scholarly journals Use of Physical Accessibility Modelling in Diagnostic Network Optimization: A Review

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 103
Author(s):  
Camille Chênes ◽  
Heidi Albert ◽  
Kekeletso Kao ◽  
Nicolas Ray
Keyword(s):  
Network Optimization ◽  
Route Optimization ◽  
Modeling Framework ◽  
Community Based ◽  
Geospatial Modeling ◽  
Disease Epidemiology ◽  
Appropriate Care ◽  
Potential Benefits ◽  
Geographical Accessibility ◽  
Physical Accessibility

Diagnostic networks are complex systems that include both laboratory-tested and community-based diagnostics, as well as a specimen referral system that links health tiers. Since diagnostics are the first step before accessing appropriate care, diagnostic network optimization (DNO) is crucial to improving the overall healthcare system. The aim of our review was to understand whether the field of DNO, and especially route optimization, has benefited from the recent advances in geospatial modeling, and notably physical accessibility modeling, that have been used in numerous health systems assessment and strengthening studies. All publications published in English between the journal’s inception and 12 August 2021 that dealt with DNO, geographical accessibility and optimization, were systematically searched for in Web of Science and PubMed, this search was complemented by a snowball search. Studies from any country were considered. Seven relevant publications were selected and charted, with a variety of geospatial approaches used for optimization. This paucity of publications calls for exploring the linkage of DNO procedures with realistic accessibility modeling framework. The potential benefits could be notably better-informed travel times of either the specimens or population, better estimates of the demand for diagnostics through realistic population catchments, and innovative ways of considering disease epidemiology to inform DNO.

scholarly journals Community-Based Cluster Randomized Controlled Trial: Empowering Households to Identify and Provide Appropriate Care for Low-Birthweight Newborns in Nepal

2020 ◽  
Author(s):  
Stephen Hodgins ◽  
Binamra Rajbhandari ◽  
Deepak Joshi ◽  
Bharat Ban ◽  
Subarna Khatry ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Care Seeking ◽  
Apparent Effect ◽  
Community Based ◽  
Randomized Controlled ◽  
Appropriate Care ◽  
Cluster Randomized ◽  
Skin To Skin

Abstract Background: Most newborn deaths occur among those of low birthweight (LBWt), due to prematurity &/or impaired fetal growth. Simple practices can mitigate this risk. In low-income country settings where many births occur at home, strategies are needed that empower mothers to determine if their babies are higher risk and take protective measures. Earlier studies suggest that foot-length may be a good proxy for birthweight. An earlier Nepal study found a 6.9cm cut-off performed relatively well, differentiating normal from low birthweight.Methods: Community-based, cluster-randomized controlled trial. Objective: to determine whether family-administered screening, with targeted messages improves care practices known to mitigate LBWt risks. Participants: pregnant women participating in a parent trial in rural Nepal. Women were given a 6.9cm card to assess whether the baby’s foot is small; if so, to call number on the card for advice. Follow-up visits were made over 2 weeks following the birth, assessing for: reported skin-to-skin thermal care, and care-seeking outside the home; restricting to low birthweight (using 2 cutoffs: 2,500g and 2,000g). Randomization: 17 clusters intervention, 17 control. The study also documented steps along the presumed causal chain from intervention through behavioral impact.Results: 2,022 into intervention, 2,432 into control. Intervention arm: 519 with birthweight <2,500g (vs. 663 among controls), of which 503 were available for analysis (vs. 649 among controls). No significant difference on care-seeking; for those <2,500g RR 1.13 (95%CI: 0.97-1.131). More of those in the intervention arm reported skin-to-skin thermal care than among controls; for those <2,500g RR 2.50 (95%CI: 2.01-3.1). Process measures suggest this apparent effect cannot be attributed to the intervention; the card performed poorly as a proxy for LBWt, misclassifying 84.5% of those <2,000 as normal.Conclusions: Although the trial found an apparent effect on one key behavioral outcome, this cannot be attributed to the intervention; most likely it was a result of pure chance. Other approaches are needed for identifying at-risk babies in such settings, and targeting them for appropriate care messaging.Trial registration : clinicaltrials.gov identifier: NCT02802332, registered 16 June 2016, https://clinicaltrials.gov/ct2/show/NCT02802332

scholarly journals Enacting agency: exploring how older adults shape their neighbourhoods

2018 ◽  
Vol 40 (3) ◽  
pp. 565-583 ◽  
Author(s):  
Carri Hand ◽  
Debbie Laliberte Rudman ◽  
Suzanne Huot ◽  
Rachael Pack ◽  
Jason Gilliland
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Social Connectedness ◽  
Community Action ◽  
Community Based ◽  
Participatory Approaches ◽  
Public Places ◽  
Helping Others ◽  
Neighbourhood Level ◽  
Potential Benefits

AbstractWithin research on ageing in neighbourhoods, older adults are often positioned as impacted by neighbourhood features; their impact on neighbourhoods is less often considered. Drawing on a study exploring how person and place transact to shape older adults’ social connectedness, inclusion and engagement in neighbourhoods, this paper explores how older adults take action in efforts to create neighbourhoods that meet individual and collective needs and wants. We drew on ethnographic and community-based participatory approaches and employed qualitative and geospatial methods with 14 older adults in two neighbourhoods. Analysis identified three themes that described the ways that older adults enact agency at the neighbourhood level: being present and inviting casual social interaction, helping others and taking community action. The participants appeared to contribute to a collective sense of connectedness and creation of social spaces doing everyday neighbourhood activities and interacting with others. Shared territories in which others were present seemed to support such interactions. Participants also helped others in a variety of ways, often relating to gaps in services and support, becoming neighbourhood-based supports for other seniors. Finally, participants contributed to change at the community level, such as engaging politically, patronising local businesses and making improvements in public places. Study findings suggest the potential benefits of collaborating with older adults to create and maintain liveable neighbourhoods.

scholarly journals The winding road to health: A systematic scoping review on the effect of geographical accessibility to health care on infectious diseases in low- and middle-income countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244921
Author(s):  
Fleur Hierink ◽  
Emelda A. Okiro ◽  
Antoine Flahault ◽  
Nicolas Ray
Keyword(s):  
Infectious Disease ◽  
Health Care ◽  
Infectious Diseases ◽  
Disease Burden ◽  
Disease Risk ◽  
Surveillance Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Geographical Accessibility ◽  
Physical Accessibility

Background Geographical accessibility to healthcare is an important component of infectious disease dynamics. Timely access to health facilities can prevent disease progression and enables disease notification through surveillance systems. The importance of accounting for physical accessibility in response to infectious diseases is increasingly recognized. Yet, there is no comprehensive review of the literature available on infectious diseases in relation to geographical accessibility to care. Therefore, we aimed at evaluating the current state of knowledge on the effect of geographical accessibility to health care on infectious diseases in low- and middle-income countries. Methods and findings A search strategy was developed and conducted on Web of Science and PubMed on 4 March 2019. New publications were checked until May 28, 2020. All publication dates were eligible. Data was charted into a tabular format and descriptive data analyses were carried out to identify geographical regions, infectious diseases, and measures of physical accessibility among other factors. Search queries in PubMed and Web of Science yielded 560 unique publications. After title and abstract screening 99 articles were read in full detail, from which 64 articles were selected, including 10 manually. Results of the included publications could be broadly categorized into three groups: (1) decreased spatial accessibility to health care was associated with a higher infectious disease burden, (2) decreased accessibility was associated to lower disease reporting, minimizing true understanding of disease distribution, and (3) the occurrence of an infectious disease outbreak negatively impacted health care accessibility in affected regions. In the majority of studies, poor geographical accessibility to health care was associated with higher disease incidence, more severe health outcomes, higher mortality, and lower disease reporting. No difference was seen between countries or infectious diseases. Conclusions Currently, policy-makers and scientists rely on data collected through passive surveillance systems, introducing uncertainty on disease estimates for remote communities. Our results highlight the need for increasing integration of geographical accessibility measures in disease risk modelling, allowing more realistic disease estimates and enhancing our understanding of true disease burden. Additionally, disease risk estimates could be used in turn to optimize the allocation of health services in the prevention and detection of infectious diseases.

scholarly journals Understanding Business Disruption and Economic Losses Due to Electricity Failures and Flooding

2019 ◽  
Vol 10 (4) ◽  
pp. 421-438 ◽  
Author(s):  
Elco Koks ◽  
Raghav Pant ◽  
Scott Thacker ◽  
Jim W. Hall
Keyword(s):  
Economic Impacts ◽  
Economic Modeling ◽  
Economic Losses ◽  
Economic Activities ◽  
Modeling Framework ◽  
Geospatial Information ◽  
Geospatial Modeling ◽  
The United Kingdom ◽  
The Uk ◽  
Infrastructure Services

Abstract Failure of critical national infrastructures can cause disruptions with widespread economic impacts. To analyze these economic impacts, we present an integrated modeling framework that combines: (1) geospatial information on infrastructure assets/networks and the natural hazards to which they are exposed; (2) geospatial modeling of the reliance of businesses upon infrastructure services, in order to quantify disruption to businesses locations and economic activities in the event of infrastructure failures; and (3) multiregional supply-use economic modeling to analyze wider economic impacts of disruptions to businesses. The methodology is exemplified through a case study for the United Kingdom. The study uses geospatial information on the location of electricity infrastructure assets and local industrial areas, and employs a multiregional supply-use model of the UK economy that traces the impacts of floods of different return intervals across 37 subnational regions of the UK. The results show up to a 300% increase in total economic losses when power outages are included in the risk assessment, compared to analysis that just includes the economic impacts of business interruption due to flooded business premises. This increase indicates that risk studies that do not include failure of critical infrastructures may be underestimating the total losses.

scholarly journals The Association between Glomerular Filtration Rate Estimated Using Different Equations and Mortality in the Japanese Community-Based Population: The Yamagata (Takahata) Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Asami Kabasawa ◽  
Tsuneo Konta ◽  
Natsuko Suzuki ◽  
Keita Kamei ◽  
Sayumi Watanabe ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Characteristic Curve ◽  
Serum Cystatin C ◽  
Community Based ◽  
Serum Cystatin ◽  
Disease Epidemiology ◽  
Mdrd Equation ◽  
All Cause Mortality

Background. To evaluate renal function, the indices of estimated glomerular filtration rate (eGFR) obtained using several equations, including the Japanese versions of the serum creatinine-based MDRD equation (eGFRcreat), Chronic Kidney Disease Epidemiology Collaboration equation (eGFR-EPI), and serum cystatin C-based equation (eGFRcys), are utilized. This study prospectively examined the association between these eGFR values and all-cause mortality during a 12-year observational period in a community-based population. Methods and Results. The subjects of this study were 1312 participants undergoing a health checkup, aged ≥40 years. In the total population, the mean eGFR values (mL·min−1·1.73 m−2) were 81.5 for eGFRcreat, 78.1 for eGFR-EPI, and 76.6 for eGFRcys. There were 141 deaths during the observation period, and the area under the receiver operating characteristic curve for predicting mortality was 0.59 for eGFRcreat, 0.67 for eGFR-EPI, and 0.70 for eGFRcys (all P<0.01). In the Cox proportional analysis adjusted for age and sex, eGFRcys, but not eGFRcreat and eGFR-EPI, showed a significant association with all-cause mortality (per 15 mL·min−1·1.73 m−2 decrease: hazard ratio 1.40, 95% confidence interval 1.18–1.67). Conclusions. This study revealed that eGFRcys showed lower values than eGFRcreat and eGFR-EPI and was significantly associated with all-cause mortality in the Japanese community-based population.

Responding to adolescent family violence: Findings from an impact evaluation

2020 ◽  
Author(s):  
Hayley Boxall ◽  
Anthony Morgan
Keyword(s):  
Young People ◽  
Family Violence ◽  
Impact Evaluation ◽  
Positive Impact ◽  
Outcome Evaluation ◽  
Community Based ◽  
Community Based Programs ◽  
Adolescent Attachment ◽  
Potential Benefits

Despite growing recognition of the prevalence of and harms associated with adolescent family violence, our knowledge of how best to respond remains underdeveloped. This paper describes the findings from the outcome evaluation of the Adolescent Family Violence Program. The results show that the program had a positive impact on young people and their families, leading to improved parenting capacity and parent–adolescent attachment. However, there was mixed evidence of its impact on the prevalence, frequency and severity of violent behaviours. The evaluation reaffirms the importance of dedicated responses for young people who use family violence, and the potential benefits, and limits, of community-based programs.

The Mental Health Acute Assessment Team: a collaborative approach to treating mental health patients in the community

2017 ◽  
Vol 25 (3) ◽  
pp. 262-265 ◽  
Author(s):  
Steven C Faddy ◽  
Kevin J McLaughlin ◽  
Peta T Cox ◽  
Senthil S Muthuswamy
Keyword(s):  
Mental Health ◽  
Primary Outcome ◽  
Proof Of Concept ◽  
Mental Health Crisis ◽  
Physical And Mental Health ◽  
Model Of Care ◽  
Community Based ◽  
Health Crisis ◽  
Appropriate Care ◽  
Mental Health Patients

Objective: Many models of community-based mental health crisis teams have been reported. We present our experience of an outreach team made up of a paramedic and mental health nurse. Methods: A proof-of-concept was conducted in Western Sydney. The primary outcome was the proportion of patients where the team were able to facilitate the most appropriate care. Results: Nearly 70% of patients were able to be treated outside the Emergency Department, with about two-thirds being transported directly to a mental health facility. Conclusion: We have demonstrated that our model of care is successful in enabling appropriate physical and mental health care for patients suffering an acute mental health crisis.

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