Search

Purpose: There are major gaps in our knowledge of hereditary ocular conditions in the Asia-Pacific population, which comprises approximately 60% of the world's population. Therefore, a concerted regional effort is urgently needed to close this critical knowledge gap and apply precision medicine technology to improve the quality of lives of these patients in the Asia-Pacific region., Design: Multi-national, multi-center collaborative network., Methods: The Research Standing Committee of the Asia-Pacific Academy of Ophthalmology and the Asia-Pacific Society of Eye Genetics fostered this research collaboration, which brings together renowned institutions and experts for inherited eye diseases in the Asia-Pacific region. The immediate priority of the network will be inherited retinal diseases (IRDs), where there is a lack of detailed characterization of these conditions and in the number of established registries., Results: The network comprises 55 members from 35 centers, spanning 12 countries and regions, including Australia, China, India, Indonesia, Japan, South Korea, Malaysia, Nepal, Philippines, Singapore, Taiwan, and Thailand. The steering committee comprises ophthalmologists with experience in consortia for eye diseases in the Asia-Pacific region, leading ophthalmologists and vision scientists in the field of IRDs internationally, and ophthalmic geneticists., Conclusions: The Asia Pacific Inherited Eye Disease (APIED) network aims to (1) improve genotyping capabilities and expertise to increase early and accurate genetic diagnosis of IRDs, (2) harmonise deep phenotyping practices and utilization of ontological terms, and (3) establish high-quality, multi-user, federated disease registries that will facilitate patient care, genetic counseling, and research of IRDs regionally and internationally., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Objective: High-quality clinical practice guidelines (CPGs) are needed to guide practitioners, policy makers, and other stakeholders to provide optimal health care. This study aims to appraise the CPGs developed in the Philippines using the AGREE II instrument., Methods: Ninety-one CPGs were appraised independently by two health-care professionals. CPGs were considered acceptable if they garnered an overall mean score of at least 75.0% for all 6 domains and a domain score of at least 75.0% for rigor of development. A mean score of <75.0% on either of the criteria implied that the CPG needed revision., Results: Overall mean scores of the CPGs ranged from 8.4% to 79.2%, with a mean of 43.9% (standard deviation = 13.4%). In general, CPGs scored better for the domains of clarity of presentation, scope and purpose, and stakeholder involvement. Lowest scores were obtained for the domains of rigor of development, applicability, and editorial independence. Only 1 (1.1%) CPG qualified as acceptable., Conclusion: AGREE II is a practical and useful guide in appraising the quality of CPGs. Strengthening technical capacity in various medical fields is essential to improve the quality of CPGs. Rigor of development, applicability issues, and editorial independence should be emphasized in CPG capacity-building activities., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objectives: The Chilean health system mandates providers to ensure assistance under a guaranteed system, the Explicit Guarantees in Healthcare (EGH) program. The Health Ministry has developed clinical practice guidelines (CPGs), but independent assessment of their quality is lacking., Study Design and Setting: We assessed all CPGs of the EGH program using Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool for appraising quality, validity period, and last update., Results: Eighty-six CPGs were published between 2005 and 2016. Only 15 (17.4%) were updated. The overall mean raw score was 4.18 (±0.98). The scaled scores for each domain were: Scope and objectives 79.7%, Stakeholder involvement 46.2%, Rigor of development 36.3%, Clarity of presentation 82.8%, Applicability 23.5%, and Editorial independence 39.2%. The highest items were: overall objectives described, population described, options for management clearly presented, and key recommendations easily identifiable. The worst evaluated items were: views and preferences of the target population, strengths and limitations of the body of evidence, methods for formulating the recommendations, external review by experts, and description of facilitators and barriers to application., Conclusion: Most Chilean CPGs included in the EGH program are outdated and show items that should be improved, mainly through a more rigorous methodology, the inclusion of patients in its development, and appropriate consideration of its applicability., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The main mechanism that causes resistance to carbapenem, one of the most potent antibiotic available, in Enterobacterales bacterial isolates, is due to Klebsiella pneumoniae carbapenemase (KPC) production by the bacterium. KPC is spread worldwide, requiring laboratories to be capable of identifying this enzyme, however some methods can be expensive for small laboratories, especially in developing countries. Therefore, the development of methods with low cost of reagents for the detection of KPC enzyme is necessary. The objective of this study was to evaluate the detection of KPC enzyme by MALDI-TOF MS from inactivated bacteria impregnated in filter paper. A total of 129 Enterobacterales isolates were impregnated in filter paper, and after 7 days at room temperature, they were subjected to a protein extraction protocol and spectra acquisition, in triplicates, by MALDI-TOF MS. The spectra were evaluated and KPC was identified according to the presence of a peak of 28,712.62 ± 27.80 m / z. Considering the presence of the KPC peak in at least one spectrum of the triplicates, this method presented 60.8% sensitivity and 96.4% specificity. However, considering the presence of KPC peak in at least two spectra of the triplicate, a specificity of 100% was achieved. The detection of KPC enzyme from inactivated bacteria impregnated in filter paper can be used as a method to confirm the presence of KPC, which could be very significant for small laboratories with limited resources. • Detection of KPC by MALDI-TOF MS can be performed from bacteria in filter-paper. • Detection of KPC from filter-paper by MALDI-TOF MS can be a confirmatory method. • The impregnation of inactivated bacteria in filter-paper is simple and inexpensive. [ABSTRACT FROM AUTHOR]

Pediatric radiotherapy is a critical part of pediatric oncology protocols and the quality of the radiotherapy may determine the future quality of life for long-term survivors. Multidisciplinary team decision making provides the basis for high-quality care. However, delivery of high-quality radiotherapy is dependent on resources. This article provides guidelines for delivery of good quality radiation therapy in resource-limited countries based on rational procurement and maintenance planning, protocol development, three-dimensional planning, quality assurance, and adequate staff numbers and training., (© 2017 Wiley Periodicals, Inc.)

Objective: To explore the development of family medicine postgraduate training in countries with varying levels of resources at different stages of development of the discipline., Composition of the Committee: Since 2012, the College of Family Physicians of Canada has hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Narrative Working Group was conceived in 2012 at the first Besrour Conference. Their mandate was to use narrative and appreciative inquiry to gather stories of family medicine worldwide. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences., Methods: A consultation process with our partners from lower-middle-income countries was undertaken from 2012 to 2014. Stories were sought from each global partner institute with ties to Canadian family medicine departments. An appreciative inquiry approach was chosen to elicit narratives. Thematic analysis was used to search for common threads and important elements of success that could serve to inform other initiatives in other nations and, in turn, offer hope for greater effect., Report: Sixteen narrative stories have been collected so far. These stories highlight insightful solutions, foresight, perseverance, and ultimately a steadfast belief that family medicine will improve the health system and the care provided to the citizens of each nation. Seventeen themes were elucidated by 3 independent Canadian readers. At a subsequent workshop, these themes were validated by Besrour Centre members from Canada and elsewhere. The linkage between the thematic analysis and the experiences of various schools helps to illustrate both the robustness and the usefulness of the narratives in exploring generalizable observations and the features supporting success in each institute., Conclusion: If we are to understand, and contribute to, the development of family medicine throughout the world (a key objective of the Besrour Centre), we must begin to hear each others' stories and search for ways in which our collective story can advance the discipline., (Copyright© the College of Family Physicians of Canada.)

The promotion of inclusive green growth is one of the most debated topics in international forums and is considered a major concern by all countries in the world. Although the existing literature has examined several determinants of inclusive green growth, the impact of environmental taxation on inclusive green growth is relatively little explored. This study is therefore the first attempt to examine the impact of the environmental tax on inclusive green growth for developing countries from 2000 to 2021. To do this, we apply the system generalised method of moments (GMM) that controls unobserved heterogeneity, heteroskedasticity, simultaneity, reverse causality and endogeneity. The empirical results show that environmental tax promotes inclusive green growth. In addition, our results indicate that the control of corruption, government efficiency, the quality of regulation and the rule of law interact with the environmental tax to promote inclusive green growth. Furthermore, this study reveals interestingly that the environmental tax has a positive impact on the two components of inclusive growth and green growth, but the institutional factors that accentuate the impact of the environmental tax are somewhat nuanced. The results of the study have important policy implications for decision-makers in developing countries in promoting inclusive and environmentally friendly growth., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Technological advancements, improved surgical access, and heightened demand for surgery have fueled unprecedented device and supply turnover impelling wealthy hospitals to upgrade continually and sell, donate, recycle, or dispose of used, expired, antiquated, or surplus goods. This paper reviews the issues related to device and supply lifecycles and discusses the opportunities and challenges they present for sustainable surgical growth in low- and middle-income (LMICs) countries., Observations: This review found, in LMICs countries, regulatory disparities persist that limit effective harmonization secondary to highly variable national policies and a lack of prioritized enforcement. Heterogeneity in the regulatory landscape, specifically in the classification, nomenclature, and identification of medical devices, encumbers effective regulation and distribution. Once devices are sold, donated, or reused in LMICs countries, complexities arise in regulatory compliance, maintenance, and appropriate use of these technologies. At the end of the lifecycle, waste management poses significant obstacles with limited resources hindering the implementation of best practices., Conclusion: There are major disparities in access to quality surgical equipment and supplies around the world. Improved communication between relevant stakeholders and harmonization of manufacture and disposal regulations will be needed to ensure adequate and appropriate responses to these challenges., Trial Registration Number: Not applicable., (© 2024 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)

The objective of this paper is to develop a prescriptive model for the inter-country allocation of aid for COVID-19 support. Aid allocations are increasing functions of three dimensions of need: (i) hazard and exposure to COVID-19; (ii) vulnerability to COVID-19 impacts; and (iii) the capacity to cope, subject to an aid budget constraint. COVID-19 support from official donors to all ODA eligible countries is modeled. Aid allocations for COVID-19 support prescribed by the model are compared to actual allocations in 2020. Findings from the main model suggest that low-income countries are over-represented among the countries that should have received a greater share of the aid for COVID-19 support. Middle-income countries tended to receive more donor support for COVID-19 than amounts suggested by the model. The choice of weights assigned to the dimensions of need is arbitrary but findings are broadly consistent with respect to the use of different weights, alternative measures of support and changes to other parameters of the model. It is recommended that the donor community commit to a transparent needs-based funding formula when addressing a global pandemic., (© 2023 The Authors. Health Economics published by John Wiley & Sons Ltd.)

Waste generated from developed states often ends its journey inside the waste management facilities of developing states and, ultimately, their landfills. Developing states end up bearing the risk of devastating their own ecological systems and poisoning their populace, while developed states are unequivocally better off. Recognizing this problem, the international community responded by adopting the Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and their Disposal (1989), the most significant international treaty governing the global waste trade. However, the Convention has not resolved the problem of fairness posed by the global waste trade. This Note argues that the Basel Convention erroneously assumes that consent is meaningful in a transaction between a developed state and developing state--when the developing state is instead incentivized to weaken its own environmental protections to participate in the global waste trade. Although the Basel Convention requires that waste be disposed in an environmentally sound manner, the Convention's explanation should go into further detail to fulfill the objectives of the Convention. Specifically, the Convention should set explicit standards for different types of waste to ensure that they are disposed of in an environmentally sound manner. Additionally, the parties to the Convention should provide more resources to developing states who participate in the global waste trade. [ABSTRACT FROM AUTHOR]

The second-hand clothing imports are very popular in the least developed countries (LDCs). The social health risk (SHR) associated with second-hand clothing products and the lack of relevant legislations in LDCs, however, bring substantial challenges. This article is therefore developed to explore the sterilization legislation design for second-hand clothing supply chains in LDCs. To address LDCs' different import requirements of fumigation, both the extended exporter responsibility (EER) legislation scheme and the extended importer responsibility (EIR) legislation scheme are considered. We also examine whether the perception of public-sector corruption in LDCs may affect the performance of sterilization legislation schemes. We compare the performance of sterilization legislation schemes under different public-sector corruption cases, different sterilization legislation structures, as well as market competition. Interestingly, our analyses show that the EER and EIR legislation schemes can achieve the same performance under a per unit SHR duty, no matter whether there is public-sector corruption or not. However, these two legislation schemes perform differently under the lump-sum SHR duty. Besides, with the presence of the public-sector corruption perception, the prospect of financial benefits from bribing the regulatory agency can induce the firm to choose a higher optimal sterilization level when the bribe is sufficiently small. These implications complement the extant knowledge on risk management of second-hand clothing in LDCs, and provide an important guidance regarding the design of sterilization legislations on second-hand clothing imports., (© 2023 The Authors. Risk Analysis published by Wiley Periodicals LLC on behalf of Society for Risk Analysis.)

In recent years the lawfulness of certain types of sanctions and the question about the usefulness of sanctions in general have become topical and widely discussed issues. Of special significance is the expanding use by powerful states of unilateral coercive measures without Security Council authorisation, or beyond Security Council authorisation, to illustrate their displeasure with the domestic or foreign policies of certain members of the international community. Over time the nature of these measures has taken on diverse forms and their encroachment on human rights and freedoms has become a matter of international concern. This contribution examines the developments that have taken place in this context since the 2000 report of the Working Group on the negative impact of sanctions by focussing on the interventions by key United Nations bodies.

Background: We sought to (1) update estimates of the prevalence of significant cognitive delay (SCD) among nationally representative samples of young children overall, and in upper-middle, lower-middle and low-income countries; (2) investigate whether variation in prevalence between countries was systematically associated with national wealth and other country characteristics; (3) investigate the stability of prevalence estimates over time; (4) examine the correlation between SCD and 2019 Global Burden of Disease estimates on the prevalence of the impairment of developmental intellectual disability under 5 years of age; and (5) investigate the extent to which risk of SCD within countries varies with child age and gender, maternal education and household wealth., Methods: Secondary analysis of data collected in 126 nationally representative Multiple Cluster Indicators Surveys (MICS) conducted under the supervision of UNICEF in 73 countries involving a total of 396 596 3- to 4-year-old children., Results: The overall prevalence of SCD was 9.7% (95% CI 8.6-10.9%). Between-country variation in prevalence was strongly related to national wealth, the Human Development Index, the Human Inequality-adjusted Development Index and the Multidimensional Poverty Index, but not income inequality. In the 46 countries in which more than one survey was available prevalence estimates were reasonably stable over time (r = 0.80, P < 0.001). There were strong independent associations between increased risk of cognitive delay and younger child age, lower levels of maternal education and lower levels of household wealth (but not male gender). There was only a weak association across countries between the estimated prevalence of SCD and Global Burden of Disease estimates of the under 5 prevalence of the impairment of developmental intellectual disability., Conclusions: UNICEF's MICS data are readily (and freely) available to researchers and provide a cost-effective opportunity for researchers who are concerned about better understanding the situation of young children growing up in the world's LMICs with a marked loss of developmental potential in areas of cognition and learning., (© 2022 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

This study delves into the intricate relationship between financial development and environmental sustainability by considering the role of the Paris Agreement in the context of developing countries. By employing advanced econometric techniques method of moment quantile regression (MMQR) and considering a period spanning from 1996 to 2021, this research unravels the non-linear impact of financial development on environmental degradation while considering population and GDP as control variables. The study reveals an inverted N-shaped relationship between financial development and environmental degradation, indicating that environmental degradation (ED) decreases as financial development increases. However, this is followed by a rise in ED before eventually witnessing a further decline. Additionally, the study highlights the positive correlation between GDP and population with ED across all quantiles, with a more pronounced impact observed in higher quantiles. Furthermore, the coefficient of the Paris Agreement demonstrates its effectiveness in decreasing environmental degradation, particularly at higher quantiles of ED. The findings of this study hold practical implications for policymakers, emphasizing the importance of designing and implementing coherent environmental and economic policies in developing countries. This study contributes to understanding the complex dynamics between financial development and environmental sustainability, offering valuable insights for fostering sustainable development pathways., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This paper examines, both theoretically and empirically, the relationship between rapid-onset disasters and women's economic freedom. Rapid-onset disasters create difficulties for all involved, but without proper discussion of and changes to women's economic status in society, they will continue to suffer disproportionately. The study answers the following question: 'how do disasters impact women's economic empowerment?'. It argues that there are underlying factors contributing to unequal economic opportunities that are exacerbated by disasters. Current literature discusses how disasters affect women's economic and political rights, but often it does not account for variables that may not have been captured in contemporary indices. The paper assesses women's burden of care, restrictions on mobility, formal economic employment, and access to recovery resources with respect to their economic empowerment. And it analyses 180 countries and territories that experienced disasters between 1981 and 2019 to uncover their effects on women's economic freedom. This research could facilitate and help to alter the overall narrative on women's empowerment., (© 2023 The Authors Disasters © 2023 ODI.)

Adaptation seeks to transfer and implement healthcare interventions developed and evaluated in one context to another. The aim of this scoping review was to understand current approaches to the adaptation of complex interventions for people with long-term conditions (LTCs) and to identify issues for studies performed in low- and middle-income countries (LMICs). Bibliographic databases were searched from 2000 to October 2022. This review involved five stages: (i) definition of the research question(s); (ii) identifying relevant studies; (iii) study selection; (iv) data charting; and (v) data synthesis. Extraction included an assessment of the: rationale for adaptation; stages and levels of adaptation; use of theoretical frameworks, and quality of reporting using a checklist based on the 2021 ADAPT guidance. Twenty-five studies were included from across 21 LTCs and a range of complex interventions. The majority (16 studies) focused on macro (national or international) level interventions. The rationale for adaptation included intervention transfer across geographical settings [high-income country (HIC) to LMIC: six studies, one HIC to another: eight studies, one LMIC to another: two studies], or transfer across socio-economic/racial groups (five studies), or transfer between different health settings within a single country (one study). Overall, studies were judged to be of moderate reporting quality (median score 23, maximum 46), and typically focused on early stages of adaptation (identification and development) with limited outcome evaluation or implementation assessment of the adapted version of the intervention. Improved reporting of the adaptation for complex interventions targeted at LTCs is needed. Development of future adaptation methods guidance needs to consider the needs and priorities of the LMIC context., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

Objective: The optimal management of placenta accreta spectrum (PAS) requires the participation of multidisciplinary teams that are often not locally available in low-resource settings. Telehealth has been increasingly used to manage complex obstetric conditions. Few studies have explored the use of telehealth for PAS management, and we aimed evaluate the usage of telehealth in the management of PAS patients in low-resource settings., Methods: Between March and April 2023, an observational, survey-based study was conducted, and obstetricians-gynecologists with expertise in PAS management in low- and middle-income countries were contacted to share their opinion on the potential use of telehealth for the diagnosis and management of patients at high-risk of PAS at birth. Participants were identified based on their authorship of at least one published clinical study on PAS in the last 5 years and contacted by email. This is a secondary analysis of the results of that survey., Results: From 158 authors contacted we obtained 65 responses from participants in 27 middle-income countries. A third of the participants reported the use of telehealth during the management obstetric emergencies (38.5%, n = 25) and PAS (36.9%, n = 24). Over 70% of those surveyed indicated that they had used "informal" telemedicine (phone call, email, or text message) during PAS management. Fifty-nine participants (90.8%) reported that recommendations given remotely by expert colleagues were useful for management of patients with PAS in their setting., Conclusion: Telehealth has been successfully used for the management of PAS in middle-income countries, and our survey indicates that it could support the development of specialist care in other low resource settings., (© 2024 International Federation of Gynecology and Obstetrics.)

In low- and middle-income countries (LMICs), the mental health consequences of trauma exposure pose a substantial personal, societal, and economic burden. Yet, the significant need for evidence-based mental health treatment remains largely unmet. To unlock the potential for mental health care for trauma survivors in lower-resource contexts, it is critical to map treatment barriers and identify strategies to improve access to evidence-based, culturally appropriate, and scalable interventions. This review, based on an International Society for Traumatic Stress (ISTSS) briefing paper, describes the treatment gap facing adults with traumatic stress in LMICs and identifies the barriers that contribute to this gap. We then highlight strategies for enhancing access to effective treatments for these populations, including task-sharing, the use of culturally adapted and multiproblem interventions, and digital tools to scale access to appropriate care. Finally, we offer recommendations for policymakers, researchers, and service providers to guide an agenda for action to close the treatment gap for trauma survivors in LMICs., (© 2024 International Society for Traumatic Stress Studies.)

Background: Infectious diseases including syphilis, HIV, and hepatitis B are major contributors to maternal and neonatal morbidity and mortality worldwide, especially in low- and middle-income countries (LMICs). The World Health Organization has prioritized elimination of vertical transmission of these three diseases., Objectives: To rapidly assess the impact of interventions designed to improve antenatal screening rates for syphilis, HIV, and hepatitis B in LMICs and to identify areas for future implementation research., Search Strategy: A comprehensive search was conducted across PubMed, Embase, and EconLit, targeting articles published between January 1, 2013, and June 27, 2023., Selection Criteria: We included quantitative interventional studies in English, involving pregnant adults (15 years or older) from LMICs. Exclusions were studies based in high-income countries, qualitative studies, or those investigating accuracy of diagnostic methods., Data Collection and Analysis: From an initial 5549 potential studies, 27 were finalized for review after various screening stages. Data extraction covered aspects such as study design, intervention details, and outcomes. Findings were qualitatively synthesized within a systems thinking framework., Main Results: The interventions assessed varied in terms of geographic locations, health care system levels, and modalities. The review highlighted the effectiveness of interventions such as community health interventions, service quality improvements, and financial incentives., Conclusions: The study underscores the potential of specific interventions in enhancing antenatal screening rates in LMICs. However, there is a discernible research gap concerning hepatitis B. The findings emphasize the importance of capacity building and health systems strengthening in public health interventions., (© 2024 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)

The global disparity of magnetic resonance imaging (MRI) is a major challenge, with many low- and middle-income countries (LMICs) experiencing limited access to MRI. The reasons for limited access are technological, economic and social. With the advancement of MRI technology, we explore why these challenges still prevail, highlighting the importance of MRI as the epidemiology of disease changes in LMICs. In this paper, we establish a framework to develop MRI with these challenges in mind and discuss the different aspects of MRI development, including maximising image quality using cost-effective components, integrating local technology and infrastructure and implementing sustainable practices. We also highlight the current solutions-including teleradiology, artificial intelligence and doctor and patient education strategies-and how these might be further improved to achieve greater access to MRI., (© 2023 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)

Retinoblastoma, the most common intraocular tumor in childhood, still faces challenges in diagnosis and treatment, particularly in low- and middle-income countries. Identifying strategies to improve the time to diagnosis and access to treatment is crucial to enhance survival rates and preserve ocular health. We conducted a systematic review to identify interventions that have demonstrated potential in addressing these challenges. We performed a comprehensive search across databases until March 2023. Out of the studies reviewed, 21 met the inclusion criteria and were categorized into five main areas: surveillance strategies, genetic counseling, education, public assistance, and international partnership. Despite the obstacles faced, the initiatives identified in this review present acts toward improving the time to diagnosis and access to treatment for retinoblastoma. Based on the extracted data, we propose a comprehensive chain of initiatives. We firmly believe that implementing this chain of initiatives can lead to improved clinical outcomes for retinoblastoma patients., (© 2024 Wiley Periodicals LLC.)