scholarly journals Resistance Training as a Countermeasure for Key Non-Communicable Diseases in Low-Resource Settings: A Review

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Brandon Stuwart Shaw ◽  
Ina Shaw
Keyword(s):  
Resistance Training ◽  
Low Cost ◽  
Active Role ◽  
Communicable Diseases ◽  
Cochrane Library ◽  
Health Improvement ◽  
Non Communicable Diseases ◽  
Low Resource Settings ◽  
Low Resource ◽  
High Resource

Background: Non-communicable diseases (NCDs) are responsible for 60% of global deaths. Of these NCD-attributable deaths, about 80% are in low- to middle-income countries (LMICs). The role of exercise in major NCDs is evident; however, popular and cost-effective aerobic modes of exercise, such as walking, consistently do not meet minimum intensity guidelines for health improvement. Interestingly, low-cost resistance training (using callisthenics, Pilates, elastic tubing, etc.) has proven equally effective to conventional resistance training using weight machines in improving several health parameters related to NCDs, although their effectiveness in LMICs is not as well documented as in high-income countries (HICs). Objectives: This review aimed to examine low-cost approaches of resistance training to health promotion, NCD risk reduction, and NCD rehabilitation/management to mitigate the epidemic of NCDs in lower-resource settings. Methods: An electronic search was performed on the following databases from inception until December 2019: PubMed/Medline, Sport Discuss, Embase, Science Direct, Current Contents, CISTI Source, Google Scholar, Cochrane Library, Cochrane Database of Systematic Reviews, CINAHL EBM Reviews, and international e-catalogues. Results: Data on resistance training provision cost in low-resource settings indicates that it is not reasonable to use this mode of training in low-resource settings in the same way as it is used in high-resource ones. This review summarized some strategies which can be employed to ensure the delivery of all core resistance training components in low-resource settings. The data suggests that resistance training be adapted for delivery in non-clinical settings in LMICs. Conclusions: Program design variables of resistance training are similar in low- and well-resourced settings. However, only individuals with low-risk will be able to perform exercise without adverse consequences in home-based settings. Health care practitioners in LMICs should take an active role in promoting resistance training when promoting health, reducing NCD risk, and NCD rehabilitation.

scholarly journals Comprehensive Diabetes and Non-Communicable Disease Educator in the Low-Resource Settings

2016 ◽  
Vol 54 (202) ◽  
pp. 94-103 ◽  
Author(s):  
Madhur Dev Bhattarai
Keyword(s):  
Management Education ◽  
Communicable Diseases ◽  
Self Management ◽  
Staff Nurse ◽  
Non Communicable Diseases ◽  
Low Resource Settings ◽  
Intensive Training ◽  
Low Resource ◽  
Health Clinics ◽  
Diabetes Educator

The role of self-management education in diabetes and other major non-communicable diseases is clearly evident. To take care of and educate people with diabetes and other major NCD under the supervision of medical professionals and for education of other health care professionals, Comprehensive Diabetes and NCD Educators are needed in the routine service in peripheral health clinics and hospitals. The areas of training of CDNCD educator should match with the cost-effective interventions for diabetes and other major NCD that are feasible and planned for implementation in primary care in the low resource settings. Most of such interventions are part of diabetes education as required for Diabetes Self-Management Education programmes and traditional Diabetes Educator. The addition of use of inhaled steroids and bronchodilator in chronic respiratory disease and identification of presenting features of cancer, also required for many people with diabetes with various such common co-morbidities, will complete the areas of training of traditional Diabetes Educator as that of CDNCD Educator. Staff nurse and health assistants, who are as such already providing routine clinical service to all patients including with diabetes and major NCD in peripheral health clinics and hospitals, are most appropriate for CDNCD Educator training. The training of CDNCD Educator, like that of traditional Diabetes Educator, requires fulfillment of sufficient hours of practical work experience under supervision and achievement of the essential competencies entailing at least 6 month or more of intensive training schedules to be eligible to appear in its final certifying examination. Keywords: CDNCD Educator; diabetes; diabetes educator; DSME; global NCD alliance; NCD; non-communicable diseases; WHO PEN. | PubMed

scholarly journals Systematic review of clinical effectiveness, components, and delivery of pulmonary rehabilitation in low-resource settings

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
GM Monsur Habib ◽  
Roberto Rabinovich ◽  
Kalyani Divgi ◽  
Salahuddin Ahmed ◽  
Samir Kumar Saha ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Low Cost ◽  
Mode Of Delivery ◽  
Well Being ◽  
Chronic Obstructive ◽  
Low Resource Settings ◽  
Chronic Respiratory Diseases ◽  
Low Resource ◽  
Breathing Exercises ◽  
High Resource

AbstractPulmonary rehabilitation (PR) is a guideline-recommended multifaceted intervention that improves the physical and psychological well-being of people with chronic respiratory diseases (CRDs), though most of the evidence derives from trials in high-resource settings. In low- and middle-income countries, PR services are under-provided. We aimed to review the effectiveness, components and mode of delivery of PR in low-resource settings. Following Cochrane methodology, we systematically searched (1990 to October 2018; pre-publication update March 2020) MEDLINE, EMBASE, CABI, AMED, PUBMED, and CENTRAL for controlled clinical trials of adults with CRD (including but not restricted to chronic obstructive pulmonary disease) comparing PR with usual care in low-resource settings. After duplicate selection, we extracted data on exercise tolerance, health-related quality of life (HRQoL), breathlessness, included components, and mode of delivery. We used Cochrane risk of bias (RoB) to assess study quality and synthesised data narratively. From 8912 hits, we included 13 studies: 11 were at high RoB; 2 at moderate RoB. PR improved functional exercise capacity in 10 studies, HRQoL in 12, and breathlessness in 9 studies. One of the two studies at moderate RoB showed no benefit. All programmes included exercise training; most provided education, chest physiotherapy, and breathing exercises. Low cost services, adapted to the setting, used limited equipment and typically combined outpatient/centre delivery with a home/community-based service. Multicomponent PR programmes can be delivered in low-resource settings, employing a range of modes of delivery. There is a need for a high-quality trial to confirm the positive findings of these high/moderate RoB studies.

Towards biomarker-based tests that can facilitate decisions about prevention and management of preeclampsia in low-resource settings

2016 ◽  
Vol 54 (1) ◽  
Author(s):  
Nathalie Acestor ◽  
Jane Goett ◽  
Arthur Lee ◽  
Tara M. Herrick ◽  
Susheela M. Engelbrecht ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Clinical Performance ◽  
Point Of Care ◽  
Low Cost ◽  
Care Providers ◽  
Low Resource Settings ◽  
Low Resource ◽  
High Resource ◽  
Rapid Assays ◽  
Urine Biomarkers

AbstractIn recent years, an increasing amount of literature is emerging on candidate urine and blood-based biomarkers associated with incidence and severity of preeclampsia (PE) in pregnant women. While enthusiasm on the usefulness of several of these markers in predicting PE is evolving, essentially all work so far has focused on the needs of high-resource settings and high-income countries, resulting primarily in multi-parameter laboratory assays based on proteomic and metabolomics analysis techniques. These highly complex methods, however, require laboratory capabilities that are rarely available or affordable in low-resource settings (LRS). The importance of quantifying maternal and perinatal risks and identifying which pregnancies can be safely prolonged is also much greater in LRS, where intensive care facilities that can rapidly respond to PE-related health threats for women and infants are limited. For these reasons, simple, low cost, sensitive, and specific point-of-care (POC) tests are needed that can be performed by antenatal health care providers in LRS and that can facilitate decisions about detection and management of PE. Our study aims to provide a comprehensive systematic review of current and emerging blood and urine biomarkers for PE, not only on the basis of their clinical performance, but also of their suitability to be used in LRS-compatible test formats, such as lateral flow and other variants of POC rapid assays.

scholarly journals A framework for designing medical devices resilient to low-resource settings

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Davide Piaggio ◽  
Rossana Castaldo ◽  
Marco Cinelli ◽  
Sara Cinelli ◽  
Alessia Maccaro ◽  
...  
Keyword(s):  
Delphi Study ◽  
Middle Income ◽  
Low Resource Settings ◽  
Health Technologies ◽  
Low Resource ◽  
Middle Income Countries ◽  
High Resource ◽  
International Experts ◽  
Global Population ◽  
Different Parts

Abstract Background To date (April 2021), medical device (MD) design approaches have failed to consider the contexts where MDs can be operationalised. Although most of the global population lives and is treated in Low- and Middle-Income Countries (LMCIs), over 80% of the MD market share is in high-resource settings, which set de facto standards that cannot be taken for granted in lower resource settings. Using a MD designed for high-resource settings in LMICs may hinder its safe and efficient operationalisation. In the literature, many criteria for frameworks to support resilient MD design were presented. However, since the available criteria (as of 2021) are far from being consensual and comprehensive, the aim of this study is to raise awareness about such challenges and to scope experts’ consensus regarding the essentiality of MD design criteria. Results This paper presents a novel application of Delphi study and Multiple Criteria Decision Analysis (MCDA) to develop a framework comprising 26 essential criteria, which were evaluated and chosen by international experts coming from different parts of the world. This framework was validated by analysing some MDs presented in the WHO Compendium of innovative health technologies for low-resource settings. Conclusions This novel holistic framework takes into account some domains that are usually underestimated by MDs designers. For this reason, it can be used by experts designing MDs resilient to low-resource settings and it can also assist policymakers and non-governmental organisations in shaping the future of global healthcare.

scholarly journals Applying heat and humidity using stove boiled water for decontamination of N95 respirators in low resource settings

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0255338
Author(s):  
Siddharth Doshi ◽  
Samhita P. Banavar ◽  
Eliott Flaum ◽  
Surendra Kulkarni ◽  
Ulhas Vaidya ◽  
...  
Keyword(s):  
Large Scale ◽  
Low Cost ◽  
Low Resource Settings ◽  
Low Resource ◽  
Surgical Masks ◽  
Temperature And Humidity ◽  
Similar Temperature ◽  
N95 Respirators ◽  
Electricity Access ◽  
Uv C

Global shortages of N95 respirators have led to an urgent need of N95 decontamination and reuse methods that are scientifically validated and available world-wide. Although several large scale decontamination methods have been proposed (hydrogen peroxide vapor, UV-C); many of them are not applicable in remote and low-resource settings. Heat with humidity has been demonstrated as a promising decontamination approach, but care must be taken when implementing this method at a grassroots level. Here we present a simple, scalable method to provide controlled humidity and temperature for individual N95 respirators which is easily applicable in low-resource settings. N95 respirators were subjected to moist heat (>50% relative humidity, 65–80°C temperature) for over 30 minutes by placing them in a sealed container immersed in water that had been brought to a rolling boil and removed from heat, and then allowing the containers to sit for over 45 minutes. Filtration efficiency of 0.3–4.99 μm incense particles remained above 97% after 5 treatment cycles across all particle size sub-ranges. This method was then repeated at a higher ambient temperature and humidity in Mumbai, using standard utensils commonly found in South Asia. Similar temperature and humidity profiles were achieved with no degradation in filtration efficiencies after 6 cycles. Higher temperatures (>70°C) and longer treatment times (>40 minutes) were obtained by insulating the outer vessel. We also showed that the same method can be applied for the decontamination of surgical masks. This simple yet reliable method can be performed even without electricity access using any heat source to boil water, from open-flame stoves to solar heating, and provides a low-cost route for N95 decontamination globally applicable in resource-constrained settings.

scholarly journals Low-Cost, Accessible Fabrication Methods for Microfluidics Research in Low-Resource Settings

Micromachines ◽  
2018 ◽  
Vol 9 (9) ◽  
pp. 461 ◽  
Author(s):  
Hoang-Tuan Nguyen ◽  
Ha Thach ◽  
Emmanuel Roy ◽  
Khon Huynh ◽  
Cecile Perrault
Keyword(s):  
Developing Countries ◽  
Scientific Community ◽  
Low Cost ◽  
Microfluidic Devices ◽  
Research Community ◽  
Access To Healthcare ◽  
Healthcare Industry ◽  
Low Resource Settings ◽  
Limited Access ◽  
Low Resource

Microfluidics are expected to revolutionize the healthcare industry especially in developing countries since it would bring portable, easy-to-use, self-contained diagnostic devices to places with limited access to healthcare. To date, however, microfluidics has not yet been able to live up to these expectations. One non-negligible factor can be attributed to inaccessible prototyping methods for researchers in low-resource settings who are unable to afford expensive equipment and/or obtain critical reagents and, therefore, unable to engage and contribute to microfluidics research. In this paper, we present methods to create microfluidic devices that reduce initial costs from hundreds of thousands of dollars to about $6000 by using readily accessible consumables and inexpensive equipment. By including the scientific community most embedded and aware of the requirements of healthcare in developing countries, microfluidics will be able to increase its reach in the research community and be better informed to provide relevant solutions to global healthcare challenges.

A Low-Resource Oxygen Blender Prototype for Use in Modified Bubble CPAP Circuits

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Jared Floersch ◽  
Elsa Hauschildt ◽  
Adam Keester ◽  
Samuel Poganski ◽  
Kiet Tran ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Low Cost ◽  
World Health ◽  
Pure Oxygen ◽  
Hypodermic Needle ◽  
Low Resource Settings ◽  
Low Resource ◽  
Tract Infections

Abstract Continuous positive airway pressure (CPAP) is a method of respiratory support used around the world to treat children with lower respiratory tract infections (LRTI) (WHO, 2016, Oxygen Therapy for Children, World Health Organization, Geneva, Switzerland, Report). Bubble continuous positive airway pressure (bCPAP) is an effective form of CPAP that is currently used in both high- and low-resource countries. Low-cost, modified bCPAP devices have been designed as an ideal form of CPAP in low-resource areas (Bjorklund, A. R., Mpora, B. O., Steiner, M. E., Fischer, G., Davey, C. S., and Slusher, T. M., 2018, “Use of a Modified Bubble Continuous Positive Airway Pressure (bCPAP) Device for Children in Respiratory Distress in Low- and Middle-Income Countries: A Safety Study,” Paediatr. Int. Child Health, 39(3), pp. 1–8). However, patients in low-resource settings undergoing bCPAP treatment are often given pure oxygen, which has been linked to retinopathy of prematurity, cardiovascular complications, and patient mortality (Rodgers, J. L., Iyer, D., Rodgers, L. E., Vanthenapalli, S., and Panguluri, S. K., 2019, “Impact of Hyperoxia on Cardiac Pathophysiology,” J. Cell. Physiol., 234(8), pp. 1–9; Ramgopal, S., Dezfulian, C., Hickey, R. W., Au, A. K., Venkataraman, S., Clark, R. S. B., and Horvat, C. M., 2019, “Association of Severe Hyperoxemia Events and Mortality Among Patients Admitted to a Pediatric Intensive Care Unit,” JAMA Network Open, 2(8), p. e199812). This problem is typically avoided by using commercial oxygen blenders, which can titrate down the concentration of oxygen delivered to the minimum needed; however, these blenders can cost nearly 1000 USD and are almost always unavailable in low-resource settings. The lack of available low-cost oxygen blenders compatible with modified bCPAP circuits creates a barrier for low-resource hospitals to be able to provide blended oxygen to patients. There is a need for a low-cost oxygen blender for use in low-resource settings. We propose a passive oxygen blender that operates via entrainment of atmospheric air. The device can easily be assembled in low-resource areas using a 22 gauge hypodermic needle, two 3 cc syringes, tape or super glue, and the materials required for bCPAP—for approximately 1.40 USD per device. The blender has not been clinically tested yet, but can achieve oxygen concentrations as low as 60% with bCPAP levels of 5 cm H2O (490 Pa) when used in a standard bCPAP circuit without a patient.

Improved Treatment of Postpartum Hemorrhage: Design, Development, and Bench-Top Validation of a Reusable Intrauterine Tamponade Device for Low-Resource Settings

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Katherine Hu ◽  
Maya M. Lapinski ◽  
Gavin Mischler ◽  
Robert H. Allen ◽  
Amir Manbachi ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Low Cost ◽  
Clinical Settings ◽  
Design Development ◽  
Low Resource Settings ◽  
Low Resource ◽  
Effective Interventions ◽  
Target Pressure ◽  
The Mean ◽  
Uterine Balloon Tamponade

Abstract Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, and effective interventions for addressing PPH are urgently needed. Uterine balloon tamponade (UBT) is a technique to control PPH. Commercially available UBT devices are expensive and frequently require imaging technology to ensure placement. Condom-catheter uterine tamponade (C-UBT) is a technique appropriate for low-resource settings. Testing of the C-UBT is needed to better understand and optimize this technique for use in a variety of clinical settings including low-resource contexts. We describe here the design, development, and bench-top validation of a reusable C-UBT device optimized for low-resource settings. The device was tested in three differently sized uterine models using a variety of condom balloon configurations. Intrauterine wall pressure application was measured to evaluate the device capacity to apply pressure of at least 90 mmHg, estimating the mean arterial pressure within the uterine vasculature. Bench-top experimental validation of pressure exerted in uterine models demonstrated the device's capability of reaching hemostatic pressure in uterine volumes ranging from 170 to 1740 mL. Device adaptability and versatility were shown through its ability to reach the target pressure of 90 mmHg in different uterine sizes by varying balloon parameters, including condom thickness and condom configuration. The results of this study show the potential of a low-cost, reusable C-UBT device optimized to treat PPH in a variety of clinical settings, including low-resource contexts.

scholarly journals Protocol for a systematic review of reviews evaluating effectiveness of mass media interventions for prevention and control of non-communicable diseases

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e032611
Author(s):  
Gursimer Jeet ◽  
J S Thakur ◽  
Shankar Prinja ◽  
Meenu Singh ◽  
Ria Nangia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Mass Media ◽  
Grey Literature ◽  
Communicable Diseases ◽  
Controlled Vocabulary ◽  
Cochrane Library ◽  
Non Communicable Diseases ◽  
Low Middle Income Countries ◽  
Media Interventions

IntroductionTimely interventions are required in order to change unhealthy lifestyles because if continued for a prolonged period of time, these become risk factors for non-communicable diseases (NCDs). Education through mass media is an important factor in bringing out the behavioural change which may get missed in community-based interventions due to their limited reach. Many countries engage in mass media interventions, however, the nature of interventions and their effectiveness differs. We, therefore, describe the protocol of a systematic review to evaluate the effectiveness of the mass media interventions to reduce the risk of NCDs in the general population and compare the differences in effectiveness estimates across low/middle-income countries and developed countries.Methods and analysisWe will search The Cochrane Library, Database of Abstracts of Reviews of Effectiveness, PubMed, Excerpta Medica Database limited to publications since 2000 to October 2019. Specific terms for the search strategy will be piloted as database-controlled vocabulary in the databases searched. The searches will include variations of the following terms: mass media, mass communication, campaign, publicity and terms for types of media, that is, print media, mobile, digital media, social media and broadcast. Study designs to be included will be systematic reviews followed by grey literature and other good quality reviews identified. The primary outcome of effectiveness will be the percentage change in population having different behavioural risk factors. In addition, mean overall change in levels of several physical or biochemical parameters will be studied as secondary outcomes.Ethics and disseminationThe review is being done under the doctoral research which has been approved by the Institute Ethics Committee of the Post Graduate Institute of Medical Education and Research Dissemination will be done by submitting scientific articles to academic peer-reviewed journals. We will present the results at relevant conferences and meetings.PROSPERO registration numberCRD42016048013

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