scholarly journals Sensor-as-a-Service: Convergence of Sensor Analytic Point Solutions (SNAPS) and Pay-A-Penny-Per-Use (PAPPU) Paradigm as a Catalyst for Democratization of Healthcare in Underserved Communities

Diagnostics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 22 ◽  
Author(s):  
Victoria Morgan ◽  
Lisseth Casso-Hartmann ◽  
David Bahamon-Pinzon ◽  
Kelli McCourt ◽  
Robert G. Hjort ◽  
...  
Keyword(s):  
Low Income ◽  
Economically Disadvantaged ◽  
Technology Development ◽  
Point Of Care ◽  
Diagnostic Tools ◽  
Marginalized Communities ◽  
Community Environment ◽  
Service Convergence ◽  
The Social

In this manuscript, we discuss relevant socioeconomic factors for developing and implementing sensor analytic point solutions (SNAPS) as point-of-care tools to serve impoverished communities. The distinct economic, environmental, cultural, and ethical paradigms that affect economically disadvantaged users add complexity to the process of technology development and deployment beyond the science and engineering issues. We begin by contextualizing the environmental burden of disease in select low-income regions around the world, including environmental hazards at work, home, and the broader community environment, where SNAPS may be helpful in the prevention and mitigation of human exposure to harmful biological vectors and chemical agents. We offer examples of SNAPS designed for economically disadvantaged users, specifically for supporting decision-making in cases of tuberculosis (TB) infection and mercury exposure. We follow-up by discussing the economic challenges that are involved in the phased implementation of diagnostic tools in low-income markets and describe a micropayment-based systems-as-a-service approach (pay-a-penny-per-use—PAPPU), which may be catalytic for the adoption of low-end, low-margin, low-research, and the development SNAPS. Finally, we provide some insights into the social and ethical considerations for the assimilation of SNAPS to improve health outcomes in marginalized communities.

scholarly journals Challenge of diagnosing acute infections in poor resource settings in Africa

2021 ◽  
Vol 4 ◽  
pp. 28
Author(s):  
Farisai Chidzwondo ◽  
Francisca Mutapi
Keyword(s):  
Low Income ◽  
Urban Areas ◽  
Point Of Care ◽  
Disease Outbreaks ◽  
Sudden Onset ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Rapid Progression ◽  
Acute Infections ◽  
Large Populations

Frequent disease outbreaks and acute infections occur in rural and low-income urban areas of Africa, with many health systems unprepared to diagnose and control diseases that are recurrent, endemic or have extended their geographic zone. In this review, we focus on acute infections that can be characterized by sudden onset, rapid progression, severe symptoms and poor prognosis. Consequently, these infections require early diagnosis and intervention. While effective vaccines have been developed against some of these diseases, lack of compliance and accessibility, and the need for repeated or multiple vaccinations mean large populations can remain vulnerable to infection. It follows that there is a need for enhancement of national surveillance and diagnostic capacity to avert morbidity and mortality from acute infections. We discuss the limitations of traditional diagnostic methods and explore the relative merits and applicability of protein-, carbohydrate- and nucleic acid-based rapid diagnostic tests that have been trialled for some infectious diseases. We also discuss the utility and limitations of antibody-based serological diagnostics and explore how systems biology approaches can better inform diagnosis. Lastly, given the complexity and high cost associated with after-service support of emerging technologies, we propose that, for resource-limited settings in Africa, multiplex point-of-care diagnostic tools be tailor-made to detect both recurrent acute infections and endemic infections.

Home point-of-care international normalised ratio monitoring sustained by a non-selective educational program in children

2012 ◽  
Vol 108 (10) ◽  
pp. 710-718 ◽  
Author(s):  
Caroline Elie ◽  
Radhia Cheurfi ◽  
Aurélie Grazioli ◽  
Maladon Traore ◽  
Patrick Souillard ◽  
...  
Keyword(s):  
Adverse Events ◽  
Point Of Care ◽  
Underlying Disease ◽  
Median Number ◽  
Self Testing ◽  
The Social ◽  
International Normalised Ratio ◽  
Compliance To Treatment

SummaryAdverse events related to vitamin K antagonist (VKA) therapy might be reduced by point-of-care international normalised ratio (POC INR) monitoring supported by an education program (EP). Our aim was to evaluate the efficacy of a non-selective VKA paediatric EP (regardless of the social, economic, educational or linguistic levels) by analysing the time spent in the therapeutic range (TTR), VKA adverse events and compliance to treatment, and INR control prescriptions. The EP was modified from the pediatric EP previously described but improved by a specifically devised child-focused game. One hundred four consecutive children (median age 8 years) receiving VKA were included in a standardised E P. Patients were in self-testing, and dose adjustments were made by a single physician for three tolerance ranges according to the underlying disease: [2.5–4], [1.8–3.2], and [1.5–2.5]. The median follow-up was 481 days [70–1,001]. The overall TTR was 81.4% [36–100]. The TTR were 74%, 85.6% and 89% for the ranges [2.5–4], [1.8–3.2], and [1.5–2.5], respectively. These results were sustainable during the study period. Only one serious VKA adverse event was recorded. The median number of POC INR tests was 2.5 [1.6–5.7] INR per patient and month. Patients/families performed POC INR when requested in 86.9% of the cases. More than 90% of the families found the EP supportive and wished to follow a long-term reinforcement program. In conclusion, this non-selective child-focused EP for VKA therapy, strongly supported by our dedicated game, is useful in maintaining efficacy, safety and compliance to anticoagulation and its monitoring.

scholarly journals Loop-Mediated Isothermal Amplification (LAMP): A Rapid, Sensitive, Specific, and Cost-Effective Point-of-Care Test for Coronaviruses in the Context of COVID-19 Pandemic

Biology ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 182 ◽  
Author(s):  
Robin Augustine ◽  
Anwarul Hasan ◽  
Suvarthi Das ◽  
Rashid Ahmed ◽  
Yasuyoshi Mori ◽  
...  
Keyword(s):  
Low Income ◽  
Point Of Care ◽  
Cost Effective ◽  
Isothermal Amplification ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Paper Strip ◽  
Ongoing Research ◽  
Loop Mediated Isothermal Amplification ◽  
Point Of Care Test

The rampant spread of COVID-19 and the worldwide prevalence of infected cases demand a rapid, simple, and cost-effective Point of Care Test (PoCT) for the accurate diagnosis of this pandemic. The most common molecular tests approved by regulatory bodies across the world for COVID-19 diagnosis are based on Polymerase Chain Reaction (PCR). While PCR-based tests are highly sensitive, specific, and remarkably reliable, they have many limitations ranging from the requirement of sophisticated laboratories, need of skilled personnel, use of complex protocol, long wait times for results, and an overall high cost per test. These limitations have inspired researchers to search for alternative diagnostic methods that are fast, economical, and executable in low-resource laboratory settings. The discovery of Loop-mediated isothermal Amplification (LAMP) has provided a reliable substitute platform for the accurate detection of low copy number nucleic acids in the diagnosis of several viral diseases, including epidemics like Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). At present, a cocktail of LAMP assay reagents along with reverse transcriptase enzyme (Reverse Transcription LAMP, RT-LAMP) can be a robust solution for the rapid and cost-effective diagnosis for COVID-19, particularly in developing, and low-income countries. In summary, the development of RT-LAMP based diagnostic tools in a paper/strip format or the integration of this method into a microfluidic platform such as a Lab-on-a-chip may revolutionize the concept of PoCT for COVID-19 diagnosis. This review discusses the principle, technology and past research underpinning the success for using this method for diagnosing MERS and SARS, in addition to ongoing research, and the prominent prospect of RT-LAMP in the context of COVID-19 diagnosis.

scholarly journals Acceptability and feasibility of strategies to shield the vulnerable during the COVID-19 outbreak: a qualitative study in six Sudanese communities

2020 ◽  
Author(s):  
Nada Abdelmagid ◽  
Salma A.E. Ahmed ◽  
Nazik Nurelhuda ◽  
Israa Zainalabdeen ◽  
Aljaile Ahmed ◽  
...  
Keyword(s):  
Low Income ◽  
Risk Groups ◽  
Low Income Countries ◽  
Vulnerable Groups ◽  
Community Members ◽  
Telephone Interviews ◽  
The Social ◽  
Urban Rural ◽  
Inductive Thematic Analysis

AbstractBackgroundShielding of high-risk groups from coronavirus disease (COVID-19), either within their households or safe communal structures, has been suggested as a realistic alternative to severe movement restrictions in response to the COVID-19 epidemic in low-income countries. To our knowledge, this concept has not been tested or evaluated in resource-poor settings. This study aimed to explore the acceptability and feasibility of strategies to shield persons at higher risk of severe COVID-19 outcomes, during the COVID-19 epidemic in six communities in Sudan.MethodsWe purposively sampled participants from six communities, illustrative of urban, rural and forcibly-displaced settings. In-depth telephone interviews were held with 59 members of households with one or more members at higher risk of severe COVID-19 outcomes. Follow-up interviews were held with 30 community members after movement restrictions were eased across the country. All interviews were audio-recorded, transcribed verbatim, and analysed using a two-stage deductive and inductive thematic analysis.ResultsMost participants were aware that some people are at higher risk of severe COVID-19 outcomes but were unaware of the concept of shielding. Most participants found shielding acceptable and consistent with cultural inclinations to respect elders and protect the vulnerable. However, extra-household shielding arrangements were mostly seen as socially unacceptable. Participants reported feasibility concerns related to the social isolation of shielded persons and loss of income for shielding families. The acceptability and feasibility of shielding strategies were reduced after movement restrictions were eased, as participants reported lower perception of risk in their communities and increased pressure to comply with social commitments outside the house.ConclusionShielding is generally acceptable in the study communities. Acceptability is influenced by feasibility, and by contextual changes in the epidemic and associated policy response. The promotion of shielding should capitalise on the cultural and moral sense of duty towards elders and vulnerable groups. Communities and households should be provided with practical guidance to implement feasible shielding options. Households must be socially, psychologically and financially supported to adopt and sustain shielding effectively.

scholarly journals Usefulness of Lung Ultrasound in Paediatric Respiratory Diseases

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1783
Author(s):  
Francesco Sansone ◽  
Marina Attanasi ◽  
Paola Di Filippo ◽  
Giuseppe Francesco Sferrazza Papa ◽  
Sabrina Di Pillo ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Lung Ultrasound ◽  
Imaging Techniques ◽  
Point Of Care ◽  
Signs And Symptoms ◽  
Diagnostic Tools ◽  
X Ray ◽  
Chest X Ray ◽  
Ionizing Radiations

Respiratory infection diseases are among the major causes of morbidity and mortality in children. Diagnosis is focused on clinical presentation, yet signs and symptoms are not specific and there is a need for new non-radiating diagnostic tools. Among these, lung ultrasound (LUS) has recently been included in point-of-care protocols showing interesting results. In comparison to other imaging techniques, such as chest X-ray and computed tomography, ultrasonography does not use ionizing radiations. Therefore, it is particularly suitable for clinical follow-up of paediatric patients. LUS requires only 5–10 min and allows physicians to make quick decisions about the patient’s management. Nowadays, LUS has become an early diagnostic tool to detect pneumonia during the COVID-19 pandemic. In this narrative review, we show the most recent scientific literature about advantages and limits of LUS performance in children. Furthermore, we discuss the major paediatric indications separately, with a paragraph fully dedicated to COVID-19. Finally, we mention potential future perspectives about LUS application in paediatric respiratory diseases.

scholarly journals Dengue Detection: Advances in Diagnostic Tools from Conventional Technology to Point of Care

Biosensors ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 206
Author(s):  
Md Alamgir Kabir ◽  
Hussein Zilouchian ◽  
Muhammad Awais Younas ◽  
Waseem Asghar
Keyword(s):  
Low Income ◽  
Point Of Care ◽  
Structural Evolution ◽  
Diagnostic Tools ◽  
Antibody Testing ◽  
Igg Antibody ◽  
Adequate Treatment ◽  
Conventional Technology ◽  
Vector Borne ◽  
Detection Strategies

The dengue virus (DENV) is a vector-borne flavivirus that infects around 390 million individuals each year with 2.5 billion being in danger. Having access to testing is paramount in preventing future infections and receiving adequate treatment. Currently, there are numerous conventional methods for DENV testing, such as NS1 based antigen testing, IgM/IgG antibody testing, and Polymerase Chain Reaction (PCR). In addition, novel methods are emerging that can cut both cost and time. Such methods can be effective in rural and low-income areas throughout the world. In this paper, we discuss the structural evolution of the virus followed by a comprehensive review of current dengue detection strategies and methods that are being developed or commercialized. We also discuss the state of art biosensing technologies, evaluated their performance and outline strategies to address challenges posed by the disease. Further, we outline future guidelines for the improved usage of diagnostic tools during recurrence or future outbreaks of DENV.

Low-income minority women at risk for cervical cancer: a process to improve adherence to follow-up recommendations

2001 ◽  
Vol 116 (6) ◽  
pp. 608-616 ◽  
Author(s):  
Virginia A Cardin ◽  
Richard M Grimes ◽  
Zhi Dong Jiang ◽  
Nancy Pomeroy ◽  
Luther Harrell ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
At Risk ◽  
Low Income ◽  
Minority Women

Re-Increased Male Suicide Rates in the Recovery Phase Following the Great East Japan Earthquake

Crisis ◽  
2020 ◽  
Vol 41 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Masatsugu Orui
Keyword(s):  
Social Connectedness ◽  
Recovery Phase ◽  
Great East Japan Earthquake ◽  
Temporary Housing ◽  
Period Analysis ◽  
Suicide Rates ◽  
Male Suicide ◽  
The Social ◽  
The Difference

Abstract. Background: Monitoring of suicide rates in the recovery phase following a devastating disaster has been limited. Aim: We report on a 7-year follow-up of the suicide rates in the area affected by the Great East Japan Earthquake, which occurred in March 2011. Method: This descriptive study covered the period from March 2009 to February 2018. Period analysis was used to divide the 108-month study period into nine segments, in which suicide rates were compared with national averages using Poisson distribution. Results: Male suicide rates in the affected area from March 2013 to February 2014 increased to a level higher than the national average. After subsequently dropping, the male rates from March 2016 to February 2018 re-increased and showed a greater difference compared with the national averages. The difference became significant in the period from March 2017 to February 2018 ( p = .047). Limitations: Specific reasons for increasing the rates in the recovery phase were not determined. Conclusion: The termination of the provision of free temporary housing might be influential in this context. Provision of temporary housing was terminated from 2016, which increased economic hardship among needy evacuees. Furthermore, disruption of the social connectedness in the temporary housing may have had an influence. Our findings suggest the necessity of suicide rate monitoring even in the recovery phase.

PAR Method

2010 ◽  
Vol 3 (3) ◽  
pp. 355-375 ◽  
Author(s):  
Michelle Billies
Keyword(s):  
New York ◽  
Low Income ◽  
Critical Consciousness ◽  
Design Method ◽  
Participatory Action ◽  
Community Members ◽  
Context Analysis ◽  
Gender Nonconforming ◽  
The Social ◽  
And Gender

The work of the Welfare Warriors Research Collaborative (WWRC), a participatory action research (PAR) project that looks at how low income lesbian, gay, bisexual, transgender, and gender nonconforming (LG-BTGNC) people survive and resist violence and discrimination in New York City, raises the question of what it means to make conscientization, or critical consciousness, a core feature of PAR. Guishard's (2009) reconceptualization of conscientization as “moments of consciousness” provides a new way of looking at what seemed to be missing from WWRC's process and analysis. According to Guishard, rather than a singular awakening, critical consciousness emerges continually through interactions with others and the social context. Analysis of the WWRC's process demonstrates that PAR researchers doing “PAR deep” (Fine, 2008)—research in which community members share in all aspects of design, method, analysis and product development—should have an agenda for developing critical consciousness, just as they would have agendas for participation, for action, and for research.

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