Population Need Research Articles

Development of an Implementation Science Telehealth Toolkit to Promote Research Capacity in Evaluation of Telehealth Programs.

The field of telehealth is rapidly growing and expanding access to quality health care, although there have been varied implementation outcomes in telehealth modalities. Dissemination and implementation (D&I) research can provide a systematic approach to identifying barriers and facilitators to telehealth implementation processes and outcomes. An interdisciplinary research and clinical team developed an implementation science telehealth toolkit to guide D&I evaluations of new and existing telehealth innovations. The toolkit includes a separate section to correspond to each step in the D&I evaluation process. Each section includes resources to guide evaluation steps, telehealth specific considerations, and case study examples based on three completed telehealth evaluations. The field of telehealth is forecasted to continue to expand, with potential to increase health care access to populations in need. This toolkit can help guide health care stakeholders to develop and carry out evaluations to improve understanding of telehealth processes and outcomes to maximize implementation and sustainability of these valuable innovations.

Equitable distribution of perishable items in a food bank supply chain

In the United States, food banks play an important role in helping to reduce the rate of food insecurity by distributing donated food among the population in need. One of the challenges that food banks face is to equitably distribute food donations among their clients such that, ideally, each recipient receives the same amount of food. They aim to do so while minimizing waste that occurs due to spoilage and capacity limitations. Perishable food items present specific challenges since they are susceptible to spoilage and need to be distributed before their expiry dates. Based on our longstanding partnership with a large food bank located in the southeastern United States, we present a capacitated, multiperiod, multiproduct network flow model to help them equitably and effectively distribute perishable food donations among the food‐insecure population in their service region. The model is applied within the context of a case study and reveals managerial insights that would be useful to practitioners. Our findings show that although equity is one of the food bank's highest priorities, inequities cannot be eliminated completely. Given the inevitability of inequitable food allocations in practice, this paper provides food banks guidance on how to strategically control inequities using two approaches: ( i) by increasing the number of periods for which equity should be satisfied or ([Formula: see text]) by allowing deviations from a perfectly equitable distribution. The results show that modest deviations from perfect equity using either approach can lead to significant improvements in both the quality and quantity of food distributed and can also reduce food waste. While approach ([Formula: see text]) is preferable, the most desirable outcomes occur when both are applied simultaneously. We also find that county capacities inhibit a food bank's ability to achieve balance between equity and effectiveness when distributing perishables. Our framework provides food banks the flexibility to balance the trade‐off between effectiveness and equity based on their preferences.

HAND EXOSKELETON FOR REHABILITATION AND FUNCTIONALIZATION

Many diseases and injuries of the hand require rehabilitation to restore function. However, the high human, financial, spatial, and temporal costs associated with rehabilitation often mean that the population in need does not have access to optimal rehabilitative care. Therefore, devices that complement the therapist are a possible solution, as they make rehabilitation more independent and frequent, and save healthcare facilities the aforementioned resources. Nevertheless, these devices are not widely distributed in the market, mainly due to their poor accessibility. The newly designed exoskeleton has four motors and a redundant transmission system that allows independent flexion and extension of each finger, except the thumb. Kinematics were analyzed with motion studies and loads were evaluated with static studies and structural analysis using motion loads. In the simulations, both flexion and extension were achieved in four seconds. A prototype transmission system was built and its kinematics matched that of the simulation and corresponded to the biomechanics of the fingers. At maximum flexion, the exoskeleton would be able to hold small objects and exert a normal force of up to 20 N with structural integrity. Keywords: Engineering design, exoskeleton, hand rehabilitation, hand functionalization.

Minimally invasive stabilization of pelvic metastatic bone disease: A review of an emerging technique.

Percutaneous pelvic stabilization is an emerging technique that provides mechanical stability to pathologic fractures of the pelvic ring and acetabulum. Variability exists in procedural technique among institutions; however, early case series consistently demonstrate an acceptable complication profile and significant improvement in patients' pain and function. This minimally invasive approach is less morbid than traditional, open acetabular and pelvic reconstructions. Therefore, this procedure is an encouraging palliative intervention for a growing patient population in need.

Assessment if the demographic aging scale of the region's population

Background. The current process of population aging manifests itself at the regional level with varying degrees of intensity, which should be taken into account when assessing the population's need for geriatric medical care and developing social support measures.
 Aim. To give a comprehensive description of the dynamics of special indicators of population aging and to assess the demographic aging scale of the population of the Irkutsk region.
 Material and methods. A comprehensive assessment of the dynamics of population aging was carried out using 6 special indicators of population aging and 3 indicators of demographic movement. The calculation of the values of the indicators was performed in accordance with the methodological provisions on demographic statistics. The scale of aging was calculated based on the results of determining the stages of aging using 4 parameters of population aging: the level of aging, the depth of aging, aging factors, and the rate of aging. The data source was the statistical accounting tables of Rosstat for the Irkutsk region: А12а_25 natural population movement; t_pt1n general results of population migration by incoming territories; 25_2PH population by sex and age. The number of statistical accounting tables separately for each municipality of the Irkutsk region and the region as a whole amounted to 99 units for each year under study.
 Results. The dynamics of the aging level parameter indicates an aggravation of the aging processes of the population, and not due to an increase in people at the age of longevity (from 75 to 90 years) and centenarians (90 years and older), but due to the population older than working age, women from 55 years old and men from 60 years up to the age of 75 years. Indicators of aging factors that characterize reproductive and migration compensatory mechanisms are at a level that does not allow compensating for the growing processes of population aging. The value of the aging rate parameter in terms of the growth rate of the aging coefficient in dynamics indicates the stability of the demographic aging of the population. An analysis of the scale of population aging in the Irkutsk region and its districts showed that the Irkutsk region has an average value of parameters and is at an intermediate stage between the aging and old population.
 Conclusion. The scale of the aging of the Irkutsk region is primarily due to the high value of the parameter of aging factors, the parameter of the level of aging is characterized by the presence of prerequisites for the transition to a more aggravated stage of population aging.

Application of Behavioral Architecture in The Land Arrangement of a Simple Rental Flat, Bong Cino Tomb Area, Madiun City

The city of Madiun is currently experiencing an increase in population with various backgrounds. Based on the description of the problem, a long-term plan is needed to anticipate the population's need for housing. There is a problem that is in the spotlight, namely residents who build homes on the slum land of the Bong Cino Cemetery area and have occupied the area for tens of years with the nature of activities that are contrary to the norm. In the problems that have been described, it is necessary to plan and design flats for residents in the Bong Cino Cemetery area by applying a behavioral architectural theme to be able to communicate with users through sensing the buildings that affect human psychology. The types of research conducted are field studies and literature studies. In collecting data using interview methods, observation methods, documentary methods, and literature methods as well as the types and sources of data used are primary data and secondary data. From the discussion of the problems, it can be concluded that designing the low-cost flat building, namely focusing on land management by applying the concept of macro-defensible space which is applied to land planning, produces a role in the mechanism of action prevention for environmental protection and is expected to be of assistance and benefit to the community and to be able to overcome problems in the Bong Cino Tomb area.

Alpha NSW: What would it take to create a state-wide paediatric population-level learning health system?

The health and well-being of children in the first 2000 days has a lasting effect on educational achievement and long-term chronic disease in later life. However, the lack of integration between high-quality data, analytic capacity and timely health improvement initiatives means practitioners, service leaders and policymakers cannot use data effectively to plan and evaluate early intervention services and monitor high-level health outcomes. Our exploratory study aimed to develop an in-depth understanding of the system and clinical requirements of a state-wide paediatric learning health system (LHS) that uses routinely collected data to not only identify where the inequities and variation in care are, but also to also inform service development and delivery where it is needed most. Our approach included reviewing exemplars of how administrative data are used in Australia; consulting with clinical, policy and data stakeholders to determine their needs for a child health LHS; mapping the existing data points collected across the first 2000 days of a child's life and geospatially locating patterns of key indicators for child health needs. Our study identified the indicators that are available and accessible to inform service delivery and demonstrated the potential of using routinely collected administrative data to identify the gap between health needs and service availability. We recommend improving data collection, accessibility and integration to establish a state-wide LHS, whereby there is a streamlined process for data cleaning, analysis and visualisation to help identify populations in need in a timely manner.

A comprehensive review of machine vision systems and artificial intelligence algorithms for the detection and harvesting of agricultural produce

Every nation's economic development depends heavily on agriculture. Fulfilling the current population's need for food is becoming increasingly difficult because of factors including population growth, frequent climate change, and a lack of resources. However, the agriculture sector's biggest problems are a lack of trained workers, urbanization, and a lack of available labour. Automation in agriculture is essential to provide food, fibre, and fuels to the rapidly growing population. Since harvesting is a critical step in farming, the authors present a systematic review of machine vision systems and artificial intelligence algorithms for detecting and harvesting agricultural produce in this article. The areas that are being concentrated on include machine vision systems, vision sensors, and different image processing and artificial intelligence algorithms utilized for detection and harvesting. Review of various image types and vision sensors used in machine vision systems for automated detection and harvesting. It demonstrates how several 3D methods, which were used to obtain the position, orientation, and 3D point cloud of the fruit or crop, function and compare them. Furthermore, it compares various image processing and artificial intelligence algorithms deployed in precision agriculture for detection and harvesting. This article shows how knowledge-based agriculture can boost agriculture produce and quality.

Representation of the population in need for pivotal clinical trials in lymphomas

AbstractDespite the advances in cancer outcomes, significant health disparities persist. Several new agents have been recently approved for treatment of lymphomas, leading to improved outcomes. Extending the benefits of these new agents starts by adequate enrollment of all affected patient populations. This study aimed to evaluate the extent to which randomized controlled trials (RCTs) match the demographic and geographic diversity of the population affected by lymphoma. Two Food and Drug Administration databases, clinicaltrials.gov, and relevant primary manuscripts were reviewed for drug approval data and demographic representation in RCTs for classical Hodgkin lymphoma (cHL) and non-Hodgkin lymphoma. Maps showing the distribution and frequency of trial participation relative to disease burden, insurance status, and racial representation were created. Black, Hispanic, and female patients were significantly underrepresented in the RCTs for lymphoma compared with that for the disease burden (3.6% [95% confidence interval (CI), 2.8-5.4] vs 14.6% [95% CI, 13.8-15.3]; 6.7% [95% CI, 5.5-7.9] vs 16.3% [95% CI, 15.5-17.1]; and 39.1% [95% CI, 37.3-40.9] vs 42.7% [95% CI, 42.3-43.1], respectively). White and male patients were overrepresented. More counties with higher mortality rates and racial minority representation had low access to the trials, particularly for cHL in the southern region of the United States. There are significant racial misrepresentations in pivotal RCTs in the United States, and geographic distribution of these trials may not provide easy access to all patients in need. Disparities in enrollment should be corrected to make results applicable to all populations.

Lazer, turismo e qualidade de vida em parques urbanos Uma reflexão sobre os impactos da pandemia no Parque Ecológico do Tietê

With the establishment of the health crisis caused by the Covid-19 pandemic and the forced quarantine, social rights such as health, leisure and tourism of the population were significantly impacted, while the performance of sports, cultural and leisure activities and outdoors trips was abruptly interrupted. Located in the East Zone of São Paulo, the most populous and needy region of the city, is the Parque Ecológico do Tietê, focus of this research, whose objective was to verify how its use in the aspects of leisure and tourism was affected during the pandemic. As methodological procedures, analyses were performed based on comments on TripAdvisor in two periods, as well as interviews with visitors and managers of that park. As main results, it is highlighted that there was a significant increase in interest in contact with nature and in trails, which can be explained by the long duration of the quarantine and the population's need to experience outdoor activities safely. There was no change in terms of the park's degree of importance to visitors, but they valued the activities that had been carried out until then and that were prevented by the occurrence of the pandemic. For the administrators, the biggest challenges were related to the removal of employees from the risk group to support the park's activities as well as the extra-budgetary expenses with personal protective equipment. In summary, the study reaffirms the relevance of urban parks for the population’s outdoor experiences and the deleterious effects of the pandemic that considerably affected the offer of activities related to leisure and tourism in actual society.

New approaches to the design and public functions of social rental housing

Social security-oriented rental housing is not only an important way to solve the housing problem for urban residents, but also an effective means to improve the quality of urban life and promote sustainable development of urban environment. Past public rental housing emphasized efficiency in construction, allocation, and use, but lacked public functionality, resulting in many projects becoming identical "miniature commercial housing". Therefore, this article focuses on the "two-type" security-oriented rental housing and lists new design cases of Modern rental housing. It proposes that social security-oriented rental housing should enjoy multiple rights and have the aesthetic function of open shared space and personalized innovation, low-carbon emission reduction intelligent function, fair transfer and participation function. Measures such as providing preferential housing, rental or new housing subsidies, and land price subsidies are provided for specific populations in need. By realizing the design concept of multiple values, social security-oriented rental housing can not only maintain basic rights, but also enhance the quality of residents' lives, further improving their quality of life and environmental friendliness.

Examination of Adaptations to the Evidence Based Supported Employment Model: Individual Placement and Support.

Individual Placement and Support (IPS) is a long-standing and innovative employment service for individuals with mental illness with dozens of clinical trials demonstrating effectiveness. Little is known, however, about intentional adaptations to IPS, especially those outside of the context of research studies. Using an implementation science framework, we conducted an exploratory study to better understand the characteristics of stakeholder-reported adaptions to IPS, the impetus for their development, and perceived impacts. We conducted qualitative interviews to analyze and describe these adaptations. Numerous adaptations of IPS were found that address the needs of new and underserved populations both within and outside of the mental health field. Programs reported adapting IPS because of the dearth of other evidence-based employment services, to serve diverse populations in need, and based on financial incentives. Benefits of adaptations were weighed against impacts on fidelity. As evidence-based practices (EBPs) are adapted, developers of EBPs should determine how fidelity of a program or service can be assessed or preserved in light of adaptations. This is critical with the increase in different service delivery methods, new populations, new service recipient needs, and new settings in need of EBPs.

Real-time sensing of war’s effects on wellbeing with smartphones and smartwatches

BackgroundModern wars have a catastrophic effect on the wellbeing of civilians. However, the nature of this effect remains unclear, with most insights gleaned from subjective, retrospective studies.MethodsWe prospectively monitored 954 Israelis (>40 years) from two weeks before the May 2021 Israel-Gaza war until four weeks after the ceasefire using smartwatches and a dedicated mobile application with daily questionnaires on wellbeing. This war severely affected civilians on both sides, where over 4300 rockets and missiles were launched towards Israeli cities, and 1500 aerial, land, and sea strikes were launched towards 16,500 targets in the Gaza Strip.ResultsWe identify considerable changes in all the examined wellbeing indicators during missile attacks and throughout the war, including spikes in heart rate levels, excessive screen-on time, and a reduction in sleep duration and quality. These changes, however, fade shortly after the war, with all affected measures returning to baseline in nearly all the participants. Greater changes are observed in individuals living closer to the battlefield, women, and younger individuals.ConclusionsThe demonstrated ability to monitor objective and subjective wellbeing indicators during crises in real-time is pivotal for the early detection of and prompt assistance to populations in need.

Comparing Pain and Pain Coping Mechanisms in Patients Undergoing Total Joint Arthroplasty as Part of a Mission Trip to Those in the United States

BackgroundAccess to total joint arthroplasty can be difficult in low-resource settings. Service trips are conducted to provide arthroplasty care to populations in need around the world. This study aimed to compare the pain, function, surgical expectations, and coping mechanisms of patients from one such service trip to the United States. MethodsIn 2019, the Operation Walk program conducted a service trip in Guyana during which 50 patients had hip or knee arthroplasties. Patient demographics, patient-reported outcome measures, questionnaires assessing pain attitudes and coping, and pain visual analog scales were collected preoperatively and at 3 months postoperatively. These outcomes were compared with a matched cohort of elective total joint arthroplasty at a US tertiary care medical center. There were 37 patients matched between the 2 cohorts. ResultsThe mission cohort had significantly lower preoperative self-reported function scores than the US cohort (38.3 versus 47.5, P = .003), as well as a significantly larger improvement at 3 months (42.4 versus 26.4, P = .014). The mission cohort had significantly higher initial pain (8.0 versus 7.0, P = .015), but there were no differences with regard to pain at 3 months (P = .420) or change in pain (P = .175). The mission cohort had significantly greater preoperative scores in pain attitude and coping responses. ConclusionPatients in low-resource settings were more likely to have preoperative functional limitations and pain, and they coped with pain through prayer. Understanding the key differences between these 2 types of populations and how they approach pain and functional limitations may help improve care for each group. Level of EvidenceII, prospective study.

Early, very high-titre convalescent plasma therapy in clinically vulnerable individuals with mild COVID-19 (COVIC-19): protocol for a randomised, open-label trial

IntroductionCOVID-19 convalescent plasma (CCP) is a possible treatment option for COVID-19. A comprehensive number of clinical trials on CCP efficacy have already been conducted. However, many aspects of CCP treatment...

The Private Sector in the Rental Housing Market

Numerous types of literature contend that housing plays a role in both the low-income population's need for public assistance and the comparatively affluent families' need for mortgage financing. Due to the failure of vacant homes, which ultimately resulted in wasted resources since medium-low income groups have curtailed purchasing power, the rental housing market is progressively where social progress is consolidated. Based on the role of rental housing, this paper goes into considerable detail about the private sector in this market. In tandem with the findings of previous studies, the research indicates that private power enhances social development in terms of active trading, achieving wealth, and alleviating the government's financial burden. However, the research discovers that some issues exist widely behind this aspect of the rental market, which not only causes significant life costs for some youngsters but also that the efficiency is constrained by governmental policies, as evidenced by data from some selected economies. Thus, the analysis is followed by some recommendations derived from the paper to use some financial investments such as leveraging and the REITs tool, as well as perspectives on adjusting governmental policies as strategies to strengthen the private rental market.

Chronic pain in children and adolescents diagnosed with cancer: the challenge of mitigating the pain and the potential of integrating exercise into pain management

Pain is one of the most common and distressing symptoms experienced by children and adolescents diagnosed with cancer. It is vital that children and adolescents receive adequate pain management early on in their cancer treatments to mitigate pain and cancer-related symptoms. Exercise training shows particular promise in the management of acute and chronic pain among children and adolescents diagnosed with cancer. This position paper comes to outline the challenge of mitigating pain in children and adolescents diagnosed with cancer, and the potential benefits of integrating exercise training to the management of chronic pain in this population in need. Integrating exercise training into the care and pain management of children and adolescents diagnosed with cancer who have chronic pain would have the advantage of addressing several shortcomings of pain medication. Pain medication aims to temporarily manage or reduce pain; it does not have the potential to directly improve a patient's physical condition in the way that exercise training can. The current paucity of data available on the use of exercise training as a complementary treatment to pain medications to reduce chronic pain in children and adolescents diagnosed with cancer allows only for hypotheses on the effectiveness of this pain management modality. More research on this important topic is necessary and mitigating pain effectively while also reducing the use of opioid pain medication is an important goal shared by patients, their families, clinicians, and researchers alike. Future research in this area has great potential to inform clinical care, clinical care guidelines, and policy-making decisions for pain management in children and adolescents diagnosed with cancer who experience chronic pain.

Development of a Low-Cost Gastroscope Prototype (GP) for Potential Cost-Effective Gastric Cancer Screening in Prevalent Regions

Abstract Background Screening for gastric cancer is known to be associated with reduced mortality in populations with high prevalence. However, many countries with high prevalence do not screen, with high costs being a significant reason for this. Aims To describe, develop, and assess the potential for a low-cost gastroscope for early cancer screening and patient risk stratification. Methods Our interdisciplinary team used both off-the-shelf and fabricated components to create multiple gastroscope prototypes (GP) in iterative fashion based off clinician feedback. Clinician endoscopists were surveyed using Likert scales regarding device potential, video quality, and handling when testing on a GI training device. Video quality comparison to clinically standard high-definition white light endoscopy (HD-WLE) was done using the absolute categorical ratings (ACR) method. Results A candidate cost-effective GP with clinical potential was developed. Although initial versions were scored as inferior via ACR on all views tested when compared to HD-WLE (p < 0.001), participants agreed the concept may be beneficial (M = 4.52/5, SD = 0.72). In testing improved versions, participants agreed the device had the ability to identify discrete (M = 4.62/5, SD = 0.51) and subtle lesions (M = 4/5, SD = 0.7) but most felt video quality, although improved, was still less than HD-WLE. Sufficiency of maneuverability of device to visualize gastric views was rated as equivocal (M = 2.69/5, SD = 1.25). Conclusion The presented low-cost gastroscopic devices have potential for clinical application. With further device development and refinement including the possible addition of technologies in telemedicine and artificial intelligence, we hope the GP can help expand gastric cancer screening for populations in need.

Economical and Easily Obtainable Tools to Manually Develop Lateral Flow Immunoassay Strips.

The development of inexpensive and highly functional lateral flow devices, which utilize simple and affordable tools, can make them accessible to many populations with insufficient resources. Therefore, this study aims to provide a method to overcome the cost challenges associated with using expensive manufacturing technologies and machinery, particularly during pandemics and upon urgent need. Here, in-house lateral flow strips to detect serum antibodies were developed using low-priced and easily available tools such as adhesive tape and CytoSep layers. The developed lateral flow immunoassay strips presented here produced signals with 93.3 and 96.6% sensitivity for SARS-CoV-2 nucleocapsid protein-specific IgM and IgG antibodies, respectively. The specificity obtained from the developed strips was 96.6% for SARS-CoV-2 nucleocapsid protein-specific IgM and 100% for the IgG antibodies by applying only 5 μL from the serum samples. The proposed design was entirely made manually to ensure a method that would make lateral flow devices available to many populations in need around the globe.

Effective Coverage in Health Systems: Evolution of a Concept.

The manner in which high-impact, life-saving health interventions reach populations in need is a critical dimension of health system performance. Intervention coverage has been a standard metric for such performance. To better understand and address the decay of intervention effectiveness in real-world health systems, the more complex measure of "effective coverage" is required, which includes the health gain the health system could potentially deliver. We have carried out a narrative review to trace the origins, timeline, and evolution of the concept of effective coverage metrics to illuminate potential improvements in coherence, terminology, application, and visualizations, based on which a combination of approaches appears to have the most influence on policy and practice. We found that the World Health Organization first proposed the concept over 45 years ago. It became increasingly popular with the further development of theoretical underpinnings, and after the introduction of quantification and visualization tools. The approach has been applied in low- and middle-income countries, mainly for HIV/AIDS, TB, malaria, child health interventions, and more recently for non-communicable diseases, particularly diabetes and hypertension. Nevertheless, despite decades of application of effective coverage concepts, there is considerable variability in the terminology used and the choices of effectiveness decay steps included in the measures. Results frequently illustrate a profound loss of service effectiveness due to health system factors. However, policy and practice rarely address these factors, and instead favour narrowly targeted technical interventions.