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Adequate cancer pain management (CPM) is challenging in resource-limited settings, where current international guideline recommendations are difficult to implement owing to constraints such as inadequate availability and accessibility of opioids, limited awareness of appropriate opioid use among patients and clinicians, and lack of guidance on how to translate the best evidence into clinical practice. The multinational and multidisciplinary CAncer Pain managEment in Resource-limited settings (CAPER) Working...
Contemporary antiretroviral therapies (ART) and management strategies have diminished both human immunodeficiency virus (HIV) treatment failure and the acquired resistance to drugs in resource-rich regions, but transmission of drug-resistant viruses has not similarly decreased. In low- and middle-income regions, ART roll-out has improved outcomes, but has resulted in increasing acquired and transmitted resistances. Our objective was to review resistance to ART drugs and methods to detect it, and to provide ...
The registration of diagnoses and diagnose-related groups (DRG) allows conclusions to be drawn about the distribution over the course of the year. Seasonal variations can be recognized and used to plan further resource management.
Harvesting behaviors of natural resource users, such as farmers, fishermen and aquaculturists, are shaped by season-to-season and day-to-day variability, or in other words risk. Here, we explore how risk-mitigation strategies can lead to sustainable use and improved management of common-pool natural resources. Over-exploitation of unmanaged natural resources, which lowers their long-term productivity, is a central challenge facing societies. While effective top-down management is a possible solution, it is ...
The lack of effective, integrated diagnostic tools pose a major challenge to the primary care management of febrile childhood illnesses. These limitations are especially evident in low-resource settings and are often inappropriately compensated by antimicrobial over-prescription. Interactive electronic decision trees (IEDTs) have the potential to close these gaps: guiding antibiotic use and better identifying serious disease.
In a resource limited settings, there is sparse information about the management of acute kidney injury (AKI) based on systemic data collection. This survey aimed to described the current management of AKI in intensive care units (ICUs) across Thailand.
Natural resource management uses expert judgement to estimate facts that inform important decisions. Unfortunately, expert judgement is often derived by informal and largely untested protocols, despite evidence that the quality of judgements can be improved with structured approaches. We attribute the lack of uptake of structured protocols to the dearth of illustrative examples that demonstrate how they can be applied within pressing time and resource constraints, while also improving judgements.
The conservation and management of natural resources operates within social-ecological systems, in which resource users are embedded in social and environmental contexts that influence their management decisions. Characterizing social networks of resource users has received growing interest as an approach for understanding social influences on decision-making, and social network analysis (SNA) has emerged as a useful technique to explore these relationships. In this review, we synthesize how SNA has been us...
Approximately 80% of the world's population lives in countries with little or no access to pain management. These countries also have 74% of the world's deaths from cancer and human immunodeficiency virus. Appropriate use of oral opioids can control 80%-90% of cancer pain. However, only 6.7% of the world's medical opioids are available in these low-resource countries. With the Lancet Commission on Global Surgery calling for a significant expansion of surgical services, postoperative pain management will nee...
Job satisfaction is one of the key elements in effective human resource management. A dental practitioner is constantly exposed to harmful effects of numerous risk factors affecting health.
To characterize global differences in otitis media (OM)-related disease burden between socioeconomically advantaged and disadvantaged nations.
Since the 2000s, Tanzania's natural resource management policy has emphasised Wildlife Management Areas (WMAs), designed to promote wildlife and biodiversity conservation, poverty alleviation and rural development. We carried out a quasi-experimental impact evaluation of social impacts of WMAs, collecting data from 24 villages participating in 6 different WMAs across two geographical regions, and 18 statistically matched control villages. Across these 42 villages, we collected participatory wealth ranking d...
Limited evidence exists on the management and outcomes of Staphylococcus aureus bacteraemia (SAB) in resource-limited settings. The aim of this study was to describe a cohort of South African patients with SAB, and explore the factors associated with complicated infection and death.
The rising burden from non-communicable diseases (NCDs) poses a huge challenge for health care delivery in Africa, where health systems are already struggling with the long-term care requirements for the millions of people now on antiretroviral therapy requiring regular visits to health facilities for monitoring, adherence support and drugs. The HIV chronic disease management programme is comparatively well-funded, well-organised and well-informed and offers many insights and opportunities for the expansion...
Chronic obstructive pulmonary disease (COPD) patients often have several comorbidities, such as cardiovascular diseases (CVD) or lung cancer (LC), which might influence resource use in the final months of life. However, no previous studies documented resource use in end-of-life COPD patients at a population level, thereby differentiating whether COPD patients die of their COPD, CVD or LC.
Few if any natural resource systems are completely understood and fully observed. Instead, there almost always is uncertainty about the way a system works and its status at any given time, which can limit effective management. A natural approach to uncertainty is to allocate time and effort to the collection of additional data, on the reasonable assumption that more information will facilitate better understanding and lead to better management. But the collection of more data, either through observation or ...
Fire agencies aim to contain wildfires before they impact on life, property and infrastructure and to reduce the risk of damage to the environment. Despite the large cost of suppression, there are few data on the success of suppression efforts under varying weather, fuel and resource scenarios. We examined over 2200 forest and 4600 grass fires in New South Wales, Australia to determine the dominant influences on the containment of wildfires. A random forest modelling approach was used to analyse the effect ...
Human factors are the individual, team, environmental and organisational aspects of the anaesthetic environment that affect performance and decision-making of anaesthesia teams. This study aimed to identify which human factors were enablers and/or barriers to anaesthesia teams during airway management challenges. Sixteen interviews were conducted with experienced anaesthetists and anaesthetic nurses using an in-depth interview technique (the Critical Decision Method) to identify human factors enablers and/o...
Management of patients with persisting pain after spine surgery (PPSS) shows significant variability, and there is limited evidence from clinical studies to support treatment choice in daily practice. This study aimed to develop patient-specific recommendations on the management of PPSS.
Protected areas are tasked with mitigating impacts to a wide range of invaluable resources. These resources are often subject to a variety of potential natural and anthropogenic impacts that require monitoring efforts and management actions to minimize the degradation of these resources. However, due to insufficient funding and staff, managers often have to prioritize efforts, leaving some resources at higher risk to impact. Attempts to address this issue have resulted in numerous qualitative and semi-quant...
Over the past few years, the need for sustainable environmental management has increased rapidly and green management has emerged as an important tool for the same. The role of Green Human Resource Management (GHRM) practices in environmental management and green management is widely known but still lesser discussed in academic literature. Thus, realizing the importance of GHRM in environmental management by organizations, this study attempts to identify the important practices of GHRM and evaluate the perf...
The tremendous increase in resource consumption over the past century and the environmental challenges it entails has spurred discussions for a shift from a linear to a circular resource use. However, to date most resource studies are restricted to one material or a single sector or process. In this work, a coupled material flow analysis taking the national phosphorus (P) and nitrogen (N) system of Austria as an example for two closely connected resource systems is conducted. Effects of different measures a...
Human thrombin appears to be a new effective tool in the armamentarium of management of bleeding gastric varices, but there are paucity of data on its use. Thus, we share our experience with human thrombin in the treatment of bleeding gastric varices.
Freshwater resource management is becoming increasingly complex as human pressure increases on available water resources, and as more participatory transparent decision-making frameworks are being advocated within water management. Complexity is further increased when environmental flow programs are integrated into existing water management programs. Adaptive management frameworks present an obvious choice for integration and implementation of environmental flows, but have so far failed to become the domina...
To evaluate the impact of the University of Kentucky's Healthy Choices for Every Body (HCEB) adult nutrition education curriculum on participants' food resource management (FRM) skills and food safety practices.