scholarly journals Joining psychiatric care and faith healing in a prayer camp in Ghana: randomised trial

2018 ◽  
Vol 212 (1) ◽  
pp. 34-41 ◽  
Author(s):  
A. Ofori-Atta ◽  
J. Attafuah ◽  
H. Jack ◽  
F. Baning ◽  
R. Rosenheck ◽  
...  
Keyword(s):  
Low Income ◽  
Psychiatric Care ◽  
Rating Scale ◽  
Randomised Trial ◽  
Faith Healing ◽  
Low Income Countries ◽  
Ethical Challenges ◽  
Significant Difference ◽  
Short Run ◽  
Psychiatric Rating Scale

BackgroundCare of people with serious mental illness in prayer camps in low-income countries generates human rights concerns and ethical challenges for outcome researchers.AimsTo ethically evaluate joining traditional faith healing with psychiatric care including medications (Clinical trials.gov identifier NCT02593734).MethodResidents of a Ghana prayer camp were randomly assigned to receive either indicated medication for schizophrenia or mood disorders along with usual prayer camp activities (prayers, chain restraints and fasting) (n= 71); or the prayer camp activities alone (n= 68). Masked psychologists assessed Brief Psychiatric Rating Scale (BPRS) outcomes at 2, 4 and 6 weeks. Researchers discouraged use of chaining, but chaining decisions remained under the control of prayer camp staff.ResultsTotal BPRS symptoms were significantly lower in the experimental group (P= 0.003, effect size –0.48). There was no significant difference in days in chains.ConclusionsJoining psychiatric and prayer camp care brought symptom benefits but, in the short-run, did not significantly reduce days spent in chains.Declaration of interestNone.

scholarly journals COVID-19 in children treated with immunosuppressive medication for kidney diseases

2020 ◽  
pp. archdischild-2020-320616
Author(s):  
Matko Marlais ◽  
Tanja Wlodkowski ◽  
Samhar Al-Akash ◽  
Petr Ananin ◽  
Varun Kumar Bandi ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Immunosuppressive Therapy ◽  
Low Income ◽  
Kidney Diseases ◽  
Low Income Countries ◽  
Reference Network ◽  
Immunosuppressive Medication ◽  
Immunosuppressive Medications ◽  
Significant Difference ◽  
The Impact

BackgroundChildren are recognised as at lower risk of severe COVID-19 compared with adults, but the impact of immunosuppression is yet to be determined. This study aims to describe the clinical course of COVID-19 in children with kidney disease taking immunosuppressive medication and to assess disease severity.MethodsCross-sectional study hosted by the European Rare Kidney Disease Reference Network and supported by the European, Asian and International paediatric nephrology societies. Anonymised data were submitted online for any child (age <20 years) with COVID-19 taking immunosuppressive medication for a kidney condition. Study recruited for 16 weeks from 15 March 2020 to 05 July 2020. The primary outcome was severity of COVID-19.Results113 children were reported in this study from 30 different countries. Median age: 13 years (49% male). Main underlying reasons for immunosuppressive therapy: kidney transplant (47%), nephrotic syndrome (27%), systemic lupus erythematosus (10%). Immunosuppressive medications used include: glucocorticoids (76%), mycophenolate mofetil (MMF) (54%), tacrolimus/ciclosporine A (58%), rituximab/ofatumumab (11%). 78% required no respiratory support during COVID-19 illness, 5% required bi-level positive airway pressure or ventilation. Four children died; all deaths reported were from low-income countries with associated comorbidities. There was no significant difference in severity of COVID-19 based on gender, dialysis status, underlying kidney condition, and type or number of immunosuppressive medications.ConclusionsThis global study shows most children with a kidney disease taking immunosuppressive medication have mild disease with SARS-CoV-2 infection. We therefore suggest that children on immunosuppressive therapy should not be more strictly isolated than children who are not on immunosuppressive therapy.

Effectiveness of the Bactiseal Universal Shunt for reducing shunt infection in a sub-Saharan African context: a retrospective cohort study in 160 Ugandan children

2014 ◽  
Vol 13 (2) ◽  
pp. 140-144 ◽  
Author(s):  
Jordan D. Lane ◽  
John Mugamba ◽  
Peter Ssenyonga ◽  
Benjamin C. Warf
Keyword(s):  
Cohort Study ◽  
Low Income ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Shunt Infection ◽  
Low Income Countries ◽  
Rank Test ◽  
Log Rank Test ◽  
Significant Difference ◽  
Chi Square Analysis

Object Antibiotic-impregnated shunts have yet to find widespread use in the developing world, largely due to cost. Given potential differences in the microbial spectrum, their effectiveness in preventing shunt infection for populations in low-income countries may differ and has not been demonstrated. This study is the first to compare the efficacy of a Bactiseal shunt system with a non–antibiotic-impregnated system in a developing country. Methods The Bactiseal Universal Shunt (BUS) was placed in 80 consecutive Ugandan children who required a shunt. In this retrospective cohort study, the outcome for that group was compared with the outcome for the immediately preceding 80 consecutive children in whom a Chhabra shunt had been placed. The primary end points were shunt failure, shunt infection, and death. Shunt survival was analyzed using the Kaplan-Meier method. Significance of differences between groups was tested using the log-rank test, chi-square analysis, Fisher's exact test, and t-test. Results There was no difference between groups in regard to age, sex, or etiology of hydrocephalus. Mean follow-up for cases of nonfailure was 7.6 months (median 7.8 months, interquartile range 6.5–9.5 months). There was no significant difference between groups for any end point. The BUS group had fewer infections (4 vs 11), but the difference was not significant (p = 0.086, log-rank test). Gram-positive cocci were the most common culturable pathogens in the Chhabra group, while the only positive culture in the BUS group was a gram-negative rod. Conclusions These results provide equipoise for a randomized controlled trial in the same population and this has been initiated. It is possible that the observed trends may become significant in a larger study. The more complex task will involve determining not only the efficacy, but also the cost-effectiveness of using antibiotic-impregnated shunt components in limited-resource settings.

scholarly journals The Short Run Effects of Health Aid in Low Income Countries:Evidence from Panel Data Analysis

2019 ◽  
Author(s):  
Keneni Gutema Negeri
Keyword(s):  
Health Status ◽  
Panel Data ◽  
Low Income ◽  
Panel Data Analysis ◽  
Health Sector ◽  
Infant Mortality Rate ◽  
Low Income Countries ◽  
Health Coverage ◽  
Health Aid ◽  
Short Run

Abstract Background The effect of health targeted aid in developing countries is debatable. This paper examines the short run effect of health aid on health status in low income countries of the world. Method The study estimates the short run effect of health aid on health status in low income countries. Infant mortality rate was used as a proxy for health status and a panel data was constructed from 34 countries for the period between 2000 and 2017. For the estimation, first difference GMM and System GMM were employed. Results The estimation results confirm the argument that health aid has a beneficial and statistically significant short run effect on the health status of low income countries: doubling health aid saves the lives of 20 infants per 10,000 live births. Conclusion From the findings of this paper it can be concluded that health aid could be one of the best tools with which the broader health status gap currently observed between high income and low income groups, could be eliminated and hence the target of Universal Health Coverage is met. However, recipient countries need to find ways of promoting domestic factors that have favorable impact on health sector as they cannot persistently relay up on external resources.

Comparative Analysis of Mobile Pain Management Applications in Developed versus Developing Countries (Preprint)

2021 ◽  
Author(s):  
Wilson Mupfururirwa ◽  
Victoria Nembaware ◽  
Jack Morrice ◽  
Khuthala Mnika ◽  
Gaston Kuzamunu Mazandu ◽  
...  
Keyword(s):  
Pain Management ◽  
Uniform Distribution ◽  
Mobile Health ◽  
Low Income ◽  
Cochrane Review ◽  
High Income ◽  
Low Income Countries ◽  
App Store ◽  
Significant Difference ◽  
The Impact

BACKGROUND The impact of mobile phones and their applications in healthcare (mobile health) is well established for a range of diseases and cross-cutting complications, such as pain. While numerous mobile health (mHealth) pain interventions have been established, an evaluation of their prevalence, adequacy and distribution remains limited. OBJECTIVE This study aims at reviewing and comparing current pain management mHealth tools in high- versus low-income countries. METHODS A literature and application (app) store search was conducted in May 2021 using combinations of the following keywords: “pain management”, “pain”, “mobile health”, “telemedicine”, and “app”. Literature searches were conducted in PubMed, Scopus, Cochrane Review Library, and Google scholar. App store searches were conducted in Google Play and Apple App Store. Data characteristics descriptive analysis was performed using R software to summarize different datasets and compute p-values (P) for testing the significance of different hypotheses with the significance level set to 0.05. RESULTS The search identified 40 publications (literature search) and 230 mHealth applications (app store search), revealing a non uniform distribution of search categories (χ2= 133.7, P < 0.004) with a ratio approximating 1:6 (OR = 5.730, 95%CI:3.745-8.909, P < 0.004). About 86.7% of these 270 applications (apps) are from high-income countries, showing a statistically significant non uniform distribution of country categories: high- and low-income (χ2= 145.2, P < 0.004) approximating the theoretical distribution of a 7:1 ratio (OR = 6.476, 95%CI:4.180-10.222, P < 0.004). Moreover, there is no significant difference in the proportion of search categories between country categories ( χ2= 0.113, P = 0.737) and the difference in pain app prevalence in high- versus low-income countries is not statistically significant. Finally, we have observed that pain-tracking apps are significantly more prevalent in developed countries in comparison to low-income countries. CONCLUSIONS As expected, pain management app prevalence is higher in high-income countries. However, more research is required to readily comprehend the effectiveness of these apps.

Interplays Between Methane Emission and Agricultural Output

2020 ◽  
Vol 11 (4) ◽  
pp. 56-69
Author(s):  
Ramesh Chandra Das ◽  
Arundhati Mukherjee
Keyword(s):  
Low Income ◽  
Methane Emissions ◽  
Low Income Countries ◽  
Middle Income ◽  
Agricultural Output ◽  
Methane Generation ◽  
Developed Economies ◽  
Middle Income Countries ◽  
Long Run ◽  
Short Run

There have been debates among the so-called developed economies and less developed and emerging economies on the issue of ‘who is responsible for' the emission of excessive greenhouse gases (GHGs) into the ambient environment. While methane emissions from agriculture and livestock is one of the important elements of GHGs, it is also required for growth of the agriculture and allied activities for all economic categories. The present study, under this backdrop, examines long run and short run linkages between methane emissions and agriculture outputs for high and low to upper middle-income countries for the period 1981-2012. The results show that the series of methane emissions and agriculture output are cointegrated in the 15 member Organization for Economic Co-operation and Development (OECD) group, low income and middle income countries signifying the responsibilities of these income groups in methane emissions. The responsible countries in the OECD are USA, UK, Japan, Germany, and Italy. Further, in short run dynamics, the Granger Causality results show that methane emissions make a cause to agriculture output for 15OECD and low-income countries, and agricultural output is a cause to methane generation for middle and all low to upper middle income countries. China, India, and Brazil cannot be blamed for making excessive methane generation as both the series are not cointegrated for them.

scholarly journals After the lockdown: macroeconomic adjustment to the COVID-19 pandemic in sub-Saharan Africa

2020 ◽  
Vol 36 (Supplement_1) ◽  
pp. S338-S358 ◽  
Author(s):  
Christopher Adam ◽  
Mark Henstridge ◽  
Stevan Lee
Keyword(s):  
Low Income ◽  
Poverty Reduction ◽  
Sub Saharan Africa ◽  
Policy Options ◽  
Macroeconomic Adjustment ◽  
The Public ◽  
Global Recession ◽  
Significant Difference ◽  
Short Run ◽  
Sub Saharan

Abstract The COVID-19 pandemic is ripping around most of the world, but not in Africa; at least, not yet. At the same time, the policy response is remarkably uniform: most of sub-Saharan Africa went into lockdown from the second week in March. What happens next for the pandemic across Africa is uncertain, but the March lockdowns are unlikely to have contained the epidemic by themselves. What is clear is that the combination of domestic lockdowns and the spill-over from the global recession means immediate and severe hardship. This paper looks beyond the public health aspects of the pandemic to examine the medium-term macroeconomic adjustment challenge confronting domestic policy-makers and international donors. We combine epidemiological and macroeconomic models to calibrate the scale of the combined shock to a representative low-income African economy and to show how alternative policy options for slowing transmission of COVID-19 impact on public revenue, and on GDP in the short run, and hence shape the path to recovery. Noting that the first lockdown, however costly, does not by itself eliminate the likelihood of a re-emergence of the epidemic, we then frame the agenda for key macroeconomic and public finance policies to sustain recovery, growth, and poverty reduction in sub-Saharan Africa. The initial hit to consumption will be up to one-third. All the public policy options are grim. International donor finance of US$40–50 billion, together with domestic reform to accelerate recovery, would make a significant difference to the outlook for poverty.

Oxcarbazepine as an Adjunct of Antipsychotic Therapy in Acute Schizophrenia: A Double-blind, Randomised Placebo-controlled Clinical Trial

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Koethe ◽  
L. Kranaster ◽  
M. Hellmich ◽  
B.M. Nolden ◽  
J. Klosterkoetter
Keyword(s):  
Rating Scale ◽  
Rate Of Change ◽  
Controlled Clinical Trial ◽  
Antipsychotic Therapy ◽  
Double Blind ◽  
Parallel Group ◽  
Significant Difference ◽  
Mixed Regression ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

The outcome in treatment of schizophrenia is still not satisfactorily, and using the adjunctive administration of various anticonvulsant drugs adjunctive to antipsychotics has become widely distributed. This study determines the efficacy of oxcarbazepine combined to olanzapine in treatment of schizophrenia in a double-blind, randomized, placebo-controlled, parallel-group, add-on therapy, 7 week study in 54 patients suffering schizophreniform disorder or schizophrenia. Patients were randomized to oxcarbazepine or placebo and titrated up to 1800 mg/ day in week 1 and maintained at that dose for another 6 weeks. Treatment of olanzapine started at week 2 with 5 mg/day. According to weekly improvement in Brief Psychiatric Rating Scale (BPRS), olanzapine dose was maintained constant or escalated in regular steps of 2.5 mg. Main outcome measure was the cumulative olanzapine dose from beginning administration of oxcarbazepine/placebo for a period of 42 days. Comparing treatment of oxcarbazepine and olanzapine with placebo and olanzapine, there was no difference in cumulative olanzapine doses in both groups. in the oxcarbazepine group was not significantly more rescue medication given. A mixed regression model was used to assess time trends in BPRS over the treatment period: the differences in the rate of change of BPRS in the two treatment groups suggested that the scores sank more rapidly in the oxcarbazepine group (p=0.063). Mean post-treatment aggression score also showed no significant difference. Results from this study do not support the use of OXC as an adjunct to atypical antipsychotics in patients with schizophrenia.

Innovative home based assertive outreach service for treatment of schizophrenia in Larkano, Pakistan (SOUL): Programme implementation and outcomes at the end of five years

2017 ◽  
Vol 41 (S1) ◽  
pp. S600-S601
Author(s):  
S. Afghan
Keyword(s):  
Low Income ◽  
Functional Outcomes ◽  
Rating Scale ◽  
Community Intervention ◽  
Psychosocial Support ◽  
Early Recognition ◽  
Dropout Rate ◽  
Low Income Countries ◽  
Good Effect ◽  
Programme Implementation

IntroductionThere is a significant service gap in provision of essential treatment to patients with severe mental disorders in low-income countries, which leads to increased mental health disability and bigger disease burden on the families and society. The SOUL programme is a first of its kind in the country, which utilizes assertively engaging patients at their homes.ObjectivesThe key objectives are early recognition, treatment and psychosocial support to patients with the diagnosis of schizophrenia. Additional objectives include social recovery of the patients, psycho education to family members and generating clinical and functional outcomes.MethodsProgramme design developed by host psychiatry department through stakeholder consultation. Training was undertaken for programme team and included training on use of outcome measures namely Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF). Hosting carers and families meetings on regular intervals serve the purpose of family psycho-education and receiving informal feedback about the service.ResultsPreliminary findings on clinical and functional outcomes of cohort of 125 patients recruited over continual basis over 5 years are presented. Complex community intervention shows significant change in all outcome scales (with good effect size) with before and after analysis at one year. The programme demonstrated excellent engagement with patients and very low dropout rate.ConclusionsLow cost community intervention involving trained doctor and psychiatric nurses working under close supervision of a senior psychiatrist is feasible and achievable and can lead to robust improvements in symptoms and functional outcomes for patients with schizophrenia.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Modelling the impact of oil price fluctuations on food price in high and low-income oil exporting countries

2020 ◽  
Vol 66 (No. 10) ◽  
pp. 458-468
Author(s):  
Chen Ding ◽  
Umar Muhammad Gummi ◽  
Shan-bing Lu ◽  
Asiya Muazu
Keyword(s):  
Least Squares ◽  
Low Income ◽  
Ordinary Least Squares ◽  
Food Prices ◽  
Oil Price ◽  
Low Income Countries ◽  
Long Run ◽  
Oil Markets ◽  
Short Run ◽  
The Impact

Oil exporting economies were the most hit by the recent oil price shock that spills on the food market in an increasingly volatile macroeconomic environment. This paper examines and compares sub-samples [before crisis <br />(2000 Q1–2013 Q1) and during crisis (2013 Q2–2019 Q4)] as to the impact of oil price on food prices in high- and low-income oil-exporting countries. We found an inverse relationship between oil and food prices in the long run based on full samples and sub-samples in high-income countries. The story is different during the crisis period: in low-income countries and all the countries combined, oil and food prices co-move in the long run as measured by the Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Ordinary Least Squares (DOLS). Our findings suggest that economic structure and uncertain events (crises) dictate the behaviour and relationship between food and oil markets. Food and oil prices may drift away in the short-run, but market forces turn them toward equilibrium in the long-run. Moreover, low-income countries are indifferent in both periods due to limited capacity to balance the increasing demand for and supply of food items.

Long-run Association Between Bank Credit and Output: A Study on Districts’ Panel of West Bengal, India

2020 ◽  
pp. 097215092091844
Author(s):  
Ramesh Chandra Das ◽  
Soniya Chavan
Keyword(s):  
Low Income ◽  
West Bengal ◽  
Panel Cointegration ◽  
Bank Credit ◽  
Low Income Countries ◽  
Vector Error Correction ◽  
Data Framework ◽  
Long Run ◽  
Short Run ◽  
Per Capita

In a globalized world, the financial sectors and the real sectors are interlinked. Although it is a common phenomenon to a developed economy in its national as well as provincial levels, it has hardly been tested for the low-income countries like India. It is further difficult to have such linkage effects at the provinces and district levels. This article aims to examine whether per capita commercial bank credit and per capita net district domestic product for the districts of West Bengal state in India have long-run associations for the period 1993–2014 in a panel data framework. Using the panel cointegration and Vector error correction mechanism (VECM) technique, the study reveals that both the financial and real sector indicators are cointegrated and the short-run errors are corrected significantly to establish that there is bilateral causality between credit and output in both long run and short run.

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