Global health innovation最新文献

{"title":"Negative impacts of waste on human health and environment in Nigeria’s urban areas: innovative solutions to the rescue","authors":"A. O. Coker","doi":"10.15641/GHI.V1I2.689","DOIUrl":"https://doi.org/10.15641/GHI.V1I2.689","url":null,"abstract":"Introduction The problems of waste collection, disposal and environmental sanitation in Nigerian urban areas have occupied the attention of the federal, state and local government authorities for many years. Public concern on these issues continues to be expressed daily through the media, such as the newspapers, radio and television. Furthermore, the attention of national policy-makers is regularly called to health hazards and potential damage to natural resources (such as the air we breathe, the water we drink), from improper collection and disposal of waste. Waste generation is an inevitable product of living. Wastes are produced from individual and family as well as from municipal, industrial, institutional anddevelopmental activities. Technological advancement continues to lead tomassive generation ofwastes of all kinds. Sanitation (an aspect of waste management) is important to the extent of constituting part of Goal 6 of the Sustainable Development Goals. In Nigeria, an average citizen used to produce about 0.41 kg solid waste per head per day (Oluwande, 1974). In a later studybySangodoyin andOsaigbovo (1992) an increased value of 1.66 kg solidwaste per head per daywas recorded.Many states and local governments devote meagre resources, both financial and human, to the possible solution of this intractable nationwide problem. Some states have establishedmunicipal authorities to handle urban solid waste problems, thereby seizing the constitutional responsibility of local government, which is, by law, charged with collecting and disposing solid waste in Nigeria. Despite concerted effort exerted over the decades on solving the problem of waste in Nigeria’s urban areas, the conclusion that one will easily reach is that, no substantial improvement is evident as far as waste management in the country is concerned. This is because mountains of waste sometimes compete with human beings for space in some Nigerian cities and indeed their effects on the environment and health are obvious (Mokuolu et al., 2016a). Various kinds of waste have been implicated in environmental degradation and danger to human health (Mokuolu et al., 2016b). These include waste streams frommassive congregations, leper colonies, hospitals, landfills, industrial and agricultural activities. The negative impacts also vary, fromminor to major and indeed to lethal. This article brings to the fore, the negative impacts of waste on human health and environment in Nigeria, and provides examples of innovation to address the menace.","PeriodicalId":92515,"journal":{"name":"Global health innovation","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49552928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel collection cup for tuberculosis sputum in South Africa: engineering design and user testing considerations","authors":"M. Doerfler, Katie Truitt, M. Fisher, G. Theron, S. McFall","doi":"10.15641/GHI.V1I2.642","DOIUrl":"https://doi.org/10.15641/GHI.V1I2.642","url":null,"abstract":"Low-cost, targeted engineering interventions can revolutionize health care, particularly in low-income environments. We outline a process for user testing of novel sputum collection cup models for PCR-based based tuberculosis assays in Cape Town, South Africa. Providing a sputum sample is difficult for many patients, and the quality of the sample affects downstream test performance. Observational data was collected from six representative sites including outpatient clinics, hospitals, and processing laboratories, and interviews were performed with individuals involved with sputum collection (n=10), processing (n=10), and transportation (n=3). Participants compared “rocket” and “squeeze” prototypes to the current cup by answering standardized questions and ranking the usability and perceived safety of the models. Sputum collectors found the current model significantly easier to use (p-value: 0.0091) and safer (p-value: 0.0044) than the “squeeze” model. Sputum processors found the “squeeze” model more difficult to use than both the current jar (p-value: 0.0091) and the “rocket” model (p-value: 0.0012). They additionally perceived the “squeeze” model to be less safe than the “rocket” prototype (p-value: 0.0007). These results were incorporated into a remodelled sputum collection cup that contains a stable, upright base, maximum and minimum markers, and a tight seal to meet the needs of primary users.","PeriodicalId":92515,"journal":{"name":"Global health innovation","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48587758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel low-cost soft-tissue mannequins for medical education","authors":"Nate P. Davidson, Charles Hwang, John T Kulesa, Jennifer L. Saluk, C. Pugh, M. Glucksberg","doi":"10.15641/GHI.V1I2.671","DOIUrl":"https://doi.org/10.15641/GHI.V1I2.671","url":null,"abstract":"Medical simulators are used to help healthcare practitioners learn and refine skills that can only come with sustained experience and practice. However, many training mannequins currently do not simulate the feel of living tissue with sufficient fidelity. This is a drawback when a diagnosis is made through palpation, as in case of the clinical breast exam (CBE), which is in many resource-limited settings the first and only screening method available. Here we describe a novel method for generating medical simulators which are low-cost and more closely resemble living tissue. \u0000Using commercially available silicone, a breast model was generated. The apparent stiffness was reduced by introducing voids throughout the interior of the model using the lost-wax method.  Finite element modeling (FEM) was used to predict the effects of size and distribution of voids on the apparent stiffness of the prototypes. The prototypes generated through this process were evaluated by physicians trained in the CBE. \u0000Our results show that removal of interior volumes produced softer, more pliant and therefore more life-like models when compared to commercially available devices. This was supported by FEM as well as provider assessment of the physical analogues. \u0000We conclude that reducing the apparent stiffness by introducing voids produced simulators which better approximated the mechanical properties of live breast tissue and improved the feel of the simulator. This application of FEM offers an effective tool for low-cost and rapid prototyping, reducing cost and increasing availability in low-resource countries. This approach has the potential to improve medical education by offering a new method for modeling not only breast, but any soft tissue.","PeriodicalId":92515,"journal":{"name":"Global health innovation","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44462846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Kahawa Declaration: a manifesto for the democratization of medical technology","authors":"A. Ahluwalia, C. Maria, A. Lantada","doi":"10.15641/GHI.V1I1.507","DOIUrl":"https://doi.org/10.15641/GHI.V1I1.507","url":null,"abstract":"Most medical technology is employed and accepted passively by patients and doctors who have little or no influence in its design or usability. Patients are not involved in the development of medical technology, which is undertaken behind closed doors and whose global impact is hindered by proprietary know-how and by costs. This has so far impeded equitable healthcare as most of the world does not have access to the technology or healthcare coverage. Understanding the relevance of international partnerships for achieving the Sustainable Development Goals, feeling specially committed to the promotion of the Goal on “Good Health and Well-Being”, and convinced about the role that open-source biomedical engineering approaches may play in the future of medical technology, we commit ourselves, through the Kahawa Declaration, to enlighten the transformation of the biomedical engineering field, towards the democratization of medical technology as a key for achieving universal equitable health care. This paper presents the content of the Kahawa Declaration, which was signed in Nairobi in December 2017.","PeriodicalId":92515,"journal":{"name":"Global health innovation","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49565240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Welcome to the inaugural issue of Global Health Innovation","authors":"T. Douglas","doi":"10.15641/GHI.V1I1.594","DOIUrl":"https://doi.org/10.15641/GHI.V1I1.594","url":null,"abstract":"I am pleased to introduce Global Health Innovation, a peer-reviewed, open-access, electronic journal. The journal was conceived as an output of a project on “Developing innovative interdisciplinary biomedical engineering programs in Africa”. Its launch has been prompted by the imperative for health innovation, both social and technological, especially in poorly resourced and underserved populations, and the increasing levels of activity, both in research and practice, targeting these communities. Other factors contributing to the genesis of Global Health Innovation include the limited availability of scholarly venues for the reporting of research on health technology for low-resource settings, and the appreciation that social factors impact considerably on the success of technologies. The journal has the mission of advancing and disseminating knowledge on all aspects of social and technological innovation for improved health and healthcare. Health innovation encompasses the conception, development and implementation of technologies, products, services, processes and systems, policies and logistical structures, with the purpose of enhancing access to and quality of healthcare, as well as improving wellness of individuals and populations. The journal serves as a platform for scholarly work on innovation at all levels of health promotion and health care at clinical facilities, in the broader health system, and in communities. The geographical scope of the journal is global, with an emphasis on research addressing developing-world settings. The journal is also meant to reflect the experiences of the developing world with a view to enhancing inclusive developmental outcomes. In addition to research and review articles and short research communications, the journal publishes commentaries on health innovation or related professional matters, as well as practice perspectives. The inaugural issue illustrates some of the dimensions of health innovation. The commentary by Ahluwalia et al. calls for the democratization of medical technology through collaborative and user-oriented design, open infrastructures, accessible and integrative biomedical engineering education, harmonisation of regulations and standards, and international partnerships. The practice perspective by Rammer et al. describes the implementation of accessible low-cost human motion analysis technology in laboratories around the world. Saidi examines the varied stakeholder interpretations of a nanotechnology-based anti-tuberculosis drug, and highlights the role of the broader social, political and cultural environment in the assessment of technologies. Sekyonda et al. discuss challenges in the deployment of routine orthopaedic implants in Uganda and describe delivery pathways arising from poverty and scarcity. The practice perspective by Young et al. reflects on the implementation of a project to engage high school learners as active participants in addressing the impact of tuberculosis in th","PeriodicalId":92515,"journal":{"name":"Global health innovation","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44089348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting global clinical care and research for children with orthopaedic disabilities through motion analysis technology","authors":"Jacob R. Rammer, Joycie Eulah H. Abiera, M. Arroyo, Luis Fernando Caicedo, Karl Canseco, Christopher S Constantino, F. Garcia, J. Gomez, Nikhil T. Kurapati, Mariano Gonzalez Lugo, Terence Miller, W. A. Rodríguez, Carlo Emmanuel J. Sumpaico, G. Harris","doi":"10.15641/GHI.V1I1.483","DOIUrl":"https://doi.org/10.15641/GHI.V1I1.483","url":null,"abstract":"Human motion analysis is a tool used to understand orthopaedic disabilities in children and to plan and monitor treatment strategies. It enables clinicians to quantitatively describe rehabilitative progress, plan surgeries, and conduct research. While this technology is prevalent in major academic medical centers, access is lacking in many regions throughout the world. This paper presents a novel approach to offer more accessible technology at greatly reduced cost. Current applications are underway in the Philippines, Mexico, and Colombia. Through international partnerships, improvements in clinical care, medical education, and research have been observed.","PeriodicalId":92515,"journal":{"name":"Global health innovation","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43903189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supply chain of routine orthopaedic implants in Kampala, Uganda: public-private workarounds arising from poverty and scarcity","authors":"Zoe Sekyonda, Ashley K. Reid, E. Mwaka, K. Abdi, D. Baguma, J. Ndyabahika, Conrad Waludde, W. Reichert","doi":"10.15641/GHI.V1I1.448","DOIUrl":"https://doi.org/10.15641/GHI.V1I1.448","url":null,"abstract":"We examined how surgical implants were accessed by orthopaedic trauma patients in selected public and private hospitals in Kampala, Uganda. The study employed a series of interviews with professionals highly familiar with this circumstance: orthopaedic surgeons from Mulago National Referral Hospital (MNRH), and staff of the MNRH and Ministry of Health (MOH) procurement departments. We also interviewed patients who had received implants in MNRH. Surgeons were forthcoming in describing how implants were made available to their patients and offered several opinions on implant quality, regulation, and the importance of donations in orthopaedic care. The health care officers corroborated the implant procurement process described by the surgeons. We observed that the procurement process was comprised of three distinct pathways: two pathways through which patients purchased implants either directly or through intermediaries, and one donations pathway that provided Western implants through collaborative partnerships. These pathways have evolved to circumvent the mismatch between the high cost of orthopaedic trauma surgery and the overall poverty of the population. This qualitative study strongly supports expanding the capability of the Uganda National Medical Stores (NMS), the arm of the MOH that stores and distributes medicines and supplies to public hospitals, into a sustainable source of orthopaedic implants, inclusive of improved regulatory oversight and quality control for implants.","PeriodicalId":92515,"journal":{"name":"Global health innovation","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47316759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived risks and benefits of nanomedicine: a case study of an anti-tuberculosis drug","authors":"T. Saidi","doi":"10.15641/GHI.V1I1.496","DOIUrl":"https://doi.org/10.15641/GHI.V1I1.496","url":null,"abstract":"Nanotechnologies are novel and have intriguing properties, and yet they have some potential for harm. Using the case study of a nanoparticle anti- tuberculosis drug, this paper analyses the considerations made by different stakeholders in assessing the potential risks and benefits of nanomedicine. Interview data from patients, nurses, caregivers and scientists from Gauteng province in South Africa were analysed through the lens of the Social Construction of Technology theoretical framework, which emphasises the importance of understanding the influence of social context on the development, interpretation and use of technologies. The stakeholders displayed varying interpretations of the drug based on their vested interests. To the patients, nurses and caregivers, the challenges and they experienced in the treatment of tuberculosis influenced what they perceived to be potential risks and benefits of the drug. The scientists considered the functionality of the drug and its potential societal benefits but were also concerned about side effects. The study reveals that the context of stakeholders matters in their assessment of the risks and benefits of nanomedicine. Thus, it is not sufficient to assess a technology focusing only on its technical properties, but it is important to consider how the technology is nested in its broader social, political and cultural environment.","PeriodicalId":92515,"journal":{"name":"Global health innovation","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42782663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The feasibility of fingerstick blood collection for point-of-care HIV-1 viral load monitoring in rural Zambia.","authors":"Catherine G Sutcliffe,&nbsp;Kara M Palamountain,&nbsp;Sylvia Maunga,&nbsp;Kelly M Searle,&nbsp;Philip E Thuma,&nbsp;William J Moss,&nbsp;Mark J Fisher","doi":"10.15641/ghi.v1i2.585","DOIUrl":"https://doi.org/10.15641/ghi.v1i2.585","url":null,"abstract":"<p><p>Viral load monitoring for HIV treatment is recommended but not feasible in many settings. A point-of-care test using capillary blood would increase access but may require up to 200 μL of blood to achieve a lower limit of detection of 1000 copies/mL. This cross-sectional study evaluated the feasibility of collecting 200 μL of capillary blood and blood collection preferences among adults in rural Zambia. Adults seeking HIV counseling and testing at Macha Hospital were recruited in 2015. Capillary blood was collected in four 50 μL tubes. Blood collection was categorized as complete (200 μL collected), partial (all tubes filled but <200 μL obtained due to collection techniques), or incomplete (1-4 tubes attempted; <200 μL obtained due to insufficient blood flow). One fingerstick was required for 90% of the 201 participants. A median blood volume of 196 μL was collected. Complete, partial and incomplete collection was achieved in 34%, 59% and 6% of participants. The majority of participants (95%) preferred fingerstick over venous blood collection. A point-of-care viral load test requiring up to 200 μL of blood is feasible in a rural setting but would require training and supervision to ensure that sufficient blood was collected.</p>","PeriodicalId":92515,"journal":{"name":"Global health innovation","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363362/pdf/nihms-1005010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36941794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}