scholarly journals Pediatric Solid Tumor Care and Multidisciplinary Tumor Boards in Low- and Middle-Income Countries in Southeast Asia

2020 ◽  
pp. 1328-1345
Author(s):  
Mohd Yusran Othman ◽  
Sally Blair ◽  
Shireen A. Nah ◽  
Hany Ariffin ◽  
Chatchawin Assanasen ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Solid Tumor ◽  
Specialist Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pediatric Solid Tumors ◽  
Tumor Boards ◽  
Pediatric Solid Tumor ◽  
Pediatric Oncologist ◽  
Low And Middle Income

PURPOSE Pediatric solid tumors require coordinated multidisciplinary specialist care. However, expertise and resources to conduct multidisciplinary tumor boards (MDTBs) are lacking in low- and middle-income countries (LMICs). We aimed to profile the landscape of pediatric solid tumor care and practices and perceptions on MDTBs among pediatric solid tumor units (PSTUs) in Southeast Asian LMICs. METHODS Using online surveys, availability of specialty manpower and MDTBs among PSTUs was first determined. From the subset of PSTUs with MDTBs, one pediatric surgeon and one pediatric oncologist from each center were queried using 5-point Likert scale questions adapted from published questionnaires. RESULTS In 37 (80.4%) of 46 identified PSTUs, availability of pediatric-trained specialists was as follows: oncologists, 94.6%; surgeons, 91.9%; radiologists, 54.1%; pathologists, 40.5%; radiation oncologists, 29.7%; nuclear medicine physicians, 13.5%; and nurses, 81.1%. Availability of pediatric-trained surgeons, radiologists, and pathologists was significantly associated with the existence of MDTBs ( P = .037, .005, and .022, respectively). Among 43 (89.6%) of 48 respondents from 24 PSTUs with MDTBs, 90.5% of oncologists reported > 50% oncology-dedicated workload versus 22.7% of surgeons. Views on benefits and barriers did not significantly differ between oncologists and surgeons. The majority agreed that MDTBs helped to improve accuracy of treatment recommendations and team competence. Complex cases, insufficient radiology and pathology preparation, and need for supplementary investigations were the top barriers. CONCLUSION This first known profile of pediatric solid tumor care in Southeast Asia found that availability of pediatric-trained subspecialists was a significant prerequisite for pediatric MDTBs in this region. Most PSTUs lacked pediatric-trained pathologists and radiologists. Correspondingly, gaps in radiographic and pathologic diagnoses were the most common limitations for MDTBs. Greater emphasis on holistic multidisciplinary subspecialty development is needed to advance pediatric solid tumor care in Southeast Asia.

scholarly journals Global neurosurgery: the current capacity and deficit in the provision of essential neurosurgical care. Executive Summary of the Global Neurosurgery Initiative at the Program in Global Surgery and Social Change

2019 ◽  
Vol 130 (4) ◽  
pp. 1055-1064 ◽  
Author(s):  
Michael C. Dewan ◽  
Abbas Rattani ◽  
Graham Fieggen ◽  
Miguel A. Arraez ◽  
Franco Servadei ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Surgical Care ◽  
Median Number ◽  
Third Party ◽  
Published Data ◽  
Executive Summary ◽  
Middle Income ◽  
Middle Income Countries ◽  
Surgical Workforce ◽  
Low And Middle Income

OBJECTIVEWorldwide disparities in the provision of surgical care result in otherwise preventable disability and death. There is a growing need to quantify the global burden of neurosurgical disease specifically, and the workforce necessary to meet this demand.METHODSResults from a multinational collaborative effort to describe the global neurosurgical burden were aggregated and summarized. First, country registries, third-party modeled data, and meta-analyzed published data were combined to generate incidence and volume figures for 10 common neurosurgical conditions. Next, a global mapping survey was performed to identify the number and location of neurosurgeons in each country. Finally, a practitioner survey was conducted to quantify the proportion of disease requiring surgery, as well as the median number of neurosurgical cases per annum. The neurosurgical case deficit was calculated as the difference between the volume of essential neurosurgical cases and the existing neurosurgical workforce capacity.RESULTSEvery year, an estimated 22.6 million patients suffer from neurological disorders or injuries that warrant the expertise of a neurosurgeon, of whom 13.8 million require surgery. Traumatic brain injury, stroke-related conditions, tumors, hydrocephalus, and epilepsy constitute the majority of essential neurosurgical care worldwide. Approximately 23,300 additional neurosurgeons are needed to address more than 5 million essential neurosurgical cases—all in low- and middle-income countries—that go unmet each year. There exists a gross disparity in the allocation of the surgical workforce, leaving large geographic treatment gaps, particularly in Africa and Southeast Asia.CONCLUSIONSEach year, more than 5 million individuals suffering from treatable neurosurgical conditions will never undergo therapeutic surgical intervention. Populations in Africa and Southeast Asia, where the proportion of neurosurgeons to neurosurgical disease is critically low, are especially at risk. Increasing access to essential neurosurgical care in low- and middle-income countries via neurosurgical workforce expansion as part of surgical system strengthening is necessary to prevent severe disability and death for millions with neurological disease.

scholarly journals Challenges and considerations of applying nature-based solutions in low- and middle-income countries in Southeast and East Asia

2020 ◽  
Vol 2 (1) ◽  
pp. 331-351 ◽  
Author(s):  
Alex M. Lechner ◽  
Rachel L. Gomes ◽  
Lucelia Rodrigues ◽  
Matthew J. Ashfold ◽  
Sivathass Bannir Selvam ◽  
...  
Keyword(s):  
Climate Change ◽  
Ecosystem Services ◽  
Southeast Asia ◽  
East Asia ◽  
Ecological Restoration ◽  
Environmental Risks ◽  
Middle Income ◽  
Middle Income Countries ◽  
Rapid Pace ◽  
Low And Middle Income

Abstract Low- and middle-income countries in Southeast and East Asia face a range of challenges related to the rapid pace of urbanisation in the region, the scale of pollution, climate change, loss of ecosystem services and associated difficulties for ecological restoration. Possible pathways towards a more sustainable future lie in the applications of nature-based solutions (NBS). However, there is relatively little literature on the application of NBS in the region, particularly Southeast Asia. In this paper we address this gap by assessing the socio-ecological challenges to the application of NBS in the region – one of the most globally biodiverse. We first provide an overview and background on NBS and its underpinnings in biodiversity and ecosystem services. We then present a typology describing five unique challenges for the application of NBS in the region: (1) Characteristics of urbanisation; (2) Biophysical environmental and climatic context; (3) Environmental risks and challenges for restoration; (4) Human nature relationships and conflicts; and (5) Policy and governance context. Exploiting the opportunities through South-South and North-South collaboration to address the challenges of NBS in Southeast and East Asia needs to be a priority for government, planners and academics.

Gynecologic pathology services in low- and middle-income countries

2021 ◽  
pp. ijgc-2021-003103
Author(s):  
Ekaternia Olkhov-Mitsel ◽  
Fang-I Lu ◽  
Anna Gagliardi ◽  
Anna Plotkin
Keyword(s):  
Online Education ◽  
Central America ◽  
Gynecologic Cancer ◽  
Molecular Testing ◽  
Subspecialty Training ◽  
Middle Income ◽  
Middle Income Countries ◽  
Tumor Boards ◽  
The Caribbean ◽  
Low And Middle Income

ObjectiveThe International Gynecologic Cancer Society (IGCS) offers multidisciplinary conferences to underserved communities. Mentor pathologists have become an integral part of these tumor boards, as pathology services in low-to-middle-income countries are often inadequate and disjointed. The IGCS Pathology Working Group conducted a survey to assess barriers to quality pathology services in low-to-middle-income countries and identified potential solutions.MethodsA 69-question cross-sectional survey assessing different aspects of pathology services was sent to 15 IGCS Extension for Community Healthcare Outcomes (ECHO) training sites in Africa, Asia, Central America, and the Caribbean. Local gynecologic oncologists distributed the survey to their pathology departments for review. The responses were tabulated in Microsoft Excel.ResultsResponses were received from nine training sites: five sites in Africa, two in Asia, one in Central America, and one in the Caribbean. There were no pathologists with subspecialty training in gynecologic pathology. Most (7/9, 78%) surveyed sites indicated that they have limited access to online education and knowledge transfer resources. Of the eight sites that responded to the questions, 50% had an electronic medical system and 75% had a cancer registry. Synoptic reporting was used in 75% of the sites and paper-based reporting was predominant (75%). Most (6/7, 86%) laboratories performed limited immunohistochemical stains on site. None of the sites had access to molecular testing.ConclusionsInitial goals for collaboration with local pathologists to improve diagnostic pathology in low- and middle-income countries could be defining minimal gross, microscopic, and reporting pathology requirements, as well as wisely designed educational programs intended to mentor local leaders in pathology. Larger studies are warranted to confirm these observations.

scholarly journals PROFILE OF PEDIATRIC SOLID TUMOR CARE AND MULTIDISCIPLINARY TUMOR BOARDS IN SOUTHEAST ASIA

2020 ◽  
Author(s):  
Mohd Yusran Othman ◽  
Sally Blair ◽  
Shireen Anne Nah ◽  
Hany Ariffin ◽  
Chatchawin Assanasen ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Solid Tumor ◽  
Tumor Boards ◽  
Pediatric Solid Tumor

Global Cancer Institute (GCI) multi-disciplinary tumor boards (MTBs) as an educational tool to improve guideline-based cancer clinical practice in low- and middle-income countries (LMICs).

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e18007-e18007
Author(s):  
Jessica St. Louis ◽  
Alexandra Bukowski ◽  
Rossana Esther Ruiz Mendoza ◽  
Carmen Herrero Vincent ◽  
Abraham Hernandez Blanquisett ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Educational Tool ◽  
Middle Income ◽  
Middle Income Countries ◽  
Tumor Boards ◽  
Low And Middle Income

scholarly journals Self-supplied drinking water in low- and middle-income countries in the Asia-Pacific

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Tim Foster ◽  
Cindy Priadi ◽  
Krishna Kumar Kotra ◽  
Mitsunori Odagiri ◽  
Emily Christensen Rand ◽  
...  
Keyword(s):  
Drinking Water ◽  
Southeast Asia ◽  
South Asia ◽  
Urban Areas ◽  
Temporal Trends ◽  
Asia Pacific ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Pacific ◽  
Low And Middle Income

AbstractThere is increasing awareness of household self-supply and the role it can play in securing water for domestic needs in low- and middle-income countries (LMICs), but its scale across the Asia-Pacific has not previously been quantified. This study analysed 77 datasets from 26 countries to estimate the prevalence of self-supplied drinking water, and its associated trends in LMICs in South Asia, Southeast Asia and the Pacific. When factoring in temporal trends, results suggest that >760 million people—or 31% of the population—relied on self-supply for their drinking water in these regions in 2018, with the number of users increasing by >9 million each year. Reliance on self-supply for drinking water is greater in rural areas than in urban areas (37% of rural population vs 20% of urban population), though results vary considerably between countries. Groundwater sources constitute the most common form of self-supply in South Asia and Southeast Asia, while rainwater collection is dominant in the Pacific. The results confirm the significance of self-supply in the Asia-Pacific and suggest that households are a major but often overlooked source of financing within the water sector. The findings raise important questions about how policy and practice should respond to this widespread phenomenon.

Some Conditions for Task Shifting in Low and Middle-Income Countries

2012 ◽  
Author(s):  
Joop de Jong ◽  
Mark Jordans ◽  
Ivan Komproe ◽  
Robert Macy ◽  
Aline & Herman Ndayisaba ◽  
...  
Keyword(s):  
Task Shifting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income
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