in health condition of the child. The strategy aims a reduction in Infant Mortality Rate, specially in those regions and countries in which it is high. Pneumonia, diarrhea, malnutrition and other preventable diseases are the main causes of deaths in this settings. Health workers can early recognized danger signs of severe diseases, as well as they can evaluate and treat the most frequent health problems. By enhancing prevention and health promotion activities, as better conditions of life, giving an holistic vision of the child and his family, and not only looking for the symptom that motivate the consultation.

scholarly journals Clinical course and disease outcomes in hospitalized patients with 2019 novel corona virus disease at Ibn- Al Khateeb Hospital in Baghdad, Iraq

2020 ◽  
Vol 62 (3) ◽  
Author(s):  
Iman Ahmed Mohammed ◽  
Abbas Hasan Ali ◽  
Jaafer Naseer Al shenaty
Keyword(s):  
Length Of Stay ◽  
Virus Disease ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
World Health ◽  
Disease Outcome ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Disease Outcomes ◽  
Corona Virus

Background: the novel coronavirus (2019-ncov), formally known as severe acute respiratory syndrome coronavirus 2 (sars-cov-2), the etiological cause of the (corona virus disease 2019) covid-19, appeared in wuhan, hubei province, china. On 11 march 2020, the world health organization (who) declared this disease as a pandemic. As new information on the clinical characteristics, treatment options, and outcomes for covid-19 emerges approximately every hour, physicians should keep themselves up-to-date on this topic.Objective: to study the demographic features, clinical signs and symptoms and certain vital and laboratory findings of covid-19 hospitalized cases; and to identify the used medication, complications, length of stay at the hospital and disease outcomes of confirmed covid-19 cases.Patients and methods: a descriptive cross-sectional study with analytic elements was conducted at ibn-al khateeb hospital, baghdad on covid-19 patients admitted to the hospital from 1st of march to 4th of may 2020. All inpatients of all age groups, diagnosed as covid-19 and had a definite outcome (recovered and discharge or death) during the period of the study were included.Results: the mean age ± sd for the patients included in the study was = 37.9±18.85 years, with 51.2% being males. The outcome was statistically significantly associated with age, marital status, hypertension, disease severity at admission and length of stay at hospital.Conclusion: this study found that age was associated with disease outcome. Care, attention and monitoring should be taken into consideration for hypertensive patients. Patients’ initial signs and symptoms of dyspnea, weakness and sore throat were significantly associated with disease outcome.

Do Sideline Tests of Vestibular and Oculomotor Function Accurately Diagnose Sports-Related Concussion in Adults? A Systematic Review and Meta-analysis

2021 ◽  
pp. 036354652110279
Author(s):  
Sarah A. Harris ◽  
Alasdair R. Dempsey ◽  
Katherine Mackie ◽  
Doug King ◽  
Mark Hecimovich ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Assessment Tools ◽  
Emotional Symptoms ◽  
Level Of Evidence ◽  
Clinical Signs And Symptoms

Background: Sports-related concussion (SRC) assessment tools are primarily based on subjective assessments of somatic, cognitive, and psychosocial/emotional symptoms. SRC symptoms remain underreported, and objective measures of SRC impairments would be valuable to assist diagnosis. Measurable impairments to vestibular and oculomotor processing have been shown to occur after SRC and may provide valid objective assessments. Purpose: Determine the diagnostic accuracy of sideline tests of vestibular and oculomotor dysfunction to identify SRC in adults. Study Design: Systematic review; Level of evidence, 4. Methods: Electronic databases and gray literature were searched from inception until February 12, 2020. Physically active individuals (>16 years of age) who participated in sports were included. The reference standard for SRC was a combination of clinical signs and symptoms (eg, the Sport Concussion Assessment Tool [SCAT]), and index tests included any oculomotor assessment tool. The QUADAS tool was used to assess risk of bias, with the credibility of the evidence being rated according to GRADE. Results: A total of 8 studies were included in this review. All included studies used the King-Devick test, with no other measures being identified. Meta-analysis was performed on 4 studies with a summary sensitivity and specificity of 0.77 and 0.82, respectively. The overall credibility of the evidence was rated as very low. Conclusion: Caution must be taken when interpreting these results given the very low credibility of the evidence, and the true summary sensitivity and specificity may substantially differ from the values calculated within this systematic review. Therefore, we recommend that clinicians using the King-Devick test to diagnose SRC in adults do so in conjunction with other tools such as the SCAT. PROSPERO Registration: CRD42018106632.

scholarly journals Predictive value of Score for Neonatal Acute Physiology and Perinatal Extension II for neonatal mortality in Sanglah Hospital, Denpasar, Indonesia

2017 ◽  
Vol 56 (5) ◽  
pp. 257
Author(s):  
I Gede Ketut Aryana ◽  
I Made Kardana ◽  
I Nyoman Adipura
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Goodness Of Fit ◽  
Assessment Tool ◽  
Area Under The Curve ◽  
Severe Infection ◽  
Scoring Systems ◽  
World Health ◽  
Severe Illness ◽  
Goodness Of Fit Test

Background Neonatal mortality, which is largely caused by severe illness, is the biggest contributor to overall infant mortality. The World Health Organization (WHO) estimated that 4 million neonates die yearly worldwide, often due to severe infection and organ system immaturity. Neonates with severe illness require treatment in the neonatal intensive care unit (NICU), in which a reliable assessment tool for illness severity is needed to guide intensive care requirements and prognosis. Neonatal disease severity scoring systems have been developed, including Score for Neonatal Acute Physiology and Perinatal Extension II  (SNAPPE II), but it has never been validated in our setting.ObjectiveTo study the prognostic value of SNAPPE II as a predictor of neonatal mortality in Sanglah Hospital, Denpasar, Indonesia.Methods This prospective cohort study was conducted in the NICU of Sanglah Hospital, Denpasar from November 2014 to February 2015. All neonates, except those with congenital anomaly, were observed during the first 12 hours of admission and their outcomes upon discharge from the NICU was recorded. We assessed the SNAPPE II cut-off point to predict neonatal mortality. The calibration of SNAPPE II was done using the Hosmer-Lemeshow goodness-of-fit test, and discrimination of SNAPPE II was determined from the receiver-operator characteristic (ROC) curve and area under the curve (AUC) value calculation.ResultsDuring the period of study, 63 children were eligible, but 5 were excluded because of major congenital abnormalities. The SNAPPE II optimum cut-off point of 37 gave a high probability of mortality and the ROC showed an AUC of 0.92 (95%CI 0.85 to 0.99). The Hosmer-Lemeshow goodness-of-fit test showed a good calibration with P = 1.0Conclusion The SNAPPE II  has a good predictive ability for neonatal mortality in Sanglah Hospital, Denpasar, Indonesia.

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