Understanding Parents’ Approaches to Care and Treatment of Children With Cancer When Standard Therapy Has Failed

2007 ◽  
Vol 25 (17) ◽  
pp. 2414-2419 ◽  
Author(s):  
Myra Bluebond-Langner ◽  
Jean Bello Belasco ◽  
Ann Goldman ◽  
Carmen Belasco
Keyword(s):  
Pediatric Oncology ◽  
Standard Therapy ◽  
Participant Observation ◽  
Health Care Systems ◽  
Ethnographic Study ◽  
Semistructured Interviews ◽  
The Us ◽  
Care Models ◽  
Care Systems ◽  
Care And Treatment

Purpose To examine US and United Kingdom (UK) parents’ approaches to care and treatment when standard therapy has failed and consider implications for clinical practice. Methods We conducted a prospective, ethnographic study of parents, patients, and staff, including participant-observation; open-ended, semistructured interviews; and review of medical records at a US and UK pediatric oncology center. Thirty-four children (n = 17 US, 17 UK), whose disease had recurred with less than 30% chance of cure, were enrolled between March 2001 and June 2002 and followed until death (n = 11 US, 14 UK) or close of study in December 2005 (n = 6 US, 3 UK). Results There were no major differences between parents’ approaches in the US and UK despite differences in health care systems, institutions, and parents’ religion or ethnicity. All parents continued to have or request meetings with the oncologist and investigative procedures. No parent initiated discontinuation of cancer- or symptom-directed interventions. In 28 of 34 cases (13 US, 15 UK), parents continued to pursue cancer-directed therapies; in 16 of 28 cases (seven US, nine UK), parents initiated inquires beyond what was offered. Conclusion Understanding parents’ behavior requires attention to the reason and emotion they bring to decision making and their children's care, their unique responsibilities as parents, and what they learn throughout the illness. Parents do not see cancer-directed therapy and symptom-directed care as mutually exclusive, alternative approaches. Parents will not be constrained by what the oncologist offers. Physicians and parents discuss and negotiate care and treatment throughout the illness. Our findings suggest developing integrative care models incorporating cancer-directed, symptom-directed, and supportive care throughout the illness; they are most consistent with parents’ approaches and advances in pediatric oncology.

scholarly journals Comparative analysis of economic provision of health care of foreign countries and Ukraine

2019 ◽  
Vol 6 (2) ◽  
pp. 319-330
Author(s):  
Irina Kinash ◽  
Liliia Savchuk
Keyword(s):  
Health Care ◽  
Comparative Analysis ◽  
Health Care Systems ◽  
Economic Regulation ◽  
Internet Resources ◽  
Foreign Countries ◽  
Economic Support ◽  
Health Care Models ◽  
Care Models ◽  
Care Systems

The manuscript focuses on researching and generalizing the experiences of the economic provision of existing foreign health care models. Under the economic regulation of health, the authors of the work understand the components, which combine financial, material, and human resources. The article presents a comparative analysis of economic support for the health systems of different countries. The study covers the period from 2007 to 2016. Indicators used are derived from the databases of the Organization for Economic Cooperation and Development (OECD) on health. A content analysis of scientific literature and Internet resources, databases of international organizations, which contain data on the economic provision of health care systems of different countries, was conducted. Bibliosemantic, comparative, and analytical methods are used.

scholarly journals Robotics in Gynecology: Why is this Technology Worth pursuing?

2013 ◽  
Vol 7 ◽  
pp. CMRH.S10850 ◽  
Author(s):  
Rodrigo Ayala-Yáñez ◽  
Emilio José Olaya-Guzmán ◽  
Javier Haghenbeck-Altamirano
Keyword(s):  
Health Care Systems ◽  
Da Vinci Surgical System ◽  
Training Design ◽  
Oncologic Surgery ◽  
Novel Technologies ◽  
The Us ◽  
Care Systems ◽  
Vinci Surgical System ◽  
Positive Effect ◽  
Surgical System

Robotic laparoscopy in gynecology, which started in 2005 when the Da Vinci Surgical System (Intuitive Surgical Inc) was approved by the US Food and Drug Administration for use in gynecologic procedures, represents today a modern, safe, and precise approach to pathology in this field. Since then, a great deal of experience has accumulated, and it has been shown that there is almost no gynecological surgery that cannot be approached with this technology, namely hysterectomy, myomectomy, sacrocolpopexia, and surgery for the treatment of endometriosis. Albeit no advantages have been observed over conventional laparoscopy and some open surgical procedures, robotics do seem to be advantageous in highly complicated procedures when extensive dissection and proper anatomy reestablishment is required, as in the case of oncologic surgery. There is no doubt that implementation of better logistics in finance, training, design, and application will exert a positive effect upon robotics expansion in gynecological medicine. Contrary to expectations, we estimate that a special impact is to be seen in emerging countries where novel technologies have resulted in benefits in the organization of health care systems.

“In our community, a friend is a psychologist”: An ethnographic study of informal care in two Bhutanese refugee communities

2017 ◽  
Vol 54 (3) ◽  
pp. 400-422 ◽  
Author(s):  
Liana Chase ◽  
Ram P. Sapkota
Keyword(s):  
Mental Health ◽  
Social Networks ◽  
Informal Care ◽  
Help Seeking ◽  
Participant Observation ◽  
Health Resources ◽  
Ethnographic Study ◽  
Care Systems ◽  
And Behavior ◽  
Bhutanese Refugee

The recent rise in suicide among Bhutanese refugees has been linked to the erosion of social networks and community supports in the ongoing resettlement process. This paper presents ethnographic findings on the role of informal care practiced by relatives, friends, and neighbors in the prevention and alleviation of mental distress in two Bhutanese refugee communities: the refugee camps of eastern Nepal and the resettled community of Burlington, Vermont, US. Data gathered through interviews ( n = 40, camp community; n = 22, resettled community), focus groups (four, camp community), and participant observation (both sites) suggest that family members, friends, and neighbors were intimately involved in the recognition and management of individual distress, often responding proactively to perceived vulnerability rather than reactively to help-seeking. They engaged practices of care that attended to the root causes of distress, including pragmatic, social, and spiritual interventions, alongside those which targeted feelings in the “heart-mind” and behavior. In line with other studies, we found that the possibilities for care in this domain had been substantially constrained by resettlement. Initiatives that create opportunities for strengthening or extending social networks or provide direct support in meeting perceived needs may represent fruitful starting points for suicide prevention and mental health promotion in this population. We close by offering some reflections on how to better understand and account for informal care systems in the growing area of research concerned with identifying and addressing disparities in mental health resources across diverse contexts.

scholarly journals Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US

2020 ◽  
Vol 180 (10) ◽  
pp. 1328 ◽  
Author(s):  
Molly M. Jeffery ◽  
Gail D’Onofrio ◽  
Hyung Paek ◽  
Timothy F. Platts-Mills ◽  
William E. Soares ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Health Care Systems ◽  
Emergency Department Visits ◽  
The Us ◽  
Care Systems

scholarly journals Work stress of primary care physicians in the US, UK and German health care systems

2010 ◽  
Vol 71 (2) ◽  
pp. 298-304 ◽  
Author(s):  
Johannes Siegrist ◽  
Rebecca Shackelton ◽  
Carol Link ◽  
Lisa Marceau ◽  
Olaf von dem Knesebeck ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Work Stress ◽  
Primary Care Physicians ◽  
Health Care Systems ◽  
German Health ◽  
The Us ◽  
Care Systems

scholarly journals Resilience of Gendered Spheres in Translational Migration: A Comparison of Two Cultures

2014 ◽  
Author(s):  
Jose Calderon
Keyword(s):  
Puerto Rican ◽  
First Generation ◽  
Participant Observation ◽  
The United States ◽  
Ethnographic Study ◽  
Observation Methods ◽  
The Us ◽  
Cultural Mores ◽  
And Gender ◽  
The U.S

Sheba George's ethnographic study used participant-observation methods, purposive sampling, and an insider's transnational journey to examine changes in family and social roles that result when nurses from Kerala, India, immigrate to the United States ahead of their husbands. The author concludes that the economic and political gain immigration affords nurses does not translate into enhanced social status for their family in India nor for their husbands in the U.S. when they undergo a gender role transferal from primary breadwinner to homemaker whilst their wives pursue their nursing careers. In a key observation, the author emphasizes that this role transferal also caused shifts in gender structure within the U.S. Kerali community. The purpose of this paper is to offer a review of George's examination of resilience of patriarchal cultural mores and gender roles of Kerali "nurse husbands" in the U.S. and to cross-culturally compare their resilience to that of Puerto Rican men who were born and raised in Puerto Rico before migrating to the US mainland. This comparison is born of George's experience as a first-generation Kerali American and that of this reviewer as a first-generation Puerto Rican American.

scholarly journals Selected models and the classification of health care systems

2019 ◽  
Vol 13 (1) ◽  
pp. 48-54
Author(s):  
Piotr Rajfur
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Management Planning ◽  
Historical Outline ◽  
New Concepts ◽  
Health Care Models ◽  
Care Models ◽  
Care Systems ◽  
Methods Of Operation

Health care is a fundamental element of each country’s social policy. It is mainly organised and implemented through the adoption of a certain political framework (defined objectives and priorities), strategic and operational management (planning, organising, motivating and controlling), and generation of resources (e.g. defined activities of collection and distribution of financial resources, training of medical professionals, and the purchase of technology and pharmaceuticals). These principles are either formulated on the basis of already functioning health care models or bespoke models are being created. An important element of a given model is to define its mission (the reasons for its creation and operation), while such elements as the functions, objectives, resources and methods of operation attribute to its individual properties and values. Health care systems may be organised differently. Their main distinguishing features are the ownership (public, private or mixed), sources of financing (public, private or mixed) and management (centralised, dispersed), or they can be structured with regard to political aspects (single-centric, multi-centric and pluralistic). This article, based on the latest scientific developments, presents the historical outline of the selected models for health care systems and the new concepts regarding their classification. The article also offers theoretical analyses of those health systems, which have become the models for others. The aim of this article is to present the classification and the characteristics of the selected models for health care systems, both from the historical perspective and the perspective of those currently in operation. The documents analysis method was used, which included the leading positions in the Polish and foreign literature, in the field of the issues addressed, as well as the literature published by the related institutions. This topic is already being discussed within the literature of the subject, nevertheless it is still relevant and, due to its undeniable importance, deserves further examination because it directly or indirectly concerns every human being.

A collection and its many relations and contexts

2020 ◽  
Vol 76 (3) ◽  
pp. 753-767
Author(s):  
Kathy Carbone
Keyword(s):  
Design Methodology ◽  
Participant Observation ◽  
Document Analysis ◽  
Ethnographic Study ◽  
Content Type ◽  
Social Lives ◽  
Archival Collection ◽  
Object Biography ◽  
Semistructured Interviews ◽  
The City

PurposeThe purpose of this paper is to report the results of an ethnographic study that used object biography with an archival collection of police surveillance files, the Police Historical/Archival Investigative Files, housed at the City of Portland Archives & Records Center in Portland, Oregon.Design/methodology/approachDocument analysis, participant observation, semistructured interviews, and object biography were conducted over four years, from 2013 to 2017.FindingsUsing object biography with the Police Historical/Archival Investigative Files uncovered numerous personal and public relationships that developed between people and this collection over several decades as well as how these records acquired, constructed, and changed meanings over time and space.Originality/valueThis paper argues that the biography of objects is a useful way for studying the relationships records form, the values people assign to them, and how people and records mutually inform and transform one another in shifting contexts of social lives. Recognizing records as having social histories and applying object biography to them contributes to and grows the greater biography and genealogy of the record and the archive—a genealogy important not only for discovering something about the lives of those who create, encounter, steward, and use records and archives but about our shared human experience.

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