scholarly journals Information Technology–Assisted Treatment Planning and Performance Assessment for Severe Thalassemia Care in Low- and Middle-Income Countries: Observational Study (Preprint)

2017 ◽  
Author(s):  
Rajat Kumar Agarwal ◽  
Amit Sedai ◽  
Kumari Ankita ◽  
Lalith Parmar ◽  
Rakesh Dhanya ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Performance Assessment ◽  
Spleen Size ◽  
Liver Size ◽  
Middle Income ◽  
Middle Income Countries ◽  
Effective Delivery ◽  
And Performance ◽  
The Impact

BACKGROUND Successful models of information and communication technology (ICT) applied to cost-effective delivery of quality care in low- and middle-income countries (LMIC) are an increasing necessity. Severe thalassemia is one of the most common life-threatening noncommunicable diseases of children globally. OBJECTIVE The aim was to study the impact of ICT on quality of care for severe thalassemia patients in LMIC. METHODS A total of 1110 patients with severe thalassemia from five centers in India were followed over a 1-year period. The impact of consistent use of a Web-based platform designed to assist comprehensive management of severe thalassemia (ThalCare) on key indicators of quality of care such as minimum (pretransfusion) hemoglobin, serum ferritin, liver size, and spleen size were assessed. RESULTS Overall improvements in initial hemoglobin, ferritin, and liver and spleen size were significant (P<.001 for each). For four centers, the improvement in mean pretransfusion hemoglobin level was statistically significant (P<.001). Four of five centers achieved reduction in mean ferritin levels, with two displaying a significant drop in ferritin (P=.004 and P<.001). One of the five centers did not record liver and spleen size on palpation, but of the remaining four centers, two witnessed a large drop in liver and spleen size (P<.01), one witnessed moderate drop (P=.05 for liver; P=.03 for spleen size), while the fourth witnessed a moderate increase in liver size (P=.08) and insignificant change in spleen size (P=.12). CONCLUSIONS Implementation of computer-assisted treatment planning and performance assessment consistently and positively impacted indexes reflecting effective delivery of care to patients suffering from severe thalassemia in LMIC.

scholarly journals CF GLOBAL CARE: Collaboration Between Two CF Centers; University of Michigan, USA and Marmara University, Istanbul, Turkey before and during the COVID-19 Pandemic

2021 ◽  
Author(s):  
Samya Nasr ◽  
Yasemin Gokdemir ◽  
Ela Erdem Eralp ◽  
Fazilet Karakoc ◽  
Almala Ergenekon ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Quality Of Care ◽  
Middle East ◽  
Improve Quality ◽  
University Of Michigan ◽  
Middle Income ◽  
Middle Income Countries ◽  
Middle East Countries ◽  
The University

Solving the world’s health challenges requires multidisciplinary collaborations that bring together the talents, experiences, resources, and ideas from multiple sectors in low and middle-income countries (LMIC) and high -income countries (HIC). Cystic Fibrosis (CF) was thought to be a disease of Caucasian populations from European decent. However, it has been shown to affect people from all ethnic backgrounds. CF care varies significantly for people with CF (pw CF) from HIC with median survival approaching 50 years of age, to LMIC with pw CF dying in infancy or early childhood. To address the discrepancy in quality of care and outcomes, we report on a collaboration between our team at the University of Michigan cystic fibrosis center (UoM CFC), through support from the Middle East CF Association (MECFA) and the CF Foundation (CFF), and a CF center in Turkey (Marmara University CF Center, Istanbul) to address deficiencies and improve quality of care in that center. The collaboration has been successful in improving Ma CFC data and patient care. This partnership can be viewed as a model of collaboration to be duplicated in other Middle East Countries and LMIC to deliver optimal CF care.

scholarly journals Using unannounced standardised patients to obtain data on quality of care in low-income and middle-income countries: key challenges and opportunities

2019 ◽  
Vol 4 (5) ◽  
pp. e001908 ◽  
Author(s):  
Virginia Wiseman ◽  
Mylene Lagarde ◽  
Roxanne Kovacs ◽  
Luh Putu Lila Wulandari ◽  
Timothy Powell-Jackson ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Low Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Challenges And Opportunities ◽  
Standardised Patients

Life expectancy’s relationship with behavioral factors and polypharmacy in Western Balkan countries

2020 ◽  
Vol 66 (1) ◽  
pp. 79-84
Author(s):  
Arben Boshnjaku ◽  
Ermira Krasniqi
Keyword(s):  
Life Expectancy ◽  
Overweight And Obesity ◽  
Modern World ◽  
Behavioral Factors ◽  
Western Balkans ◽  
Middle Income ◽  
Middle Income Countries ◽  
Increasing Trend ◽  
And Performance

Ageing is a multidisciplinary studied process characterized with a gradual increased time of homeostasis and decreased time of reaction and performance. Expected life expectancy is an important measure of a populations’ health status and healthcare system’s performance, which is characterized with a gradual increase in the modern world. This increasing trend changes between different countries and societies, while being affected by several internal, external and behavioral factors. This narrative review analyses and compares the countries of Western Balkans, all of whom classified as middle income countries. Increasing physical activity, avoiding smoking as well as decreasing overweight and obesity present reliable mechanisms to invest in terms of providing a better lifestyle and quality of life. Polypharmacy presents another integral player into this process, which affects and interacts with each and every other factor. Altogether should be taken in consideration in policy makings, healthcare approaches and intervention plans. Keywords: life expectancy, polypharmacy, western Balkan, overweight, obesity

Enhancing quality of medical care in low income and middle income countries through simulation-based initiatives: recommendations of the Simnovate Global Health Domain Group

2017 ◽  
Vol 3 (Suppl 1) ◽  
pp. S15-S22 ◽  
Author(s):  
Lekha Puri ◽  
Jishnu Das ◽  
Madhukar Pai ◽  
Priya Agrawal ◽  
J Edward Fitzgerald ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Global Health ◽  
Medical Care ◽  
Low Income ◽  
Middle Income ◽  
Health Domain ◽  
Middle Income Countries ◽  
Simulation Based ◽  
Quality Of Medical Care

BackgroundQuality of medical care in low income and middle income countries (LMICs) is variable, resulting in significant medical errors and adverse patient outcomes. Integration of simulation-based training and assessment may be considered to enhance quality of patient care in LMICs. The aim of this study was to consider the role of simulation in LMICs, to directly impact health professions education, measurement and assessment.MethodsThe Simnovate Global Health Domain Group undertook three teleconferences and a direct face-to-face meeting. A scoping review of published studies using simulation in LMICs was performed and, in addition, a detailed survey was sent to the World Directory of Medical Schools and selected known simulation centres in LMICs.ResultsStudies in LMICs employed low-tech manikins, standardised patients and procedural simulation methods. Low-technology manikins were the majority simulation method used in medical education (42%), and focused on knowledge and skills outcomes. Compared to HICs, the majority of studies evaluated baseline adherence to guidelines rather than focusing on improving medical knowledge through educational intervention. There were 46 respondents from the survey, representing 21 countries and 28 simulation centres. Within the 28 simulation centres, teachers and trainees were from across all healthcare professions.DiscussionBroad use of simulation is low in LMICs, and the full potential of simulation-based interventions for improved quality of care has yet to be realised. The use of simulation in LMICs could be a potentially untapped area that, if increased and/or improved, could positively impact patient safety and the quality of care.

scholarly journals Instrumental Activities of Daily Living Scales to Detect Cognitive Impairment and Dementia in Low- and Middle-Income Countries: A Systematic Review

2021 ◽  
pp. 1-24
Author(s):  
Heather Yemm ◽  
Dame Louise Robinson ◽  
Stella-Maria Paddick ◽  
Catherine Dotchin ◽  
Michaela Louise Goodson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Middle Income ◽  
Middle Income Countries ◽  
Instrumental Activities ◽  
The Impact ◽  
Low And Middle Income

Background: The largest proportion of people with dementia worldwide live in low- and middle- income countries (LMICs), with dementia prevalence continuing to rise. Assessment and diagnosis of dementia involves identifying the impact of cognitive decline on function, usually measured by instrumental activities of daily living (IADLs). Objective: This review aimed to identify IADL measures which are specifically developed, validated, or adapted for use in LMICs to guide selection of such tools. Methods: A systematic search was conducted (fourteen databases) up to April 2020. Only studies reporting on development, validation, or adaptation of IADL measures for dementia or cognitive impairment among older adults (aged over 50) in LMICs were included. The QUADAS 2 was used to assess quality of diagnostic accuracy studies. Results: 22 papers met inclusion criteria; identifying 19 discrete IADL tools across 11 LMICs. These were either translated from IADL measures used in high-income countries (n = 6), translated and adapted for cultural differences (n = 6), or newly developed for target LMIC populations (n = 7). Seven measures were investigated in multiple studies; overall quality of diagnostic accuracy was moderate to good. Conclusion: Reliability, validity, and accuracy of IADL measures for supporting dementia diagnosis within LMICs was reported. Key components to consider when selecting an IADL tool for such settings were highlighted, including choosing culturally appropriate, time-efficient tools that account for gender- and literacy-bias, and can be conducted by any volunteer with appropriate training. There is a need for greater technical and external validation of IADL tools across different regions, countries, populations, and cultures.

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