scholarly journals Biological basis for novel mesothelioma therapies

2021 ◽  
Author(s):  
Joanna Obacz ◽  
Henry Yung ◽  
Marie Shamseddin ◽  
Emily Linnane ◽  
Xiewen Liu ◽  
...  
Keyword(s):  
Recent Work ◽  
Targeted Therapies ◽  
Nutrient Stress ◽  
Conventional Chemotherapy ◽  
Middle Income ◽  
Biological Basis ◽  
Middle Income Countries ◽  
Tumour Suppressors ◽  
Aggressive Cancer ◽  
The Uk

AbstractMesothelioma is an aggressive cancer that is associated with exposure to asbestos. Although asbestos is banned in several countries, including the UK, an epidemic of mesothelioma is predicted to affect middle-income countries during this century owing to their heavy consumption of asbestos. The prognosis for patients with mesothelioma is poor, reflecting a failure of conventional chemotherapy that has ultimately resulted from an inadequate understanding of its biology. However, recent work has revolutionised the study of mesothelioma, identifying genetic and pathophysiological vulnerabilities, including the loss of tumour suppressors, epigenetic dysregulation and susceptibility to nutrient stress. We discuss how this knowledge, combined with advances in immunotherapy, is enabling the development of novel targeted therapies.

scholarly journals Understanding asthma phenotypes: the World Asthma Phenotypes (WASP) international collaboration

2018 ◽  
Vol 4 (3) ◽  
pp. 00013-2018 ◽  
Author(s):  
Lucy Pembrey ◽  
Mauricio L. Barreto ◽  
Jeroen Douwes ◽  
Philip Cooper ◽  
John Henderson ◽  
...  
Keyword(s):  
Clinical Information ◽  
Clinical Severity ◽  
Middle Income ◽  
Asthma Phenotypes ◽  
Middle Income Countries ◽  
High Prevalence ◽  
The World ◽  
The Uk ◽  
New Treatments ◽  
Low Prevalence

The World Asthma Phenotypes (WASP) study started in 2016 and has been conducted in five centres, in the UK, New Zealand, Brazil, Ecuador and Uganda.The objectives of this study are to combine detailed biomarker and clinical information in order to 1) better understand and characterise asthma phenotypes in high-income countries (HICs) and low and middle-income countries (LMICs), and in high and low prevalence centres; 2) compare phenotype characteristics, including clinical severity; 3) assess the risk factors for each phenotype; and 4) assess how the distribution of phenotypes differs between high prevalence and low prevalence centres.Here we present the rationale and protocol for the WASP study to enable other centres around the world to carry out similar analyses using a standardised protocol. Large collaborative and integrative studies like this are essential to further our understanding of asthma phenotypes. The findings of this study will help elucidate the aetiological mechanisms of asthma and might potentially identify new causes and guide the development of new treatments, thereby enabling better management and prevention of asthma in both HICs and LMICs.

scholarly journals Is overseas volunteering beneficial to the NHS? The analysis of volunteers’ responses to a feedback questionnaire following experiences in low-income and middle-income countries

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017517 ◽  
Author(s):  
Daniel Yeomans ◽  
Grace Le ◽  
Hemant Pandit ◽  
Chris Lavy
Keyword(s):  
Professional Development ◽  
Low Income ◽  
Personal Development ◽  
Positive Impact ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Feedback Questionnaire ◽  
Sub Saharan ◽  
The Uk

IntroductionLocally requested and planned overseas volunteering in low-income and middle-income countries by National Health Service (NHS) staff can have benefits for the host or receiving nation, but its impact on the professional development of NHS staff is not proven. The Knowledge and Skills Framework (KSF) and Leadership Framework (LF) are two tools used by employers as a measure of individuals' development. We have used dimensions from both tools as a method of evaluating the benefit to NHS doctors who volunteer overseas.Methods88 NHS volunteers participating with local colleagues in Primary Trauma Care and orthopaedic surgical training courses in sub-Saharan Africa were asked to complete an online self-assessment questionnaire 6 months following their return to the UK. The survey consisted of questions based on qualities outlined in both the KSF and LF.Results85 completed responses to the questionnaire were received. In every KSF domain assessed, the majority of volunteers agreed that their overseas volunteering experience improved their practice within the NHS. Self-assessed pre-course and post-course scores evaluating the LF also saw a universal increase, notably in the ‘working with others’ domain.DiscussionThere is a growing body of literature outlining the positive impact of overseas volunteering on NHS staff. Despite increasing evidence that such experiences can develop volunteers’ essential skills, individuals often find it difficult to gain support of their employers. Our study, in line with the current literature, shows that overseas volunteering by NHS staff can provide an opportunity to enhance professional and personal development. Skills gained from volunteering within international links match many of the qualities outlined in both KSF and LF, directly contributing to volunteers’ continued professional development.

scholarly journals Indirect maternal deaths: UK and global perspectives

2017 ◽  
Vol 10 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Manisha Nair ◽  
Catherine Nelson-Piercy ◽  
Marian Knight
Keyword(s):  
Communicable Diseases ◽  
Reproductive Age ◽  
Steady Increase ◽  
Access To Health Services ◽  
Maternal Deaths ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Delay In Diagnosis ◽  
Middle Income Countries ◽  
The Uk

Indirect maternal deaths outnumber direct deaths due to obstetric causes in many high-income countries, and there has been a significant increase in the proportion of maternal deaths due to indirect medical causes in low- to middle-income countries. This review presents a detailed analysis of indirect maternal deaths in the UK and a perspective on the causes and trends in indirect maternal deaths and issues related to care in low- to middle-income countries. There has been no significant decrease in the rate of indirect maternal deaths in the UK since 2003. In 2011–2013, 68% of all maternal deaths were due to indirect causes, and cardiac disease was the single largest cause. The major issues identified in care of women who died from an indirect cause was a lack of clarity about which medical professional should take responsibility for care and overall management. Under-reporting and misclassification result in underestimation of the rate of indirect maternal deaths in low- to middle-income countries. Causes of indirect death include a range of communicable diseases, non-communicable diseases and nutritional disorders. There has been evidence of a shift in incidence from direct to indirect maternal deaths in many low- to middle-income countries due to an increase in non-communicable diseases among women in the reproductive age. The gaps in care identified include poor access to health services, lack of healthcare providers, delay in diagnosis or misdiagnosis and inadequate follow-up during the postnatal period. Irrespective of the significant gains made in reducing maternal mortality in many countries worldwide, there is evidence of a steady increase in the rate of indirect deaths due to pre-existing medical conditions. This heightens the need for research to generate evidence about the risk factors, management and outcomes of specific medical comorbidities during pregnancy in order to provide appropriate evidence-based multidisciplinary care across the entire pathway: pre-pregnancy, during pregnancy and delivery, and postpartum.

scholarly journals Understanding Learning Trajectories Is Key to Helping Adolescent Girls

2021 ◽  
Author(s):  
Lant Pritchett ◽  
Marla Spivack
Keyword(s):  
Adolescent Girls ◽  
Critical Time ◽  
Full Potential ◽  
Learning Trajectories ◽  
Education Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Leave Policy ◽  
The Uk ◽  
National Governments

There is a growing consensus among national governments and development partners about the importance of girls’ education. This is reflected in the UK government’s commitment to quality education for every girl for 12 years, and in targets for increasing girls’ schooling and learning adopted by the Group of 7 (G-7) countries at their meeting in mid-2021 (G7, 2021). The emergence of this consensus comes at a critical time. Education systems in low- and middle-income countries are facing a learning crisis, with many systems failing to equip children with the foundational skills they need to reach their full potential. Within this movement for girls’ education, much attention is focused on the unique challenges adolescent girls face, and on programmes to help girls stay in school. But designing interventions without sufficient understanding of the drivers of adolescent girls’ challenges will leave policy makers frustrated and girls unaided. To help adolescents reach their full potential, we must first understand what is undermining their progress in the first place. Understanding learning trajectories (how much children learn over time) is key to helping both today’s and tomorrow’s adolescent girls. This insight note briefly explains what learning trajectories are and then offers six analytical insights about learning trajectories that can inform education systems reforms to ensure that every girl meets her full potential.

scholarly journals Systematic review of early abortion services in low- and middle-income country primary care: potential for reverse innovation and application in the UK context

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Jacy Zhou ◽  
Rebecca Blaylock ◽  
Matthew Harris
Keyword(s):  
Primary Care ◽  
Service Delivery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Service Delivery Models ◽  
Primary Care Settings ◽  
The Uk ◽  
Delivery Models ◽  
Low And Middle Income

Abstract Background In the UK, according to the 1967 Abortion Act, all abortions must be approved by two doctors, reported to the Department of Health and Social Care (DHSC), and be performed by doctors within licensed premises. Removing abortion from the criminal framework could permit new service delivery models. We explore service delivery models in primary care settings that can improve accessibility without negatively impacting the safety and efficiency of abortion services. Novel service delivery models are common in low-and-middle income countries (LMICs) due to resource constraints, and services are sometimes provided by trained, mid-level providers via “task-shifting”. The aim of this study is to explore the quality of early abortion services provided in primary care of LMICs and explore the potential benefits of extending their application to the UK context. Methods We searched MEDLINE, EMBASE, Global Health, Maternity and Infant Care, CINAHL, and HMIC for studies published from September 1994 to February 2020, with search terms “nurses”, “midwives”, “general physicians”, “early medical/surgical abortion”. We included studies that examined the quality of abortion care in primary care settings of low-and-middle-income countries (LMICs), and excluded studies in countries where abortion is illegal, and those of services provided by independent NGOs. We conducted a thematic analysis and narrative synthesis to identify indicators of quality care at structural, process and outcome levels of the Donabedian model. Results A total of 21 indicators under 8 subthemes were identified to examine the quality of service provision: law and policy, infrastructure, technical competency, information provision, client-provider interactions, ancillary services, complete abortions, client satisfaction. Our analysis suggests that structural, process and outcome indicators follow a mediation pathway of the Donabedian model. This review showed that providing early medical abortion in primary care services is safe and feasible and “task-shifting” to mid-level providers can effectively replace doctors in providing abortion. Conclusion The way services are organised in LMICs, using a task-shifted and decentralised model, results in high quality services that should be considered for adoption in the UK. Collaboration with professional medical bodies and governmental departments is necessary to expand services from secondary to primary care.

scholarly journals COVID-19 Modelling: The Effects of Social Distancing

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Oliva Bendtsen Cano ◽  
Sabrina Cano Morales ◽  
Claus Bendtsen
Keyword(s):  
South Africa ◽  
Open Source ◽  
Source Code ◽  
Stochastic Simulations ◽  
Middle Income ◽  
Open Source Code ◽  
Social Distancing ◽  
Middle Income Countries ◽  
The Uk

The purpose of this article is to reach all those who find it difficult to become well informed about the steps that have been implemented to tackle the COVID-19 pandemic and to spark discussion and thought. Here, we use simple stochastic simulations to evaluate different approaches taken to manage the crisis. We then compare these results with updated data of what really happened in the UK and in South Africa. The initial simulations aligned well with how the pandemic has evolved throughout five months following lockdown. The models are, as expected, not fully accurate, but exact enough to be used as a guideline to the evolution of the disease in both high- and middle-income countries. This is shown through simulations formed by an open source code, which allows evaluation of the outcomes from different intervention scenarios or conditions.

Deliberate corrosive substance attacks – A systematic review

Trauma ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 169-175
Author(s):  
S Moffatt ◽  
P Rhimes
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Case Reports ◽  
Evidence Base ◽  
Injury Patterns ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Uk ◽  
Areas Of Interest ◽  
Geographical Locations

Introduction Deliberate corrosive substance attacks (DCSA) have traditionally been associated with low- and middle-income countries (LMIC). However, the incidence of DCSA in certain geographical locations of the UK has increased in recent years. These attacks have a relatively low mortality rate but cause extensive life-changing injuries and the management from point of wounding to definitive care is challenging for all involved. Methods A systematic review was used to identify literature about DCSA and establish how much evidence about these attacks has been published over the last decade. Victim and perpetrator characteristics, substances used, injury patterns, mortality, pre-hospital and hospital-based management and complications associated with management were areas of interest. The review included any medical literature (case reports, letters, reviews) published within the last 10 years that described DCSA against human victims. Non-English language articles were excluded. Results Eighteen articles containing 762 victims of DCSA were included; seven victims had incomplete data. Articles were mostly from LMIC (Bangladesh, Columbia, Cambodia, India, Iran, Sri Lanka and Pakistan) but there were five articles were from the UK (three ‘Letters to Editors’, one survivor letter and one retrospective review of 21 victims). UK victim and perpetrator characteristics varied from those in LMIC. Seven papers described pre-hospital management and nine described hospital/surgical management. Conclusions The evidence base surrounding DCSA is limited especially in the UK setting. More research into the epidemiology and management of DCSA in the UK is warranted.

scholarly journals The UK Fleming Fund: Developing AMR surveillance capacity in low- and middle-income countries

2020 ◽  
Vol 101 ◽  
pp. 40
Author(s):  
N. Gordon ◽  
V. Aggarwal ◽  
B. Amos ◽  
C. Buhler ◽  
A. Huszar ◽  
...  
Keyword(s):  
Middle Income ◽  
Middle Income Countries ◽  
The Uk ◽  
Low And Middle Income

scholarly journals What is important for quality of life of psychiatrists?

2006 ◽  
Vol 3 (2) ◽  
pp. 46-47
Author(s):  
Santosh K. Chaturvedi
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Well Being ◽  
High Income ◽  
Cultural Resources ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Uk ◽  
Better Than

The concern for the mental health of people living in low-resource and industrially developing countries has been blown out of proportion. Economic well-being, as a psychological factor, has a complex association with mental health and may prove to be good or bad for it; after all, mental health in low- and middle-income countries (even with few psychiatrists!) is generally better than it is in high-income countries. Government funding may be low but there are innumerable socio-cultural resources, many more than in most high-income countries. The number of psychiatrists per population may be low but numerous (informal and alternative) mental health services exist, many more popular and even more effective than psychiatry. The healthcare systems are so different that, whereas the average waiting period for a psychiatric patient in the UK may be about 90 days, it is about 90 minutes in India (and all patients are seen the same day). In fact, less than 10% of mental health problems are seen by psychiatrists!

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