Low resource setting

Qualitative scoring methods are tools for rapid freshwater health assessments. Total score is often calculated as the sum or mean of the values of the species involved, with minor nuances in interpretation, but with significant implications. We used the Dragonfly Biotic Index (DBI) calculated on Central European odonate species to demonstrate these implications. Each species within a community has a score ranging from 0 (widespread generalists) to 9 (sensitive specialists). A total score is calculated as the sum of the scores of all species (DBIsum ) or is calculated by dividing by species richness (DBImean )...

OBJECTIVES: Community-based arts interventions have the potential to support contextually relevant nurturing care programmes and policies that adapt to different settings. Understanding the distinctive features of using the arts in local, culturally specific ways in low/middle-income countries (LMICs); how this varies by context; and gaining a better understanding of the perspectives on desirable outcomes for communities is important evidence that this review generates. DESIGN: We conducted a realist review of papers that covered outcomes related to child health or development (0-5 years) AND arts-based approaches AND community-based, participatory approaches AND based in LMICs using a range of databases and other networks...

Few published data science tools are ever translated from academia to real-world clinical settings for which they were intended. One dimension of this problem is the software engineering task of turning published academic projects into tools that are usable at the bedside. Given the complexity of the data ecosystem in large health systems, this task often represents a significant barrier to the real-world deployment of data science tools for prospective piloting and evaluation. Many information technology companies have created Machine Learning Operations (MLOps) teams to help with such tasks at scale, but the low penetration of home-grown data science tools in regular clinical practice precludes the formation of such teams in healthcare organizations...

Life cycle assessment (LCA) plays a crucial role in green manufacturing to uncover the critical aspects for alleviating the environmental burdens due to manufacturing processes. However, the scarcity of life cycle inventory (LCI) data for the manufacturing processes is a considerable challenge. This paper proposes a novel approach to extrapolate LCI data of manufacturing processes. Taking advantage of LCI data in the Ecoinvent datasets, decision tree-based supervised machine learning models, namely decision tree, random forest, gradient boosting, and adaptive boosting, have been developed to extrapolate the data of GHG emissions, i...

Quantum coherence is one of the fundamental aspects distinguishing classical and quantum theories. Coherence between different energy eigenstates is particularly important, as it serves as a valuable resource under the law of energy conservation. A fundamental question in this setting is how well one can prepare good coherent states from low coherent states and whether a given coherent state is convertible to another one. Here, we show that any low coherent state is convertible to any high coherent state arbitrarily well in two operational settings: asymptotic and catalytic transformations...

The quality of parenting program implementation significantly affects the extent to which a program is delivered effectively as well as the likelihood of it becoming embedded in everyday services. The group based Parenting for Lifelong Health for Young Children (PLH-YC) program for parents of children aged 2-9 years was developed specifically for implementation in low- and middle-income contexts, has been tested in five randomized trials, and incorporates a number of strategies to encourage fidelity of delivery...

Self-management interventions (SMIs) may improve disease management in adults living with obesity. We formulated evidence-based recommendations for SMIs within the context of the COMPAR-EU project. The multidisciplinary panel selected critical outcomes based on the COMPAR-EU core outcome set and established decision thresholds for each outcome. Recommendations were informed by systematic reviews of effects, cost-effectiveness, and a contextual assessment. To assess the certainty of the evidence and formulate the recommendations, we used the GRADE approach guidance...

BACKGROUND AND PURPOSE: Cerebral palsy (CP) is a congenital neurological disorder that causes musculoskeletal weakness and biomechanical dysfunctions. Strength training guidelines recommend at least 70% of 1-repetition maximum to increase muscle strength and mass. However, individuals with CP may not tolerate such high exercise intensity. Blood flow restriction (BFR) can induce similar gains in strength and muscle mass using loads as low as 20% to 30% 1-repetition maximum. This case series described the safety, feasibility, and acceptability of BFR in adults with CP and examined changes in muscle mass and strength...

INTRODUCTION: In low resource settings (LRS), utilization of Computed Tomography scan (CTS) for mild traumatic brain injuries (mTBIs) presents unique challenges and considerations given the limited infrastructure, financial resources, and trained personnel. The Theoretical Domains Framework (TDF) offers a comprehensive theoretical lens to explore factors influencing the decision-making to order CTS for mTBI by imaging referrers (IRs). OBJECTIVES: The primary objective was to explore IRs' beliefs about factors influencing CT utilization in mTBIs using TDF in Uganda...

BACKGROUND: We sought to assess the performance of commonly used clinical scoring systems to predict imminent clinical deterioration in patients hospitalized with suspected infection in rural Thailand. METHODS: Patients with suspected infection were prospectively enrolled within 24 hours of admission to a referral hospital in northeastern Thailand between 2013 and 2017. In patients not requiring intensive medical interventions, multiple enrollment scores were calculated including the National Early Warning Score (NEWS), the Modified Early Warning Score, Between the Flags, and the quick Sequential Organ Failure Assessment score...

Health care performance metrics are offered predominantly in terms of outcomes, processes, or structural components of health care delivery. However, measurement is limited by variability in data sources, definitions, and workarounds. The American College of Surgeons has recently developed a new type of performance metric known as a "programmatic measure". These metrics align structures, processes, and outcomes to better coordinate quality measurement with support of frontline care teams. In this multifaceted way, these measures differ from current "single" measures such as targeting surgical site infection...

BACKGROUND: Multisectoral collaboration is essential for advancing primary health care (PHC). In low- and middle-income countries (LMICs), limited institutional capacities, governance issues, and inadequate stakeholder engagement impede multisectoral collaboration. India faces similar challenges, especially at the meso-level (districts and subdistricts). Owing to its dependence on context, and insufficient evidence, understanding "How" to improve multisectoral collaboration remains challenging...

BACKGROUND: Article 14 of the WHO 'Framework Convention on Tobacco Control' recommends, that all oral healthcare providers provide support for tobacco cessation, to all patients. Despite evidence on the effectiveness of tobacco cessation interventions in dental settings, implementation remains low in most high-burden countries like Pakistan. A pragmatic pilot trial of a dentist-delivered behavioural support intervention for smokeless tobacco (ST) cessation, was conducted in dental hospitals in Pakistan...

INTRODUCTION: Even though childhood diarrhea is treated with a simple treatment solution, it continues to be one of the leading causes of under-five child mortality and malnutrition globally. In resource-limited settings such as Sub-Saharan Africa (SSA), the combination of oral rehydration salts (ORS) and zinc is regarded as an effective treatment for diarrhea; however, its utilization is very low. The purpose of this study was to determine the proportion and associated factors of co-utilization of ORS and zinc among under-five children with diarrhea in SSA...

Automated disease diagnosis and prediction, powered by AI, play a crucial role in enabling medical professionals to deliver effective care to patients. While such predictive tools have been extensively explored in resource-rich languages like English, this manuscript focuses on predicting disease categories automatically from symptoms documented in the Afaan Oromo language, employing various classification algorithms. This study encompasses machine learning techniques such as support vector machines, random forests, logistic regression, and Naïve Bayes, as well as deep learning approaches including LSTM, GRU, and Bi-LSTM...

This study determined the prevalence and the associated factors with meeting the recommended amount of physical activity among type 2 diabetes mellitus (T2DM) patients receiving care in resource-limited settings of the West Bank of Palestine. Physical activity was assessed using the World Health Organization's Global Physical Activity Questionnaire. Associations were examined using multivariate logistic regression. Of the 302 patients included, 117 (38.7%) met the recommended amount of physical activity. Being younger than 58 years [aOR = 2...

INTRODUCTION: Monitoring the SARS-CoV-2 pandemic in low-resource countries such as Malawi requires cost-effective surveillance strategies. This study explored the potential utility of phone-based syndromic surveillance in terms of its reach, monitoring trends in reported SARS-CoV-2-like/influenza-like symptoms (CLS/ILS), SARS-CoV-2 testing and mortality. METHODS: Mobile phone-based interviews were conducted between 1 July 2020 and 30 April 2022, using a structured questionnaire...

BACKGROUND: Poor-quality care is linked to higher rates of neonatal mortality in low-income and middle-income countries (LMICs). Limited educational and upskilling opportunities for healthcare professionals, particularly those who work in remote areas, are key barriers to providing quality neonatal care. Novel digital technologies, including mobile applications and virtual reality, can help bridge this gap. This scoping review aims to identify, analyse and compare available digital technologies for staff education and training to improve newborn care...

BACKGROUND: Depressive disorder and type 2 diabetes mellitus (T2DM) are prevalent in primary care (PC). Pharmacological treatment, despite controversy, is commonly chosen due to resource limitations and difficulties in accessing face-to-face interventions. Depression significantly impacts various aspects of a person's life, affecting adherence to medical prescriptions and glycemic control and leading to future complications and increased health care costs. To address these challenges, information and communication technologies (eg, eHealth) have been introduced, showing promise in improving treatment continuity and accessibility...

PURPOSE: Molecular characterization is key to optimally diagnose and manage cancer. The complexity and cost of routine genomic analysis have unfortunately limited its use and denied many patients access to precision medicine. A possible solution is to rationalize use-creating a tiered approach to testing which uses inexpensive techniques for most patients and limits expensive testing to patients with the highest needs. Here, we tested the utility of this approach to molecularly characterize pediatric glioma in a cost- and time-sensitive manner...