scholarly journals Improving Access to Cancer Testing and Treatment in Kenya

2018 ◽  
pp. 1-8 ◽  
Author(s):  
Louise K. Makau-Barasa ◽  
Sandra B. Greene ◽  
Nicholas A. Othieno-Abinya ◽  
Stephanie Wheeler ◽  
Asheley Skinner ◽  
...  
Keyword(s):  
Policy Development ◽  
Treatment Options ◽  
Health Sector ◽  
Late Presentation ◽  
Policy Recommendations ◽  
Health Seeking ◽  
Patients With Cancer ◽  
Treatment Services ◽  
Effective Interventions ◽  
Treatment Facilities

Purpose In response to the increasing cancer burden in Kenya, this study identified barriers to patients seeking access to cancer testing and treatment and to clinicians in delivering these services. Policy recommendations based on findings are presented. Methods This qualitative study used semistructured key informant interviews. Purposive sampling was used to recruit 14 participants: seven oncology clinicians and seven support and advocacy leaders for patients with cancer. Qualitative analysis was used to identify themes. Results Seven barriers to cancer testing and treatment were identified: high cost of testing and treatment, low level of knowledge about cancer among population and clinicians, poor health-seeking behaviors among population, long distances to access diagnostic and treatment services, lack of decentralized diagnostic and treatment facilities, poor communication, and lack of better cancer policy development and implementation. Conclusion Kenyans seeking cancer services face significant barriers that result in late presentation, misdiagnosis, interrupted treatment, stigma, and fear. Four policy recommendations to improve access for patients with cancer are (1) improve health insurance for patients with cancer; (2) establish testing and treatment facilities in all counties; (3) acquire diagnosis and treatment equipment and train health personnel to screen, diagnose, and treat cancer; and (4) increase public health awareness and education about cancer to improve diagnoses and treatment. Effective cancer testing and treatment options can be developed to address cancer in a resource-constrained environment like Kenya. An in-depth look at effective interventions and policies being implemented in countries facing similar challenges would provide valuable lessons to Kenya’s health sector and policymakers.

scholarly journals Public Investment for Health in Vietnam: The Current State and Policy Recommendations

2021 ◽  
Vol 04 (10) ◽  
Author(s):  
Nguyen Viet Hoang ◽  
◽  
Keyword(s):  
Public Investment ◽  
Health Sector ◽  
Secondary Data ◽  
Policy Recommendations ◽  
State Budget ◽  
Government Bonds ◽  
The Public ◽  
Current State ◽  
Treatment Facilities ◽  
Research Show

The latest Vietnamese health system is being steadily renewed and strengthened in the direction of equality- efficiency-development and social security. Over past years, the health sector has been involved in investing in the construction of central-to-local medical examination and treatment facilities with state budget money, government bonds, ODA and other sources. The main purpose of this study is to empirically test the Public investment for health in Vietnam. The author collected secondary data from previous studies and the reports of Ministry of Health, Ministry of Planning and Investment, Ministry of Finance. The results of the research show that the public investment plan for the period 2016-2020 is focused on the ability to collect the state budget; State budget expenditure on health is not consistent every year, but tends to increase; the demand for investment in health in the period 2016-2020 is very large and is surely to increase in the future. Based on the findings, some conclusions are given.

scholarly journals Extended adverse effects of cyclophosphamide on mouse ovarian function

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jihyun Kim ◽  
Sooseong You
Keyword(s):  
Adverse Effects ◽  
Cancer Survivors ◽  
Cancer Survival ◽  
Ovarian Function ◽  
Treatment Options ◽  
Bioinformatics Analyses ◽  
Hormonal Stimulation ◽  
Patients With Cancer ◽  
Multiple Exposures

Abstract Purpose Most patients with cancer undergo multiple administrations of anticancer drugs during treatment, resulting in chronic impairment of their reproductive health. As improved treatment options increase cancer survival, it has become increasingly important to address fertility issues in cancer survivors. In this study, we examined the pathophysiological effects of multiple exposures to cyclophosphamide (Cy) on the ovaries of mice and their underlying molecular mechanism. Methods Female C57BL/6 mice were intraperitoneally injected with 100 mg/kg Cy six times over 2 weeks; 4 weeks later, the mice were sacrificed and their ovaries, sera, and oocytes were collected for histological observation, measurement of anti-Müllerian hormone levels, and assessment of oocyte quantity and quality in response to hormonal stimulation. Gene expression changes in Cy-treated ovaries were examined by microarray and bioinformatics analyses. Results After repeated Cy exposure, the anti-Müllerian hormone level was decreased, and follicle loss and impairments in the quality of oocyte were irreversible. The expression levels of genes involved in folliculogenesis, oogenesis, and zona pellucida glycoprotein transcription displayed sustained alterations in Cy-exposed ovaries even after 4 weeks. Conclusion The adverse effects of Cy on ovarian function and oocytes remained even after chemotherapy was complete. Therefore, strategies to prevent ovarian damage or restore ovarian function after treatment are required to safeguard the fertility of young cancer survivors.

Knowledge, Awareness and Perception on Malaria in Tribal Regions of Vadodara District, Gujarat (India)

2019 ◽  
Vol 21 (3) ◽  
pp. 406-416
Author(s):  
Bindu Bhatt ◽  
Janak P. Joshi
Keyword(s):  
Malaria Control ◽  
Control Measure ◽  
Health Sector ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Well Being ◽  
Clear Understanding ◽  
Major Public Health Problem ◽  
Health Seeking ◽  
Tropical Regions

Malaria affects health and general well-being of many people in the developing world. In India also, malaria is a major public health problem. It continues to be a leading cause of morbidity and mortality in many tropical regions of the world, despite global efforts to eradicate the disease. To achieve the targets of reducing malaria prevalence and preventing malaria epidemic, it is essential to have active community participation. Therefore, clear understanding of the Knowledge, Awareness and Perception (KAPs) of a particular community can help in framing the policy of prevention and promotion of any malaria control measure. In this context, the decision makers in the health sector are recognizing the importance of community’s KAPs on malaria and, thus, is gaining stimulus as one of the methods for malaria control. KAPs, however, play an important role in the improvement of health and health-seeking behaviour of a disease-burdened group. This study, therefore, investigates a local community’s KAPs on malaria in tribal areas of Vadodara District. The KAP investigates the community’s understanding of malaria transmission, their recognition of signs and symptoms, their treatment-seeking behaviours and community preventive measures and practices.

scholarly journals INNV-17. INNOVATIVE EDUCATIONAL APPROACHES TO ENHANCE PATIENT AND CAREGIVER UNDERSTANDING OF TTFIELDS FOR GLIOBLASTOMA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi134-vi134
Author(s):  
Melissa Shackelford ◽  
Peggy Frongillo ◽  
Jeanine Certo
Keyword(s):  
Treatment Options ◽  
Information Age ◽  
Emerging Technology ◽  
Accurate Information ◽  
Patients With Cancer ◽  
Tumor Treating Fields ◽  
Education Of Patients ◽  
Educational Paradigm ◽  
Device Manufacturer ◽  
Methods Of Learning

Abstract INTRODUCTION The most common, aggressive malignant brain tumor is Glioblastoma (GBM) with patient median survival of 15–21 months. Patients with GBM face devastation of diagnosis, disease-burden, and hardship of seeking accurate information regarding treatment options. Evolving technology-enhanced methods of learning challenge traditional ways patients with cancer are educated and create an educational paradigm shift. The device manufacturer of Tumor Treating Fields (TTFields)) has developed innovative supplementary educational platforms to compliment healthcare provider (HCP) education of patients-caregivers with GBM treated with TTFields. This report aimed to evaluate these supplementary educational platforms. METHODS Emerging technology methods were employed to address patient-caregiver frequently asked questions, which included queries regarding treatment overview, mechanism of action, treatment initiation, and management to potentially ease the emotional burden of patients-caregivers seeking TTFields information. The TTFields educational platforms included incorporation of Web program, Buddy Program, Open-House Program (live and webinar), Chalk-Talk Video, and Facebook. RESULTS Educational platforms connecting potential and current TTFields patients-caregivers via live/webinar Open-House events ensured patient support. The phone-based Buddy Program allowed for direct 1:1 discussions between potential and current TTFields patients-caregivers. Patient-caregiver surveys revealed 100% would recommend the program to others (n=91); 98% were satisfied with the call experience (n=90); 76% felt the most valuable takeaway was speaking to someone who understands their situation (n=82). Of ambassadors, 98% felt they helped address registrants’ concerns (n=150). A dedicated TTFields Facebook page and first-ever, industry-led Facebook Live event (national broadcast; patients-caregivers discussed unique issues) were launched. Additionally, vignettes (eg, videos, written stories) were shared through a dedicated patient-caregiver website and YouTube channel. CONCLUSIONS In an ever-growing information age, it is important that HCPs become aware of innovative ways to reach and provide education for patients with brain cancer. Emerging technology utilization may improve GBM supportive care, by improving communication channels and potentially easing burden.

scholarly journals Developing Best Practice in Linking and Sharing Administrative Data – A Comparison of Views in Health and Higher Education

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Jackie Street ◽  
Annette Braunack-Mayer ◽  
Stacy Carter ◽  
Tam Ha ◽  
Xiaoqi Feng ◽  
...  
Keyword(s):  
Higher Education ◽  
Administrative Data ◽  
Policy Development ◽  
Best Practice ◽  
Ethical Issues ◽  
Health Sector ◽  
Clear Understanding ◽  
Data Governance ◽  
Sensitive Data ◽  
Wide Range

IntroductionLarge administrative datasets are now being used for secondary purposes across a wide range of public sector organisations, including in health and higher education. However, governance, regulation and policy surrounding the use of these datasets are at different stages of development in these sectors. Our aim was to explore similarities and differences in the use of administrative data between the health and higher education sectors to inform policy development. Objectives and ApproachWe investigated views on the use of administrative data in both the health and higher education sectors. We conducted 18 qualitative in-depth interviews with key stakeholders, to provide insight into the ethical, social and legal issues associated with the use of big data in these settings. The interviews were transcribed and thematically coded. ResultsParticipants indicated the rapid pace of technological change and large volume of potentially sensitive data collected raises governance, infrastructure and ethical issues in both settings. Common challenges include communication, staff capabilities, delays in access, multiple policies and governance committees, and technical and operational issues. In the health sector, there was clear understanding of the issues and governance structures to address these issues, whereas this understanding was more variable in the higher education sector. Trust in government (to use responsibly and store securely) was raised in the health sector but not in universities. Conclusion / ImplicationsUnderstanding and use of administrative data are at quite different levels of development in the higher education and health sectors. Higher education needs policy and ethical guidance and higher level governance and greater consultation across the sector. Both sectors would benefit from a national approach to data governance.

scholarly journals Late complication of the oral cavity and oropharynx after interstitial neutron therapy with sources of Cf-252

2021 ◽  
Vol 30 (2) ◽  
pp. 123-132
Author(s):  
V.V. Polkin ◽  
◽  
V.S. Medvedev ◽  
D.N. Derbugov ◽  
P.A. Isaev ◽  
...  
Keyword(s):  
Treatment Options ◽  
Late Complication ◽  
Radiotherapy Planning ◽  
Radiation Injuries ◽  
Management Options ◽  
Photon Irradiation ◽  
Patients With Cancer ◽  
Neutron Therapy ◽  
Lower Jaw ◽  
Radiation Ulcers

Radiotherapy is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in radiotherapy planning and delivery, a significant number of pa-tients will experience radiation-associated toxicities. Many effective management options are available for acute radiotherapy-associated toxicities, but treatment options are much more lim-ited and of variable benefit among patients who develop late sequelae after radiotherapy. The present work is based on observations of 586 patients with oral and oropharynx cancer, for which interstitial neutron therapy was carried out in an independent version or in combination with re-mote radiation therapy. Radiation injuries occurred in 130 (22.2%) patients, in 92 (15.7%) they appeared in the form of radiation ulcers and in 38 (6.4%) – osteoradionecrosis of the lower jaw. The clinical picture and the course of radiation injuries after interstitial neutron therapy with sources of 252Cf did not differ significantly from radiation complications after photon irradiation.

Clinical update on public and private psychiatric practice shared-care partnerships – Can the twain work together?

2021 ◽  
pp. 103985622110528
Author(s):  
Jeffrey C.L. Looi ◽  
Michelle Atchison ◽  
May Matias
Keyword(s):  
Policy Development ◽  
Health Sector ◽  
Mental Healthcare ◽  
Shared Care ◽  
Psychiatric Practice ◽  
Public And Private ◽  
Health Strategy ◽  
Care Models ◽  
Private And Public ◽  
National Mental Health

Objective: We explore the previous research and current context regarding opportunities for shared-care partnerships between public and private psychiatric practice. Conclusions: Since the early 2000s, when there was impetus for the development of public-private psychiatric shared-care models as part of a previous National Mental Health Strategy, there has been surprisingly little research and policy development. Given an apparent exodus of psychiatrists to private practice due to current challenges facing the public health sector, it is timely to reconsider models of private and public sector shared-care that may improve the quality of public mental healthcare.

Postpartum Depression

Depression ◽  
2019 ◽  
pp. 435-445
Author(s):  
Nikita Patel ◽  
Emily B. Kroska ◽  
Zachary N. Stowe
Keyword(s):  
Primary Care ◽  
Postpartum Depression ◽  
Perinatal Care ◽  
Treatment Options ◽  
Primary Care Clinic ◽  
Depression Scale ◽  
Risk Groups ◽  
Primary Care Providers ◽  
Her Family ◽  
Effective Interventions

Perinatal care, including the management of mental health issues, is often under the auspices of primary care providers. This chapter provides an overview of identification, diagnosis, and treatment of postpartum depression (PPD). It reviews the prevalence of PPD in the general and minority populations, related disorders, common symptoms, and genetic and psychosocial risk factors to facilitate PPD management in the primary care clinic. The most commonly employed screening scale, the Edinburgh Postnatal Depression Scale, has several advantages in the primary care setting. The potential adverse consequences of untreated PPD on the mother and her family underscore the importance of identifying and providing effective interventions, including preventive strategies, in high-risk groups. As a class, antidepressant medications have amassed a large reproductive safety literature, including considerable data in breastfeeding and women with PPD. Notably, psychosocial therapies have demonstrated equal efficacy in women with PPD and are viable treatment options.

Assessing health needs

2020 ◽  
pp. 42-53
Author(s):  
Andrew O’Shaughnessy ◽  
John Wright ◽  
Ben Cave
Keyword(s):  
Public Health ◽  
Health Professional ◽  
Policy Development ◽  
Professional Training ◽  
Health Sector ◽  
Service Planning ◽  
Health Needs ◽  
Health Needs Assessment ◽  
Healthcare Needs ◽  
Health Agencies

HNA (health needs assessment) is a systematic method of identifying the unmet health and healthcare needs of a population and recommending changes to meet these unmet needs. It is used to improve health and other service planning, priority setting, and policy development. HNA is an example of public health working outside the formal health sector and presenting back to colleagues. Successful HNAs will also ensure that non-health agencies benefit from their findings. This chapter will describe why HNA is important and what it means in practice. Professional training and clinical experience teach that a health professional must systematically assess a patient before administering any treatment that is believed to be effective. This systematic approach is often omitted when assessing the health needs of populations

Benign disease of the uterus

2020 ◽  
pp. 609-624
Author(s):  
Sahana Gupta ◽  
Isaac Manyonda
Keyword(s):  
Focused Ultrasound ◽  
Treatment Options ◽  
Uterine Fibroids ◽  
Transvaginal Sonography ◽  
Benign Diseases ◽  
Endometrial Polyps ◽  
Focused Ultrasound Surgery ◽  
Effective Interventions ◽  
Outpatient Hysteroscopy ◽  
Dramatic Shift

The benign diseases of the uterus compromise endometrial polyps, adenomyosis, and uterine fibroids or leiomyomas. Polyps are often asymptomatic, or may cause intermenstrual bleeding, and recent technological developments allow for rapid diagnosis (transvaginal sonography) and treatment (outpatient hysteroscopy and polypectomy with or without local anaesthesia). Precious little progress has been made over the past few decades in the understanding of the pathophysiology of adenomyosis, or its effective management beyond hysterectomy. Until as recently as two decades ago, the only treatment options for fibroids were hysterectomy and myomectomy, but the advent of radiological interventions (uterine artery embolization and focused ultrasound surgery) has revolutionized uterine-preserving management options of fibroid disease, while the recent emergence of selective progesterone receptor modulators has, at long last, heralded effective medical therapy for fibroids. This rapid expansion in fertility-preserving treatments for fibroids could not have been more timely since in recent years there has been a dramatic shift in the demography of childbirth, with many women postponing childbirth to their late 30s and early 40s, when fibroids are more prevalent and more symptomatic. Parallel developments in assisted reproduction technology now allow women to achieve pregnancies at an age that was unthinkable three decades ago. Even when child bearing is not an issue, hysterectomy no longer need be the only effective treatment for the menstrual disturbance and other symptoms associated with benign diseases of the uterus—new minimally invasive procedures now allow for equally effective interventions that improve women’s quality of life.

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