Adapting PRISMA for software development in rural areas: A mobile-based healthcare application case study

This paper reports on the use of a proposed methodological framework called PRISMA (Participatory Action Research in Software Development Methodology Augmentation) to support and design a mobile-based healthcare application for a remote Penan community in Malaysian Borneo. PRISMA employs participatory action research (PAR). The approach has been successfully applied in projects with rural communities. The intent of PRISMA is to strengthen community participation and local management in order to ensure software system is built at interest of community. The healthcare application is targeted at young school-children and mothers as they have a major influence on health issues affecting their family. A key aspect of PRISMA is the active participation of multiple stakeholders - in our case, the villagers, medical doctors, researchers as well as teachers, who will be assisting in the monitoring of the usage and health change process for the children. Preliminary results of the health intervention will be reported

Participatory Action Research in Software Development: Indigenous Knowledge Management Systems Case Study

Participatory action Research In Software Methodology Augmentation (PRISMA) is a software development methodology which has been amalgamated with Participatory Action Research (PAR). This paper justifies the inclusion of PAR in software development, and describes the PRISMA methodology vis-à-vis a case study. Specifically, the case study encompasses the development of eToro, an Indigenous Knowledge Management System for the Penans, a remote and rural community in Malaysian Borneo

Sustainable remote and rural eco-tourism: Applying a systemic, holistic, a interdisciplinary and participatory (Ship) approach

Long Lamai is a remote and rural Penan community in the interiors of Borneo in Sarawak, Malaysia. It is only accessible by either an 8-hour 4- wheel-drive on the logging road or an hour's flight via a 19-seater Twin Otter, and then a mandatory hour's river ride upriver. Long Lamai is being developed as an eco-tourism site, given the existence of natural attractions such as untouched flora and fauna, and the unique Penan's culture. A telecentre (which provides computing facilities and Internet connection via a satellite system, and using solar-power), was established in 2009. The management committee, which is running the telecentre, is also spearheading the use of ICTs in establishing Long Lamai as a tourist attraction and hence, to improve the socio-economic status. In addition to this, there are many aspects which need to be addressed, for example, the issues of environment, e-commerce, handicraft development, transportation, sourcing of food, sourcing of raw materials for the handicrafts, tour guiding, and development of tourism activities. One approach to the design and development of sustainable eco-tourism industry is by viewing the whole socio-economic transformation process as a complex system. The complex system comprises the various "sub-systems" such as those described above, e.g. environment, e-commerce, and handicraft development. All these subsystems interact and affect each other, and has to work effectively and efficiently together. To understand this complex system, we take the SHIP (systemic, holistic, interdisciplinary and participatory) approach. This paper thus details a study of Long Lamai as an eco-tourism site from the SHIP perspective

Ethical implications of digitised medical and biometric data

In this paper, ethical implications of data collection, use and retention of medical and biometric data in biometrics and medical applications are identified. These implications are discussed in the context of five main ethical rinciplesprivacy, confidentiality, security, property and ownership, and reliability and trustworthiness. In addition, to illustrate unethical uses of medical and biometric data, cases of misuse are described. Our research contributes to the European UnionГs FP7 ETHIcAL project, which aims to promote international...�

Screening and treatment of obstructive sleep apnea in acute coronary syndrome. A randomized clinical trial

10.1016/j.ijcard.2019.07.003INTERNATIONAL JOURNAL OF CARDIOLOGY29920-2

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London