scholarly journals Core Competencies of Truck Drivers Responding to Emergencies during Transportation of Hazardous Materials

2020 ◽  
Vol 10 (27) ◽  
pp. 200909
Author(s):  
Adnan Fazal Manzoor
Keyword(s):  
Core Competencies ◽  
Truck Drivers ◽  
Middle Income ◽  
Safe Delivery ◽  
Emergency Responders ◽  
Study Protocols ◽  
Effective Manner ◽  
Financial Interests ◽  
Hazmat Transportation ◽  
Multiple Challenges

Background. Hazardous material (HAZMAT) transportation drivers are responsible for safe delivery of consignments and face multiple challenges carrying out their duties. Drivers are also the first to respond to emergencies and accidents. Objectives. The purpose of the present study was to identify the essential competencies needed by HAZMAT transportation drivers to deal with emergencies. Methods. Three rounds of focus groups were conducted using expert panels comprised of HAZMAT specialists, health, safety and emergency representatives, security experts and transportation advisors from June to July 2019. The panel discussed competencies, gathered from a literature review, for emergency responders. Results. The panel identified six (6) core and 23 sub-competencies of HAZMAT drivers. This is the first study in low- and middle-income countries (LMIC) to identify core competencies of HAZMAT truck drivers. Conclusions. The integration of these competencies into a development and training program for drivers will better enable drivers to handle emergencies in an efficient and effective manner. Participant Consent. Obtained Ethics Approval. The Graduate Advisory Committee of Comsats University approved study protocols. Participant Consent. Obtained Competing Interests. The authors declare no competing financial interests.

scholarly journals Role of Fibrinolytic Enzymes in Anti-Thrombosis Therapy

2021 ◽  
Vol 8 ◽  
Author(s):  
Farwa Altaf ◽  
Shourong Wu ◽  
Vivi Kasim
Keyword(s):  
Plasminogen Activator ◽  
Thrombus Formation ◽  
Low Cost ◽  
Cost Effective ◽  
Tissue Type ◽  
High Yield ◽  
Efficacy Rate ◽  
Middle Income ◽  
Fibrinolytic Enzymes ◽  
Effective Manner

Thrombosis, a major cause of deaths in this modern era responsible for 31% of all global deaths reported by WHO in 2017, is due to the aggregation of fibrin in blood vessels which leads to myocardial infarction or other cardiovascular diseases (CVDs). Classical agents such as anti-platelet, anti-coagulant drugs or other enzymes used for thrombosis treatment at present could leads to unwanted side effects including bleeding complication, hemorrhage and allergy. Furthermore, their high cost is a burden for patients, especially for those from low and middle-income countries. Hence, there is an urgent need to develop novel and low-cost drugs for thrombosis treatment. Fibrinolytic enzymes, including plasmin like proteins such as proteases, nattokinase, and lumbrokinase, as well as plasminogen activators such as urokinase plasminogen activator, and tissue-type plasminogen activator, could eliminate thrombi with high efficacy rate and do not have significant drawbacks by directly degrading the fibrin. Furthermore, they could be produced with high-yield and in a cost-effective manner from microorganisms as well as other sources. Hence, they have been considered as potential compounds for thrombosis therapy. Herein, we will discuss about natural mechanism of fibrinolysis and thrombus formation, the production of fibrinolytic enzymes from different sources and their application as drugs for thrombosis therapy.

scholarly journals The story of critical care in Asia: a narrative review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jason Phua ◽  
Chae-Man Lim ◽  
Mohammad Omar Faruq ◽  
Khalid Mahmood Khan Nafees ◽  
Bin Du ◽  
...  
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
End Of Life ◽  
End Of Life Care ◽  
Main Body ◽  
Life Care ◽  
Middle Income ◽  
Care Community ◽  
Multiple Challenges

Abstract Background Asia has more critically ill people than any other part of our planet. The aim of this article is to review the development of critical care as a specialty, critical care societies and education and research, the epidemiology of critical illness as well as epidemics and pandemics, accessibility and cost and quality of critical care, culture and end-of-life care, and future directions for critical care in Asia. Main body Although the first Asian intensive care units (ICUs) surfaced in the 1960s and the 1970s and specialisation started in the 1990s, multiple challenges still exist, including the lack of intensivists, critical care nurses, and respiratory therapists in many countries. This is aggravated by the brain drain of skilled ICU staff to high-income countries. Critical care societies have been integral to the development of the discipline and have increasingly contributed to critical care education, although critical care research is only just starting to take off through collaboration across groups. Sepsis, increasingly aggravated by multidrug resistance, contributes to a significant burden of critical illness, while epidemics and pandemics continue to haunt the continent intermittently. In particular, the coronavirus disease 2019 (COVID-19) has highlighted the central role of critical care in pandemic response. Accessibility to critical care is affected by lack of ICU beds and high costs, and quality of critical care is affected by limited capability for investigations and treatment in low- and middle-income countries. Meanwhile, there are clear cultural differences across countries, with considerable variations in end-of-life care. Demand for critical care will rise across the continent due to ageing populations and rising comorbidity burdens. Even as countries respond by increasing critical care capacity, the critical care community must continue to focus on training for ICU healthcare workers, processes anchored on evidence-based medicine, technology guided by feasibility and impact, research applicable to Asian and local settings, and rallying of governments for support for the specialty. Conclusions Critical care in Asia has progressed through the years, but multiple challenges remain. These challenges should be addressed through a collaborative approach across disciplines, ICUs, hospitals, societies, governments, and countries.

scholarly journals Study protocol and design for the assessment of paediatric pneumonia from X-ray images using deep learning

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044461
Author(s):  
Mark GF Sun ◽  
Senjuti Saha ◽  
Syed Ahmar Shah ◽  
Saturnino Luz ◽  
Harish Nair ◽  
...  
Keyword(s):  
Deep Learning ◽  
Low Income ◽  
Majority Vote ◽  
Open Access Journal ◽  
Ethical Review ◽  
Middle Income ◽  
X Ray ◽  
Automated Method ◽  
Study Protocols ◽  
Chest X Ray

IntroductionIn low-income and middle-income countries, pneumonia remains the leading cause of illness and death in children<5 years. The recommended tool for diagnosing paediatric pneumonia is the interpretation of chest X-ray images, which is difficult to standardise and requires trained clinicians/radiologists. Current automated computational tools have primarily focused on assessing adult pneumonia and were trained on images evaluated by a single specialist. We aim to provide a computational tool using a deep-learning approach to diagnose paediatric pneumonia using X-ray images assessed by multiple specialists trained by the WHO expert X-ray image reading panel.Methods and analysisApproximately 10 000 paediatric chest X-ray images are currently being collected from an ongoing WHO-supported surveillance study in Bangladesh. Each image will be read by two trained clinicians/radiologists for the presence or absence of primary endpoint pneumonia (PEP) in each lung, as defined by the WHO. Images whose PEP labels are discordant in either lung will be reviewed by a third specialist and the final assignment will be made using a majority vote. Convolutional neural networks will be used for lung segmentation to align and scale the images to a reference, and for interpretation of the images for the presence of PEP. The model will be evaluated against an independently collected and labelled set of images from the WHO. The study outcome will be an automated method for the interpretation of chest radiographs for diagnosing paediatric pneumonia.Ethics and disseminationAll study protocols were approved by the Ethical Review Committees of the Bangladesh Institute of Child Health, Bangladesh. The study sponsor deemed it unnecessary to attain ethical approval from the Academic and Clinical Central Office for Research and Development of University of Edinburgh, UK. The study uses existing X-ray images from an ongoing WHO-coordinated surveillance. All findings will be published in an open-access journal. All X-ray labels and statistical code will be made openly available. The model and images will be made available on request.

scholarly journals Unpacking the ‘Business Model’ for Fortification Initiatives in Low- and Middle-Income Countries: Stakeholder Identified Drivers of Success and Constraints to Progress

2020 ◽  
Vol 17 (23) ◽  
pp. 8862
Author(s):  
Baqir Lalani ◽  
Michael Ndegwa ◽  
Ben Bennett
Keyword(s):  
Business Model ◽  
Online Survey ◽  
Economies Of Scale ◽  
Bivariate Analysis ◽  
Target Market ◽  
Middle Income ◽  
Middle Income Countries ◽  
Perceived Success ◽  
Effective Manner ◽  
Low And Middle Income

Background: Initiatives to tackle micronutrient deficiencies (MNDs) in low-and middle-income countries (LMICs) have increased steadily in recent years. Commodities such as staple foods (e.g., cereals) and condiments (e.g., salt) have been targeted as ‘vehicles’ for industrial fortification through numerous projects and initiatives. However, mixed experiences with delivery, coverage and sustainability have been found. Methods: Using an online survey of 71 key stakeholders (from 35 countries) consisting of the public/private sector, academia and civil society, this study sought to unpack the ‘business model’ for fortification initiatives to identify the key drivers of success and constraints faced by stakeholders in LMICs. Bivariate analysis was conducted to identify factors associated with the coverage of the target market and the perceived success and sustainability of fortification initiatives. Results: We identified four key factors contributing to the success of fortification initiatives. The first involves the size of the firm. Large firms had a significantly higher (p 0.05) self-sustaining index (perceived level of sustainability of the fortification initiative) than smaller sized firms. In addition, a higher perceived success score (p 0.05) was associated with non-targeted initiatives compared to those specifically targeted at a certain cohort of the population, further illustrating the benefits of producing at scale. Secondly, a significant relationship was found between whether standards were enacted and the coverage of the target market by the project/firm (p 0.05).). The third key factor relates to the ability to source adequate testing for the fortified produce in-house. A positive correlation was found for post-mix in-factory testing and the self-sustaining index (p 0.05). Finally, delays to importation and high charges were cited as key constraints to the use of premix. Conclusions: We argue therefore that a successful ‘business model’ for industrial fortification initiatives invariably consist of: (i) the involvement of larger sized firms that have the advantage of benefiting from economies of scale; (ii) the availability and application of agreed standards by the producer; (iii) high quality assurance/compliance monitoring (including post-mix testing where relevant), and; (iv) the ability to procure premix in a timely/cost-effective manner. These criteria are likely to be important factors that contribute to the success of fortification initiatives in LMICs.

scholarly journals Engineering Geodesy - Definition and Core Competencies

2014 ◽  
Vol 8 (4) ◽  
Author(s):  
Heiner Kuhlmann ◽  
Volker Schwieger ◽  
Andreas Wieser ◽  
Wolfgang Niemeier
Keyword(s):  
Data Processing ◽  
Quality Assessment ◽  
Core Competencies ◽  
Cost Effective ◽  
Problem Solution ◽  
Effective Manner ◽  
Engineering Geodesy ◽  
Measurement And Analysis ◽  
Research Questions ◽  
Definition Of

AbstractThis article summarises discussions concerning the definition of "engineering geodesy" within the German Geodetic Commission. It is noted that engineering geodesy by means of its tasks, methods and characteristics is an application-oriented science whose research questions often arise from observed phenomena or from unsolved practical problems. In particular it is characterised by the professional handling of geometry-related problems in a cost-effective manner that includes comprehensive quality assessment at all phases of the problem solution - from planning through measurement to data processing and interpretation. The current methodical developments are primarily characterised by the increasing integration of the measurement and analysis into challenging construction, production and monitoring processes as well as by the transition to spatially continuous methods. A modern definition of engineering geodesy is proposed at the end of this article.

scholarly journals Rethinking research ethics committees in low- and medium-income countries

2017 ◽  
Vol 14 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Luchuo Engelbert Bain ◽  
Ikenna Desmond Ebuenyi ◽  
Nkoke Clovis Ekukwe ◽  
Paschal Kum Awah
Keyword(s):  
Research Ethics ◽  
Monitoring And Evaluation ◽  
Ethics Committees ◽  
Board Members ◽  
Research Ethics Committees ◽  
Middle Income ◽  
Unethical Research ◽  
Lack Of Control ◽  
Financial Interests ◽  
Nazi Doctors

Key historical landmark research malpractice scandals that shocked the international community (Nazi doctors’ experiments, Tuskegee study, Jewish chronic disease experiments, Krugman’s Willowbrook hepatitis study) were the origin of the institution of ethics review prior to carrying out research involving humans. Nonetheless, it is plausible that unethical research is ongoing or may have been conducted in recent times that has escaped public notice, especially in the vulnerable low- and middle-income country contexts. The basic constitution of these committees at some point has not been clearly defined, with most scientists declaring political maneuvers at times. These committees today are characterized by bureaucratic bottlenecks, financial interests, inadequate training in research ethics, and lack of control and coordination of their functions. Compulsory and adequate research ethics training for researchers and ethical committee members could guarantee trust, and appreciation of the utmost importance of the latter. The independence of protocol review should be guaranteed as much as possible so that the process attains its set goals. It might be too simplistic, and hypocritical, to allow ethics committees to continue to function on an ‘altruistic’ basis. Governments must strengthen the roles of national ethics committees – their independence, oversight roles, and as monitoring and evaluation bodies for smaller research ethics committees. Funding and objective constitution of board members is critical. Only then would research ethics committees be metamorphosed from the ‘bad guys’ to the trusted friends. The fear is preventing the research ethics committee from being seen and thus becoming an ethical oxymoron.

scholarly journals An exploratory study of the need for curriculum review of Master of Public Health Degree at a Rural-based University in South Africa

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Takalani G. Tshitangano
Keyword(s):  
Public Health ◽  
South Africa ◽  
Core Competencies ◽  
Target Population ◽  
Health Science ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Middle Income ◽  
Master Of Public Health ◽  
Curriculum Review

Background: Master of Public Health (MPH) training programmes were developed worldwide in response to the crisis in human resources for health.Aim: To determine whether the MPH programme at the selected rural-based university in South Africa enabled students to achieve the MPH core competencies relevant for Lower Middle Income Countries.Setting: The study was carried out at a rural-based University in South Africa. The target population was the 2011 first-year cohort of MPH students who by the beginning of 2014 had just completed their coursework.Methodology: A quantitative cross-sectional descriptive research design was adapted. Eighty-five students were randomly selected to participate in the study. A structured questionnaire comprising seven competency clusters was developed. The selected students completed a self-administered questionnaire. Only those students who signed consent forms participated in this study. The questionnaire was tested for construct validity and reliability using 10 students with similar characteristics to those sampled for the study. Microsoft Excel software was used to analyse the data descriptively in terms of frequency and percentages.Results: The students were confident of their competencies regarding public health science skills. Amongst these were analytical assessment, communication, community and intersectorial competencies as well as ethics. However, the students lacked confidence in contextsensitive issues, planning and management, research and development, and leadership competencies. Yet the latter is the backbone of public health practice.Conclusion and recommendation: There is a need for revamping public health curricula. In this respect, a follow-up study that builds a deeper understanding of the subject is needed.

Medical Tourism in Guatemala: Qualitatively Exploring How Existing Health System Inequities Facilitate Sector Development

2019 ◽  
Vol 49 (4) ◽  
pp. 754-772
Author(s):  
Alejandro Cerón ◽  
Valorie A. Crooks ◽  
Ronald Labonté ◽  
Jeremy Snyder ◽  
Walter Flores
Keyword(s):  
Health System ◽  
Medical Tourism ◽  
Health Sector ◽  
Health Inequities ◽  
Tourism Industry ◽  
Middle Income ◽  
Middle Income Countries ◽  
Private Health Sector ◽  
Regulatory Capacity ◽  
Multiple Challenges

This article explores how existing health inequities in the Guatemalan health system facilitate the emergence of its medical tourism industry. We report on our thematic analysis of 50 key informant interviews conducted with 4 groups of stakeholders in the local medical tourism sector. Participants frequently discussed the interplay between the country’s longstanding health inequities and the promotion of medical tourism, characterized by 4 thematic viewpoints: the private health sector is already flourishing; the highly fragmented health system already faces multiple challenges; the underfunded public health sector has a weak regulatory capacity; and the commodification of health care has already advanced. Medical tourism and health inequities shape each other in low- and middle-income countries. In addition to the potential for medical tourism to exacerbate health inequities, previously existing health inequities create opportunities for the industry’s growth. Although regulation of the medical tourism industry is necessary, it needs to be implemented both at the domestic and supranational levels for it to be effective in preventing greater health inequities, and it needs to address the political and economic drivers that make health systems generate health disparities.

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