Heterogeneity of Intermediate Care Organization Within a Single Healthcare System.

Intermediate care (IC) is prevalent nationwide, but little is known about how to best organize this level of care. Using a 99-item cross-sectional survey assessing four domains (hospital and physical IC features, provider and nurse staffing, monitoring, and interventions/services), we describe the organizational heterogeneity of IC within a five-hospital healthcare system. Surveys were completed by nurse managers from 12 (86%) of 14 IC settings.

Heterogeneity of Intermediate Care Organization Within a Single Healthcare System.

Intermediate care (IC) is prevalent nationwide, but little is known about how to best organize this level of care. Using a 99-item cross-sectional survey assessing four domains (hospital and physical IC features, provider and nurse staffing, monitoring, and interventions/services), we describe the organizational heterogeneity of IC within a five-hospital healthcare system. Surveys were completed by nurse managers from 12 (86%) of 14 IC settings.

Optimizing Exposure Measures in Large-Scale Household Air Pollution Studies: Results from the Multicountry HAPIN Trial.

Repeated measurements of household air pollution may provide better estimates of average exposure but can add to costs and participant burden. In a randomized trial of gas versus biomass cookstoves in four countries, we took supplemental personal 24-h measurements on a 10% subsample for mothers and infants, interspersed between protocol samples. Mothers had up to five postrandomization protocol measurements over 16 months, while infants had three measurements over one year.

Exposure Contrasts of Women Aged 40-79 Years during the Household Air Pollution Intervention Network Randomized Controlled Trial.

Exposure to household air pollution has been linked to adverse health outcomes among women aged 40-79. Little is known about how shifting from biomass cooking to a cleaner fuel like liquefied petroleum gas (LPG) could impact exposures for this population. We report 24-h exposures to particulate matter (PM), black carbon (BC), and carbon monoxide (CO) among women aged 40 to <80 years participating in the Household Air Pollution Intervention Network trial.

Effects of a liquefied petroleum gas stove and fuel intervention on head circumference and length at birth: A multi-country household air pollution intervention network (HAPIN) trial.

Background: Air pollution may impair child growth and cognitive development, with potential markers including birth length and head circumference.

Methods: The Household Air Pollution Intervention Network (HAPIN) trial was an open label multi-country-randomized controlled trial, with 3200 pregnant women aged 18-34 years (9-19 weeks of gestation) randomly assigned in a 1:1 ratio to receive liquefied petroleum gas (LPG) stove intervention compared to women continuing to cook with solid fuels for 18 months. Particulate matter ≤ 2.

Multimorbidity patterns, sociodemographic characteristics, and mortality: Data science insights from low-resource settings.

Multimorbidity data is typically analysed by tallying disease counts, which overlooks nuanced relationships among conditions. We identified clusters of multimorbidity and subpopulations with varying risks and examined their association with all-cause mortality using a data-driven approach. We analysed 8-year follow-up data of people ≥35 years who were part of the CRONICAS Cohort Study, a multisite cohort from Peru.

Medication adherence among people living with hypertension and diabetes in Puno, Peru: A secondary analysis of formative data of the ANDES trial.

Background: Hypertension is the leading modifiable risk factor for premature death globally despite the existence of evidence-based and cost-effective treatments. Medication nonadherence is cited as the main cause of treatment failure for hypertension. In Peru, adherence to anti-hypertensive medications of individuals with both hypertension and type 2 diabetes (T2D) is not well studied.

Effect of diet on the management of hypertension and type 2 diabetes mellitus in adults from low-income and middle-income countries: protocol for a systematic review of randomised controlled trials.

Introduction: Hypertension and type 2 diabetes mellitus (T2DM) are two highly prevalent non-communicable diseases worldwide, both leading to disability and premature mortality in low-and-middle-income countries (LMICs). Nutritional interventions towards a healthier dietary pattern or food and nutrients intake have an important role on the management of this disease. This systematic review aims to evaluate the effect of nutritional interventions on the management of blood pressure and glycaemia in adults with hypertension and T2DM from LMICs.

Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change.

Traditional patient- and provider-level hypertension interventions have proven insufficient to halt hypertension as the leading cause of morbidity and mortality globally. Systems-level interventions are required to address factors challenging hypertension control across a social ecological framework, an under-studied topic particularly salient in low- and middle-income countries (LMICs) such as Peru. To inform such interventions, we sought to identify key health systems barriers to hypertension care in Puno, Peru.

Assessing the prevalence and impact of preserved ratio impaired spirometry in low-income and middle-income countries: a post-hoc cross-sectional analysis.

Background: More than 90% of the morbidity and mortality from chronic respiratory disease occurs in low-income and middle-income countries (LMICs), with substantial economic impact. Preserved ratio impaired spirometry (PRISm) is a prevalent lung function abnormality associated with increased mortality in high-income countries. We aimed to conduct a post-hoc analysis of a cross-sectional study to assess the prevalence of, the risk factors for, and the impact of PRISm in three diverse LMIC settings.

Health-related quality of life and hypertension in people with HIV on long-term antiretroviral therapy in Uganda.

Introduction: The presence of hypertension could reduce the health-related quality of life (HRQoL) of people with HIV (PWH). Yet, literature describing the HRQoL of PWH who have hypertension in Uganda is scarce making the design of locally adapted interventions cumbersome. In our study, we compared HRQoL scores of people with HIV with and without hypertension on long term antiretroviral therapy (ART) in Uganda.

Cooking with liquefied petroleum gas or biomass and fetal growth outcomes: a multi-country randomised controlled trial.

Background: Household air pollution might lead to fetal growth restriction during pregnancy. We aimed to investigate whether a liquefied petroleum gas (LPG) intervention to reduce personal exposures to household air pollution during pregnancy would alter fetal growth.

Methods: The Household Air Pollution Intervention Network (HAPIN) trial was an open-label randomised controlled trial conducted in ten resource-limited settings across Guatemala, India, Peru, and Rwanda.

Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study.

Introduction: Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. We aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥55 years in Lima, Peru.

Methods: This cross-sectional study was conducted between 2018 and 2020.

Implementing an ICU registry in Ethiopia-Implications for critical care quality improvement.

Purpose: Intensive care units (ICUs) in low- and middle-income countries have high mortality rates, and clinical data are needed to guide quality improvement (QI) efforts. This study utilizes data from a validated ICU registry specially developed for resource-limited settings to identify evidence-based QI priorities for ICUs in Ethiopia.

Materials And Methods: A retrospective cohort analysis of data from two tertiary referral hospital ICUs in Addis Ababa, Ethiopia from July 2021-June 2022 was conducted to describe casemix, complications and outcomes and identify features associated with ICU mortality.