A comparative study of non-Hodgkin lymphoma between public versus private institution in a middle-income country: A report of 2,317 cases.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19569-e19569
Author(s):  
Jule Franve Vasquez Chavez ◽  
Alonso Diaz ◽  
Daniel Enriquez ◽  
Luis Malpica ◽  
Michaell Cabrejos ◽  
...  
Keyword(s):  
T Cell ◽  
Public Institution ◽  
Cancer Center ◽  
Private Institutions ◽  
Extranodal Involvement ◽  
Private Institution ◽  
Public And Private ◽  
Middle Income ◽  
The Public ◽  
Non Hodgkin Lymphoma

e19569 Background: Non-Hodgkin lymphoma (NHL) is the most frequent hematological malignancy. B-cell (BCL) and T-cell (TCL) NHL subtypes differs in high income and low-and middle-income countries. In Peru, the healthcare system is divided mainly into public and private institutions. We aimed to describe the subtypes of NHL seen according to healthcare facilities. Methods: We reviewed medical records at National Cancer Institute and Oncosalud, both the leading public and private cancer centers in Peru, respectively. All patients diagnosed with NHL from 2015-2018 according to the 2016 WHO classification were included. Baseline characteristics were compared between public and private institutions using Student’s t test and Chi-square as appropriate. Results: A total of 2,317 NHL were included from both institutions. The median age was 61 years (range 15-99), 49.7% were male. Most patients NHL cases were encountered at the public institution (88.9%, n = 2,059); 84.4% (n = 1,957) were BCL and 15.5% (n = 360) TCL. Differences of BCL and TCL frequencies were seen among institutions. More BCL cases were seen at the private institution (96.6%, n = 230 versus 83.9%, n = 1,727, respectively) whereas TCL were common in the public institution (16.1%, n = 332 versus 11.8%, n = 28, respectively) (p < 0.035). The most frequent BCL was DLBCL with 70.0% (n = 1209) and 49.6% (n = 114) seen in public and private institutions, respectively (p < 0.001). The second most frequent BCL was follicular lymphoma (FL) with 10.8% (n = 187) and 20.4% (n = 47) seen in the public and private institutions, respectively (p < 0.001). Chronic lymphocytic lymphoma (CLL) and Burkitt lymphoma (BL) were most frequent in private institution (CLL 7%, n = 16 vs. 3.5%, n = 60, p = 0.017; BL 3.9%, n = 9 vs. 1.2%, n = 21, p = 0.004). The most frequent TCL was peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) (27.7%, n = 92) for the public institution and mycosis fungoides (MF) (39.3%, n = 11) for the private institution. The second most frequent TCL was natural killer/TCL (NKTCL) (22.6%, n = 75) for the public institution, and PTCL, NOS (17.9%, n = 5) for the private institution. There was significant difference in the number of NKTCL and MF cases seen during the study period among institutions (NKTCL public 22.6%, n = 75 vs. private 3.6%, n = 1, p = 0.033; MF public 15.1%, n = 50 vs. private 39.3%, n = 11, p = 0.003). The presence of extranodal involvement was more frequent in the public institution (52.3%, n = 1,049 vs. 35.3%, n = 84, p < 0.001). Conclusions: The distribution of NHL differs according to the type of healthcare system in Peru. Extranodal involvement, TCL, DLBCL and NKTCL are more frequent in patients treated at the public cancer center than in private center. On the contrary BCL, FL, CLL, BL and MF are more frequent in private cancer center. Our institutions are currently building the largest registry of NHL patients diagnosed and treated in Peru.

scholarly journals Differences in the Distribution of Non-Hodgkin Lymphoma in Public Versus Private Institution in a Latin American Country: A Cohort of 5,807 Cases

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4511-4511
Author(s):  
Jule F Vasquez ◽  
Alonso Diaz ◽  
Any S Mendoza ◽  
Claudio Flores ◽  
Carlos Barrionuevo ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Latin American ◽  
Public Institution ◽  
Cancer Center ◽  
Private Institutions ◽  
Private Institution ◽  
Public And Private ◽  
The Public ◽  
Non Hodgkin Lymphoma ◽  
Public Versus Private

Abstract Differences in the Distribution of non-Hodgkin Lymphoma in public versus private institution in a Latin American country: A cohort of 5,807 cases. Background: Non-Hodgkin lymphoma (NHL) is the most frequent hematological malignancy. B-cell (BCL) and T-cell (TCL) NHL subtypes differs in high income and low-and middle-income countries. In Peru, the healthcare system (HCS) is divided mainly into public and private institutions. We previously demonstrated that there is a difference in the distribution of NHL between the HCS. We aimed to describe the subtypes of NHL seen according to healthcare facilities in a large cohort. Methods: We reviewed medical records at National Cancer Institute and Oncosalud, both the leading public and private cancer centers in Peru, respectively. All patients diagnosed with NHL from 2010-2019 according to the 2016 WHO classification were included. Baseline characteristics were compared between public and private institutions using Student's t test and Chi-square as appropriate. Results: A total of 5,807 NHL were included from both institutions. The median age was 60 years (range 15-103), 50.6% were male. Most patients NHL cases were encountered at the public institution (92.4%, n = 5,368); 82.9% (n = 4,815) were BCL and 17.1% (n = 992) TCL. Differences of BCL and TCL frequencies were seen among institutions. More BCL cases were seen at the private institution (86.1%, n = 378 versus 82.7%, n = 4,437, respectively) whereas TCL were common in the public institution (17.3%, n = 931 versus 13.9%, n = 61, respectively) (p &lt; 0.065). The most frequent BCL was DLBCL with 68.6% (n = 3045) and 54.2% (n = 205) seen in public and private institutions, respectively (p &lt; 0.001). The second most frequent BCL was follicular lymphoma (FL) with 11.2% (n = 495) and 20.9% (n = 79) seen in the public and private institutions, respectively (p &lt; 0.001). Chronic lymphocytic lymphoma (CLL) and Burkitt lymphoma (BL) were most frequent in private institution (CLL 6.3%, n = 24 vs. 3.5%, n = 154, p = 0.004; BL 3.4%, n = 13 vs. 1.4%, n = 60, p = 0.001). The most frequent TCL was peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) (24.5%, n = 228) for the public institution and mycosis fungoides (MF) (42.6%, n = 26) for the private institution. The second most frequent TCL was natural killer/TCL (NKTCL) (23.5%, n = 219) for the public institution, and PTCL, NOS (21.3%, n = 13) for the private institution. There was significant difference in the number of NKTCL and MF cases seen during the study period among institutions (NKTCL public 23.5%, n = 219 vs. private 4.9%, n = 3, p = 0.001; MF public 9.1%, n = 90 vs. private 42.6%, n = 26, p &lt;0.001). Conclusions: The distribution of NHL subtypes differs according to the type of healthcare system in Peru. Our large cohort confirms that DLBCL and NKTCL are more frequent in patients treated at the public cancer center than in private center. On the contrary FL, CLL, BL and MF are more frequent in private cancer center. The difference in the distribution of BCL and TCL was not statistically significant. Disclosures No relevant conflicts of interest to declare.

Who Said What to Whom

2021 ◽  
pp. 246-255
Author(s):  
Cass R. Sunstein
Keyword(s):  
Water Quality ◽  
Private Institutions ◽  
Costs And Benefits ◽  
Public And Private ◽  
Daily Lives ◽  
The Public ◽  
Its Analysis ◽  
Drone Strikes ◽  
The Government

It is important to distinguish between two kinds of transparency. The government can be transparent about its “inputs”: about who, within government, said what to whom, and when, and why. The government can also be transparent about its “outputs”: its regulations and its policies, its findings about air and water quality, or its analysis of the costs and benefits of drone strikes. The argument for output transparency is often very strong, because members of the public can receive information that can help them in their daily lives and because output transparency can improve the performance of both public and private institutions. The argument for input transparency is different and often weaker, because the benefits of disclosure can be low and the costs can be high. It is challenging to make general pronouncements about input transparency and the appropriate evaluation of leaks and leakers without making a contestable judgment about whether a particular government is well-functioning and capable of self-correction.

Factors That Predict Institutional Adoption of Professional Physical Therapist Education Programs

2019 ◽  
Vol 99 (7) ◽  
pp. 849-861 ◽  
Author(s):  
Tara Dickson ◽  
Barrett J Taylor
Keyword(s):  
Education Program ◽  
Physical Therapist ◽  
Full Time ◽  
Private Institutions ◽  
Education Programs ◽  
Full Time Equivalent ◽  
Private Institution ◽  
Public And Private ◽  
Physical Therapist Education ◽  
Therapist Education

AbstractBackgroundBetween 1995 and 2015, the number of accredited physical therapist education programs in the United States rose from 127 to 224. Colleges and universities have been known to develop new programs in an effort to generate revenues through student tuition.ObjectiveIn the present study, sources of institutional revenue and expenditures were used as predictors for the adoption of physical therapist education programs.DesignYearly data from the Integrated Postsecondary Education Data System for 1731 higher education institutions were combined with dates from the Commission on Accreditation in Physical Therapy Education for physical therapist education program accreditation from 1995 to 2015.MethodsA retrospective event history analysis of yearly institutional data was used to calculate the hazard of an institution adopting a physical therapist education program on the basis of institutional revenues and expenditures.ResultsPrivate institutions were 62% less likely to adopt a physical therapist education program when they experienced a 1% increase in total revenue per full-time–equivalent student. Conversely, a given private institution was 2.71 times more likely to adopt a physical therapist education program for every 1% increase in total expenditures per full-time–equivalent student. Both public and private institutions experienced an increased chance of adopting an entry-level (professional) physical therapist education program when instructional expenditures rose. They were also more than twice as likely to adopt physical therapist education programs when they experienced a 1% increase in the number of students.LimitationsCausation between professional physical therapist education program adoption and the variables studied cannot be determined through observational analysis alone.ConclusionsThe more revenue a private institution generated, the less likely it was to add a program in the search for further revenues. As expenses rose, the chance of adoption trended upward beyond increases in institutional revenues for both public and private not-for-profit institutions.

scholarly journals Venezuelan Higher Education: The Chavez Revolution

2015 ◽  
Author(s):  
Daniel Levy
Keyword(s):  
Higher Education ◽  
Latin America ◽  
Public Sector ◽  
Private Universities ◽  
Institutions Of Higher Education ◽  
Private Institutions ◽  
Public And Private ◽  
The Public ◽  
History Of

Hugo Chavez's clash with Venezuelan higher education is a vivid present-day example of a history of confrontation between leftist, populist regimes and higher education in Latin America. Chavez has transformed the public sector through creation and expansion of new universities. Chavez's policies have alienated the country's private institutions of higher education. Both public and private universities are reduced in importance.

Personality disorder among first ever admissions to an Irish public and private hospital

1996 ◽  
Vol 13 (1) ◽  
pp. 6-8 ◽  
Author(s):  
John M Cooney ◽  
Conor K Farren ◽  
Anthony W Clare
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Private Hospital ◽  
Psychiatric Morbidity ◽  
Psychiatric Hospitals ◽  
Private Institutions ◽  
Public And Private ◽  
The Public ◽  
True Prevalence ◽  
Significant Difference

AbstractObjective: The identification of personality disorder among psychiatric in-patients is important because of the effect on the course and outcome of illness. The introduction of a multiaxial approach to diagnosis, has resulted in a higher than previously reported rate of occurrence of personality disorder in a variety of psychiatric settings. A prevalence of personality disorder of 4.9% is reported in the official statistics for Irish psychiatric hospitals. The aim of this study is to determine the true prevalence of personality disorders in two Irish psychiatric hospitals, one public and one private, using a multiaxial approach to diagnosis.Methods: The Standardised Assessment of Personality (SAP) is a validated, semistructured, informant based instrument that reliably generates diagnoses of personality disorder irrespective of current mental state. Over a four month period, 78 consecutive, first ever admissions to two hospitals were examined using the SAP.Results: The prevalence of personality disorder in this population was 26%. There was no significant difference in the rate of personality disorder between the public and private institutions.Conclusions: The prevalence of personality disorder amongst in-patients in both public and private psychiatric hospitals in Ireland is far higher than previously reported. This highlights the importance of a multiaxial approach to diagnosis in order to establish the true extent of psychiatric morbidity.

scholarly journals Acute Kidney Injury in Poor Countries Should No Longer Be a Death Sentence: The ISN ‘0 by 25' Project

2015 ◽  
Vol 66 (Suppl. 3) ◽  
pp. 42-44 ◽  
Author(s):  
Norberto Perico ◽  
Giuseppe Remuzzi
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Death Sentence ◽  
Public And Private ◽  
Middle Income ◽  
Poor Countries ◽  
The Public ◽  
Middle Income Countries ◽  
Timely Fashion

Acute kidney injury (AKI) is a common disorder throughout the world that is associated with severe morbidity, mortality and cost. Although deaths due to AKI occur in both high- and low- and middle-income countries (LMIC), the majority of avoidable deaths occur in LMIC nations. If managed adequately and in a timely fashion, the majority of these cases of AKI are preventable, treatable and often reversible with simple measures. AKI also has a major economic impact on healthcare expenditure. This is particularly true in poor countries where AKI especially impacts young productive people, imposing severe penury on their families. The International Society of Nephrology (ISN) has launched a long-term program, the ‘0 by 25' project, which advocates that zero people should die of untreated AKI in the poorest part of Africa, Asia and Latin America by 2025. The mission is to eventually lessen the high burden in terms of deaths consequent to this disorder in resource-poor regions worldwide. This is a challenging but potentially feasible and productive initiative that requires a broad vision about how the public and private sectors can work in partnership with the governments of the LMIC countries and leading nongovernmental organizations operating locally, to ensure sustainability of the 0 by 25 program and save many lives.

II. Benefice and Vassalage in the Age of Charlemagne

1939 ◽  
Vol 6 (2) ◽  
pp. 147-175 ◽  
Author(s):  
F. L. Ganshof
Keyword(s):  
Middle Ages ◽  
Essential Feature ◽  
Eighth Century ◽  
Private Institutions ◽  
Public And Private ◽  
The Public ◽  
The Gift ◽  
History Of ◽  
Preceding Period ◽  
The Subject

A Number of important studies have been published in recent years on the subject of benefice and vassalage during the early Middle Ages, and it may consequently be worth while to re-examine some of the problems raised by the origin and early development of these two institutions. I have dealt elsewhere with, the circumstances which tended towards their union early in the eighth, century, under the early Carolingians, In this article I hope to indicate at least the principal features of the history of benefice and vassalage during the reign of Charlemagne. The Influence which Charles exercised on the public and private institutions of the Frankish state was so definite and far-reaching as fully to justify the limitation of the subject-matter of my inquiry to the space of a single reign. Unfortunately the lack of adequate sources, though less serious than for the preceding period, renders the task of tracing their history a somewhat difficult one. Although the capitularies contain a relatively large number of provisions that deal specifically with these institutions, we have very little information as to how they worked in practice. The narrative sources, with the exception of two or three texts, tell us little or nothing. We have to fall back on the evidence of charters, though even these only rarely, when dealing with a dispute or legal proceeding, throw some light on the subject. This is what we might in any case expect, for the essential feature of the entry of a person into vassalage or of the gift of a benefice was the oral act, and not any embodiment of it in writing.

scholarly journals Educação a Distância (EaD): Processos de Mediação e Uso das Tecnologias em uma Abordagem Transdisciplinar

EAD em FOCO ◽  
2015 ◽  
Vol 5 (3) ◽  
Author(s):  
Daniela Da Costa Britto Pereira Lima ◽  
Lívia Soares de Lima Sousa
Keyword(s):  
Higher Education ◽  
Access To Higher Education ◽  
Private Institutions ◽  
Public And Private ◽  
Reconstruction Process ◽  
Historical Process ◽  
The Public ◽  
E Learning ◽  
Almost All ◽  
Education In Brazil

A utilização da EaD como forma de democratizar o ensino superior no Brasil tem sido discutida por pesquisadores afetos aos mais diversos temas educacionais. Trazemos neste estudo uma breve retomada histórica, demonstrando que os primeiros cursos de ensino superior no Brasil não se destinavam às consideradas classes subalternas. Esse processo histórico fez com que o ensino superior se tornasse algo quase restrito às classes dominantes. Apresentamos a EaD e sua legislação a fim de introduzir também a criação e implementação do Sistema Universidade Aberta do Brasil (UAB), política com vistas à democratização do acesso ao ensino superior. Elencamos alguns autores contrários ao uso da EaD como forma de democratizar o ensino no Brasil. Embora em direções diferentes, os autores contrários ao uso da EaD caminham quase sempre num mesmo viés. Um dos principais argumentos trazidos no bojo de suas argumentações contrárias é de que a EaD estaria servindo apenas aos interesses mercantilistas? preconizados pela reestruturação do aparelho do Estado, operacionalizado principalmente na década de 1990. Tais autores desconsideram os avanços obtidos por meio da EaD, a despeito dos percalços e/ou dificuldades enfrentadas em tal modalidade. Sendo assim, trazemos autores favoráveis à implementação da EaD como política de popularização do ensino, a fim de demonstrar como ela tem sido importante no processo histórico de democratizar o ensino superior em nosso país, ampliando suas vagas, avançando na questão do acesso e, ainda, interiorizando as IES públicas e privadas em praticamente todo o território nacional.Palavras-chave: EaD; Ensino a distância no Brasil; Democratização do ensino superior.The EaD in Brazil and the Process of Democratization of Access to Higher Education: Possible DialoguesAbstractThe use of E-learning as a way to democratize higher education in Brazil has been discussed by researchers concerned about the most diverse educational themes. We bring in this study a brief historic overview showing that the first higher education courses in Brazil were not destined to the classes considered subaltern. This historical process has made higher education to become something almost restricted to the dominant classes. We present E-learning and its legislation in order to introduce also the creation and implementation of Open University System of Brazil (UAB), with aiming the access to higher education democratization. We also mention some authors opposed to use of E-learning as a way to democratize the education in Brazil. Although in different directions, authors opposed to use of E-learning follow the same bias almost always. One of the main arguments is that E-learning was only serving the "mercantilist" interests recommended by the State reconstruction process which took place mainly in the 90s. Such authors disregard the advances obtained by education through E-learning, despite the difficulties faced in such modality. Therefore, we bring authors in favor of E-learning as education democratization policy implementation in order to demonstrate how E-learning has been important in the historical process higher education democratization in our country, increasing their number of vacancies, improving the issue of access and interiorizing the public and private Institutions of Higher Education in almost all the national territory.Keywords: E-learning; Distance education in Brazil; Higher education; Democratization.

scholarly journals Evaluation of the knowledge of university students in the health area about sexually transmitted infections: A cross-sectional study

2021 ◽  
Vol 10 (5) ◽  
pp. e52710515370
Author(s):  
Carlos Izaias Sartorão Filho ◽  
Carlos Izaias Sartorão Neto ◽  
Carla Fabiana Souza Guazelli ◽  
Camila Rodrigues Avello ◽  
Ivana Geraldelli Neiva Rodrigues ◽  
...  
Keyword(s):  
University Students ◽  
Cross Sectional Study ◽  
Public Institution ◽  
Sectional Study ◽  
Private Institution ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
The Public ◽  
Health Area ◽  
The Mean

Introduction: Sexually transmitted infections (STI) have consequences that negatively affect the population's quality of life and health. Young adults are susceptible to low access to preventive measures and a greater behavior risk. The objective was to evaluate and compare STI' Knowledge in university students from health courses, a public institution, and a private institution of higher education in Brazil. Methods: a cross-sectional study conducted in 2019 in Brazil at the FEMA School of Medicine in Assis-SP and the University of the State of São Paulo (UNESP) in Marília in the courses of Physiotherapy, Speech Therapy, and Occupational Therapy, in undergraduate students, over 18 years of age, through a self-applied questionnaire translated and adapted to the Brazilian Portuguese from the STD-KQ – Transmitted Disease Knowledge Questionnaire.Results: 462/700 students participated (66.66%) 18-46 years of age (mean 21.46 years, +/- 3.61), 99 men and 363 women. In the private institution, 262/340 (77.06%), and in the public institution, 200/360 (55.55%). The mean age was 22.21 (+/- 4.21) years among men and 21.25 (+/- 3.41) years among women. The mean percentage of the 28 test questions' correct answers was 52.07%.  The average number of correct responses per student was 17.49 out of 28 possible, 62% (+/-4.97). The distribution between the groups was normal. In the multiple linear regression model for the percentage of correct answers, adjusted for the confounding variables, the intercept was 55.2. The students of the private institution answered 19,655 questions more than the public one (P<.001), and for each semester of graduation, the students answered 1,628 more questions (P<.001). There were no relevant differences regarding the gender and age of the students. Conclusion: there are gaps in STI knowledge among university students in the health area. The students of the first semesters of the courses, and, in particular, students from a public educational institution, had a significantly lower performance of the right in the questionnaire applied. Thus, actions to promote STI knowledge and preventive attitudes are necessary among university students.

THE PROSPECTS AND CHALLENGES OF YOUTH ENTREPRENEURSHIP IN ZANZIBAR, TANZANIA: ADMINISTRATORS’ PERSPECTIVES

2021 ◽  
Vol 7 (2) ◽  
pp. 13-22
Author(s):  
Said Mohamed Khamis ◽  
Mohar Yusof
Keyword(s):  
Public Institution ◽  
Policy Intervention ◽  
Private Institutions ◽  
Poor Growth ◽  
Public And Private ◽  
Analysis Techniques ◽  
Necessity Entrepreneurship ◽  
Strategic Initiative ◽  
Entrepreneurial Culture ◽  
Youth Entrepreneurship

Youth entrepreneurship is an emerging enquiry, which is critical in addressing unemployment crisis among young people. This paper explored prospects and challenges of youth entrepreneurship in developing economy, Zanzibar in Tanzania. The paper adopted qualitative methods using thematic analysis techniques to derive prospects and challenges from recorded transcripts according to administrator’s perspective from public and private institutions responsible for entrepreneurship in the country. The study found that youth entrepreneurship is strategic initiative of transforming necessity entrepreneurship into opportunity entrepreneurship, stimulating innovation initiatives for solving challenges facing society, promoting sectoral linkage, job creation and building entrepreneurial culture. However, youth entrepreneurship is constrained internally by lack of funds, poor growth and sustainability of youth enterprises, lack of entrepreneurial mindset and alertness to opportunities, while externally by poor coordination of public institution responsible for entrepreneurship development, bureaucracy, and lack of family support. The study becomes empirical evidence on the importance of youth entrepreneurship and thereby recommended for policy intervention would ameliorate the challenges and helps build entrepreneurial culture for the development of entrepreneurship in the country.

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