scholarly journals Mapping Geospatial Access to Comprehensive Cancer Care in Nigeria

2019 ◽  
pp. 1-8
Author(s):  
Gregory C. Knapp ◽  
Gavin Tansley ◽  
Olalekan Olasehinde ◽  
Olusegun I. Alatise ◽  
Funmilola Wuraola ◽  
...  
Keyword(s):  
Cancer Control ◽  
Population Level ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Travel Times ◽  
Cancer Centers ◽  
North East ◽  
The North ◽  
Comprehensive Cancer Centers ◽  
The Impact

PURPOSE To address the increasing burden of cancer in Nigeria, the National Cancer Control Plan outlines the development of 8 public comprehensive cancer centers. We map population-level geospatial access to these eight centers and explore equity of access and the impact of future development. METHODS Geospatial methods were used to estimate population-level travel times to the 8 cancer centers. A cost distance model was built using open source road infrastructure data with verified speed limits. Geolocated population estimates were amalgamated with this model to calculate travel times to cancer centers at a national and regional level for both the entire population and the population living on < US$2 per day. RESULTS Overall, 68.9% of Nigerians have access to a comprehensive cancer center at 4 hours of continuous vehicular travel. However, there is significant variability in access between geopolitical zones ( P < .001). The North East has the lowest access at 4 hours (31.4%) and the highest mean travel times (268 minutes); this is significantly lower than the proportion with 4-hour access in the South East (31.4% v 85.0%, respectively; P < .001). The addition of a second comprehensive cancer center in the North East, in either Bauchi or Gombe, would significantly improve access to this underserved region. CONCLUSION The Federal Ministry of Health endorses investment in 8 public comprehensive cancer centers. Strengthening these centers will allow the majority of Nigerians to access the full complement of multidisciplinary care within a reasonable time frame. However, geospatial access remains inequitable, and the impact on outcomes is unclear. This must be considered as the cancer control system matures and expands.

scholarly journals Cancerpedia: A Framework for Implementing Comprehensive Cancer Centres

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 244s-244s
Author(s):  
N. Abdelmutti ◽  
A. Chudak ◽  
M. Merali ◽  
T. Sullivan ◽  
M. Escaf ◽  
...  
Keyword(s):  
Palliative Care ◽  
Best Practices ◽  
Cancer Care ◽  
Care Delivery ◽  
Cancer Control ◽  
System Level ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cancer Centers ◽  
Comprehensive Cancer Centers

Background and context: Comprehensive cancer centers or programs form a nucleus of cancer care delivery. Although there are frameworks for population cancer control, no similar published framework exists for cancer centers. Aim: We sought to develop a framework for designing and implementing a comprehensive cancer center or program within the context of a population-based model of cancer control that spans diagnosis, treatment, supportive care, and palliative care as well as integration with primary care and the community. Strategy/Tactics: The framework was constructed with the patient at the center and provides a system-level perspective as well as a granular view of the fundamental resources and structures needed to build and maintain individual cancer centers and programs. Due to its breadth, we focused the framework on essential information while linking to a wide range of vetted publications that detail additional standards, guidelines and best practices. Program/Policy process: “Cancerpedia” emerged as a cohesive framework for the delivery of high-quality cancer care within and beyond the cancer center. It provides an overview of the cancer control and care delivery framework, describes cancer care services (e.g., radiotherapy, chemotherapy, palliative care) and details infrastructure and core services (e.g., physical facilities, human resources). In addition to these services, the framework presents guidelines for governance that ensure oversight and quality, describes the critical need for integrating education and research and presents the best practices for engaging in philanthropy. Cancerpedia also outlines the role of the comprehensive cancer center in integration with the community and influencing policy and regulation. Over 30 chapters provide a detailed description of each element and include a description of the service or function, resources requirements such as people, equipment and facilities, management structures, quality performance guidelines and future trends in innovation. Outcomes: To our knowledge, no comparable published framework exists as a reference for developing comprehensive cancer centers. Cancerpedia was designed to serve as a global public good and is adaptable and applicable to diverse contexts and healthcare environments. It is relevant to high-, middle- and low-income countries alike and provides a reference point from which to structure a plan for growth. What was learned: While it is important to describe the various elements required for cancer care delivery, it is critical to consider and address the integration and interdependencies of these various elements. Future opportunities for learning include seeking input from a global audience to gauge the utility and applicability of Cancerperdia to local contexts.

scholarly journals Building a Comprehensive Cancer Center: Overall Structure

2021 ◽  
pp. 3-13
Author(s):  
Dolores Grosso ◽  
Mahmoud Aljurf ◽  
Usama Gergis
Keyword(s):  
Medical Center ◽  
Cancer Control ◽  
Community Outreach ◽  
Control Program ◽  
Cancer Center ◽  
Cancer Centers ◽  
Comprehensive Cancer Centers ◽  
Private Donations ◽  
Cancer Control Program ◽  
Health Organization

AbstractAccording to the World Health Organization (WHO), cancer is the second leading cause of death globally, accounting for approximately 9.6 million deaths [1]. The WHO recommends that each nation has a national cancer control program (NCCP) to reduce the incidence of cancer and deaths related to cancer, as well as to improve the quality of life of cancer patients [2]. Comprehensive cancer centers form the backbone of a NCCP and are charged with developing innovative approaches to cancer prevention, diagnosis, and treatment [3]. This is accomplished through basic and clinical research, the provision of patient care, the training of new clinicians and scientists, and community outreach and education. Most comprehensive cancer centers are affiliated with university medical centers, but their cancer care initiatives may involve partnering outside the institution with other comprehensive cancer centers, community leaders, or members of industry [3]. When affiliated with a university medical center, cancer center executives must work in concert with their counterparts at the hospital, patient practice, medical school, and allied health science leaders resulting in an overlapping, often complicated reporting structure. Comprehensive cancer centers and the departments in the center receive funding for their services from various sources, including national and local grants, institutional funds, private donations, and industry [4].

The effect of care at NCI comprehensive cancer centers on disparities in outcome in adolescents and young adults (AYAs) with cancer.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 217-217 ◽  
Author(s):  
Julie Anna Wolfson ◽  
Can-Lan Sun ◽  
Heeyoung Kim ◽  
Tongjun Kang ◽  
Smita Bhatia
Keyword(s):  
Overall Survival ◽  
Multivariable Analysis ◽  
Cancer Center ◽  
Insurance Status ◽  
Cancer Centers ◽  
Risk Of Death ◽  
Comprehensive Cancer Centers ◽  
Increased Risk ◽  
Race Ethnicity ◽  
The Impact

217 Background: AYAs (15-39y at diagnosis) with cancer have not seen the survival improvement evidenced by younger and older age groups with similar diagnoses, leaving an AYA Gap. While treatment on pediatric protocols is associated with superior survival in 15-21y, impact of site of care on survival for vulnerable AYA subpopulations (race/ethnicity) between 22-39y at diagnosis remains unstudied. Methods: Utilizing a cohort of 10,602 AYAs newly diagnosed between 22-39y with lymphoma, leukemia, brain tumors, melanoma, thyroid and GU cancers, and reported to the Los Angeles County cancer registry between 1998 and 2008, we aimed to determine the impact of receiving care at NCI Comprehensive Cancer Centers (NCICCC) on overall survival for AYAs, and disparities in survival by race/ethnicity. We further aimed to understand the role of SES and insurance status in accessing care at NCICCC. Multivariable analyses included race/ethnicity, age at diagnosis, SES, insurance status, primary cancer diagnosis and diagnosis year in the model. Results: A total of 904 (9%) patients received treatment at the 3 NCICCC (City of Hope, Jonsson Cancer Center, and Norris Cancer Center) in LA County. Ten-year overall survival (10y OS) was significantly worse for patients treated at non-NCICCC (81%) when compared with those treated at NCICCC (83%, p=0.02). Also, 10y OS was worse for African Americans (AA) (68%) vs. non-Hispanic whites (86%, p<0.0001). Multivariable analysis adjusting for SES, insurance status, diagnosis and diagnosis year revealed that AA (HR=1.5, p=0.0001) were at an increased risk of death. Among patients treated at NCICCC, the difference in risk of death due to race (HR=0.9, p=0.84) was abrogated. However, among patients treated at non-NCICCC, these differences in outcome persisted (HR=1.48, p<0.0001). Independent of SES, insurance and tumor factors, AA (OR=0.44, p<0.001) were less likely to use NCICCC. Conclusions: Population-based data reveal that receipt of care at an NCICCC abrogates the inferior outcome observed among AA with cancer. AA are less likely to use NCICCC for treatment. Barriers to accessing care at NCICCC are currently being explored.

scholarly journals EVALUATION OF THE IMPACT OF ENVIRONMENTAL CONDITIONS ON THE STATUS OF THE BODY OF YOUNG PEOPLE OF 17-19 YEARS OF DIFFERENT ETHNIC GROUPS OF THE NORTH-EAST RUSSIA

2019 ◽  
Vol 96 (8) ◽  
pp. 766-769 ◽  
Author(s):  
Inessa V. Averyanova ◽  
S. I. Vdovenko ◽  
A. L. Maksimov
Keyword(s):  
Gas Exchange ◽  
Climatic Conditions ◽  
The Body ◽  
External Respiration ◽  
Adaptive Responses ◽  
Northeast Russia ◽  
North East ◽  
The North ◽  
Magadan Region ◽  
The Impact

Natural and climatic conditions of the environment of Northeast Russia and particularly Magadan region are the very factor mostly influencing adaptive responses by individuals inhabiting the region. Compensatory and adaptive responses in indigenes and newcomers of the region can be assumed to have their specific features. In 2009 there was executed the examination of the cardiovascular and respiratory systems and gas exchange in 392 cases aged of 17-19 years, including Europeans (Caucasians) born in the North in the 1st-2nd generation and indigenes. The methodologically similar study was carried out in 2014 in 265 persons, referred to the same cohorts of North-born Caucasians and Indigenes from the Magadan region. The results of the study executed in 2009 testified to a small number of physiological parameters that were reliably different in Caucasians vs. Indigene subjects. In 2014 no difference was found between the two examined cohorts throughout the observed parameters. The revealed changes in gas exchange, external respiration and cardiovascular systems demonstrated by modern young Indigenes of Northeast Russia testified to the fall in the effectiveness of their breathing. All that makes them farther from the classic “polar metabolic type” and their morphofunctional status becomes closer to European male subjects of Northeast Russia. Thus, we can observe a clear tendency towards “convergence in programs” of the adaptive changes between populations of the North residents undergoing similar natural, environmental and social factors.

scholarly journals 'Greenfields' and 'Brownfields': automotive industrial development in the UK and in Portugal

Finisterra ◽  
2012 ◽  
Vol 31 (62) ◽  
Author(s):  
Andrew Pike ◽  
Mário Vale
Keyword(s):  
Industrial Policy ◽  
Automobile Industry ◽  
Industrial Development ◽  
Development Strategies ◽  
North West ◽  
Demonstration Effect ◽  
North East ◽  
The North ◽  
The Uk ◽  
The Impact

The industrial policy in the UK and in Portugal, as in most EU countries, seeks to attract new investment capacity, to create jobs and to promote the impact of the so-called "demonstration efect" of "greenfield" development strategies pursued in the new plants of inward investors on existing or "brownfield" plants. This industrial policy focus is particularly evident in the automobile industry.This paper compares the industrial policy oriented towards the automobile industry in the UK and in Portugal. Two recent "greenfield" investments are analised: Nissan in the North-East region (UK) and Ford/VW in the Setúbal Peninsula (Portugal), as well as three "brownfield" plants: Ford Halewood and GM Vauxhall Ellesmere Port in the North-West region (UK) and Renault in Setúbal (Portugal). The first part starts with a discussion of industrial policy in the automobile sector, the role of "greenfield" development strategies and the "demonstration effect" on "brownfield" plants. Then, the limits of new inward investment are pointed out, basically their problems and restrictions. Afterwards, the structural barriers to the "demonstration effect" within "brownfield" plants are outlined and some possabilities for alternative "brownfield" development strategies are presented.

Inequalities in awareness and availability of bereavement services in North-East England

2020 ◽  
pp. bmjspcare-2020-002422
Author(s):  
Donna Wakefield ◽  
Elizabeth Fleming ◽  
Kate Howorth ◽  
Kerry Waterfield ◽  
Emily Kavanagh ◽  
...  
Keyword(s):  
Phase 1 ◽  
Waiting Times ◽  
Financial Strain ◽  
Web Based ◽  
North East ◽  
The North ◽  
Referral Criteria ◽  
National Guidance ◽  
The Uk ◽  
The Impact

ObjectivesNational guidance recommends equality in access to bereavement services; despite this, awareness and availability appears inconsistent. The aim of this study was to explore availability and accessibility of bereavement services across the North-East of England and to highlight issues potentially applicable across the UK, at a time of unprecedented need due to the impact of COVID-19.MethodsPhase 1: an eight item, web-based survey was produced. A survey link was cascaded to all GP practices (General Practitioners) in the region. Phase 2: an email was sent to all services identified in phase 1, requesting details such as referral criteria and waiting times.ResultsAll 392 GP practices in the region were invited to participate. The response rate was 22% (85/392). Twenty-one per cent (18/85) of respondents reported that they do not refer patients, comments included ‘not aware of any services locally’. A total of 36 services were contacted with 72% responding with further information. Most bereavement specific support was reliant on charity-funded services including hospices, this sometimes required a pre-existing link with the hospice. Waiting times were up to 4 months.ConclusionsAlthough multiple different, usually charity-funded services were identified, awareness and accessibility were variable. This survey was conducted prior to the COVID-19 pandemic, where complex situations surrounding death is likely to impact on the usual grieving process and increase the need for bereavement support. Meanwhile, charities providing this support are under severe financial strain. There is an urgent need to bridge the gap between need and access to bereavement services.

scholarly journals Reducing pressure ulcers across multiple care settings using a collaborative approach

2019 ◽  
Vol 8 (3) ◽  
pp. e000409 ◽  
Author(s):  
Julia Wood ◽  
Bob Brown ◽  
Annette Bartley ◽  
Andreia Margarida Batista Custódio Cavaco ◽  
Anthony Paul Roberts ◽  
...  
Keyword(s):  
Pressure Ulcers ◽  
Length Of Hospital Stay ◽  
Community Services ◽  
Care Community ◽  
North East ◽  
The North ◽  
Healthcare Improvement ◽  
The Uk ◽  
Breakthrough Series Collaborative ◽  
The Impact

In the UK, over 700 000 patients are affected by pressure ulcers each year, and 180 000 of those are newly acquired each year. The occurrence of pressure ulcers costs the National Health Service (NHS) more than 3.8 million every day. In 2004, pressure ulcers were estimated to cost the NHS £1.4–£2.4 billion per year, which was 4% of the total NHS expenditure.The impact on patients can be considerable, due to increased pain, length of hospital stay and decreased quality of life. However, it is acknowledged that a significant number of these are avoidable.In early 2015, it was identified that for the North East and North Cumbria region the incidence of pressure ulcers was higher than the national average. Because of this, a 2-year Pressure Ulcer Collaborative was implemented, involving secondary care, community services, care homes and the ambulance service, with the aim of reducing the percentage of pressure ulcers developed by patients within their care.The Breakthrough Series Collaborative Model from the Institute for Healthcare Improvement provided the framework for this Collaborative.In year 1, pressure ulcers were reduced by 36%, and in year 2 by 33%, demonstrating an estimated cost saving during the lifespan of the Collaborative of £513 000, and a reduction in the number of bed days between 220 and 352.

scholarly journals An interrupted time-series analysis of the impact of emergency department reconfiguration on regional emergency department trolley numbers in Ireland from 2005 to 2015

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029261 ◽  
Author(s):  
Brenda Lynch ◽  
John Browne ◽  
Claire Mary Buckley ◽  
Orla Healy ◽  
Paul Corcoran ◽  
...  
Keyword(s):  
Emergency Department ◽  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
North East ◽  
The North ◽  
Number Of Patients ◽  
Geographical Regions ◽  
The Impact

ObjectivesTo understand the impact of emergency department (ED) reconfiguration on the number of patients waiting for hospital beds on trolleys in the remaining EDs in four geographical regions in Ireland using time-series analysis.SettingEDs in four Irish regions; the West, North-East, South and Mid-West from 2005 to 2015.ParticipantsAll patients counted as waiting on trolleys in an ED for a hospital bed in the study hospitals from 2005 to 2015.InterventionThe system intervention was the reconfiguration of ED services, as determined by the Department of Health and Health Service Executive. The timing of these interventions varied depending on the hospital and region in question.ResultsThree of the four regions studied experienced a significant change in ED trolley numbers in the 12-month post-ED reconfiguration. The trend ratio before and after the intervention for these regions was as follows: North-East incidence rate ratio (IRR) 2.85 (95% CI 2.04 to 3.99, p<0.001), South IRR 0.68 (95% CI 0.51 to 0.89, p=0.006) and the Mid-West IRR 0.03 (95% 1.03 to 2.03, p=0.03). Two of these regions, the South and the Mid-West, displayed a convergence between the observed and expected trolley numbers in the 12-month post-reconfiguration. The North-East showed a much steeper increase, one that extended beyond the 12-month period post-ED reconfiguration.ConclusionsFindings suggest that the impacts of ED reconfiguration on regional level ED trolley trends were either non-significant or caused a short-term shock which converged on the pre-reconfiguration trend over the following 12 months. However, the North-East is identified as an exception due to increased pressures in one regional hospital, which caused a change in trend beyond the 12-month post reconfiguration.

scholarly journals Parenting while living with advanced cancer: A qualitative study

2016 ◽  
Vol 31 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Eliza M Park ◽  
Devon K Check ◽  
Mi-Kyung Song ◽  
Katherine E Reeder-Hayes ◽  
Laura C Hanson ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Functional Status ◽  
Advanced Cancer ◽  
Metastatic Cancer ◽  
Eastern Cooperative Oncology Group ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Parental Concerns ◽  
The Impact

Background: Patients with advanced cancer who have dependent children are an important population with a life-limiting illness and high levels of psychological distress. Few studies have addressed the experience of being a parent with advanced cancer and their potential palliative needs. Aim: To describe the experience of living with advanced cancer as a parent, including illness experience, parental concerns, and treatment decision making and to explore whether these experiences differ by their functional status. Design: We conducted a cross-sectional, qualitative study using in-depth, semi-structured interviews. Data were analyzed using thematic content analysis. Setting and participants: A total of 42 participants with metastatic cancer and with at least one child under the age of 18 years were recruited from a comprehensive cancer center. 25 participants were rated as having high functional status (the Eastern Cooperative Oncology Group (ECOG) Performance Status Scale = 0–1) and 17 with low functional status (ECOG=2–4). Results: We identified four themes regarding the experience of being a parent with advanced cancer: (1) parental concerns about the impact of their illness and death on their children, (2) “missing out” and losses of parental role and responsibilities, (3) maintaining parental responsibilities despite life-limiting illness, and (4) parental identity influencing decision making about treatment. Parental functional status influenced not only physical responsibilities but also intensified parenting psychological concerns. Conclusion: Parents with metastatic cancer may have unique palliative care needs as they experience parenting concerns while managing the psychological and physical demands of advanced cancer.

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