Co-innovation: the future of telemedicine in developing countries

Telemedicine which has been widely adopted in developed countries to reach all its citizens irrespective of their location is only being used for education purposes or disaster relief in developing countries. Since developing countries already suffer inadequate healthcare provision especially in remote areas, it would be essential to implement telemedicine practices for daily clinical uses rather than education use. This research argues that to understand the future of telemedicine in developing countries, both well-established technology innovations adoption factors as well as co-innovation factors should be addressed. In the context of healthcare provision, we propose a conceptual framework that integrates the healthcare resources and the organisational affiliations in co-innovation

A framework for collaborative innovation to facilitate E-health systems adoption

The promise of telemedicine is great as observed in developed countries. However, its adoption in developing countries has been very slow. Extant literature on healthcare technological innovation indicates that organization collaboration can expedite the adoption of telemedicine especially in developing countries. The Kenyan government approved telemedicine (use of ICT to overcome geographical barriers and increase access to health care services) as a strategic approach of improving healthcare delivery especially in the marginalized areas of the country. However, the adoption of telemedicine is further hindered in developing countries by the fact that the cost of implementing telemedicine technology is deemed to be high and the resources needed are scarce especially in the public sector. This study employed a conceptual research framework to examine organizational factors that may influence organization collaboration in facilitating telemedicine adoption in developing countries. A questionnaire survey was conducted in 50 hospitals located in Eastern Kenya. The findings of this research revealed that Kenyan hospitals may enhance their ability to adopt telemedicine by affiliating with other organizations. Organization affiliation was found to significantly influence organizational resources, organization innovation acceptance, organization innovation capacity, organization agility and collaborative innovation aspects

Effect of Insulin Storage and Administration Methods on Long Term Glycaemic Control among Adult Diabetic Patients in a Kenyan Referral Hospital

Insulin storage methods and the techniques of its administration impact on bloodsugar control. A hospital based cross-sectional study was conducted to assess theeffects of insulin administration techniques and storage on the long term control ofblood glucose among 73 freely consenting adult diabetic outpatients at KenyattaNational Hospital. Participants were selected through convenient sampling andinterviewed using a pre-designed questionnaire. Long term glycaemia control wasassessed by measuring the blood levels of glycated haemoglobin. Ethical approvalwas granted by the institutional review board and participants’ confidentiality wasmaintained throughout the study. Data analysis was done using STATA version 10software; with statistical significance set at 95% confidence limit. Logisticregression was used to determine associations between glycated haemoglobin levelsversus insulin storage methods and the administration techniques. Correctperformance of the critical injection techniques (p=0.0001), insulin storage byrefrigeration (p=0.041) and during travel (p=0.019) were associated with good longterm glycaemic control. Patients need to be regularly encouraged on good insulininjection techniques and storage methods in order to improve long term glycaemiccontrol.Key words: Insulin storage, injection technique, glycated haemoglobin, glycaemic contro

Red blood cell tension protects against severe malaria in the Dantu blood group.

Malaria has had a major effect on the human genome, with many protective polymorphisms-such as the sickle-cell trait-having been selected to high frequencies in malaria-endemic regions1,2. The blood group variant Dantu provides 74% protection against all forms of severe malaria in homozygous individuals3-5, a similar degree of protection to that afforded by the sickle-cell trait and considerably greater than that offered by the best malaria vaccine. Until now, however, the protective mechanism has been unknown. Here we demonstrate the effect of Dantu on the ability of the merozoite form of the malaria parasite Plasmodium falciparum to invade red blood cells (RBCs). We find that Dantu is associated with extensive changes to the repertoire of proteins found on the RBC surface, but, unexpectedly, inhibition of invasion does not correlate with specific RBC-parasite receptor-ligand interactions. By following invasion using video microscopy, we find a strong link between RBC tension and merozoite invasion, and identify a tension threshold above which invasion rarely occurs, even in non-Dantu RBCs. Dantu RBCs have higher average tension than non-Dantu RBCs, meaning that a greater proportion resist invasion. These findings provide both an explanation for the protective effect of Dantu, and fresh insight into why the efficiency of P. falciparum invasion might vary across the heterogenous populations of RBCs found both within and between individuals.JCR, AM and DK were supported by the Wellcome Trust (206194/Z/17/Z). MPW is funded by a Wellcome Senior Fellowship (108070). TNW is funded through Fellowships awarded by the Wellcome Trust (091758 and 202800). SNK is supported by the Wellcome Trust-funded Initiative to Develop African Research Leaders (IDeAL) early-career postdoctoral fellowship (107769/Z/10/Z), supported through the DELTAS Africa Initiative (DEL-15-003). The Wellcome Trust provides core support to The KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya (084535), Wellcome Sanger Institute, Cambridge, UK (206194/Z/17/Z) and the Wellcome Centre for Human Genetics, Oxford, UK (090532/Z/09/Z, 203141). PC is supported by the Engineering and Physical Sciences Research Council (EPSRC) (EP/R011443/1), and VI is supported by the EPSRC and the Sackler fellowship

How 'universal' is the United Nations' Universal Periodic Review process? An examination of the discussions held on polygamy

In 2006, United Nations Human Rights Council was tasked to establish a new human rights monitoring mechanism: Universal Periodic Review process. The primary aim of this process is to promote and protect the universality of all human rights issues and concerns via a dialogical peer review process. The aim of this investigation isto ask the following question: has this claim of promoting and protecting the universality of the human rights been met, or challenged, during state reviews in the UPR process? The issue of polygamy has been selected as the focus for this investigation to be used, primarily, as a tool to undertake an in-depth analysis of the discussions held during state reviews in the review process. In addition, this paper will employ scholarly debates between universalism and cultural relativism, as well as the sophisticated and nuanced approaches that fall in between the polarised opposites, to analyse the discussions held on human rights during state reviews. Ultimately, the findings and discussion of this investigation will provide a unique and valuable insight to the work and operation of the UPR process, so far

Towards Customary Legal Empowerment

Rule of Law and Development: Formation, Implementation and Improvement of Law and Governance in Developing Countrie