Cohort monitoring of persons with diabetes mellitus in a primary healthcare clinic for Palestine refugees in Jordan.

Objective  To illustrate the method of cohort reporting of persons with diabetes mellitus (DM) in a primary healthcare clinic in Amman, Jordan, serving Palestine refugees with the aim of improving quality of DM care services. Method  A descriptive study using quarterly and cumulative case findings, as well as cumulative and 12-month analyses of cohort outcomes collected through E-Health in UNRWA Nuzha Primary Health Care Clinic. Results  There were 55 newly registered patients with DM in quarter 1, 2012, and a total of 2851 patients with DM ever registered on E-Health because this was established in 2009. By 31 March 2012, 70% of 2851 patients were alive in care, 18% had failed to present to a healthcare worker in the last 3 months and the remainder had died, transferred out or were lost to follow-up. Cumulative and 12-month cohort outcome analysis indicated deficiencies in several components of clinical care: measurement of blood pressure, annual assessments for foot care and blood tests for glucose, cholesterol and renal function. 10-20% of patients with DM in the different cohorts had serious late complications such as blindness, stroke, cardiovascular disease and amputations. Conclusion  Cohort analysis provides data about incidence and prevalence of DM at the clinic level, clinical management performance and prevalence of serious morbidity. It needs to be more widely applied for the monitoring and management of non-communicable chronic diseases

The potential of low-intensity and online interventions for depression in low- and middle-income countries

The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care (WHO in 2010). Traditional forms of mental health services (i.e. face-to-face, individualised assessments and interventions) are therefore not feasible. We propose three strategies for addressing this mental health gap: delivery of evidence-based, low-intensity interventions by non-specialists, the use of transdiagnostic treatment protocols, and strategic deployment of technology to facilitate access and uptake. We urge researchers from all over the world to conduct feasibility studies and randomised controlled studies on the effect of low-intensity interventions and technology supported (e.g. online) interventions in LMICs, preferably using an active control condition as comparison, to ensure we disseminate effective treatments in LMICs

Geo-located Twitter as the proxy for global mobility patterns

In the advent of a pervasive presence of location sharing services researchers gained an unprecedented access to the direct records of human activity in space and time. This paper analyses geo-located Twitter messages in order to uncover global patterns of human mobility. Based on a dataset of almost a billion tweets recorded in 2012 we estimate volumes of international travelers in respect to their country of residence. We examine mobility profiles of different nations looking at the characteristics such as mobility rate, radius of gyration, diversity of destinations and a balance of the inflows and outflows. The temporal patterns disclose the universal seasons of increased international mobility and the peculiar national nature of overseen travels. Our analysis of the community structure of the Twitter mobility network, obtained with the iterative network partitioning, reveals spatially cohesive regions that follow the regional division of the world. Finally, we validate our result with the global tourism statistics and mobility models provided by other authors, and argue that Twitter is a viable source to understand and quantify global mobility patterns.Comment: 17 pages, 13 figure

User-centred design of a digital advisory service: enhancing public agricultural extension for sustainable intensification in Tanzania

Sustainable intensification (SI) is promoted as a rural development paradigm for sub-Saharan Africa. Achieving SI requires smallholder farmers to have access to information that is context-specific, increases their decision-making capacities, and adapts to changing environments. Current extension services often struggle to address these needs. New mobile phone-based services can help. In order to enhance the public extension service in Tanzania, we created a digital service that addresses smallholder farmers’ different information needs for implementing SI. Using a co-design methodology – User-Centered Design – we elicited feedback from farmers and extension agents in Tanzania to create a new digital information service, called Ushauri. This automated hotline gives farmers access to a set of pre-recorded messages. Additionally, farmers can ask questions in a mailbox. Extension agents then listen to these questions through an online platform, where they record and send replies via automated push-calls. A test with 97 farmers in Tanzania showed that farmers actively engaged with the service to access agricultural advice. Extension agents were able to answer questions with reduced workload compared to conventional communication channels. This study illustrates how User-Centered Design can be used to develop information services for complex and resource-restricted smallholder farming contexts

An Evidence-Based Approach To Digital Inclusion for Health

This report is the first deliverable of the ?Digital Inclusion and Social Knowledge Media for Health: Frameworks and Roadmaps? project. It discusses the concept of social and digital exclusion and suggests that a focus on the digital mediation of social processes may provide more purchase for public service providers. This focus leads to the consideration of the way in which digital services might support a range of health-related factors which are both directly and indirectly linked to specific health outcomes. The report discusses some examples in the light of a consideration of the specific (and spatial) health needs and priorities of Solihull Care Trust. The report concludes with suggestions for directions for future research and development