Suchergebnisse

The world is facing an increasing frequency and intensity of disasters both natural and man-made that have devastating impact on life, livelihood and economy of the affected communities. In the context it is very important to plan for disaster response activities and preparedness to minimize the economic and human loss. In a post disaster situation various aid organizations and government agencies start supplying food, water, clothing, medicines and other emergency relief materials efficiently and quickly to maximize survival rate and continue normalcy. However, managing disaster response supply chain is not that straight forward. In most disasters, information is scarce (between the supplier and end users) and coordination rarely exists (Long Wood, 1995) which creates disruption in flow of supply chain. Hence disaster response supply chain operates in a level of high uncertainty and is very different from what most supply chain managers perceive. This article describes the main characteristics of disaster response supply chain, particular issues faced by the managers and the opportunities on which the future strategy could be capitalized. It also suggests a model that captures the interaction between different components of supply chain and controls the flow of the commodities from the source through the chain to reach the end users.

BACKGROUND: In developing countries like India, irrespective of the various government laws and actions, substance abuse is a growing problem. Individuals with illicit drug dependence face social and psychological stigma with considerable health problems. Negligence to oral hygiene and lack of oral health treatments intensifies the sensations experienced by the subjects. AIM: The aim is to determine the patterns of substance abuse and oral health sensations among individuals with illicit drug dependence. MATERIALS AND METHODS: A cross-sectional study was conducted wherein 213 male individuals with illicit drug dependence history, admitted in rehabilitation centers of Bhubaneswar, formed the study population. Information pertaining to the type and duration of drug dependence along with oral sensations experienced by the individuals during a period of 3 months was obtained by interviewing by the subjects. Chi-square test was done to identify variations in oral sensations produced by different illicit drugs and its relationship with their usage pattern. RESULTS: About 40.8% of dependents reported cannabis intake, thus making it the most commonly consumed drug. About 80.8% of all the subjects reported dryness of the mouth, 47.9% reported sensitivity of teeth and 28.2% suffered from the numbness of their mouth. About 19.7% of the individuals felt like chewing on something, 23% inclined toward grinding, whereas 11.7% experienced pain in the jaw muscles and joint. Sixty percent of substance dependents who smoked drugs had sensitive teeth (P ≤ 0.05). All the oral sensations experienced were significantly more among drug dependents with a history of illicit drug usage for >5years in comparison to others. CONCLUSION: Substance abuse results in a range of oral sensations. De-addiction programs in India lack oral health-care components. Studies on oral complications related to addiction stresses on the need of oral healthcare at various levels, including education, prevention, and treatment. All these components should ...

INTRODUCTION: In 2016, cardiovascular diseases (CVDs) led to 17.9 million deaths worldwide, representing 31% of all global deaths. CVDs are the leading cause of mortality worldwide and significant barriers to achieving the sustainable development goals. Modern medicines have been significant in improving health outcomes. However, non-adherence to medication is one of the reasons behind adverse health-related outcomes among patients suffering from atherosclerotic cardiovascular disease in low- and middle-income countries. PATIENTS AND METHODS: This qualitative study was conducted at two tertiary care hospitals in India and Ghana. A total of 35 in-depth interviews were conducted with atherosclerosis cardiovascular disease (ASCVD) patients. The data were analysed thematically using the Capability Opportunity and Motivation (COM-B) framework. FINDINGS: The findings were summarised under three important broad themes of the COM-B framework: capability, opportunity and behaviour. Under capability, comprehension of disease, medication schedule, and unplanned travel affected adherence among patients. Cost of medication, insurance and access were the critical factors under opportunity, which negatively influenced medication adherence. Mood, beliefs about treatment and outcome expectations under motivation led to non-adherence among patients. Apart from these factors, some important health system factors such as health care experience and trust in the facilities and reliance on alternative medication also affected adherence in both countries. CONCLUSION: This study has highlighted that the health system factors have dominantly influenced adherence to medication in India and Ghana. In India, we found participants to be satisfied with their health care provided at the government hospitals. However, limited time for consultation, lack of well-stocked pharmacy and unclear prescription negatively influenced adherence among participants in India and Ghana. The study emphasises that the health system needs to be strengthened, and ...

Introduction: In 2016, cardiovascular diseases (CVDs) led to 17.9 million deaths worldwide, representing 31% of all global deaths. CVDs are the leading cause of mortality worldwide and significant barriers to achieving the sustainable development goals. Modern medicines have been significant in improving health outcomes. However, non-adherence to medication is one of the reasons behind adverse health-related outcomes among patients suffering from atherosclerotic cardiovascular disease in low- and middle-income countries. Patients and Methods: This qualitative study was conducted at two tertiary care hospitals in India and Ghana. A total of 35 in-depth interviews were conducted with atherosclerosis cardiovascular disease (ASCVD) patients. The data were analysed thematically using the Capability Opportunity and Motivation (COM-B) framework. Findings: The findings were summarised under three important broad themes of the COM-B framework: capability, opportunity and behaviour. Under capability, comprehension of disease, medication schedule, and unplanned travel affected adherence among patients. Cost of medication, insurance and access were the critical factors under opportunity, which negatively influenced medication adherence. Mood, beliefs about treatment and outcome expectations under motivation led to non-adherence among patients. Apart from these factors, some important health system factors such as health care experience and trust in the facilities and reliance on alternative medication also affected adherence in both countries. Conclusion: This study has highlighted that the health system factors have dominantly influenced adherence to medication in India and Ghana. In India, we found participants to be satisfied with their health care provided at the government hospitals. However, limited time for consultation, lack of well-stocked pharmacy and unclear prescription negatively influenced adherence among participants in India and Ghana. The study emphasises that the health system needs to be strengthened, and the patients' belief system needs to be explored to address the issue of medication adherence in LMICs.

Pallavi Mishra,1 Ajay S Vamadevan,1,2 Ambuj Roy,3 Rohit Bhatia,4 Nitish Naik,3 Sandeep Singh,3 Gideon Senyo Amevinya,5 Ernest Amoah Ampah,5 Yolanda Fernandez,6 Caroline Free,7 Amos Laar,5 Dorairaj Prabhakaran,1,8,9 Pablo Perel,6 Helena Legido-Quigley10,11 1Health Systems Unit, Centre for Chronic Disease Control, New Delhi, India; 2Goa Institute of Management, Goa, India; 3Department of Cardiology, All India Institute of Medical Science, New Delhi, India; 4Department of Neurology, All India Institute of Medical Science, New Delhi, India; 5Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana; 6Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK; 7Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK; 8Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; 9Research and Policy, Public Health Foundation of India, Gurugram, India; 10Saw Swee Hock School of Public Health, National University of Singapore, Singapore; 11Department of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London, UKCorrespondence: Pablo PerelCentre for Global Chronic Conditions, London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, UKTel +44 20 7636 8636Email Pablo.Perel@lshtm.ac.ukIntroduction: In 2016, cardiovascular diseases (CVDs) led to 17.9 million deaths worldwide, representing 31% of all global deaths. CVDs are the leading cause of mortality worldwide and significant barriers to achieving the sustainable development goals. Modern medicines have been significant in improving health outcomes. However, non-adherence to medication is one of the reasons behind adverse health-related outcomes among patients suffering from atherosclerotic cardiovascular disease in low- and middle-income countries.Patients and Methods: This qualitative study was conducted at two tertiary care hospitals in India and Ghana. A total of 35 in-depth interviews were conducted with atherosclerosis cardiovascular disease (ASCVD) patients. The data were analysed thematically using the Capability Opportunity and Motivation (COM-B) framework.Findings: The findings were summarised under three important broad themes of the COM-B framework: capability, opportunity and behaviour. Under capability, comprehension of disease, medication schedule, and unplanned travel affected adherence among patients. Cost of medication, insurance and access were the critical factors under opportunity, which negatively influenced medication adherence. Mood, beliefs about treatment and outcome expectations under motivation led to non-adherence among patients. Apart from these factors, some important health system factors such as health care experience and trust in the facilities and reliance on alternative medication also affected adherence in both countries.Conclusion: This study has highlighted that the health system factors have dominantly influenced adherence to medication in India and Ghana. In India, we found participants to be satisfied with their health care provided at the government hospitals. However, limited time for consultation, lack of well-stocked pharmacy and unclear prescription negatively influenced adherence among participants in India and Ghana. The study emphasises that the health system needs to be strengthened, and the patients' belief system needs to be explored to address the issue of medication adherence in LMICs.Keywords: non-communicable diseases, atherosclerotic cardiovascular disease, public health, qualitative research