-
Malaria Journal Dec 2023The primary reason for the failure of malaria vector control across endemic regions is the widespread insecticide resistance observed in Anopheles vectors. The most... (Review)
Review
The primary reason for the failure of malaria vector control across endemic regions is the widespread insecticide resistance observed in Anopheles vectors. The most dominant African vectors of malaria parasites are Anopheles gambiae and Anopheles funestus mosquitoes. These species often exhibit divergent behaviours and adaptive changes underscoring the importance of deploying active and effective measures in their control. Unlike An. gambiae, An. funestus mosquitoes are poorly studied in Benin Republic. However, recent reports indicated that An. funestus can adapt and colonize various ecological niches owing to its resistance against insecticides and adaptation to changing breeding habitats. Unfortunately, scientific investigations on the contribution of An. funestus to malaria transmission, their susceptibility to insecticide and resistance mechanism developed are currently insufficient for the design of better control strategies. In an attempt to gather valuable information on An. funestus, the present review examines the progress made on this malaria vector species in Benin Republic and highlights future research perspectives on insecticide resistance profiles and related mechanisms, as well as new potential control strategies against An. funestus. Literature analysis revealed that An. funestus is distributed all over the country, although present in low density compared to other dominant malaria vectors. Interestingly, An. funestus is being found in abundance during the dry seasons, suggesting an adaptation to desiccation. Among the An. funestus group, only An. funestus sensu stricto (s.s.) and Anopheles leesoni were found in the country with An. funestus s.s. being the most abundant species. Furthermore, An. funestus s.s. is the only one species in the group contributing to malaria transmission and have adapted biting times that allow them to bite at dawn. In addition, across the country, An. funestus were found resistant to pyrethroid insecticides used for bed nets impregnation and also resistant to bendiocarb which is currently being introduced in indoor residual spraying formulation in malaria endemic regions. All these findings highlight the challenges faced in controlling this malaria vector. Therefore, advancing the knowledge of vectorial competence of An. funestus, understanding the dynamics of insecticide resistance in this malaria vector, and exploring alternative vector control measures, are critical for sustainable malaria control efforts in Benin Republic.
Topics: Animals; Insecticide Resistance; Insecticides; Anopheles; Malaria; Benin; Mosquito Vectors; Mosquito Control
PubMed: 38129880
DOI: 10.1186/s12936-023-04815-9 -
BMC Health Services Research Apr 2024Resilience, in the field of Resilience Engineering, has been identified as the ability to maintain the safety and the performance of healthcare systems and is aligned...
BACKGROUND
Resilience, in the field of Resilience Engineering, has been identified as the ability to maintain the safety and the performance of healthcare systems and is aligned with the resilience potentials of anticipation, monitoring, adaptation, and learning. In early 2020, the COVID-19 pandemic challenged the resilience of US healthcare systems due to the lack of equipment, supply interruptions, and a shortage of personnel. The purpose of this qualitative research was to describe resilience in the healthcare team during the COVID-19 pandemic with the healthcare team situated as a cognizant, singular source of knowledge and defined by its collective identity, purpose, competence, and actions, versus the resilience of an individual or an organization.
METHODS
We developed a descriptive model which considered the healthcare team as a unified cognizant entity within a system designed for safe patient care. This model combined elements from the Patient Systems Engineering Initiative for Patient Safety (SEIPS) and the Advanced Team Decision Making (ADTM) models. Using a qualitative descriptive design and guided by our adapted model, we conducted individual interviews with healthcare team members across the United States. Data were analyzed using thematic analysis and extracted codes were organized within the adapted model framework.
RESULTS
Five themes were identified from the interviews with acute care professionals across the US (N = 22): teamwork in a pressure cooker, consistent with working in a high stress environment; healthcare team cohesion, applying past lessons to present challenges, congruent with transferring past skills to current situations; knowledge gaps, and altruistic behaviors, aligned with sense of duty and personal responsibility to the team. Participants' described how their ability to adapt to their environment was negatively impacted by uncertainty, inconsistent communication of information, and emotions of anxiety, fear, frustration, and stress. Cohesion with co-workers, transferability of skills, and altruistic behavior enhanced healthcare team performance.
CONCLUSION
Working within the extreme unprecedented circumstances of COVID-19 affected the ability of the healthcare team to anticipate and adapt to the rapidly changing environment. Both team cohesion and altruistic behavior promoted resilience. Our research contributes to a growing understanding of the importance of resilience in the healthcare team. And provides a bridge between individual and organizational resilience.
Topics: Humans; COVID-19; Pandemics; Resilience, Psychological; Patient Care Team; Qualitative Research
PubMed: 38609968
DOI: 10.1186/s12913-024-10895-3 -
Heliyon Oct 2023Nowadays, evaporatively cooled office buildings commonly observed in dry hot areas in summer of China. However, few dedicated studies to record the local residents'...
Nowadays, evaporatively cooled office buildings commonly observed in dry hot areas in summer of China. However, few dedicated studies to record the local residents' thermal comfort and adaptability in these buildings. The contribution of adaptive comfort theory on thermal perception still remains unclear for optimizing office building design parameters. Hence, to deeper probe the adaptive thermal comfort of the related indoor environment, a field study of office buildings during summer considering evaporative cooling air conditioned (ECA) and naturally ventilated (NV) mode was conducted in Turpan, China. Based on 931 valid datasets collected from questionnaires, we found that the neutral temperature (T) of 28.4 °C in ECA group, 0.6 °C lower than NV group (29.0 °C). A lower air temperature (T) and higher humidity (RH)/air-velocity (V) were expected in two modes, and V has a stronger influence than RH on mean thermal sensation votes (MTSV). Meanwhile, occupants can adapt to current indoor environment through physiological, psychological and behavioral adjustments, while the clothing regulation had limited effect on MTSV unless the outdoor temperature exceeds 38 °C. Whether in ECA or NV mode, the predicted mean votes (PMV) model overestimated actual thermal sensation when operative temperature (T) beyond 28 °C. Adaptive models were also proved varied from that in current standards, which indicated that they were not suitable for evaluating the studied buildings in Turpan. Above findings could suggest us a better understanding of the occupants' thermal adaptability, thereby providing the reference of design parameters revision and passive strategies for local newly/renovated buildings.
PubMed: 37860505
DOI: 10.1016/j.heliyon.2023.e20646 -
Pharmaceutical Statistics 2023We consider outcome adaptive phase II or phase II/III trials to identify the best treatment for further development. Different from many other multi-arm multi-stage...
We consider outcome adaptive phase II or phase II/III trials to identify the best treatment for further development. Different from many other multi-arm multi-stage designs, we borrow approaches for the best arm identification in multi-armed bandit (MAB) approaches developed for machine learning and adapt them for clinical trial purposes. The best arm identification in MAB focuses on the error rate of identification at the end of the trial, but we are also interested in the cumulative benefit of trial patients, for example, the frequency of patients treated with the best treatment. In particular, we consider Top-Two Thompson Sampling (TTTS) and propose an acceleration approach for better performance in drug development scenarios in which the sample size is much smaller than that considered in machine learning applications. We also propose a variant of TTTS (TTTS2) which is simpler, easier for implementation, and has comparable performance in small sample settings. An extensive simulation study was conducted to evaluate the performance of the proposed approach in multiple typical scenarios in drug development.
Topics: Humans; Research Design; Sample Size; Computer Simulation
PubMed: 37571869
DOI: 10.1002/pst.2331 -
Annals of Medicine Dec 2024While Cardiac Rehabilitation (CR) programs have shown effectiveness in improving cardiac outcomes, there is limited understanding of how patients perceive and adapt to...
BACKGROUND
While Cardiac Rehabilitation (CR) programs have shown effectiveness in improving cardiac outcomes, there is limited understanding of how patients perceive and adapt to these interventions. Furthermore, alternative modes of delivering CR that have received positive evaluations from participants remain underexplored, yet they have the potential to enhance CR uptake.
OBJECTIVES
To explore the patient experience in CR programmes following Acute Myocardial Infarction (AMI) and describe their adaptive processing.
PATIENTS AND METHODS
This qualitative study was conducted at a nationally certified centre in China between July 2021 and September 2022, encompassing three stages: in-hospital, centre-based, and home-based CR programs. Purposive sampling was used to select eligible AMI patients for in-depth semi-structured interviews. The interview outline and analytical framework were aligned with the key concepts derived from the middle-range theory of adaptation to chronic illness and the normalization process theory. The findings were reported following the Consolidated Criteria for Reporting Qualitative Research checklist.
RESULTS
Forty AMI patients were recruited. Four main themes describing the process of AMI patients normalizing CR intervention were identified, including (1) experiencing CR service driving by role's responsibilities, (2) engaging in collaborative relationship based on interpersonal trust, (3) exploring a personalized rehabilitation plan by complex integration, and (4) expecting a promised outcome to shape decision-making.
CONCLUSION
Integrated care interventions for AMI patients could benefit from a collaborative co-designed approach to ensure that CR interventions are normalized and fit into patients' daily lives. Organizational-level CR services should align with the rehabilitation needs and expectations of patients.
Topics: Humans; Cardiac Rehabilitation; Myocardial Infarction; Research Design; China
PubMed: 38306095
DOI: 10.1080/07853890.2024.2311227 -
Systems thinking in local government: intervention design and adaptation in a community-based study.Health Research Policy and Systems Sep 2023Systems thinking approaches are increasingly being used by communities to address complex chronic disease. This paper reports on the VicHealth Local Government...
BACKGROUND
Systems thinking approaches are increasingly being used by communities to address complex chronic disease. This paper reports on the VicHealth Local Government Partnership (VLGP) which sought to co-create improvements in the health and well-being of children and young people by working with local government in Victoria, Australia.
METHODS
The VLGP included a series of health promotion modules, aimed at creating policy, programme and practice changes across local government. One of these modules, Connecting the Dots - creating solutions for lasting change, aimed to build capacity for systems thinking in municipal public health and well-being planning across 13 councils. The approach was adapted and data were collected on the stimuli for, and results of, adaptation.
RESULTS
The council adapted the systems thinking approach to meet geographic characteristics, priority health issue/s and participant target group needs. Adaptions applied to workshop materials, training delivery, existing and new resources, and to align with other community-based approaches. Stimuli for adaptation included the COVID-19 pandemic, needs of children and young people, capacity of council to deliver the workshop series, and time available within the project or for the participant group.
CONCLUSIONS
Systems thinking was used and adapted by councils to improve the health and well-being of children and young people and increase the voices of children and young people in decision-making. Flexible delivery is critical to ensure communities can adapt the approach to meet local needs.
Topics: Child; Humans; Adolescent; Local Government; Pandemics; COVID-19; Victoria; Systems Analysis
PubMed: 37667377
DOI: 10.1186/s12961-023-01034-1 -
Journal of Medical Internet Research Oct 2023The COVID-19 pandemic forced numerous touch-based fields, including manual therapy, body psychotherapy, arts therapy, creative arts practices, and the fitness industry,... (Review)
Review
BACKGROUND
The COVID-19 pandemic forced numerous touch-based fields, including manual therapy, body psychotherapy, arts therapy, creative arts practices, and the fitness industry, to swiftly transition to web-based service delivery. These disciplines faced substantial challenges in adapting their traditionally in-person practices, which rely heavily on physical touch and close proximity, to a web format.
OBJECTIVE
This review intends to provide a systematically sourced overview of the literature concerning innovative approaches for adapting touch-based practices to the web format in response to the COVID-19 pandemic.
METHODS
A systematic search across 7 databases and gray literature sources identified studies presenting innovative web delivery methods, particularly those addressing the challenges arising from the absence of physical proximity and touch. The inclusion criteria were designed to encompass studies exploring the creative adaptation of touch-based practices to web formats in response to the COVID-19 pandemic irrespective of study methodology. The exclusion criteria applied to studies focusing solely on technical aspects of web delivery or nontouch or noninteractive practices. There were no geographical restrictions, but the selection was limited to publications from 2020 onward. As only qualitative studies were found, data synthesis was conducted thematically.
RESULTS
The review encompassed 17 studies revealing that touch-based fields successfully devised innovative and creative methods for web service delivery. These methods were categorized into five main themes: (1) adapted working methods (cross-field methods), (2) adapted working methods for sensorial experiences and nonphysical connections, (3) creative methods using materials or additional tools, (4) creative use of web-based platform tools or additional technologies, and (5) creative methods requiring previous preparation of practitioners or participants. These creative approaches allowed practitioners to address the challenges of web touch-based practices, fostering connections and offering unique sensory experiences, albeit with some concerns related to technology and preparation.
CONCLUSIONS
These innovative methods demonstrate promise in circumventing the limitations imposed by the lack of physical touch and proximity in web settings during the COVID-19 pandemic. Furthermore, these insights hold potential for application in other fields in the future. This systematic search and thematic synthesis provide valuable guidance for practitioners and educators seeking to navigate the evolving landscape of web service delivery in touch-based disciplines, ensuring continuity of care even in challenging circumstances.
TRIAL REGISTRATION
PROSPERO CRD42022379731; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=379731.
Topics: Humans; Touch; Pandemics; COVID-19; Databases, Factual; Exercise
PubMed: 37883151
DOI: 10.2196/46355 -
Health Policy and Planning May 2024The design of complex health systems interventions, such as pay for performance (P4P), can be critical to determining such programmes' success. In P4P programmes, the...
The design of complex health systems interventions, such as pay for performance (P4P), can be critical to determining such programmes' success. In P4P programmes, the design of financial incentives is crucial in shaping how these programmes work. However, the design of such schemes is usually homogenous across providers within a given scheme. Consequently, there is a limited understanding of the strengths and weaknesses of P4P design elements from the implementers' perspective. This study takes advantage of the unique context of Brazil, where municipalities adapted the federal incentive design, resulting in variations in incentive design across municipalities. The study aims to understand why municipalities in Brazil chose certain P4P design features, the associated challenges, and the local adaptations made to address problems in scheme design. This study was a multiple-case study design relying on qualitative data from twenty municipalities from two states in northeastern Brazil. We conducted two key informant interviews with municipal-level stakeholders and focus group discussions with primary care providers. We also reviewed municipal PMAQ laws in each municipality. We found substantial variation in the design choices made by municipalities regarding 'who was incentivised', the 'payment size' and 'frequency'. Design choices affected relationships within municipalities and within teams. Challenges were chiefly associated with fairness relating to 'who received the incentive', 'what is incentivised', and the 'incentive size'. Adaptations were made to improve fairness, mostly in response to pressure from the healthcare workers. The significant variation in design choices across municipalities and providers' response to them highlights the importance of considering local context in the design and implementation of P4P schemes and ensuring flexibility to accommodate local preferences and emerging needs. Attention is needed to ensure the choice of 'who is incentivised' and the 'size of incentives' are inclusive and fair, and the allocation and 'use of funds' are transparent.
PubMed: 38706154
DOI: 10.1093/heapol/czae033 -
Contemporary Clinical Trials Oct 2023Successful translation of evidence-based exercise training interventions from research to clinical practice depends on the balance of treatment fidelity and adaptability...
BACKGROUND
Successful translation of evidence-based exercise training interventions from research to clinical practice depends on the balance of treatment fidelity and adaptability when delivering the exercise program across settings. The current paper summarizes fidelity of study design, provider training, and intervention delivery strategies from best practice recommendations, and reports challenges experienced and adaptations instrumented by behavioral coaches delivering the multi-site Supervised versus Telerehabilitation Exercise Programs for Multiple Sclerosis (STEP for MS) Trial.
METHODS
Using a reflexive thematic analysis approach, open-ended survey questions were analyzed to explore experiences of behavioral coaches, transcripts from team meetings among behavioral coaches, and notes from audits of one-on-one sessions between behavioral coaches and participants.
RESULTS
Themes related to the fidelity of study design and delivery of the STEP for MS Trial included adaptations to the intervention itself (e.g., completion of virtual supervised exercise sessions with behavioral coaches in place of face-to-face sessions during COVID-19 pandemic restrictions), modification of exercise equipment, and adjustments of program delivery. The adjustments of program delivery reported by behavioral coaches included increasing program fit, maintaining engagement, and addressing participant safety concerns; however, these adaptations did not jeopardize the content of the essential elements of the program model.
CONCLUSIONS
The current paper demonstrates that when best practice recommendations are implemented, it is possible to address challenges to study design and evidence-based intervention delivery in ways that adaptations to overcome real-world obstacles can be accomplished without compromising fidelity.
PubMed: 37633458
DOI: 10.1016/j.cct.2023.107320 -
Journal of Long-term Effects of Medical... 2024This paper presents the design and simulation of an Interval type 2 fuzzy system (IT2FS) based, adaptive neuro-fuzzy inference system (ANFIS) pacemaker controller in...
This paper presents the design and simulation of an Interval type 2 fuzzy system (IT2FS) based, adaptive neuro-fuzzy inference system (ANFIS) pacemaker controller in MATLAB. After designing the type 1 fuzzy logic model, the stability of the designed system has been verified in the time-domain (unit step response). In previous works, the type 1 (IT1FS) model step response was analyzed. They are compared with the other proportional integral derivative (PID) and fuzzy models that only least-square-estimation and the backpropagation algorithms are used for tuning membership functions (MF) and generation of type 1 fis (fuzzy inference system) file. At current work, fuzzy C means (FCM) method shows better results than other methods have been used. The pacemaker controller determines the pacing rate and adjusts the heart rate of the patient for the reference input signal. The rise-time, overshoot and settling-time have been improved significantly.
Topics: Humans; Computer Simulation; Pacemaker, Artificial
PubMed: 37938200
DOI: 10.1615/JLongTermEffMedImplants.2023044398