SEARCH · PubMed Health

Results for “Developed Countries”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,135 records · Page 63Linked to original sources

PubMed2001

Establishing a cancer pain clinic in a developing country: effect of a collaborative link project with a UK cancer pain center.

This paper describes a project for the establishment of a cancer pain clinic in a developing country. The project was conducted according to guidelines from the World Health Organization and utilized a link with an existing cancer pain clinic in the UK. The principal methods used for establishing the new pain clinic included: an assessment of barriers to effective cancer pain control, teaching programs for nurses and trainee doctors, educational links with a UK cancer pain clinic, and analgesic guidelines and introduction of a pain assessment tool. As a result of these interventions, a new cancer pain clinic was founded. The methods used serve as one possible model for establishing cancer pain treatment facilities in developing countries.

Cooperative Behavior↗

PubMed1990

Intraocular lens implantation in developing countries.

One of the chief aims of ophthalmic workers in developing countries is to operate on as many cataract patients as possible in the most cost-efficient manner. Therefore, our intraocular lens (IOL) implantation policy in Nakuru and Kikuyu, Kenya, is to reserve IOLs for monocular cataract patients of all ages, who otherwise would not have use of the aphakic eye. In this study, we review 105 of our first IOL implantations. In 60%, the uncorrected postoperative visual acuity was 20/60 or better.

Adolescent↗

PubMed2005

Telemedicine diffusion in a developing country: the case of India (March 2004).

Telemedicine (health-care delivery where physicians examine distant patients using telecommunications technologies) has been heralded as one of several possible solutions to some of the medical dilemmas that face many developing countries. In this study, we examine the current state of telemedicine in a developing country, India. Telemedicine has brought a plethora of benefits to the populace of India, especially those living in rural and remote areas (constituting about 70% of India's population). We discuss three Indian telemedicine implementation cases, consolidate lessons learned from the cases, and culminate with potential researchable critical success factors that account for the growth and modest successes of telemedicine in India.

Biotechnology↗

PubMed2001

Oxygen delivery to children with hypoxaemia in small hospitals in developing countries.

Oxygen administration is one of the most important modalities of therapy for a patient with hypoxaemia to prevent death. This review summarises the methods of oxygen delivery applicable in small hospitals in developing countries, and evaluates information about their safety and efficacy. The following criteria were considered: cost and availability, efficiency/oxygen concentration achieved, tolerability/comfort of the method, requirement of humidification, demand for nursing care, and safety of the method and complications. In summary, it is concluded that all low-flow methods, i.e., nasopharyngeal catheters, nasal catheters and prongs, are effective in the oxygenation of sick children with severe pneumonia or bronchiolitis. Nasal prongs are the safest method of oxygen delivery, but nasopharyngeal catheters and nasal catheters are more easily available and less expensive. However, if they are used, they need close supervision to avoid serious complications. Nasal prongs are the method of choice for oxygen delivery in small hospitals in developing countries.

Child↗

PubMed2002

The modified Blalock-Taussig shunt: a 6-year experience from a developing country.

Since 1992 we have performed the modified Blalock-Taussig shunt (MBTS) for cyanotic children in Libya. This retrospective study reviews our results as a developing country, comparing them with those in the literature, and makes suggestions to improve our results. Between May 1992 and May 1998, 94 children (58 males and 36 females) underwent 100 MBTSs in Mesallata Cardiothoracic Centre, Libya. The age ranged from 4 days to 15 years, (median 12 months) and 25 patients were neonates. Patients' weights ranged from 3 to 31 kg (median 6.4 kg). Eighty-nine shunts were performed on the left side and 11 on the right. A 6-mm polytetrafluoroethylene graft was used in 68 children and a 4-mm graft in 32 cases. Tetralogy of Fallot (TOF) comprised the majority of cases (63; 67%), the remaining 31 (33%) included tricuspid atresia (13), pulmonary atresia (9), univentricular heart complex (6), and others (3). Acute shunt failure occurred in 3 cases (2 with 4-mm and 1 with 6-mm grafts), all of which had not received perioperative heparin. Hospital mortality was 6% (6 patients); risk factors were neonates, a diagnosis other than TOF, and emergency surgery. There were 12 late deaths, 6 of which were due to sepsis. Follow-up was achieved in 82 of 88 early survivors for a period of 2 to 60 months (median 26 months). All surviving patients had subjective and objective improvement. We conclude that MBTS is an excellent palliative procedure for children requiring a systemic-pulmonary shunt in developing as well as developed countries. This series shows an early mortality rate comparable to that of other studies, but the late mortality is higher, mainly due to sepsis, which warrants further attention.

Adolescent↗

PubMed2001

Biological and social feasibility of Sesbania fallow practice in small holder agricultural farms in developing countries: a Zambian case study.

Many small holder farmers in developing countries face problems of declining soil fertility and crop yields and insufficient money to buy expensive inorganic fertilizers. The Sesbania fallow system, an agroforestry technology, seems to hold a key to these problems. Based on field studies in eastern Zambia, this paper reports that fallow system has the potential to improve and sustain soil productivity in the small holder farms. However, the paper also reports that the ability for subsistence farmers to adopt the Sesbania fallow system is affected by gender differences in resource allocation to productive resources and institutional, cultural, and social structural settings in which farmers exist and make decisions.

Agriculture↗

PubMed2006

Performance of a pediatric ambulatory anesthesia program--a developing country experience.

BACKGROUND: The aim of this study was to evaluate the performance of a pediatric ambulatory anesthesia program in a tertiary care teaching hospital in a developing country. METHODS: Data on all pediatric patients (<16 years of age) scheduled to have elective day-care surgery during a 1 year period from January 1999 to December 1999 were collected retrospectively. An audit form was used to determine the specialty of the procedures, anesthesia techniques, postoperative analgesia, perioperative complications, unplanned admissions and outcomes with respect to morbidity and mortality. RESULTS: A total of 763 pediatric ambulatory surgical procedures were performed during the year of 1999. The procedures included general surgery, ENT, orthopedic and plastic surgery. The most common procedure was inguinal hernia repair followed by umbilical hernia repair, adenotonsillectomy and circumcision and 96% of the patients had general anesthesia. There were only three unplanned admissions (0.4%); one for a surgical reason and two for anesthetic reasons. There was no serious morbidity or mortality in any patient. CONCLUSIONS: Performance of pediatric day-care anesthesia has been good in our day-care unit and we have a successful ambulatory surgery program, despite the limitations of a developing country.

Adolescent↗

PubMedDate not supplied

Trials in developing countries.

Good clinical trials can be carried out in the developing countries but ethical issues concerning the trials are frequently brought up for international debate. The concern has its own merit but can be amended if investigators (local and international) pay serious attention to these criticisms and work out the way that will most benefit the trial participants. Although scientific progress is important, it must come after the rights, the safety and the benefit of the patients. Frequently, the ethical standard is delicately balanced, depending on who looks at it and from what angles they look. Critics, investigators, volunteers, sponsors and regulatory agencies have their own mandates, expectations and limitations, and thus they need to keep an open line of communication in order to benefit all parties involved.

Acquired Immunodeficiency Syndrome↗

PubMed1992

A questionnaire to screen for cognitive impairment among elderly people in developing countries.

Most questionnaires designed to assess cognitive impairment among elderly people are constructed in the West, where literacy is high. However, such questionnaires may not be applicable in developing countries because of cultural differences or low literacy. The Elderly Cognitive Assessment Questionnaire (ECAQ) is derived from items in the Mini-Mental State Examination and Geriatric Mental State Schedule. It is a satisfactory scale for quantitative assessment of cognitive impairment among elderly people living in developing countries. This 10-item questionnaire shows a sensitivity of 85.3%, specificity 91.5%, positive predictive value 82.8% and overall miscalculation rate 10.5%. In a sample of 105 elderly subjects from 2 day centres and a psychiatric outpatient clinic in Singapore, the ECAQ was compared with Kahn's Mental Status Questionnaire. The sensitivity of the scales was found to be similar but the ECAQ had a higher specificity and positive predictive value, and lower overall miscalculation rate.

Age Factors↗

PubMed1992

[Problems of drug resistance in developing countries--use and abuse of anti-infective agents].

Widespread use and misuse of anti-infective agents have resulted in a problem of drug resistance linked to treatment of infectious diseases. In developing countries especially, the sale of such drugs is poorly controlled and the pharmaceutical industry is dumping obsolete products. Intensive marketing, lack of diagnostic facilities and receptive local cultural attitudes to new "wonder drugs" such as antibiotics, have resulted in dramatic unnecessary use of such. Therefore the ideal strategies for treatment of infectious diseases guided by microbiological diagnosis and resistance pattern are violated in most developing countries, leading to excessive use of anti-infective agents and development of resistance. This has serious consequences for the infections that cause most cases of infant mortality, namely malaria, diarrhoeas and infections of the respiratory tract. Improvements in this vicious circle of drug use and resistance can only be made by attacking several factors simultaneously. There is a need for general information, stricter legislation, essential drug lists, national drug policies, better knowledge of local resistance patterns, better diagnostic facilities, better knowledge about local beliefs about drugs and better communication to local health workers and the community.

Anti-Bacterial Agents↗

PubMed2003

The need for maternal zinc supplementation in developing countries: an unresolved issue.

Maternal zinc deficiency during pregnancy has been related to adverse pregnancy outcomes. Most studies in which pregnant women have been supplemented with zinc to examine effects on pregnancy outcome have been carried out in industrialized countries and the results have been inconclusive. This review discusses preliminary findings of eight randomized, controlled intervention trials performed recently in less-developed countries. It is based on evidence presented by investigators and discussed during a workshop held in Wageningen, The Netherlands in June 2001. Preliminary findings from these studies indicate maternal zinc supplementation has a beneficial effect on neonatal immune status, early neonatal morbidity and infant infections. With respect to labor and delivery complications, gestational age at birth, maternal zinc status and health and fetal neurobehavioral development, evidence is conflicting and more research is required. Data currently available do not support the hypothesis that maternal zinc supplementation promotes intrauterine growth. Thus despite the emerging evidence for a positive effect of zinc on some outcomes of pregnancy, the workshop concluded that the full results of studies carried out need to be known and that more research is required to determine the benefits of large-scale introduction of zinc supplementation of pregnant women in less-developed countries.

Developing Countries↗

PubMed1990

Epidemiology of cardiovascular disease in developing countries.

As infection and malnutrition are steadily overcome in the developing world, cardiovascular disease loom large in the profile of morbidity and mortality in these societies. Hypertension, rheumatic heart disease and the cardiomyopathies are already taking their toll and atherosclerosis is certain to pose public health problems soon unless steps are taken now, through attention to known risk factors, to pre-empt or at least minimize its consequences. There are populations in developing countries among whom blood pressure does not appear to rise with age and in whom the prevalence of hypertension is very low. Studies of these communities and of migrant groups indicate that salt has an important effect on blood pressure. In spite of these observations, however, it is well known that black communities tend, on the whole, to show a higher prevalence of hypertension and more severe target-organ damage than white communities. Other distinguishing features are lower cholesterol, triglyceride and low-density lipoprotein fractions and a delayed response to a sodium load in black populations. Economic constraints limit the effective application of stepped-care therapy in the management of moderate to severe hypertension. Beta-blockers and angiotensin converting enzyme (ACE) inhibitors are not so effective in black communities unless combined with diuretics.

Antihypertensive Agents↗

PubMed2003

Locally advanced breast cancer in developing countries: the place of surgery.

Most breast cancer patients in developing countries still present with locally advanced breast cancer (LABC). Because surgery is the most widely available treatment modality, we examine its place in the management of LABC. Historically, single local treatment modalities have had disappointing results, and multimodality therapy has become the norm for combatting LABC. Combining surgery and radiotherapy will lead to superior local control rates. Surgery should precede radiotherapy. Preoperative systemic treatment-with the possible exception of cyclophosphamide, methotrexate, 5-fluououracil (CMF) chemotherapy-does not influence surgical complication rates. Hormonal therapy is understudied and underutilized; its benefits become apparent only in prolonged follow-up. Sequencing of local and systemic treatments does not influence oncologic outcome, but failure to respond to preoperative systemic therapy may identify patients with a poor prognosis. With multimodality management including hormonal therapy, chemotherapy, radiotherapy, and surgery, local control rates of more than 80% and 5-year survival rates of more than 50% have become the norm.

Breast Neoplasms↗

PubMed2005

Predictive value of frequency doubling technology perimetry for detecting glaucoma in a developing country.

PURPOSE: To determine the feasibility and diagnostic precision of Frequency Doubling Technology (FDT) perimetry as a method to detect glaucoma in rural villages of a developing country. DESIGN: Cross-sectional study. METHODS: Testing included FDT perimetry (C-20-5 screening protocol), tonometry, anterior segment biomicroscopy, and dilated ophthalmoscopy in 296 rural, non-English speaking residents of Southern India over 35 years old. Participants repeated the FDT if they had a location with reduced sensitivity or an unreliable result. We defined an abnormal FDT as one location of reduced sensitivity present on both the initial and repeat examination. We determined the diagnostic precision of FDT separately for a glaucomatous optic disc, a cup to disc ratio (C/D) > or = 0.7, and a C/D > or = 0.8. RESULTS: Ninety-three percent of subjects were able to complete the test satisfactorily. With repeat FDT testing, 37% of eyes with abnormal FDT results subsequently converted to normal and 67% of eyes with unreliable results subsequently became reliable. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for a glaucomatous optic disc were 7%, 87%, 13%, 76%, and 69%, respectively; for a C/D > or = 0.7, they were 0%, 87%, 0%, 91%, and 81%, respectively; and for a C/D > or = 0.8, they were 0%, 87%, 0%, 99%, and 87%, respectively. CONCLUSION: Clinicians can use FDT perimetry to rapidly screen for glaucoma in rural villages of a developing country. FDT testing had high specificity and negative predictive value, but low sensitivity and positive predictive value. The low sensitivity suggests that FDT has limited applicability as the sole test for glaucoma screening in this population. Repeat testing of FDT results that are unreliable or suspected of being abnormal is beneficial for this screening procedure.

Adult↗

PubMed1993

Health care for elderly people in developing countries: a case study of Thailand.

The elderly populations of many developing countries are increasing rapidly. These demographic changes are a direct result of the success of socio-economic development that has led to declines in mortality rates at all ages and reductions in fertility. However, an aged population might be expected to suffer with the problems of dependency and disability leading to an increased burden of disease. Adequate disability and life expectancy data are essential for planning health and social policy but are currently insufficient. Making best use of the limited resources available for health care will require an emphasis on training of professional staff and carers, but with integration of health care for elderly people with established health services, particularly the existing primary health care systems. Strategies aimed at developing separate services for elderly people should be avoided because of the high likelihood of producing services of low quality with an inappropriate hospital emphasis.

Aged↗

PubMed1998

Wetland systems for bioregenerative reclamation of wastewater: from closed systems to developing countries.

Results are presented from constructed wetland systems designed to treat wastewater in Akumal, Quintana Roo, Mexico, which was developed after prior experience with the Biosphere 2 closed ecological system wetland systems. These systems illustrate the congruity of needs in advanced life support systems and in solving social and environmental problems in developing countries. For sustainable food production for life support, closed ecological systems need to bioregenerate and recycle nutrient-rich wastewater. Developing countries need low-tech ecologically engineered systems that minimize requirements for capital, nonrenewable energy, and technical expertise. Biosphere 2's surface flow wetlands covered 41 m2 and treated the wastewater from eight inhabitants, laboratories, and domestic animals during the 1991-1993 closure experiment. The Mexican wetlands are subsurface flow wetlands using limestone gravel as substrate. Two wetland systems treat sewage from 40 people and cover 131 m2. During the initial year of operation, the wetlands in Akumal reduced BOD 86%, TSS 39%, total P 80%, total N 75%, and coliform bacteria 99.85%. Phosphorus uptake in the limestone gravel was around 6 mg/kg. High biodiversity, with 70 plant species, was maintained in the Akumal constructed wetlands 1.5 years after planting. The Shannon diversity index was 4.7 (base 2). Plant diversity was slightly less than tropical forest ecosystems of the region, but far greater than biodiversity in natural mangrove wetlands.

Arizona↗

PubMed2004

Life cycle assessment as a tool for the environmental improvement of the tannery industry in developing countries.

A representative leather tannery industry in a Latin American developing country has been studied from an environmental point of view, including both technical and economic analysis. Life Cycle Analysis (LCA) methodology has been used for the quantification and evaluation of the impacts of the chromium tanning process as a basis to propose further improvement actions. Four main subsystems were considered: beamhouse, tanyard, retanning, and wood furnace. Damages to human health, ecosystem quality, and resources are mainly produced by the tanyard subsystem. The control and reduction of chromium and ammonia emissions are the critical points to be considered to improve the environmental performance of the process. Technologies available for improved management of chromium tanning were profoundly studied, and improvement actions related to optimized operational conditions and a high exhaustion chrome-tanning process were selected. These actions related to the implementation of internal procedures affected the economy of the process with savings ranging from US dollars 8.63 to US dollars 22.5 for the processing of 1 ton of wet salt hides, meanwhile the global environmental impact was reduced to 44-50%. Moreover, the treatment of wastewaters was considered in two scenarios. Primary treatment presented the largest reduction of the environmental impact of the tanning process, while no significant improvement for the evaluated impact categories was achieved when combining primary and secondary treatments.

Animals↗

PubMed2003

Intravenous lines-related sepsis in newborn babies admitted to NICU in a developing country.

Nosocomial sepsis is very common in newborn units in developing countries. Routes of infection are multiple but the personal factor stays important. The hypothesis of this study was that intravenous lines may be important routes of infection and that contamination of cannula hub may preceded sepsis episodes. Infants in the neonatal intensive care unit level III were enrolled in the study. Culture samples were obtained from the intravenous line hubs every day until removed. At times of suspected sepsis, all patients had blood obtained for culture from a peripheral vein and from the i.v. line hubs at the same time. Sepsis was considered i.v. line-related if the micro-organism isolated from the peripheral blood culture was identical to the organism recovered from the cannula hub or tip or from purulent material at the site of skin entry of the cannula. Two hundred and sixty lines were placed in 83 patients. Forty-five episodes of sepsis were diagnosed clinically and by blood culturing. Klebsiella species was the predominant organism. Among the Klebsiella cases, the organism was isolated from the i.v. line hub in more than 50 per cent of the cases before the onset of clinical and laboratory sepsis, and in 14 per cent of the cases it was also isolated from the i.v. line hub at the time of sepsis. This study supports the hypothesis that the cannula hub is a major portal of entry for causing sepsis in newborn units.

Candida↗