Comparative Analysis of Mobile Pain Management Applications in Developed versus Developing Countries (Preprint)

2021 ◽  
Author(s):  
Wilson Mupfururirwa ◽  
Victoria Nembaware ◽  
Jack Morrice ◽  
Khuthala Mnika ◽  
Gaston Kuzamunu Mazandu ◽  
...  
Keyword(s):  
Pain Management ◽  
Uniform Distribution ◽  
Mobile Health ◽  
Low Income ◽  
Cochrane Review ◽  
High Income ◽  
Low Income Countries ◽  
App Store ◽  
Significant Difference ◽  
The Impact

BACKGROUND The impact of mobile phones and their applications in healthcare (mobile health) is well established for a range of diseases and cross-cutting complications, such as pain. While numerous mobile health (mHealth) pain interventions have been established, an evaluation of their prevalence, adequacy and distribution remains limited. OBJECTIVE This study aims at reviewing and comparing current pain management mHealth tools in high- versus low-income countries. METHODS A literature and application (app) store search was conducted in May 2021 using combinations of the following keywords: “pain management”, “pain”, “mobile health”, “telemedicine”, and “app”. Literature searches were conducted in PubMed, Scopus, Cochrane Review Library, and Google scholar. App store searches were conducted in Google Play and Apple App Store. Data characteristics descriptive analysis was performed using R software to summarize different datasets and compute p-values (P) for testing the significance of different hypotheses with the significance level set to 0.05. RESULTS The search identified 40 publications (literature search) and 230 mHealth applications (app store search), revealing a non uniform distribution of search categories (χ2= 133.7, P < 0.004) with a ratio approximating 1:6 (OR = 5.730, 95%CI:3.745-8.909, P < 0.004). About 86.7% of these 270 applications (apps) are from high-income countries, showing a statistically significant non uniform distribution of country categories: high- and low-income (χ2= 145.2, P < 0.004) approximating the theoretical distribution of a 7:1 ratio (OR = 6.476, 95%CI:4.180-10.222, P < 0.004). Moreover, there is no significant difference in the proportion of search categories between country categories ( χ2= 0.113, P = 0.737) and the difference in pain app prevalence in high- versus low-income countries is not statistically significant. Finally, we have observed that pain-tracking apps are significantly more prevalent in developed countries in comparison to low-income countries. CONCLUSIONS As expected, pain management app prevalence is higher in high-income countries. However, more research is required to readily comprehend the effectiveness of these apps.

scholarly journals COVID-19 in children treated with immunosuppressive medication for kidney diseases

2020 ◽  
pp. archdischild-2020-320616
Author(s):  
Matko Marlais ◽  
Tanja Wlodkowski ◽  
Samhar Al-Akash ◽  
Petr Ananin ◽  
Varun Kumar Bandi ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Immunosuppressive Therapy ◽  
Low Income ◽  
Kidney Diseases ◽  
Low Income Countries ◽  
Reference Network ◽  
Immunosuppressive Medication ◽  
Immunosuppressive Medications ◽  
Significant Difference ◽  
The Impact

BackgroundChildren are recognised as at lower risk of severe COVID-19 compared with adults, but the impact of immunosuppression is yet to be determined. This study aims to describe the clinical course of COVID-19 in children with kidney disease taking immunosuppressive medication and to assess disease severity.MethodsCross-sectional study hosted by the European Rare Kidney Disease Reference Network and supported by the European, Asian and International paediatric nephrology societies. Anonymised data were submitted online for any child (age <20 years) with COVID-19 taking immunosuppressive medication for a kidney condition. Study recruited for 16 weeks from 15 March 2020 to 05 July 2020. The primary outcome was severity of COVID-19.Results113 children were reported in this study from 30 different countries. Median age: 13 years (49% male). Main underlying reasons for immunosuppressive therapy: kidney transplant (47%), nephrotic syndrome (27%), systemic lupus erythematosus (10%). Immunosuppressive medications used include: glucocorticoids (76%), mycophenolate mofetil (MMF) (54%), tacrolimus/ciclosporine A (58%), rituximab/ofatumumab (11%). 78% required no respiratory support during COVID-19 illness, 5% required bi-level positive airway pressure or ventilation. Four children died; all deaths reported were from low-income countries with associated comorbidities. There was no significant difference in severity of COVID-19 based on gender, dialysis status, underlying kidney condition, and type or number of immunosuppressive medications.ConclusionsThis global study shows most children with a kidney disease taking immunosuppressive medication have mild disease with SARS-CoV-2 infection. We therefore suggest that children on immunosuppressive therapy should not be more strictly isolated than children who are not on immunosuppressive therapy.

scholarly journals The Impact of Imports and Exports on the Size and Composition of Government Expenditures

2017 ◽  
Vol 9 (3) ◽  
pp. 57
Author(s):  
Michael Benarroch ◽  
Manish Pandey
Keyword(s):  
International Trade ◽  
Causal Relationship ◽  
Low Income ◽  
High Income ◽  
Low Income Countries ◽  
Government Expenditures ◽  
Foreign Competition ◽  
Negative Consequences ◽  
The Impact ◽  
Casual Relationship

This paper examines the casual relationship between greater exposure to international trade and the size and composition of government expenditures, productive versus unproductive. To capture differential impacts on how government responds to greater international exposure three measures are used: the ratio of exports plus imports to GDP (openness), the ratio of exports to GDP, and the ratio imports to GDP. For all countries in aggregate, we find no causal relationship between openness and total government expenditures or productive and unproductive expenditures. For low-income countries however, there is a positive causal relationship between openness and productive government expenditures. Further, there is a positive causal relationship between the import ratio and productive expenditures for all countries as well as for low- and high-income countries separately. Exports, conversely, have no causal relationship with any measure of government expenditures. Our findings suggest that governments in economies with greater imports as a share of GDP increase productive expenditure to counteract the negative consequences from more exposure to foreign competition.

The Impact of Earthquakes on the Domestic Stock Market

2013 ◽  
Vol 29 (1) ◽  
pp. 325-337 ◽  
Author(s):  
Bert Scholtens ◽  
Yvonne Voorhorst
Keyword(s):  
Stock Market ◽  
Low Income ◽  
German Law ◽  
Low Income Countries ◽  
Negative Effects ◽  
Key Characteristics ◽  
Significant Difference ◽  
Study Methodology ◽  
The Impact ◽  
Event Study Methodology

How do financial markets respond to the impact of earthquakes? We investigate this for more than 100 earthquakes with fatalities in 21 countries from five continents in the period 1973–2011. Using an event study methodology we conclude that there are significant negative effects on stock market value. We find that the stock market's response to earthquakes is more pronounced in recent years than in the 1970s and 1980s. There is no difference in the responses to the most and least severe earthquakes or to those in high-income and low-income countries. There is hardly a significant difference in the response to earthquakes in German law–based countries and English or French law–based countries. This suggests that the stock market is not very sensitive regarding key characteristics of earthquakes.

scholarly journals Free Trade Agreements and Environment for Sustainable Development: A Gravity Model Analysis

2019 ◽  
Vol 11 (3) ◽  
pp. 597 ◽  
Author(s):  
Xing Yao ◽  
Rizwana Yasmeen ◽  
Yunong Li ◽  
Muhammad Hafeez ◽  
Ihtsham Padda
Keyword(s):  
Free Trade ◽  
Low Income ◽  
Positive Impact ◽  
Group Analysis ◽  
Free Trade Agreements ◽  
Trade Agreements ◽  
High Income ◽  
Low Income Countries ◽  
Middle Income ◽  
The Impact

Free trade agreements (FTAs) have a key role in the global value chain. In the meantime, these are also disturbing the environmental balance of the world. The objective of this study is to check whether the trade is good or bad for the environments of countries that are bonded by trade agreements. This study examines the impact of FTAs on bilateral carbon emissions within the gravity framework. We find a positive impact of FTA agreements on bilateral CO2 pollution. However, in an income-based country group analysis, we find mixed evidence regarding FTAs. The analysis concerning high income countries indicates that free trade agreements are beneficial for high income countries, while, in the case of upper middle income and lower middle income countries, we find that the free trade agreements are not beneficial for their environments. These results of the effects of FTAs on bilateral CO2 pollution imply that low income countries have a greater pollution effect even after the implementation of an FTA due to lenient environmental standards. There is a need for developing countries to learn from high income countries, as their FTAs are beneficial for decreasing pollution.

scholarly journals Effectiveness of transverse speed reducers and exploring factors contributing to road traffic crashes on a rural two-lane highway: A mixed methods study

2020 ◽  
Author(s):  
Nigus Asefa ◽  
Hannah S Yang ◽  
Znabu H Kahsay ◽  
Abrahim Hassen ◽  
Tesfay G Gebrehiwot
Keyword(s):  
Low Income ◽  
Planning Process ◽  
Road Traffic ◽  
High Income ◽  
Low Income Countries ◽  
P Value ◽  
Interrupted Time Series Analysis ◽  
Traffic Crashes ◽  
Road Traffic Crashes ◽  
Significant Difference

Abstract Background: In Ethiopia, there are an estimated 25.3 road traffic related deaths per 100,000 population, which is much higher than the global average road traffic fatality rate. Speed is the most well-known risk factor influencing both the risk as well as the severity of the resulting injuries. Although there is paucity of data from low-income countries, speed reducers have been widely approved as an effective traffic calming countermeasure in high-income countries. We aimed to (i) explore the effectiveness of transverse vertical speed reducers and, (ii) qualitatively explore stakeholders’ perceptions of the factors that affect the risk of road traffic crashes.Methods: Data on all crashes occurring from September 2010 to August 2015 were obtained. Interrupted time series analysis using Poisson regression was used to estimate the effect of speed reducers on the number of crashes per month before and after their installation in January 2012. Focus group discussions and in-depth interviews were conducted with traffic police, drivers, drivers’ training center owners, and community members to describe their perceptions about the effects of the speed reducers. Quantitative and qualitative results were triangulated.Results: There were 130 crashes during the study period. Of these, 45.4% were property damage only, and 16.9% were fatal. After the speed reducers were installed, there was no statistically significant difference (incidence rate ratio, IRR =1.17, 95% CI[0.60-2.30], p-value =0.644) in the number of crashes per month, but there were changes in the distribution of crash severity (p-value <0.001). Four core themes, with subsequent sub-themes, emerged as perceived contributors to road traffic crashes. Of these core-themes, speedy and reckless driving, were perceived as the strongest force perpetuating road collisions. Qualitative respondents disagreed on whether the speed reducers were effective and expressed concerns such as the lack of signage to warn drivers.Conclusions: Although speed reducers are proven to reduce collisions in high-income settings, this study in Ethiopia was inconclusive. Inappropriate design for the roadway type, sporadic placement, lack of signage and maintenance, and poor stakeholder coordination may have hampered effectiveness. An evidence-based planning process prior to implementing road design interventions is recommended to achieve the desired results.

Impacts of ecosystem vitality on ASEAN’s agricultural exports: A System Generalized Method of Moments approach

2020 ◽  
Vol 23 (4) ◽  
pp. 335-351
Author(s):  
Nguyen Khanh Doanh ◽  
Nguyen Ngoc Quynh ◽  
Yoon Heo
Keyword(s):  
Low Income ◽  
Generalized Method Of Moments ◽  
Jel Classification ◽  
High Income ◽  
Low Income Countries ◽  
Potent Effect ◽  
Agricultural Exports ◽  
Asean Countries ◽  
The Impact

This study examined the impact of the Association of Southeast Asian Nations (ASEAN)’s ecosystem vitality (EV) on its agricultural exports to the rest of the world. Using a sample of the six major ASEAN countries (ASEAN-6) (including Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam) and their 72 trading partners for the period 2007–2016, we found robust evidence of a positive relationship between the quality of EV and the volume of agricultural exports. At the sectoral level, the quality of EV had the most substantial effects on the ASEAN’s exports of SITC-0 (food and live animals) and exerted the least impact on the ASEAN’s exports of SITC-2 (crude materials, inedible, except fuels). This empirical evidence implies that natural resource-intensive products are more sensitive to the quality of EV. At the country level, EV has the most potent effect on the ASEAN’s agricultural exports to high-income countries and the least impact on the ASEAN’s agricultural exports to low-income countries. To promote agricultural exports, especially to high-income countries, our empirical results suggest that ASEAN countries need to build specific and effective plans for conservation of environment and management of sustainable ecosystems. JEL Classification: C33, F14, and Q56

scholarly journals The Impact of the Asian Crisis on Governance: Does OECD Membership or Income Levels Matter?

2018 ◽  
Vol 13 (2) ◽  
pp. 115-130
Author(s):  
Halil Dincer Kaya
Keyword(s):  
Low Income ◽  
Political Stability ◽  
Income Group ◽  
Oecd Countries ◽  
High Income ◽  
Asian Crisis ◽  
Low Income Countries ◽  
Middle Income ◽  
Governance Indicators ◽  
The Impact

AbstractWe examine the impact of the 1997 Asian Crisis on governance. We look into how the crisis affected High-Income OECD, High-Income Non-OECD, Upper-middle Income, Lower- Middle Income, and Low Income Countries. For measures of governance, we use the World Bank’s Governance Indicators dataset which includes six measures of governance. We find that pre- and post-crisis, the ranking of each income group has not changed except for year 2004 when the High-Income Non-OECD Countries surpassed the High-Income OECD Countries in “Political Stability and Absence of Violence” category. In other words, our results show that, other than that exception in 2004, both pre- and post-crisis, the High-Income OECD Countries had the best governance measures, the High-Income Non-OECD Countries had the second best measures, and so on, in the order shown above. One point to note here: The High-Income Non- OECD Countries performed much better than the other groups after year 1998. After 1998, this group improved in all six dimensions of governance. We conclude that although crises affect all income groups, because of certain characteristics of the High-Income Non-OECD group, they tend to better react to crises.

scholarly journals Digital health in the Americas: advances and challenges in connected health

2018 ◽  
Vol 4 (3) ◽  
pp. 123-127 ◽  
Author(s):  
David Novillo-Ortiz ◽  
Elsy Maria Dumit ◽  
Marcelo D’Agostino ◽  
Francisco Becerra-Posada ◽  
Edward Talbott Kelley ◽  
...  
Keyword(s):  
Information And Communication Technologies ◽  
Mobile Health ◽  
Low Income ◽  
Digital Health ◽  
Health Sector ◽  
Developed Countries ◽  
High Income ◽  
Low Income Countries ◽  
Health Coverage ◽  
Middle Income

In 2005, all WHO Member States pledged to fight for universal health coverage (UHC). The availability of financial, human and technological resources seems to be necessary to develop efficient health policies and also to offer UHC. One of the main challenges facing the health sector comes from the need to innovate efficiently. The intense use of information and communication technologies (ICTs) in the health field evidences a notable improvement in results obtained by institutions, health professionals and patients, principally in developed countries. In the Americas, the relationship between economic development and health innovation is not particularly evident. Data from 19 of 35 countries surveyed in the 2015 Third Global Survey on eHealth for the region of the Americas were analysed. 52.6% of the countries of the Americas have a national policy or strategy for UHC. 57.9% of the countries in the sample indicate that they have a national eHealth policy or strategy, but only 26.3% have an entity that supervises the quality, safety and reliability regulations for mobile health applications. The survey data indicate that high-income and low-income to middle-income countries show higher percentages in relation to the existence of entities that promote innovation. These countries also exceed 60%—compared with 40% and 50% in lower-income countries—in all cases regarding the use of eHealth practices, such as mobile health, remote patient monitoring or telehealth. 100% of low-income countries report offering ICT training to healthcare professionals, compared with 83% of wealthy countries and 81% of middle-income to high-income countries.

scholarly journals Financial Crises, Income Levels and Access to Finance

2017 ◽  
Vol 12 (2) ◽  
pp. 112-124
Author(s):  
Halil Dincer Kaya
Keyword(s):  
Low Income ◽  
High Income ◽  
Low Income Countries ◽  
Access To Finance ◽  
Global Crisis ◽  
Middle Income ◽  
Market Capitalization ◽  
Middle Income Countries ◽  
Run Up ◽  
The Impact

Abstract In this study, we examine the impact of the 2008 Global Crisis on “access to finance” in high-income OECD, high-income non-OECD, middle-income, and low-income countries. We use three measures of access to finance. These are “Number of bank branches per 100,000 adults”, “Value traded of top 10 traded companies to total value traded (%)”, and “Market capitalization outside of top 10 largest companies to total market capitalization (%)”. During the run-up to the crisis and immediately after the crisis, we do not find any significant change in any of the three “access to finance” measures. We find that, during the crisis, only middle-income countries were affected significantly. These countries were affected in only one of the measures which is “Value traded of top 10 traded companies to total value traded (%)”. This measure went up and this change is marginally significant. We conclude that the global crisis only affected “access to finance” in middle-income countries.

scholarly journals The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Giorgia Gon ◽  
Abdunoor M. Kabanywanyi ◽  
Petri Blinkhoff ◽  
Simon Cousens ◽  
Stephanie J. Dancer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Study Design ◽  
Low Income ◽  
High Volume ◽  
Surface Cleaning ◽  
Low Income Countries ◽  
Training Period ◽  
Future Research ◽  
Environmental Hygiene ◽  
The Impact

Abstract Background Healthcare associated infections (HAI) are estimated to affect up to 15% of hospital inpatients in low-income countries (LICs). A critical but often neglected aspect of HAI prevention is basic environmental hygiene, particularly surface cleaning and linen management. TEACH CLEAN is an educational intervention aimed at improving environmental hygiene. We evaluated the effectiveness of this intervention in a pilot study in three high-volume maternity and newborn units in Dar es Salaam, Tanzania. Methods This study design prospectively evaluated the intervention as a whole, and offered a before-and-after comparison of the impact of the main training. We measured changes in microbiological cleanliness [Aerobic Colony Counts (ACC) and presence of Staphylococcus aureus] using dipslides, and physical cleaning action using gel dots. These were analysed with descriptive statistics and logistic regression models. We used qualitative (focus group discussions, in-depth interviews, and semi-structured observation) and quantitative (observation checklist) tools to measure why and how the intervention worked. We describe these findings across the themes of adaptation, fidelity, dose, reach and context. Results Microbiological cleanliness improved during the study period (ACC pre-training: 19%; post-training: 41%). The odds of cleanliness increased on average by 1.33 weekly during the pre-training period (CI = 1.11–1.60), and by 1.08 (CI = 1.03–1.13) during the post-training period. Cleaning action improved only in the pre-training period. Detection of S. aureus on hospital surfaces did not change substantially. The intervention was well received and considered feasible in this context. The major pitfalls in the implementation were the limited number of training sessions at the hospital level and the lack of supportive supervision. A systems barrier to implementation was lack of regular cleaning supplies. Conclusions The evaluation suggests that improvements in microbiological cleanliness are possible using this intervention and can be sustained. Improved microbiological cleanliness is a key step on the pathway to infection prevention in hospitals. Future research should assess whether this bundle is cost-effective in reducing bacterial and viral transmission and infection using a rigorous study design.

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