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Background: Community Health Workers (CHWs) play a critical role in supporting the delivery of health services globally. Competency-based learning programs can improve the transfer of learning to practice. This scoping review aims to characterize the published literature on competency-based education as an instructional and curricular strategy in community health worker training programs. We conducted a scoping review of the literature to identify how, by who, and in what ways CHWs are trained using competency-based education; and to characterize the extent of available evidence, as well as the gaps in that evidence. Methods: We conducted a review of the peer-reviewed literature on CHW competency-based education and training published between January 2010 to March 2023, drawing from four databases: EMBASE, OVID Medline, Web of Science, and CINAHL. We followed the PRISMA guidelines for scoping reviews. A total of 713 articles were reviewed and 236 were included for extraction based on the inclusion and exclusion criteria. Due to methodological heterogeneity, results were analyzed and synthesized only through a descriptive approach. Results: The literature on competency-based CHW education and training is most voluminous in high income contexts, primarily the USA. Overall, the included studies described very small-scale training interventions. Study types included observational (qualitative, quantitative, mixed methods, case studies) intervention or experimental studies, systematic or scoping reviews, and literature reviews. The most common practice area included was ‘promotive and preventive services’, whereas ‘personal safety’ was the rarest. Learning programs tailored to CHWs with low-literacy, content tailored to local cultural contexts, and curricula that were co-designed with CHWs were identified in the literature as effective strategies for converting learning to practice. Information on institutional support for CHWs was not provided in most of the articles reviewed. While the focus of our review was on education and training and not broader supports for CHWs, we still found it notable that training was usually discussed in isolation from other related supportive factors, including professionalization and career progression. Conclusions: We found considerable academic interest in utilizing competency-based education to support CHWs and improve their work, yet this exploration was largely limited to smaller, ad hoc programs, in high income settings. Learning programs should be tailored to the realities and practice requirements of CHWs. Further work should illuminate the extent to which the design and delivery of education and training activities lead to acquiring and maintaining the requisite competencies. [ABSTRACT FROM AUTHOR]

In many parts of the world, the availability of clean water is almost an impossible task owing to the intrusion of contaminants in flowing or stagnant streams which renders them unsafe for use by man. Water pollution is a serious environmental problem that poses serious dangers to humans, the environment and aquatic life. Also, the recent rise in the spate of emerging contaminants as well as bacteria in waters recovered from process streams, manufacturing and other production activities, have resulted in unforeseen consequences including environmental pollution, health related sicknesses (diarrhoea, dysentery, cholera, skin irritations, lung infection, etc.) as well as loss and extinction of aquatic lives, hence, the need to consider viable methods of treating waste waters so as to render them safe for use by these organisms. This will in turn preserve life below water- SDG 14 as well as promote the use of clean water and a healthy environment- SDG 6. Among the several existing nanotechnologies tailored towards the treatment of wastewater, a couple of inorganic toxic nanomaterials/nanosubstances have been adopted which render such treated waters as potential risks to humans and aquatic lives. However, green nanoparticles are considered potent and viable means of treating these waters, especially when literature has it that some nanomaterials are toxic in nature. Furthermore, the paper also reports on some unpopular but very potent emerging green nanomaterials, alongside recent advances, applications, related challenges and ways to address them. Information on future prospects of green nanoparticles as potential long-term sustainable water purification and wastewater treatment technologies are also included; therefore, this study is focused on addressing issues related to SDGs 3 (ensure healthy lives and promote wellbeing), 6 (clean water and sanitation), 12 (responsible consumption and production) and 14 (life below water). [ABSTRACT FROM AUTHOR]

Background: Evidence-based decision-making is essential to improve public health benefits and resources, especially in low- and middle-income countries (LMICs), but the mechanisms of its implementation remain less straightforward. The availability of high-quality, reliable, and sufficient data in LMICs can be challenging due to issues such as a lack of human resource capacity and weak digital infrastructure, among others. Health information systems (HISs) have been critical for aggregating and integrating health-related data from different sources to support evidence-based decision-making. Nutrition information systems (NISs), which are nutrition-focused HISs, collect and report on nutrition-related indicators to improve issues related to malnutrition and food security—and can assist in improving populations' nutritional statuses and the integration of nutrition programming into routine health services. Data visualization tools (DVTs) such as dashboards have been recommended to support evidence-based decision-making, leveraging data from HISs or NISs. The use of such DVTs to support decision-making has largely been unexplored within LMIC contexts. In Bangladesh, the Mukto dashboard was developed to display and visualize nutrition-related performance indicators at the national and subnational levels. However, despite this effort, the current use of nutrition data to guide priorities and decisions remains relatively nascent and underused. Objective: The goal of this study is to better understand how Bangladesh's NIS, including the Mukto dashboard, has been used and areas for improvement to facilitate its use for evidence-based decision-making toward ameliorating nutrition-related service delivery and the health status of communities in Bangladesh. Methods: Primary data collection was conducted through qualitative semistructured interviews with key policy-level stakeholders (n=24). Key informants were identified through purposive sampling and were asked questions about the experiences and challenges with the NIS and related nutrition dashboards. Results: Main themes such as trust, data usability, personal power, and data use for decision-making emerged from the data. Trust in both data collection and quality was lacking among many stakeholders. Poor data usability stemmed from unstandardized indicators, irregular data collection, and differences between rural and urban data. Insufficient personal power and staff training coupled with infrastructural challenges can negatively affect data at the input stage. While stakeholders understood and expressed the importance of evidence-based decision-making, ultimately, they noted that the data were not being used to their maximum potential. Conclusions: Leveraging DVTs can improve the use of data for evidence-based decision-making, but decision makers must trust that the data are believable, credible, timely, and responsive. The results support the significance of a tailored data ecosystem, which has not reached its full potential in Bangladesh. Recommendations to reach this potential include ensuring a clear intended user base and accountable stakeholders are present. Systems should also have the capacity to ensure data credibility and support ongoing personal power requirements. [ABSTRACT FROM AUTHOR]

Intracranial stenosis is prevalent among Asians and constitutes a common cause of cerebral ischemia. While the best medical therapy carries stroke recurrence rates in excess of 10% per year, trials with intracranial stenting have been associated with unacceptable peri-procedural ischemic events. Cerebral ischemic events are strongly related to the severity of intracranial stenosis, which is high in patients with severe intracranial stenosis with poor vasodilatory reserve. Enhanced External Counter Pulsation (EECP) therapy is known to improve myocardial perfusion by facilitating the development of collateral blood vessels in the heart. In this randomized clinical trial, we evaluate whether EECP therapy may be useful in patients with severe stenosis of intracranial internal carotid (ICA) or middle cerebral artery (MCA). The review of literature, methods of evaluation, status of currently used therapeutic approaches, and trial protocol have been presented. Clinical trial registration: ClinicalTrials.gov, Identifier: NCT03921827. [ABSTRACT FROM AUTHOR]