Use of antimicrobials and other medical products in an ethnic minority context of South-Central Vietnam: A qualitative study of vulnerability DOI Creative Commons
Maya Ronse, Thuan T. Nguyen,

Xa Xuan Nguyen

et al.

PLOS Global Public Health, Journal Year: 2024, Volume and Issue: 4(4), P. e0002982 - e0002982

Published: April 9, 2024

Despite the global threat of antimicrobial resistance (AMR), evidence on use and quality medicines at community level is limited, particularly in impoverished, rural areas where prevalence (bacterial) infections high. To better understand processes that drive vulnerability to AMR’ effects, this study aimed assess social factors underpinning access to–and of–medical products healthcare, among people from Raglai ethnic minority Ninh Thuan Province, Vietnam. We conducted ethnographic research eight villages 2018–2019, using interviewing participant observation methods for data collection. Different types informants (including members healthcare providers) were selected purposive sampling strategies analysis was retroductive. Our findings show that, despite existence a government-funded health insurance scheme, people’s flexible therapeutic itineraries did not systematically start with formal healthcare. care (private/informal, public, shamanic) combined parallel or alternation, determined by distance provider, cost, workload, perceived diagnostic capacity, severity aetiology illness, trust provider. Available often tablets dispensed plastic bags containing labelled tablets, unlabelled (in bulk) ground powder. Treatment considered effective when it relieved symptoms, which led abandonment treatment course. When symptoms speedily abate, illness would be reinterpreted, “stronger” sought. The precarious socio-economic status some drove them cycles severe poverty additional unforeseen such as animal disease loss crops arose, hampering (in)formal providers and/or appropriate diagnosis treatment. conclude communities are structurally unable buffer themselves against consequences AMR. vulnerability, they least targeted efforts optimize antibiotic use, concentrated secondary tertiary facilities urban populations.

Language: Английский

Overuse of computed tomography for mild head injury: A systematic review and meta-analysis DOI Creative Commons

Maryam Saran,

Morteza Arab‐Zozani, Meysam Behzadifar

et al.

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(1), P. e0293558 - e0293558

Published: Jan. 11, 2024

Background Computed tomography (CT) scan is a common imaging technique used to evaluate the severity of head injury. The overuse diagnostic interventions in health system growing concern worldwide. Objectives: aim this systematic review investigate rate CT cases mild Methods Eligibility criteria: We encompassed observational studies—either designed as cohort, case-control, or cross-sectional investigations—that reported on rates for injuries. Studies had be published peer-reviewed, English-language sources and provide full content access Information sources: Web Sciences, Scopus, Medline via PubMed, Cochrane Library Embase were searched from inception until April 1, 2023. included if reporting scans injuries using validated criteria. Risk bias: Of Bias In Non-randomised ‐ Interventions (ROBINS-I) tool risk bias assessment studies. Two independent reviewers evaluated eligibility studies, extracted data, assessed study quality by Newcastle-Ottawa Scale. Synthesis results: Overuse estimates calculated random-effects model. Subgroup analyses performed any heterogeneity. Point was main outcome measured percentage point with corresponding 95% CIs. Results Included studies: 913 potentially relevant studies identified, eight selected final analysis. pooled patients injury found 27% [95% CI: 16–43; I 2 = 99%]. varied depending criteria used. 37% 32–42; 0%] Glasgow Coma Scale (GCS), 30% 16–49; 99%] Canadian computed rule, 10% 8–14; Pediatric Emergency Care Applied Research Network criterion (PERCAN). Based subgroup analyses, observed rule criterion, 43% National Institute Health Clinical Excellence 18% New Orleans criterion. Conclusion Limitations evidence: restricted number may impact generalizability. High heterogeneity observed, leading based age, criteria, region. Absent data causes hinders drawing conclusions contributing factors. Furthermore, solely addressed rates, not associated harm benefits. Interpretation: concerning, it can result unnecessary radiation exposure higher healthcare costs. Clinicians policymakers should prioritize implementation guidelines reduce exposure, costs, potential patients. Trial registration protocol registered PROSPERO under identification code CRD42023416080 . https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023416080

Language: Английский

Citations

12
Antimicrobial Resistance in Migratory Paths, Refugees, Asylum Seekers and Internally Displaced Persons: A Narrative Review DOI Creative Commons

Agnese Comelli,

Alberto Gaviraghi, Paolo Cattaneo

et al.

Current Tropical Medicine Reports, Journal Year: 2024, Volume and Issue: 11(3), P. 153 - 166

Published: June 11, 2024

Abstract Purpose of Review Antimicrobial resistance (AMR) is a significant global health challenge, especially for populations with limited access to healthcare services and poor living conditions. This narrative review focuses on the determinants figures related AMR in context migration. Recent Findings Migrants face risk MDRO (multidrug resistant organisms) acquisition at every stage their migration journey, from country origin transit centres destination countries. While there lack systematic data, existing information justifies raising alertness among community. Moreover, recent years, growing body literature has reported that armed conflicts act as magnifier spreading. Summary Targeted interventions each are urgently needed limit spread pandemic, particularly this vulnerable population.

Language: Английский

Citations

4
The green ICU: how to interpret green? A multiple perspective approach DOI Creative Commons
Elisabeth M. Smale, Heather Baid,

Marko Balan

et al.

Critical Care, Journal Year: 2025, Volume and Issue: 29(1)

Published: Feb. 19, 2025

Language: Английский

Citations

0
Responsible consumption of medicines: a cross-sectional qualitative exploration DOI Open Access
Sanju Kaladharan,

Dhanya Manayath,

Rejikumar Gopalakrishnan

et al.

Global Health Journal, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

Citations

0
Biological treatments: Nonpharmacological perspective on psychopharmacology and somatic therapies in developing countries with special reference to India DOI
Samir Kumar Praharaj, Chittaranjan Andrade

Oxford University Press eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 340 - 356

Published: Feb. 1, 2025

Abstract Prescribing medications or somatic therapies to older adults involves consideration of several sociocultural factors that could influence treatment decisions, in addition conventionally recognized medical, physiological, and psychological factors; an understanding the local cultural beliefs environment is therefore necessary negotiate decisions such patients. Medical pluralism widely prevalent developing countries as India, acceptance certain forms taken not only by patient but also their families, often with guidance from relatives friends. Thus, successful prescribing requires beyond those associated biology comorbidities old age; these comprise interactions between illness, patient, doctor, treatment, environment. In this article, we provide a nonpharmacological perspective on psychopharmacology special reference India.

Language: Английский

Citations

0
Medication Management in Patients With Polypharmacy in Primary Care: A Scoping Review of Clinical Practice Guidelines DOI Creative Commons
L Engels, Marjan van den Akker, Petra Denig

et al.

Journal of Evidence-Based Medicine, Journal Year: 2025, Volume and Issue: 18(1)

Published: March 1, 2025

Inappropriate polypharmacy increases the risk of medication-related issues. Adequate management is a challenge involving different healthcare professionals, complex decision-making and ideally including patient involvement. The objective this scoping review was to provide an overview national recommendations for medication patients with in primary care. A clinical practice guidelines focusing on adults polypharmacy, applicable care performed. Databases (G-I-N, Turning Research into Practice PubMed), network, global report were screened published after 2000 English, Dutch, German, Spanish, French, or Russian. Raw data extracted duplicate using extraction framework strategies, involvement involvement, implementation. Qualitative content analysis used. Guideline quality assessed AGREE-II. study registered Open Science Framework. Eight originating from eight countries included. most common recommended strategy conducted by general practitioner and/or community pharmacist. Tasks target population differed per guideline. Most process, mostly elicit patient's experiences treatment goals. Few included advice implementation recommendations. Three out good (AGREE-II score >70% 5/6 domains). review, as Guidance task division less clear. This illustrates room guideline improvements.

Language: Английский

Citations

0
Perspectives on Analgesia for Craniotomy: A Survey of Anesthetic Practices DOI
Anita Vincent, Mark A. Burbridge, Nophanan Chaikittisilpa

et al.

Journal of Neurosurgical Anesthesiology, Journal Year: 2025, Volume and Issue: unknown

Published: March 3, 2025

Background: This study aimed to compare analgesic practices for patients undergoing craniotomy in high-income countries (HICs) and low-income middle-income (LMICs), focusing on variations medication use techniques. Methods: An English-language Spanish-language electronic survey was sent over 300 anesthesiologists 35 from March 22 May 19, 2024, gather data analgesia patients. Anonymous responses through REDCap were analyzed as a whole by income category (HICs LMICs). Results: We received 328 (105 HICs, 221 LMICs, 2 missing locations). Acetaminophen used 78% of respondents (HIC: 82%, LMIC: 76%), with low nonavailability both groups (0.95% 4.98% Fentanyl boluses 57% cases 60%, 55%). Incisional local anesthesia administered 51% 52%, 50%), minimal (1.9% HIC, 1.4% LMIC). The remifentanil infusion more common HICs (64%) than LMICs (31%), where significantly higher (43.89% vs. 7.62% HICs). Scalp blocks 15% 43% LMICs. Craniotomy indication influenced the choice 61% respondents. Conclusions: Analgesic vary between primarily due availability. Global guidelines should consider resource differences improve postoperative pain management.

Language: Английский

Citations

0
Comparing AGS Beers 2019, STOPP version 2, and EU(7)-PIM list in Portuguese older adults in primary health care DOI Creative Commons
Daniela A. Rodrigues, María Teresa Herdeiro, Ramona Mateos-Campos

et al.

European Journal of Clinical Pharmacology, Journal Year: 2024, Volume and Issue: 80(4), P. 603 - 612

Published: Feb. 6, 2024

Abstract Purpose This study aims to identify PIM prevalence in older adults according the 2019 Beers criteria, Screening Tool of Older Person’s Prescriptions version 2 (STOPP v2) and Portuguese EU(7)-PIM list also analyze concordance between these criteria. Methods A retrospective was conducted among 1200 (≥ 65 years old), users primary health care. Demographic, clinical, pharmacological data were collected concerning period April 2021 August 2022. comparative analysis performed three identification determined Lin correlation coefficient. Results The mean age 76.3 (SD 7.7) old 57.6% females. Our findings indicate varying rates criteria with 63.8% (95% CI 61.0–66.6%), 66.8% 64.1–69.5%), 50.1% 47.2–53.0%) take at least one list, 2019, STOPP v2 respectively. highest observed for proton pump inhibitors (30.1%, 95% 27.6–32.9) alprazolam (10.1%, 8.4–11.9%). poor (< 0.834). coefficient found (0.833), lowest (0.735). Conclusion reveals adults, as assessed by different highlights need targeted interventions improved prescribing practices. In future, studies should focus on occurrence negative outcomes associated consumption.

Language: Английский

Citations

3
Mapping the environmental co-benefits of reducing low-value care: a scoping review and bibliometric analysis DOI Creative Commons
Gillian Parker, Sarah Hunter, Karen Born

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: April 23, 2024

ABSTRACT Background Reducing low-value care (LVC) and improving healthcare’s climate readiness are critical factors to improve the sustainability of health systems across globe. Care practices that have been deemed low or no value, in effect, generate carbon emissions, waste pollution without patient population health. There is nascent, but growing, research evaluation inform practice change focused on environmental co-benefits reducing LVC. The objective this study was develop foundational knowledge field through a scoping review bibliometric analysis. Methods We searched four databases, Medline, Embase, Scopus CINAHL, each from inception July 2023. followed established analysis methodology collect analyze data. Publication characteristics, healthcare focus (scoping review); authors, institutions, institution countries, collaborations (bibliometric analysis) data were collected. Findings 145 publications met inclusion criteria published between 2013 – 2023; with over 80% since 2020. Empirical studies represented 21% while commentary, editorials opinions 51% publications. majority generally (27%), by laboratory testing (14%), medications (14%). covered broad range issues general practice-specific ‘Greenhouse gas (GHG) emissions’, ‘waste management’ ‘resource use’ as most common topics. ‘GHG emissions’ reported outcome. revealed numerous international collaboration networks prolific authors producing work settings, studying issues. Conclusions This reveals LVC growing internationally, multiple areas. Results demonstrate need opportunity for emerging community clarify approaches strengthen evidence-base further empirical field.

Language: Английский

Citations

3
Exploring Outputs of the Intergovernmental Science-Policy Panel on Chemicals, Waste, and Pollution Prevention DOI Creative Commons
Miriam L. Diamond, Gabriel Sigmund, Michael G. Bertram

et al.

Environmental Science & Technology Letters, Journal Year: 2024, Volume and Issue: 11(7), P. 664 - 672

Published: June 6, 2024

The Science-Policy Panel (SPP) on Chemicals, Waste, and Pollution Prevention, now being established under a mandate of the United Nations Environment Assembly, will address chemical pollution, one element triple planetary crises along with climate change biodiversity loss. SPP should provide governments consensual, authoritative, holistic solution-oriented assessments, particularly relevant to low- middle-income countries (LMICs) and, we suggest, issues regarding global commons. assessments be flexible in scope breadth, existing retrospectively prospectively minimize high costs human environment health that come from delayed, slow, and/or fragmented policy responses. Two examples are presented here. retrospective example is pharmaceutical which increasing importance, especially LMICs. SPP's assessment could identify data gaps, develop regionally attuned options for mitigation, promote "benign-by-design" chemistry, explore educational capacity-building activities, investigate financial mechanisms implementation. prospective risks posed by chemicals waste release critical technological infrastructure sites vulnerable sea level rise extreme weather events. Multisectoral multidisciplinary inputs needed map "disaster-proofing" responses, financing mechanisms. new offers ambition enabling much-needed explicitly framed as policy-making, protect, support recovery of, local environmental health.

Language: Английский

Citations

3