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Gene Therapy Jan 2024In the rapidly evolving landscape of biotechnologies, cell and gene therapies are being developed and adopted at an unprecedented pace. However, their access and... (Review)
Review
In the rapidly evolving landscape of biotechnologies, cell and gene therapies are being developed and adopted at an unprecedented pace. However, their access and adoption remain limited, particularly in low- and middle-income countries (LMICs). This study aims to address this critical gap by exploring the potential of applying a hub and spoke model for cell and gene therapy delivery in LMICs. We establish the identity and roles of relevant stakeholders, propose a hub and spoke model for cell and gene therapy delivery, and simulate its application in Brazil and the Middle East and North Africa. The development and simulation of this model were informed by a comprehensive review of academic articles, grey literature, relevant websites, and publicly available data sets. The proposed hub and spoke model is expected to expand availability of and access to cell and gene therapy in LMICs and presents a comprehensive framework for the roles of core stakeholders, laying the groundwork for more equitable access to these lifesaving therapies. More research is needed to explore the practical adoption and implications of this model.
Topics: Developing Countries; Genetic Therapy; Gene Transfer Techniques; Brazil
PubMed: 37903929
DOI: 10.1038/s41434-023-00425-x -
Journal of the Intensive Care Society Nov 2023Lung ultrasound (LUS) is an emerging assessment tool for intensive care unit (ICU) therapists (physiotherapists, physical therapists and respiratory therapists) to aid...
INTRODUCTION
Lung ultrasound (LUS) is an emerging assessment tool for intensive care unit (ICU) therapists (physiotherapists, physical therapists and respiratory therapists) to aid pathology identification, intervention selection, clinical reasoning and as an outcome measure to assess intervention efficacy. However, the extent of LUS adoption and use by ICU therapists internationally has not been described in the literature.
OBJECTIVES
This survey explored the interest in LUS amongst ICU therapists internationally. In addition, LUS training, use in clinical practice and barriers to implementation were also explored. The survey findings were used to facilitate recommendations for future adoption.
METHODS
International ICU therapists were invited to answer a 37 question cross-sectional open e-survey, distributed using the online survey tool REDCap. The exact sample size of eligible ICU therapists from around the world is unknown, therefore the participant responses received were a representative convenience sample of the international ICU therapist population. Survey links were posted on the relevant web pages and social media forums utilised by various ICU therapist associations and professional organisations worldwide. A snowballing technique was used to encourage survey participants to forward the survey link within their professional networks. The survey was open on REDCap for an 8-week period between March and May 2021.
RESULTS
Three hundred twenty ICU therapists from 30 countries responded with most respondents coming from either the United Kingdom ( = 94) or Australia ( = 87). Eighty-nine of the ICU therapist respondents (30%) reported being users of LUS, however, 40 of those 89 respondents reported having no formal accreditation. The top clinical indications to perform a LUS scan were changes on chest radiograph, altered findings on auscultation and a low partial pressure of arterial oxygen/fraction of inspired oxygen ratio. The 71% of LUS users reported that their ICU does not have a local policy in place to guide ICU therapists' use of LUS. Most LUS users (82%) only document their LUS findings in the patient's medical notes and (73%) only store the LUS clips on the ICU's ultrasound machine. The 85% of respondents perceive LUS becoming an increasing part of their objective assessment in the future and 96% report that they have other ICU therapist colleagues interested in adopting LUS. Main reasons why respondents believe that ICU therapists are not adopting LUS in their ICU are a difficulty in access to appropriate training, mentorship, and a lack of local governance policy guiding their use of LUS.
CONCLUSIONS
To the authors' knowledge this is the first study to explore the international adoption and utility of LUS by ICU therapists. LUS is a growing technique with widespread interest from ICU therapists internationally with a desire to adopt LUS into their assessments and upskill their practice. ICU therapists' use of LUS could allow more targetted and appropriate treatment for patients on ICU. Barriers to LUS adoption could be mitigated by having access to quality training programmes and mentorship. Development of profession specific guidance and policies within local infrastructure should facilitate growth and ensure robust quality assurance and governance processes.
PubMed: 37841297
DOI: 10.1177/17511437221148920 -
NPJ Digital Medicine Sep 2023The rapid advancement of telehealth technologies has the potential to revolutionize healthcare delivery, especially in developing countries and resource-limited... (Review)
Review
The rapid advancement of telehealth technologies has the potential to revolutionize healthcare delivery, especially in developing countries and resource-limited settings. Telehealth played a vital role during the COVID-19 pandemic, supporting numerous healthcare services. We conducted a systematic review to gain insights into the characteristics, barriers, and successful experiences in implementing telehealth during the COVID-19 pandemic in China, a representative of the developing countries. We also provide insights for other developing countries that face similar challenges to developing and using telehealth during or after the pandemic. This systematic review was conducted through searching five prominent databases including PubMed/MEDLINE, Embase, Scopus, Cochrane Library, and Web of Science. We included studies clearly defining any use of telehealth services in all aspects of health care during the COVID-19 pandemic in China. We mapped the barriers, successful experiences, and recommendations based on the Consolidated Framework for Implementation Research (CFIR). A total of 32 studies met the inclusion criteria. Successfully implementing and adopting telehealth in China during the pandemic necessitates strategic planning across aspects at society level (increasing public awareness and devising appropriate insurance policies), organizational level (training health care professionals, improving workflows, and decentralizing tasks), and technological level (strategic technological infrastructure development and designing inclusive telehealth systems). WeChat, a widely used social networking platform, was the most common platform used for telehealth services. China's practices in addressing the barriers may provide implications and evidence for other developing countries or low-and middle- income countries (LMICs) to implement and adopt telehealth systems.
PubMed: 37723237
DOI: 10.1038/s41746-023-00908-6 -
Behavioral Sciences (Basel, Switzerland) Jul 2023Nurses and paramedics play a pivotal role when mass casualty incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for... (Review)
Review
Nurses and paramedics play a pivotal role when mass casualty incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including virtual reality (VR) and augmented reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR and AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full texts were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR and AR and immersive simulation generally show promising evidence in enhancing practical skills and knowledge in MCI management. VR and AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experiential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources.
PubMed: 37504063
DOI: 10.3390/bs13070616 -
MedEdPORTAL : the Journal of Teaching... 2023The 2020 Focused Asthma Updates introduced a paradigm shift in the treatment of asthma that includes symptom-based adjustments to outpatient asthma treatment that vary...
INTRODUCTION
The 2020 Focused Asthma Updates introduced a paradigm shift in the treatment of asthma that includes symptom-based adjustments to outpatient asthma treatment that vary by age and severity. The length and complexity of the updates have made them challenging to adopt.
METHODS
We implemented an educational session among pediatric residents to increase their familiarity with, comprehension of, and plans to adopt two evidence-based recommendations introduced in the 2020 Updates for symptom-based therapy. Facilitators led groups of four to six pediatric residents in cased-based discussions during a 30-minute, ambulatory care-based session. One week prior, participants and facilitators received synopses of the 2007 Guidelines for the Diagnosis and Management of Asthma and the 2020 Updates. Facilitators also received a guide and scripts explaining new concepts, providing supporting data, and highlighting learning objectives. Retrospective pre/post surveys assessed participants' familiarity with, comprehension of, and planned adoption of recommendations for intermittent steroids and single maintenance and reliever therapy (SMART) before and after the conference. The surveys also assessed prior exposure to the 2020 Updates and reflections on the educational session.
RESULTS
There were 26 participants. Ratings of familiarity, comprehension, and adoption plans regarding the recommendations significantly improved (s < .001, Wilcoxon signed rank test). The case-based approach was well received, and the material was deemed relevant.
DISCUSSION
This educational session significantly increased pediatric residents' familiarity with, comprehension of, and plans to adopt two new evidence-based treatments. Dissemination of this educational session may improve outpatient asthma management.
Topics: Humans; Child; Retrospective Studies; Asthma; Internship and Residency; Steroids; Surveys and Questionnaires
PubMed: 37441565
DOI: 10.15766/mep_2374-8265.11320 -
Research Square Oct 2023The Nigerian Revised National Policy on Science, Technology and Innovation 2022 formally proposed the adoption of open science principles among researchers and all other...
BACKGROUND
The Nigerian Revised National Policy on Science, Technology and Innovation 2022 formally proposed the adoption of open science principles among researchers and all other stakeholders in Nigeria. With regard to health research, open science would allow the dissemination and sharing of scientific data and other research outputs among health researchers, thereby accelerating the scientific process and the development of innovative solutions for health challenges. However, in this context, the existing privacy and data protection rules can profoundly affect the adoption and sustainability of open science in Nigeria. This is because researchers rely heavily on accessing and sharing personal information and the biological samples of human subjects. Therefore, this study identifies and examines possible legal issues and challenges arising from the existing privacy and data protection rules as researchers adopt an open science approach to health research in Nigeria.
METHODS
This study adopts a qualitative approach, providing a legal analysis of existing national, regional and international instruments on privacy, data protection and health research in the context of open science in Nigeria. The study also draws on relevant research and non-research articles on open science, health research, privacy and data protection published in English. Searches for the articles were conducted on various sites through the Google search engine, using terms such as 'sharing of data', 'data privacy', 'principles of data protection', 'open science', etc.
RESULTS/CONCLUSION
The study finds that the right to privacy and data protection could affect the promotion, adoption and sustainability of open science among health researchers in Nigeria, as well as their ability to engage in open collaborative research with their peers in Africa and other jurisdictions. To prevent infringements of the privacy and data protection rules by researchers and thereby ensure the adoption of open science approaches in health research, the study further identifies various legal options for researchers, including using personal data or material transfer arrangements, which, among other things, require recipients or users of human data or biological samples to commit not to re-identify human subjects.
PubMed: 37961613
DOI: 10.21203/rs.3.rs-3293485/v1 -
Heliyon Dec 2023The penetration of digital technologies to enhance market participation by farmers, and intensify farmers' access to support services such as finance, farm inputs, and...
The penetration of digital technologies to enhance market participation by farmers, and intensify farmers' access to support services such as finance, farm inputs, and agricultural production information is on the rise in developing countries. However, the drivers and intensity of the adoption of these technologies by Ghanaian farmers have received little attention in policy and academic circles. This study analyzed the factors that drive the adoption and intensity of adoption of digital agricultural solutions by smallholder farmers in the Bono East Region of Ghana. The study used a survey questionnaire to collect data from 1199 randomly selected smallholder farmers in 2023. The multivariate probit model and the Heckpoisson regression model were used to analyze the drivers of different digital agricultural solutions and the intensity of adoption of these solutions, respectively. The results show that there is a joint demand for technologies that enhance access to extension services and those that accelerate access to inputs. Market-oriented solutions and agricultural extension solutions exhibited a complementary relationship. In addition to selected socio-demographic factors, the study found that membership in farmer-based organizations, access to credit, and participation in agronomic training increased farmers' propensity to adopt different digital agricultural solutions and increased the number of solutions adopted by farmers. Receiving visits from extension officers reduced the likelihood and intensity of adopting digital agricultural solutions. The results suggest that government and development partners should enhance access to credit and promote capacity development programmes among farmers. This will capacitate them to adopt digital agricultural solutions.
PubMed: 38125414
DOI: 10.1016/j.heliyon.2023.e23023 -
Sensors (Basel, Switzerland) Jul 2023A digital twin is a computer-based "virtual" representation of a complex system, updated using data from the "real" twin. Digital twins are established in product...
Using the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) Framework to Identify Barriers and Facilitators for the Implementation of Digital Twins in Cardiovascular Medicine.
A digital twin is a computer-based "virtual" representation of a complex system, updated using data from the "real" twin. Digital twins are established in product manufacturing, aviation, and infrastructure and are attracting significant attention in medicine. In medicine, digital twins hold great promise to improve prevention of cardiovascular diseases and enable personalised health care through a range of Internet of Things (IoT) devices which collect patient data in real-time. However, the promise of such new technology is often met with many technical, scientific, social, and ethical challenges that need to be overcome-if these challenges are not met, the technology is therefore less likely on balance to be adopted by stakeholders. The purpose of this work is to identify the facilitators and barriers to the implementation of digital twins in cardiovascular medicine. Using, the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework, we conducted a document analysis of policy reports, industry websites, online magazines, and academic publications on digital twins in cardiovascular medicine, identifying potential facilitators and barriers to adoption. Our results show key facilitating factors for implementation: preventing cardiovascular disease, in silico simulation and experimentation, and personalised care. Key barriers to implementation included: establishing real-time data exchange, perceived specialist skills required, high demand for patient data, and ethical risks related to privacy and surveillance. Furthermore, the lack of empirical research on the attributes of digital twins by different research groups, the characteristics and behaviour of adopters, and the nature and extent of social, regulatory, economic, and political contexts in the planning and development process of these technologies is perceived as a major hindering factor to future implementation.
Topics: Humans; Technology; Delivery of Health Care; Empirical Research; Computer Simulation
PubMed: 37514627
DOI: 10.3390/s23146333 -
Ciencia & Saude Coletiva Apr 2024The present theoretical essay is based on six reports concerning same-sex couples and gay and lesbian people in order to interconnect homoparenting and the adoption of...
The present theoretical essay is based on six reports concerning same-sex couples and gay and lesbian people in order to interconnect homoparenting and the adoption of children with disabilities, through the lenses of human and social sciences in public health. The reports were interpreted in light of studies on same-sex adoption and the adoption of children with disabilities. Feminist approaches related to care and disability were also included in the interpretative perspective, operating as expressive webs of grammars of ableism. It was found that media approaches endorse the right to family formation and the adoption of children with disabilities by homoparental families, but with little critical depth on the category of disability and without highlighting support for the adoption of all adoptee profiles. Moreover, the intersections between homophobia and ableism increase discriminatory and oppressive logics, with the union of social groups considered to be "undesirable" representing a strategy of governmentality that reveals the complexity of grammars of ableism, applied to the sexual and reproductive rights of LGBTQIA+ adopters and to the fundamental rights of children and adolescents with disabilities who are available for adoption.
Topics: Humans; Adoption; Child; Disabled Children; Female; Male; Adolescent; Sexual and Gender Minorities; Homophobia; Human Rights; Feminism
PubMed: 38655973
DOI: 10.1590/1413-81232024294.19772023 -
Heliyon Nov 2023This study explores the factors influencing the intention to adopt blockchain technology and the alignment between respondents' work characteristics and blockchain...
This study explores the factors influencing the intention to adopt blockchain technology and the alignment between respondents' work characteristics and blockchain technology. It addresses the lack of attention from previous literature on these factors in the context of blockchain adoption, especially amidst the recent blockchain hype. By integrating Task-Technology Fit (TTF) and a modified version of the Unified Theory of Acceptance and Use of Technology (UTAUT), this study employs a questionnaire survey. The results demonstrate that the alignment between blockchain and work characteristics significantly impacts performance expectations and the recognition of opportunities, thereby influencing the intention to adopt blockchain. Furthermore, factors such as effort expectancy, social influence, facilitating conditions, and perceived policy uncertainty influence adoption intention by identifying opportunities. Exposure to blockchain-related knowledge reinforces the relationships mentioned above. Additionally, digital natives display greater confidence in blockchain's potential to enhance work performance than digital immigrants. These study findings offer valuable insights and strategies for blockchain technology providers and provide a comprehensive survey for individuals and professionals interested in embracing or understanding the dynamics of blockchain adoption.
PubMed: 38034816
DOI: 10.1016/j.heliyon.2023.e21887