Background: To inform the development of the European Academy of Allergy and

The exchange and use of health information can help healthcare professionals and policymakers make informed decisions on ways of improving patient and population health. Many low- and middle-income countries (LMICs) have however failed to embrace the approaches and technologies to facilitate health information exchange (HIE). We sought to understand the barriers and facilitators to the implementation and adoption of HIE in LMICs. Two reviewers independently searched 11 academic databases for published and on-going qualitative, quantitative and mixed-method studies and searched for unpublished work through the Google search engine. The searches covered the period from January 1990 to July 2014 and were not restricted by language. Eligible studies were independently, critically appraised and then thematically analysed. The searches yielded 5461 citations after de-duplication of results. Of these, 56 articles, three conference abstracts and four technical reports met the inclusion criteria. The lack of importance given to data in decision making, corruption and insecurity, lack of training and poor infrastructure were considered to be major challenges to implementing HIE, but strong leadership and clear policy direction coupled with the financial support to acquire essential technology, improve the communication network, and provide training for staff all helped to promote implementation. The body of work also highlighted how implementers of HIE needed to take into account local needs to ensure that stakeholders saw HIE as relevant and advantageous. HIE interventions implemented through leapfrog technologies such as telehealth/telemedicine and mHealth in Brazil, Kenya, and South Africa, provided successful examples of exchanging health information in LMICs despite limited resources and capability. It is important that implementation of HIE is aligned with national priorities and local needs.

PurposeThe aim of this study is to find out the type of motivation that provokes an individual to trust and use the internet banking system in a low income country. In this paper, extrinsic motivation and intrinsic motivation are studied that may build trust in an individual to accept internet banking technology.Design/methodology/approachWith the sample size of 109 respondents, structural equation modeling is used to find the measurement and the structural model for this research.FindingsExtrinsic motivation did not fit within the measurement model and was therefore excluded. Finally, the research model showed that intrinsic motivation is responsible in building user's trust in the acceptance of internet banking.Research limitations/implicationsThis research is difficult to generalize because of the relatively small sample size. However, the sample has been taken from the biggest city of Pakistan, Karachi, which accommodates people from almost every region of the country suggesting that the results could be generalized to an extent. Future research can use this model to study the adoption of internet banking in other regions.Practical implicationsThis research contributes to the banking industry including foreign banks that have laid the foundations and infrastructure for a robust internet banking environment but still have not reached the optimal user base due to lack of trust. Banks need to follow a strategy to work on intrinsic motivational factors such as perceived ease of use, and perceived enjoyment to induce trust in individuals to attract more internet banking users.Originality/valueDespite the benefits, internet banking is not being used extensively in low income countries. The research fills the gap for the low income country by using the motivation theory and the technology acceptance model to increase the level of trust in individuals to adopt internet banking. This integrated model can also be applied to other developing countries which are relatively new to internet banking.

To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness, and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma. The strongest evidence of an association was seen in studies of children. Countries in the European Union currently recommend influenza vaccination of adults with asthma; however, coverage varied between regions. Coverage was lower among children with asthma. Limited data suggest that good seroprotection and seroconversion can be achieved in both children and adults with asthma and that vaccination confers a degree of protection against influenza illness and asthma-related morbidity to children with asthma. There were insufficient data to determine efficacy in adults. Overall, influenza vaccines appeared to be safe for people with asthma. We identify knowledge gaps and make recommendations on future research needs in relation to influenza in patients with asthma.

Purpose – More research is needed to understand the online shopping behaviors and intentions of consumers in emerging economies. The purpose of this paper is to examine the extent to which key variables from the Technology Acceptance Model (perceived usefulness (PU) and ease of use (PEOU)), and others theoretically associated with digital engagement (distrust, perceived risk (PR), perceived enjoyment (PE) and legal framework (LF)), accounted for variation in online shopping intentions in Pakistan, focussing on affiliates of a large metropolitan university. Design/methodology/approach – Online survey using a convenience sample of university staff, students and alumni recruited through the university’s online network. A questionnaire capturing the above constructs was tested for content validity and reliability prior to dissemination. The survey results were factor analyzed to determine the degree to which the constructs were independent, and regression was used to examine their ability to predict online purchasing intentions. User characteristics were analyzed descriptively. Findings – All six independent factors, PU, PEOU, PR, PE, distrust and LF, in the model were independently predictive of intention to shop online and supported the theoretical model by demonstrating the predicted direction of the relationship. Research limitations/implications – There are limitations in the generalizability of the findings. Most of the data being collected were only from Karachi, the biggest metropolitan city and the business hub of Pakistan. Practical implications – This research may help retailers in becoming e-tailers. The model would also help existing e-tailers to streamline their business according to the research findings. In addition, government may work on policies to provide a better online business environment to the people of Pakistan. Originality/value – A new online shopping model has been discovered for an emerging market, Pakistan. Developing countries could take advantage of this model to get real insights of their e-tailing industry.