1,477 research outputs found
Cluster analyses from the real-world NOVELTY study : six clusters across the asthma COPD spectrum
Full text linkFunding The NOVELTY study is funded by AstraZeneca. ACKNOWLEDGMENTS The authors would like to thank the patients who participated in this study and the NOVELTY Scientific Community and the NOVELTY study investigators who are listed in full in Tables E7 and E8 in the Online Repository. Medical writing support, under the direction of the authors, was provided by Richard Knight, PhD, CMC Connect, a division of IPG Health Medical Communications, funded by AstraZeneca in accordance with Good Publication Practice (GPP 2022) guidelines (Ann Intern Med. 2022;175[9]:1298-1304). J. Vestbo is supported by the NIHR Manchester Biomedical Research Centre and the NIHR Manchester Clinical Research FacilityPeer reviewe
How are falls and fear of falling associated with objectively measured physical activity in a cohort of community-dwelling older men?
Full text linkFalls affect approximately one third of community-dwelling older adults each year and have serious health and social consequences. Fear of falling (FOF) (lack of confidence in maintaining balance during normal activities) affects many older adults, irrespective of whether they have actually experienced falls. Both falls and fear of falls may result in restrictions of physical activity, which in turn have health consequences. To date the relation between (i) falls and (ii) fear of falling with physical activity have not been investigated using objectively measured activity data which permits examination of different intensities of activity and sedentary behaviour
Accuracy of assessment of eligibility for early medical abortion by community health workers in Ethiopia, India and South Africa
Full text linkTo assess the accuracy of assessment of eligibility for early medical abortion by community health workers using a simple checklist toolkit.; Diagnostic accuracy study.; Ethiopia, India and South Africa.; Two hundred seventeen women in Ethiopia, 258 in India and 236 in South Africa were enrolled into the study. A checklist toolkit to determine eligibility for early medical abortion was validated by comparing results of clinician and community health worker assessment of eligibility using the checklist toolkit with the reference standard exam.; Accuracy was over 90% and the negative likelihood ratio <0.1 at all three sites when used by clinician assessors. Positive likelihood ratios were 4.3 in Ethiopia, 5.8 in India and 6.3 in South Africa. When used by community health workers the overall accuracy of the toolkit was 92% in Ethiopia, 80% in India and 77% in South Africa negative likelihood ratios were 0.08 in Ethiopia, 0.25 in India and 0.22 in South Africa and positive likelihood ratios were 5.9 in Ethiopia and 2.0 in India and South Africa.; The checklist toolkit, as used by clinicians, was excellent at ruling out participants who were not eligible, and moderately effective at ruling in participants who were eligible for medical abortion. Results were promising when used by community health workers particularly in Ethiopia where they had more prior experience with use of diagnostic aids and longer professional training. The checklist toolkit assessments resulted in some participants being wrongly assessed as eligible for medical abortion which is an area of concern. Further research is needed to streamline the components of the tool, explore optimal duration and content of training for community health workers, and test feasibility and acceptability
Thanks, Sci-Hub!
No full textFinding discussion topics around open access that resonate with your campus community is often quite difficult. In general, authors can agree that academic publishing is broken, but when it comes to action involving negotiating with publishers or paying author processing charges for open access, it is a hard sell to move from talk to walk. One conversation topic, however, has been generating quite the buzz on Vanderbilt University’s campus. Sci-Hub is a crowd favorite when it comes to engaging workshop or meeting attendees, and never fails to generate lively conversation ranging from apathy regarding the website’s illegal status to absolute horror at the idea of their work ending up on the site. Sci-Hub has been the greatest discussion generator since the Science sting, and it often ends with the author recognizing that action can and should be taken to ensure readers worldwide do not have to resort to black open access simply to perform research. This talk will discuss the various angles one could use when discussing Sci-Hub and demonstrates how you can advocate for open access publishing by making Sci-Hub conversations a regular part of your engagement and outreach efforts.</p
South African responses to Open Access publishing: a survey of the research community
Full text linkOpen access publishing offers wide benefits to the scholarly community and may also afford relief to financially embattled academic libraries. The progress of the open access model rests upon the acceptance and validation of open access journals and open archives or institutional repositories by the academic mainstream, particularly by publishing researchers. To what extent are the key actors in the South African research system aware of the advantages of open access? This article reports on the findings of a recent survey undertaken to assess the current awareness, concerns and depth of support for open access amongst local researchers, research managers and policy makers in South Africa. The study focuses on issues of quality, article or author charges and the established academic reward system. It concludes that within the prevailing framework, there is little prospect that academics would choose to publish within open access
journals. Recommendations for advocacy by the library community are proposed
Community health workers in Sergipe, Brazil : Implications for their future role in maternal and child health
Full text linkEvery year six million children die worldwide due to diseases that are easily preventable or curable. Interventions to reduce the number of deaths are offered by health facilities, yet many children continue to die at home without receiving any type of health care. Expansion of the strategy for the Integrated Management of Childhood Illness (IMCI), promoted by WHO and UNICEF, provides a unique opportunity to improve health care for young children at the household level. This thesis examines the potential role for community health workers (CHWs) in extending the IMCI strategy from health facilities to the community. A review of the literature on CHWs and IMCI is followed by a description of two state-wide questionnaire surveys and a qualitative study carried out in Sergipe, Northeastern Brazil, aimed at evaluating child health care with particular emphasis on the role ofCHWs. In the first survey, children less than five years of age were investigated regarding morbidity patterns, utilization of health services, socioeconomic and household conditions. A two-stage process led to a representative sample of caretakers of 1,785 children (response rate of 98%). About one third of the families with children were living below the poverty line and under unfavourable environmental conditions. Of all the children studied, 39% had been ill in the two weeks preceding the survey, mostly with acute lower respiratory infections which is the main reason for medical consultations and hospital admissions in the State. Co-morbidity was frequent and 85% of all reported illness episodes were covered by the IMCI strategy. Nine out of 10 children were fully immunized, and 69% had had their growth monitored in the last month. Almost all children who sought care were seen by a health worker. Despite high access to health care, essential drugs were often unavailable in health facilities. Overprescribing was also common with two thirds of children, seen by a doctor, having received an antibiotic. The median duration of total and exclusive breastfeeding were very short at 5.4 months and 2.1 months, respectively. Complementary feeding was also inappropriate with a median number of three meals in the previous 24 hours when, at least, five meals are recommended. There is therefore a potentially significant role for IMCI in improving the quality of care and nutritional management of children under five years of age. CHWs were regularly visiting 81% of all children under five years of age in the State. There was a clear trend towards higher coverage among the poor. Coverage was highest among children living in municipalities in the interior of the State (86.9% against 58.1% in the capital) and in rural areas (88.5% against 76.3% in urban areas). CHWs were also more 8 likely to visit children whose mothers did not attend school (86.3% against 69.3% with nine years or more of schooling) and those belonging to families earning less than one minimum wage (89.2% against 69.4% of families receiving four minimum wages or more). This suggests that CHWs are contributing to reducing inequities in access to basic health care and may explain the high coverage of immunization and growth monitoring activities as CHWs playa major role in delivering these activities. In the second representative survey, 311 CHWs were asked about their knowledge on child survival issues as well as about the support and supervision they received from their local health teams. Again, a two-stage sampling process (municipalities and CHWs) was used with a response rate of 96%. CHWs from Sergipe state were usually female, young and married. Their educational level was substantially higher than that of mothers of young children. Yet, CHWs were inadequately trained, supervised and supported. They were overloaded having to deliver 26 different tasks and usually worked alone in the community. In addition, their professional standing was negatively affected by low salaries, a lack of job security and few fringe benefits. A comparison of families who were regularly visited by CHWs and those that were not, showed a positive effect on maternal knowledge about oral rehydration therapy, breastfeeding and kind of delivery. Children who were visited were also more likely to receive vitamin A and be weighed regularly. The positive impact of CHW visits remained after adjustment for confounding variables. These findings suggest that CHWs are already effective in improving maternal knowledge as well as in providing several interventions that are part of the IMCI strategy. In order to investigate perceptions and beliefs regarding health care, the qualitative study included expert interviews with doctors, nurses and heads of municipal departments of health as well as in-depth interviews with a sample of CHWs. Mothers of children under five years old were enrolled in the qualitative study through focus groups discussions. A total of 90 qualitative interviews and six focus groups were carried out by the author of this thesis and an anthropologist. These data showed that the relationships between facility workers, CHWs and community mothers were often conflicting. Facility workers did not take part in community activities and, in tum, mothers did not participate in group activities in the health facilities. As a result, integration was poor or non-existent. Mothers, especially those from rural areas, wanted a greater availability of doctors and nurses. Most facility workers, in contrast, judged mothers to be highly demanding, making excessive use of health services by seeking health care for mild illnesses, and making inappropriate demands because they 9 lacked knowledge about the roles of the different cadres of health workers. The role of CHWs in the health team was unclear and their tasks were not properly defined. Their relationship with facility workers, especially doctors, was often conflicting. They also did not relate well to urban mothers, who wanted direct access to doctors and who did not feel that CHWs had greater knowledge than themselves. Rural mothers had a generally positive view of CHWs. Currently the main task of CHWs is to act as messengers between the community and the health facility. While this is a positive role per se, CHWs could have a greater impact if their roles in urban and rural areas were more specialized. In urban areas, they should be better trained to deliver educational messages, whereas in rural areas they should also be allowed to perform simple curative tasks to improve their professional standing as well as to deliver key interventions in areas with poor access to health facilities. Almost all respondents stated that extending the activities related to IMCI - such as identifying pneumonia and dysentery at household level through CHWs - would be highly appropriate and desirable. However, to effectively extend IMCI to the community through CHWs, substantial changes would have to occur in their selection, training, supervision, support and professional standing. Several policy recommendations for improving child health in Sergipe are presented. These include improving the performance and professional standing of CHWs and redefining their tasks in the light of the IMCI strategy. Recommendations are also given for improving the integration between communities, facility-based health workers and CHWs, and on how to extend IMCI more effectively to the community through an enhanced role for CHWs
Social and community intelligence : technologies and trends
No full textInternational audienceWith the pervasiveness of sensors, Internet-enabled devices, mobile phones, Internet applications and services, and wireless communication, a new field of social and community intelligence (SCI) has emerged quite quickly. SCI aims to reveal individual and group behaviors, social interactions, and community dynamics by mining the digital traces that people leave while interacting with Web applications, static infrastructure, and mobile and wearable devices. Author Daqing Zhang and colleagues provide an introduction to this field and highlight the various technologies
Groundtruthing next-gen sequencing for microbial ecology-biases and errors in community structure estimates from PCR amplicon pyrosequencing
No full textAnalysis of microbial communities by high-throughput pyrosequencing of SSU rRNA gene PCR amplicons has transformed microbial ecology research and led to the observation that many communities contain a diverse assortment of rare taxa-a phenomenon termed the Rare Biosphere. Multiple studies have investigated the effect of pyrosequencing read quality on operational taxonomic unit (OTU) richness for contrived communities, yet there is limited information on the fidelity of community structure estimates obtained through this approach. Given that PCR biases are widely recognized, and further unknown biases may arise from the sequencing process itself, a priori assumptions about the neutrality of the data generation process are at best unvalidated. Furthermore, post-sequencing quality control algorithms have not been explicitly evaluated for the accuracy of recovered representative sequences and its impact on downstream analyses, reducing useful discussion on pyrosequencing reads to their diversity and abundances. Here we report on community structures and sequences recovered for in vitro-simulated communities consisting of twenty 16S rRNA gene clones tiered at known proportions. PCR amplicon libraries of the V3-V4 and V6 hypervariable regions from the in vitro-simulated communities were sequenced using the Roche 454 GS FLX Titanium platform. Commonly used quality control protocols resulted in the formation of OTUs with >1% abundance composed entirely of erroneous sequences, while over-aggressive clustering approaches obfuscated real, expected OTUs. The pyrosequencing process itself did not appear to impose significant biases on overall community structure estimates, although the detection limit for rare taxa may be affected by PCR amplicon size and quality control approach employed. Meanwhile, PCR biases associated with the initial amplicon generation may impose greater distortions in the observed community structure
Animal Health Policy and Practice: Scaling-up Community-based Animal Health Systems, Lessons from Human Health
Full text linkIn an extensive literature review, the author develops policy recommendations to facilitate scaling up community-based animal health systems to the national level. Noting that human and animal health services in rural areas have much in common, and that an extensive literature studies policy regarding primary healthcare for humans exists, she surveys that literature for observations and conclusions applicable to policy analysis of primary animal healthcare. She notes differences in the history and development of the two delivery systems. The push for human health services came with a worldwide initiative agreed at a high level in 1978. Health for All was set out as a moral imperative, and programmes have been strongly top-down. Delivery of animal health services, by contrast, has been viewed mainly in terms of economic development, and community-based systems have been cobbled together bottom-up, with NGOs taking the lead. As a result, community animal health workers are not integrated into national systems, and how they are trained and monitored varies even within districts. More broadly, the author details regional differences in community-based animal healthcare initiatives. Whereas in Asia there is considerable government involvement, private practitioners hold much more sway in East Africa. Although the literature is sparse on West Africa and Latin America, professional acceptance of community health workers appears to be high in both regions. The core of the paper is devoted to elaborating six criteria for assessing community-based animal health systems, which the author adapts from studies on primary healthcare systems for humans. She argues that the criteria equity, efficiency, accessibility of services, quality of services, human resources and financial resources must be addressed when scaling-up community-based programmes. The author recommends that policymakers clearly state their national animal health objectives and encourage dialogue between NGOs and existing national structures to allow better coordination of efforts and more equitable and consistent delivery of animal health services in rural areas. She adds that bringing community animal health workers into institutional frameworks and agreeing a standard training curriculum would improve equity in the distribution of benefits.Livestock Production/Industries,
Evaluating a community based participatory approach to research with disadvantaged women in the southern suburbs of Beirut
No full textThis manuscript presents the evaluation of a 3 year community-based participatory research (CBPR) approach involving the testing of a psychosocial intervention to improve reproductive and mental health of married women in a disadvantaged community in Beirut, Lebanon. The community-based participatory approach involved a community advisory committee (CAC), a local women committee (LWC), and university researchers. The evaluation of the CBPR approach followed qualitative assessment which included: analysis of compiled field notes and minutes of meetings of CAC and LWC throughout the 3 years of the intervention, and focus group discussions and individual interviews conducted with the CAC and the LWC members following completion of the trial. The CBPR approach confirmed feasibility, cultural adequacy, as well as representation of community needs. Five main emerging themes came out of the FGD and interviews with CAC and LWC. The community and women involved viewed that the CBPR approach allowed for a good understanding of the community, they felt ownership of the study, acknowledged that participation gave the women voices, and established trust, and acknowledged the challenges faced. This manuscript describes how the community was involved, reports on their evaluation of the CBPR process, and discusses challenges to CBPR in this particular context. © Springer Science+Business Media, LLC 2011.El-Kak F, 2009, INT J GYNECOL OBSTET, V104, P60, DOI 10.1016-j.ijgo.2008.09.006; Israel A., 1998, ANNU REV PUBL HEALTH, V19, P173; Kaddour A, 2005, REPROD HEALTH MATTER, V13, P34, DOI 10.1016-S0968-8080(05)25170-4; Leung MW, 2004, INT J EPIDEMIOL, V33, P499, DOI 10.1093-ije-dyh010; Makhoul J, 2003, PHYS SOCIAL CO UNPUB; Viswanathan M, 2004, EVIDENCE REPORTS TEC; Washington OGM, 2009, CONTEMP NURSE, V33, P140; Zurayk Huda, 2007, Health Care Women Int, V28, P614, DOI 10.1080-0739933070146201722
- …
