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Kwete XJ, Bhadelia A, Arreola-Ornelas H, Mendez O, Rosa WE, Connor S, Downing J, Jamison D, Watkins D, Calderon R, Cleary J, Friedman JR, De Lima L, Ntizimira C, Pastrana T, Pérez-Cruz PE, Spence D, Rajagopal MR, Vargas Enciso V, Krakauer EL, Radbruch L, Knaul FM. Global Assessment of Palliative Care Need: Serious Health-Related Suffering Measurement Methodology. J Pain Symptom Manage 2024:S0885-3924(24)00708-5. [PMID: 38636816 DOI: 10.1016/j.jpainsymman.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/05/2024] [Accepted: 03/27/2024] [Indexed: 04/20/2024]
Abstract
CONTEXT Inequities and gaps in palliative care access are a serious impediment to health systems especially in low- and middle-income countries and the accurate measurement of need across health conditions is a critical step to understanding and addressing the issue. Serious Health-related Suffering (SHS) is a novel methodology to measure the palliative care need and was originally developed by The Lancet Commission on Global Access to Palliative Care and Pain Relief. In 2015, the first iteration - SHS 1.0 - was estimated at over 61 million people worldwide experiencing at least 6 billion days of SHS annually as a result of life-limiting and life-threatening conditions. OBJECTIVES In this paper, an updated methodology - SHS 2.0 - is presented building on the work of the Lancet Commission and detailing calculations, data requirements, limitations, and assumptions. METHODS AND RESULTS The updates to the original methodology focus on measuring the number of people who die with (decedents) or live with (non-decedents) SHS in a given year to assess the number of people in need of palliative care across health conditions and populations. Detail on the methodology for measuring the number of days of SHS that was pioneered by the Lancet Commission, is also shared, as this second measure is essential for determining the health system responses that are necessary to address palliative care need and must be a priority for future methodological work on SHS. CONCLUSIONS The methodology encompasses opportunities for applying SHS to future policy making assessment of future research priorities particularly in light of the dearth of data from low- and middle-income countries, and sharing of directions for future work to develop SHS 3.0.
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Affiliation(s)
- Xiaoxiao J Kwete
- University of Miami Institute for Advanced Study of the Americas, University of Miami (X.J.K., A.B., H.A.-O., W.E.R., R.C., V.V.E., F.M.K.), Miami, Florida, USA; Yangzhou Philosophy and Social Science Research and Communication Center (X.J.K.), Yangzhou, China.
| | - Afsan Bhadelia
- University of Miami Institute for Advanced Study of the Americas, University of Miami (X.J.K., A.B., H.A.-O., W.E.R., R.C., V.V.E., F.M.K.), Miami, Florida, USA; Department of Public Health, College of Health and Human Sciences (A.B.), Purdue University, West Lafayette, Indiana, USA
| | - Héctor Arreola-Ornelas
- University of Miami Institute for Advanced Study of the Americas, University of Miami (X.J.K., A.B., H.A.-O., W.E.R., R.C., V.V.E., F.M.K.), Miami, Florida, USA; Institute for Obesity Research, Tecnologico de Monterrey (H.A.-O.), Monterrey, Mexico; School of Government and Public Transformation, Tecnologico de Monterrey, Mexico City, Mexico; Tómatelo a Pecho, A.C. (H.A-O., O.M., F.M.K.), Mexico City, Mexico; Fundación Mexicana para la Salud (FUNSALUD) (H.A.-O.), Mexico City, México
| | - Oscar Mendez
- Tómatelo a Pecho, A.C. (H.A-O., O.M., F.M.K.), Mexico City, Mexico
| | - William E Rosa
- University of Miami Institute for Advanced Study of the Americas, University of Miami (X.J.K., A.B., H.A.-O., W.E.R., R.C., V.V.E., F.M.K.), Miami, Florida, USA; Department of Psychiatry and Behavioral Sciences (W.E.R.), Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Stephen Connor
- Worldwide Hospice Palliative Care Alliance (S.C.), London, UK
| | - Julia Downing
- International Children's Palliative Care Network (J.D.), Bristol, UK
| | - Dean Jamison
- University of California (D.J.), San Francisco, California, USA
| | - David Watkins
- Department of Global Health, University of Washington (D.W.), Seattle, Washington, USA
| | - Renzo Calderon
- University of Miami Institute for Advanced Study of the Americas, University of Miami (X.J.K., A.B., H.A.-O., W.E.R., R.C., V.V.E., F.M.K.), Miami, Florida, USA
| | - Jim Cleary
- Indiana University School of Medicine (J.C.), Indianapolis, Indiana, USA
| | - Joseph R Friedman
- Center for Social Medicine and Humanities, University of California, Los Angeles, California, USA
| | - Liliana De Lima
- International Association of Hospice and Palliative Care (L.D.L.), Houston, Texas, USA
| | | | - Tania Pastrana
- International Association of Hospice and Palliative Care (L.D.L.), Houston, Texas, USA; Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Pedro E Pérez-Cruz
- Sección Medicina Paliativa, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Centro para la Prevención y el Control del Cáncer (CECAN), Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - Valentina Vargas Enciso
- University of Miami Institute for Advanced Study of the Americas, University of Miami (X.J.K., A.B., H.A.-O., W.E.R., R.C., V.V.E., F.M.K.), Miami, Florida, USA
| | - Eric L Krakauer
- Department of Global Health & Social Medicine, Harvard Medical School (E.L.K.), Boston, Massachusetts, USA
| | - Lukas Radbruch
- International Association of Hospice and Palliative Care (L.D.L.), Houston, Texas, USA; Department of Palliative Medicine, University Hospital Bonn, Germany
| | - Felicia Marie Knaul
- University of Miami Institute for Advanced Study of the Americas, University of Miami (X.J.K., A.B., H.A.-O., W.E.R., R.C., V.V.E., F.M.K.), Miami, Florida, USA; Tómatelo a Pecho, A.C. (H.A-O., O.M., F.M.K.), Mexico City, Mexico; Sylvester Comprehensive Cancer Center, Miller School of Medicine (F.M.K.), University of Miami, Miami, Florida, USA; Leonard M. Miller School of Medicine (F.M.K.), University of Miami, Miami, Florida, USA
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Rahman R, Mariam L, Su R, Malhotra C, Ozdemir S. Quality of life and its predictors among patients with metastatic cancer in Bangladesh: the APPROACH survey. BMC Palliat Care 2024; 23:2. [PMID: 38166890 PMCID: PMC10762837 DOI: 10.1186/s12904-023-01301-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 10/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND This study aimed to assess the health-related quality of life (HRQOL) (physical, functional, emotional, social, spiritual) and psychological (anxiety and depression) well-being and their associations with patient characteristics among patients with metastatic cancer in Bangladesh. METHODS A convenience sample of 386 Bangladeshi patients with stage IV solid cancers was recruited from a palliative care outpatient department and an inpatient palliative center. Dependent variables included the physical, functional, emotional, social, and overall scores of the Functional Assessment of Cancer Therapy-General (FACT-G) scale, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) scale, the anxiety, depression, and overall scores of the Hospital Anxiety and Depression (HADS) scale. Linear regressions examined the association between dependent variables and patient characteristics. RESULTS A substantial proportion of Bangladeshi patients reported anxiety (59% of outpatients and 55% of inpatients) and depression (60% of outpatients and 73% of inpatients) symptoms. Generally, greater financial difficulty and symptom burden scores were associated with worse health outcomes. Older patients reported poorer functional and spiritual well-being but better anxiety scores. Females reported worse anxiety and depressive symptoms and physical well-being but better spiritual outcomes. CONCLUSIONS Additional efforts must be directed at improving the HRQOL of patients with metastatic cancer in Bangladesh. Furthermore, assistance should be made more accessible to vulnerable groups, including women, the elderly, and those with financial difficulty.
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Affiliation(s)
- Rubayat Rahman
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Lubna Mariam
- Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh
| | - Rebecca Su
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Signature Programme in Health Services and System Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Signature Programme in Health Services and System Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Signature Programme in Health Services and System Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
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Samuels A, Lemos Dekker N. Palliative care practices and policies in diverse socio-cultural contexts: aims and framework of the ERC globalizing palliative care comparative ethnographic study. Palliat Care Soc Pract 2023; 17:26323524231198546. [PMID: 37706167 PMCID: PMC10496469 DOI: 10.1177/26323524231198546] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/15/2023] [Indexed: 09/15/2023] Open
Abstract
Background Palliative care as a specialist professional practice of care for people with advanced illness is becoming increasingly influential worldwide. This process is affected by global health inequalities as well as cultural dimensions of approaching death and practicing care in life-limiting illness. Objectives The European Research Council-funded Globalizing Palliative Care (ENDofLIFE) project aims to understand how palliative care policies, discourses and practices are translated, adapted and reconstituted in diverse socio-cultural settings and how cultural dimensions of approaching death and local practices of care shape palliative care implementation. Methods and Analysis Using a multi-scalar and multi-sited ethnographic approach, the project uses person-centered ethnography, participant observation, semi-structured interviewing, focus group discussions and policy and discourse analysis at transnational, national and local levels. Ethnographic case-studies are conducted in Brazil, India and Indonesia. Discussion The globalizing palliative care project develops a novel ethnographic methodology of studying end-of-life care trajectories through long-term participant observation with individual patients and families as they manage and practice formal and informal health care in advanced illness. By analyzing how patients and families experience and navigate care over time, complemented by stakeholder interviews, the study advances critical theoretical insight into the relation between (large-scale and dynamically traveling) palliative care models, policies and discourses on the one hand and the experience and practice of palliative care in the lives of patients and informal care givers in local health care practices on the other hand. Insights are expected to benefit culturally situated palliative care policies and practices.
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Affiliation(s)
- Annemarie Samuels
- Institute of Cultural Anthropology and Development Sociology, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
| | - Natashe Lemos Dekker
- Institute of Cultural Anthropology and Development Sociology, Leiden University, Leiden, The Netherlands
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Khulbe Y, Chandani Y, Kamaraj B, Agrawal V. Under-representation of low-income countries in the literature - targeting the bummock of neglected tropical diseases. Trop Doct 2023:494755231153977. [PMID: 37116891 DOI: 10.1177/00494755231153977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
More than 50% of the world's youth and many economies with the greatest growth rates are in tropical and subtropical regions of Africa, Asia, and Latin America. Many prevailing diseases in these areas comprise neglected tropical diseases (NTDs) - the 13 bacterial and parasitic infections that predominantly affect the poorest one-sixth of the world's population. The lack of published data, heightened by the disregard of researchers of developed countries, amounts to the 'missing piece' when attempting to draw a global picture of such diseases using systematic reviews or meta-analyses because of the imbalance in distribution. Defining and measuring the problem, evaluating the effectiveness and cost of interventions, and assessing cost-effectiveness are all necessary steps in determining health priorities for eradicating these NTDs.
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Affiliation(s)
- Yashita Khulbe
- MBBS, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Yash Chandani
- MBBS, King George's Medical University, Lucknow, Uttar Pradesh, India
| | | | - Vibhor Agrawal
- MBBS, King George's Medical University, Lucknow, Uttar Pradesh, India
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Barragan-Carrillo R, Pabon CM, Chavarri-Guerra Y, Soto-Perez-de-Celis E, Duma N. End-of-Life Care and Advanced Directives in Hispanic/Latinx Patients: Challenges and Solutions for the Practicing Oncologist. Oncologist 2022; 27:1074-1080. [PMID: 36288534 DOI: 10.1093/oncolo/oyac211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/13/2022] [Indexed: 02/06/2023] Open
Abstract
Advanced end-of-life care (EOL) comprises a group of strategies to provide comfort to patients at the end of life. These are associated with better quality of life, better satisfaction, and a lower rate of hospitalizations and aggressive medical treatment. Advanced EOL care, including advanced directives completion and hospice enrollment, is suboptimal among Hispanic/Latinx patients with cancer due to personal, socio-cultural, financial, and health system-related barriers, as well as due to a lack of studies specifically designed for this population. In addition, the extrapolation of programs that increase participation in EOL for non-white Hispanics may not work appropriately for Hispanic/Latinx patients and lead to overall lower satisfaction and enrollment in EOL care. This review will provide the practicing oncologist with the tools to address EOL in the Hispanic/Latinx population. Some promising strategies to address the EOL care disparities in Latinx/Hispanic patients have been culturally tailored patient navigation programs, geriatric assessment-guided multidisciplinary interventions, counseling sessions, and educational interventions. Through these strategies, we encourage oncologists to take advantage of every clinical setting to discuss EOL care. Treating physicians can engage family members in caring for their loved ones while practicing cultural humility and respecting cultural preferences, incorporating policies to foster treatment for the underserved migrant population, and providing patients with validated Spanish language tools.
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Affiliation(s)
- Regina Barragan-Carrillo
- Hematology-Oncology Department Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Cindy M Pabon
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico
| | - Yanin Chavarri-Guerra
- Hematology-Oncology Department Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Narjust Duma
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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LeBaron VT, Horton BJ, Adhikari A, Chapagain S, Dhakal M, Gongal R, Kattel R, Koirala G, Kutcher A, Hass B, Maurer M, Munday D, Neupane B, Sharma K, Shilpakar R, Shrestha A, Shrestha S, Thapa U, Dillingham R, Paudel BD. A Global Collaboration to Develop and Pilot Test a Mobile Application to Improve Cancer Pain Management in Nepal. FRONTIERS IN PAIN RESEARCH 2022; 3:910995. [PMID: 35965597 PMCID: PMC9366104 DOI: 10.3389/fpain.2022.910995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionQuality palliative care, which prioritizes comfort and symptom control, can reduce global suffering from non-communicable diseases, such as cancer. To address this need, the Nepalese Association of Palliative Care (NAPCare) created pain management guidelines (PMG) to support healthcare providers in assessing and treating serious pain. The NAPCare PMG are grounded in World Health Organization best practices but adapted for the cultural and resource context of Nepal. Wider adoption of the NAPCare PMG has been limited due to distribution of the guidelines as paper booklets.MethodsBuilding on a long-standing partnership between clinicians and researchers in the US and Nepal, the NAPCare PMG mobile application (“app”) was collaboratively designed. Healthcare providers in Nepal were recruited to pilot test the app using patient case studies. Then, participants completed a Qualtrics survey to evaluate the app which included the System Usability Scale (SUS) and selected items from the Mobile App Rating Scale (MARS). Descriptive and summary statistics were calculated and compared across institutions and roles. Regression analyses to explore relationships (α = 0.05) between selected demographic variables and SUS and MARS scores were also conducted.ResultsNinety eight healthcare providers (n = 98) pilot tested the NAPCare PMG app. Overall, across institutions and roles, the app received an SUS score of 76.0 (a score > 68 is considered above average) and a MARS score of 4.10 (on a scale of 1 = poor, 5 = excellent). 89.8% (n = 88) “agreed” or “strongly agreed” that the app will help them better manage cancer pain. Age, years of experience, and training in palliative care were significant in predicting SUS scores (p-values, 0.0124, 0.0371, and 0.0189, respectively); institution was significant in predicting MARS scores (p = 0.0030).ConclusionThe NAPCare PMG mobile app was well-received, and participants rated it highly on both the SUS and MARS. Regression analyses suggest end-user variables important to consider in designing and evaluating mobile apps in lower resourced settings. Our app design and pilot testing process illustrate the benefits of cross global collaborations to build research capacity and generate knowledge within the local context.
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Affiliation(s)
- Virginia T. LeBaron
- University of Virginia School of Nursing, Charlottesville, VA, United States
- *Correspondence: Virginia T. LeBaron
| | - Bethany J. Horton
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | | | - Sandhya Chapagain
- National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Manita Dhakal
- B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | | | - Regina Kattel
- Nepal Cancer Hospital & Research Center, Lalitpur, Nepal
| | | | - Anna Kutcher
- University of Virginia School of Nursing, Charlottesville, VA, United States
| | - Ben Hass
- Hass Software Consulting, Brooklyn, NY, United States
| | - Martha Maurer
- Sonderegger Research Center, University of Wisconsin School of Pharmacy, Madison, WI, United States
| | - Daniel Munday
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Bijay Neupane
- B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | | | - Ramila Shilpakar
- National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Amuna Shrestha
- Nepal Cancer Hospital & Research Center, Lalitpur, Nepal
| | - Sudip Shrestha
- Nepal Cancer Hospital & Research Center, Lalitpur, Nepal
| | - Usha Thapa
- B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | - Rebecca Dillingham
- University of Virginia School of Medicine, Charlottesville, VA, United States
- University of Virginia Center for Global Health Equity, Charlottesville, VA, United States
| | - Bishnu D. Paudel
- National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
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Mutebi M, Dehar N, Nogueira LM, Shi K, Yabroff KR, Gyawali B. Cancer Groundshot: Building a Robust Cancer Control Platform in Addition To Launching the Cancer Moonshot. Am Soc Clin Oncol Educ Book 2022; 42:1-16. [PMID: 35561297 DOI: 10.1200/edbk_359521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cancer Groundshot is a philosophy that calls for prioritization of strategies in global cancer control. The underlying principle of Cancer Groundshot is that one must ensure access to interventions that are already proven to work before focusing on the development of new interventions. In this article, we discuss the philosophy of Cancer Groundshot as it pertains to priorities in cancer care and research in low- and middle-income countries and the utility of technology in addressing global cancer disparities; we also address disparities seen in high-income countries. The oncology community needs to realign our priorities and focus on improving access to high-value cancer control strategies, rather than allocating resources primarily to the development of technologies that provide only marginal gains at a high cost. There are several "low-hanging fruit" actions that will improve access to quality cancer care in low- and middle-income countries and in high-income countries. Worldwide, cancer morbidity and mortality can be averted by implementing highly effective, low-cost interventions that are already known to work, rather than investing in the development of resource-intensive interventions to which most patients will not have access (i.e., we can use Cancer Groundshot to first save more lives before we focus on the "moonshots").
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Affiliation(s)
- Miriam Mutebi
- Breast Surgical Oncology, Aga Khan University, Nairobi, Kenya
| | - Navdeep Dehar
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
| | - Leticia M Nogueira
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA
| | - Kewei Shi
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA
| | - K Robin Yabroff
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA
| | - Bishal Gyawali
- Department of Oncology, Queen's University, Kingston, Ontario, Canada.,Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.,Division of Cancer Care and Epidemiology, Queen's University, Kingston, Ontario, Canada
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Tirupakuzhi Vijayaraghavan BK, Gupta E, Ramakrishnan N, Beane A, Haniffa R, Lone N, de Keizer N, Adhikari NKJ. Barriers and facilitators to the conduct of critical care research in low and lower-middle income countries: A scoping review. PLoS One 2022; 17:e0266836. [PMID: 35511911 PMCID: PMC9071139 DOI: 10.1371/journal.pone.0266836] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Improvements in health-related outcomes for critically ill adults in low and lower-middle income countries need systematic investments in research capacity and infrastructure. High-quality research has been shown to strengthen health systems; yet, research contributions from these regions remain negligible or absent. We undertook a scoping review to describe barriers and facilitators for the conduct of critical care research.
Methods
We searched MEDLINE and EMBASE up to December 2021 using a strategy that combined keyword and controlled vocabulary terms. We included original studies that reported on barriers or facilitators to the conduct of critical care research in these settings. Two reviewers independently reviewed titles and abstracts, and where necessary, the full-text to select eligible studies. For each study, reviewers independently extracted data using a standardized data extraction form. Barriers and facilitators were classified along the lines of a previous review and based on additional themes that emerged. Study quality was assessed using appropriate tools.
Results
We identified 2693 citations, evaluated 49 studies and identified 6 for inclusion. Of the included studies, four were qualitative, one was a cross-sectional survey and one was reported as an ‘analysis’. The total number of participants ranged from 20–100 and included physicians, nurses, allied healthcare workers and researchers. Barriers identified included limited funding, poor institutional & national investment, inadequate access to mentors, absence of training in research methods, limited research support staff, and absence of statistical support. Our review identified potential solutions such as developing a mentorship network, streamlining of regulatory processes, implementing a centralized institutional research agenda, developing a core-outcome dataset and enhancing access to low-cost technology.
Conclusion
Our scoping review highlights important barriers to the conduct of critical care research in low and lower-middle income countries, identifies potential solutions, and informs researchers, policymakers and governments on the steps necessary for strengthening research systems.
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Affiliation(s)
| | - Ena Gupta
- Department of Pulmonary and Critical Care Medicine, Einstein Health Network, Philadelphia, Pennsylvania, United States of America
| | | | - Abi Beane
- Mahidol-Oxford Tropical Research Unit, Bangkok, Thailand
| | - Rashan Haniffa
- Mahidol-Oxford Tropical Research Unit, Bangkok, Thailand
- Department of Anaesthesia and Critical Care Medicine, University College London, London, United Kingdom
| | - Nazir Lone
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Nicolette de Keizer
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Neill K. J. Adhikari
- Interdepartmental Division of Critical Care Medicine, Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
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Akter S, Sarker M, Hossain P, Ahmad N, Zaman S. Solidarity and suffering: enrolled terminal patients’ and their caregiver’s experiences of the community-based palliative care programme in an urban slum of Bangladesh. Palliat Care Soc Pract 2022; 16:26323524221095104. [PMID: 35548025 PMCID: PMC9081719 DOI: 10.1177/26323524221095104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 03/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Palliative care has been recognised as a global health challenge. Although accessibility has increased, there is little recognition of the importance of palliative care in low- and middle-income countries. In Bangladesh, institutional palliative care is not accessible due to a lack of awareness, financial constraints, and fewer facilities. Hence, there needs to be a better understanding of providing and improving existing community-based palliative care. For this, it is essential to understand the experiences of patients and their caregivers who require palliative care. With this aim, this study explores the experiences of palliative patients and their primary caregivers enrolled in a palliative care project, ‘Momotamoy Korail’ run by Bangabandhu Sheikh Mujib Medical University in an urban slum, Dhaka. Methods: This research is a part of a larger qualitative study that relied on a focused ethnographic approach. For this study, we used 19 in-depth interviews following a semi-structured guideline with the palliative care patients and their primary caregivers enrolled in the community-based palliative care project. Results: Mostly women (wives and daughters-in-law) are the primary caregivers in a family. Therefore, male patients are more likely to receive family care than female patients. Both male and female patients expressed the desire for a death free of suffering. All patients felt lonely and socially abandoned with a perception of being a burden to their families. Despite the diversity in physical, social, psychological, and financial suffering, patients and caregivers were optimistic towards a healthy life free of illness. All respondents were satisfied with the care they received from the palliative care assistants, which provide them hope and dignity for life. Conclusion: Experiences of the respondents can improve the quality of the existing community-based palliative care services and add great value to the discipline of palliative care in public health. The findings provided an understanding of what would be required to extend community-based palliative care to other healthcare settings. More awareness through community mobilisation about the need for and benefit of palliative care is needed to make it sustainable.
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Affiliation(s)
- Sayema Akter
- Research Fellow, BRAC James P Grant School of Public Health, BRAC University, 6th Floor, Medona Tower, 28 Mohakhali Commercial Area, Bir Uttom A K Khandakar Road, Dhaka 1213, Bangladesh
| | - Malabika Sarker
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Heidelberg University, Heidelberg, Germany
| | - Puspita Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Department of Health Research Methods, McMaster University, Hamilton, ON, Canada
| | | | - Shahaduz Zaman
- Global Health and Infection Department, Brighton and Sussex Medical School, Brighton, UK
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Knaul FM, Rosa WE, Arreola-Ornelas H, Nargund RS. Closing the global pain divide: balancing access and excess. Lancet Public Health 2022; 7:e295-e296. [PMID: 35366402 PMCID: PMC9245675 DOI: 10.1016/s2468-2667(22)00063-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 12/29/2022]
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Dissemination of Plastic Surgery Research: An Analysis of PRS and PRS-GO. Plast Reconstr Surg Glob Open 2022; 10:e3808. [PMID: 35291334 PMCID: PMC8916205 DOI: 10.1097/gox.0000000000003808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
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Sallnow L, Smith R, Ahmedzai SH, Bhadelia A, Chamberlain C, Cong Y, Doble B, Dullie L, Durie R, Finkelstein EA, Guglani S, Hodson M, Husebø BS, Kellehear A, Kitzinger C, Knaul FM, Murray SA, Neuberger J, O'Mahony S, Rajagopal MR, Russell S, Sase E, Sleeman KE, Solomon S, Taylor R, Tutu van Furth M, Wyatt K. Report of the Lancet Commission on the Value of Death: bringing death back into life. Lancet 2022; 399:837-884. [PMID: 35114146 PMCID: PMC8803389 DOI: 10.1016/s0140-6736(21)02314-x] [Citation(s) in RCA: 170] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023]
Affiliation(s)
| | | | | | - Afsan Bhadelia
- Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | - Yali Cong
- Peking University Health Science Center, Beijing, China
| | | | | | | | | | | | | | | | | | | | | | | | - Julia Neuberger
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | - Sarah Russell
- Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Eriko Sase
- Georgetown University, Washington, DC, USA
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Afzal M, Siddiqi N, Ahmad B, Afsheen N, Aslam F, Ali A, Ayesha R, Bryant M, Holt R, Khalid H, Ishaq K, Koly KN, Rajan S, Saba J, Tirbhowan N, Zavala GA. Prevalence of Overweight and Obesity in People With Severe Mental Illness: Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:769309. [PMID: 34899604 PMCID: PMC8656226 DOI: 10.3389/fendo.2021.769309] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/21/2021] [Indexed: 11/23/2022] Open
Abstract
Aims 1) To determine the pooled prevalence of overweight and obesity in people with severe mental illness (SMI), overall and by type of SMI, geographical region, and year of data collection; and 2) to assess the likelihood of overweight and obesity, in people with SMI compared with the general population. Methods PubMed, Medline, EMBASE, and PsycINFO databases were searched to identify observational studies assessing the prevalence of obesity in adults with SMI. Screening, data extraction and risk of bias assessments were performed independently by two co-authors. Random effect estimates for the pooled prevalence of overweight and obesity and the pooled odds of obesity in people with SMI compared with the general population were calculated. Subgroup analyses were conducted for types of SMI, setting, antipsychotic medication, region of the world, country income classification, date of data collection and sex. We assessed publication bias and performed a series of sensitivity analyses, excluding studies with high risk of bias, with low sample size and those not reporting obesity according to WHO classification. Result 120 studies from 43 countries were included, the majority were from high income countries. The pooled prevalence of obesity in people with SMI was 25.9% (95% C.I. = 23.3-29.1) and the combined pooled prevalence of overweight and obesity was 60.1% (95% C.I. = 55.8-63.1). Sub-Saharan Africa (13.0%, 95%C.I. = 6.7-25.1) and South Asia (17.7%, 95%C.I. = 10.5-28.5) had the lowest prevalence of obesity whilst North Africa and the Middle East (35.8%, 95%C.I. = 23.8-44.8) reported the highest prevalence. People with SMI were 3.04 more likely (95% C.I. = 2.42-3.82) to have obesity than the general population, but there was no difference in the prevalence of overweight. Women with schizophrenia were 1.44 (95% C.I. = 1.25-1.67) times more likely than men with schizophrenia to live with obesity; however, no gender differences were found among those with bipolar disorder. Conclusion People with SMI have a markedly high prevalence and higher odds of obesity than the general population. This may contribute to the very high prevalence of physical health conditions and mortality in this group. People with SMI around the world would likely benefit from interventions to reduce and prevent obesity.
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Affiliation(s)
- Medhia Afzal
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
- Health and Care of Older People, East Kent Hospitals University National Health Service (NHS Foundation), Kent, United Kingdom
| | - Najma Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Bilal Ahmad
- Institute of Psychiatry, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Nida Afsheen
- Institute of Psychiatry, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Faiza Aslam
- Institute of Psychiatry, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Ayaz Ali
- Institute of Psychiatry, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Rubab Ayesha
- Institute of Psychiatry, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Maria Bryant
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Richard Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Humaira Khalid
- Health and Care of Older People, East Kent Hospitals University National Health Service (NHS Foundation), Kent, United Kingdom
| | - Kousar Ishaq
- Health and Care of Older People, East Kent Hospitals University National Health Service (NHS Foundation), Kent, United Kingdom
| | - Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sukanya Rajan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Bangalore, India
| | - Jobaida Saba
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Gerardo A. Zavala
- Department of Health Sciences, University of York, York, United Kingdom
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Ukrani RD, Shaikh AN, Martins RS, Fatima SS, Naseem HA, Baig MA. Low-cost peer-taught virtual research workshops for medical students in Pakistan: a creative, scalable, and sustainable solution for student research. BMC MEDICAL EDUCATION 2021; 21:557. [PMID: 34724950 PMCID: PMC8560217 DOI: 10.1186/s12909-021-02996-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Pakistan has not been a major contributor to medical research, mainly because of the lack of learning opportunities to medical students. With the increase in online learning systems during COVID-19, research related skills can be taught to medical students via low-cost peer taught virtual research workshops. AIM OF THE STUDY To assess the effectiveness of a comprehensive low-cost peer-taught virtual research workshops amongst medical students in Pakistan. METHODS This quasi-experimental study assessed the effectiveness of five virtual research workshops (RWs) in improving core research skills. RWs for medical students from across Pakistan were conducted over Zoom by medical students (peer-teachers) at the Aga Khan University, Pakistan, with minimal associated costs. The content of the workshops included types of research, ethical approval and research protocols, data collection and analysis, manuscript writing, and improving networking skills for research. Improvement was assessed via pre-and post-quizzes for each RW, self-efficacy scores across 16 domains, and feedback forms. Minimum criteria for completion of the RW series was attending at least 4/5 RWs and filling the post-RW series feedback form. A 6-month post-RW series follow-up survey was also emailed to the participants. RESULTS Four hundred medical students from 36 (/117; 30.8%) different medical colleges in Pakistan were enrolled in the RWs. However, only 307/400 (76.75%) medical students met the minimum requirement for completion of the RW series. 56.4% of the participants belonged to the pre-clinical years while the rest were currently to clinical years. The cohort demonstrated significant improvement in pre-and post-quiz scores for all 5 RWs (p < 0.001) with the greatest improvement in Data Collection and Analysis (+ 34.65%), and in self-efficacy scores across all domains (p < 0.001). 166/307 (54.1%) participants responded to the 6 months post-RWs follow-up survey. Compared to pre-RWs, Research involvement increased from 40.4 to 62.8% (p < 0.001) while proportion of participants with peer-reviewed publications increased from 8.4 to 15.8% (p = 0.043). CONCLUSION Virtual RWs allow for a wide outreach while effectively improving research-related knowledge and skills, with minimal associated costs. In lower-middle-income countries, virtual RWs are a creative and cost-effective use of web-based technologies to facilitate medical students to contribute to the local and global healthcare research community.
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Affiliation(s)
- Ronika Devi Ukrani
- Medical College, Aga Khan University, Stadium Road, 74800, Karachi, Pakistan
- Research Mentor, Research and Development Wing, Society for Promoting Innovation in Education, Center for Innovation in Medical Education, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Ayesha Niaz Shaikh
- Medical College, Aga Khan University, Stadium Road, 74800, Karachi, Pakistan
- Research Mentor, Research and Development Wing, Society for Promoting Innovation in Education, Center for Innovation in Medical Education, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Russell Seth Martins
- Medical College, Aga Khan University, Stadium Road, 74800, Karachi, Pakistan
- Research Mentor, Research and Development Wing, Society for Promoting Innovation in Education, Center for Innovation in Medical Education, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Syeda Sadia Fatima
- Department of Biological and Biomedical Sciences, Aga Khan University, Stadium Road, 74800, Karachi, Pakistan.
| | - Hamna Amir Naseem
- Medical College, Aga Khan University, Stadium Road, 74800, Karachi, Pakistan
- Research Mentor, Research and Development Wing, Society for Promoting Innovation in Education, Center for Innovation in Medical Education, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Mishall Ahmed Baig
- Research Mentor, Research and Development Wing, Society for Promoting Innovation in Education, Center for Innovation in Medical Education, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
- Medical College, DOW University of Health Sciences, Karachi, 74200, Pakistan
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15
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Rees CA, Ali M, Kisenge R, Ideh RC, Sirna SJ, Britto CD, Kazembe PN, Niescierenko M, Duggan CP, Manji KP. Where there is no local author: a network bibliometric analysis of authorship parasitism among research conducted in sub-Saharan Africa. BMJ Glob Health 2021; 6:e006982. [PMID: 34706882 PMCID: PMC8552133 DOI: 10.1136/bmjgh-2021-006982] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/25/2021] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Authorship parasitism (ie, no authors affiliated with the country in which the study took place) occurs frequently in research conducted in low-income and middle-income countries, despite published recommendations defining authorship criteria. The objective was to compare characteristics of articles exhibiting authorship parasitism in sub-Saharan Africa to articles with author representation from sub-Saharan African countries. METHODS A bibliometric review of articles indexed in PubMed published from January 2014 through December 2018 reporting research conducted in sub-Saharan Africa was performed. Author affiliations were assigned to countries based on regular expression algorithms. Choropleth maps and network diagrams were created to determine where authorship parasitism occurred, and multivariable logistic regression was used to determine associated factors. RESULTS Of 32 061 articles, 14.8% (n=4754) demonstrated authorship parasitism, which was most common among studies from Somalia (n=175/233, 75.1%) and Sao Tome and Principe (n=20/28, 71.4%). Authors affiliated with USA and UK institutions were most commonly involved in articles exhibiting authorship parasitism. Authorship parasitism was more common in articles: published in North American journals (adjusted OR (aOR) 1.26, 95% CI 1.07 to 1.50) than in sub-Saharan African journals, reporting work from multiple sub-Saharan African countries (aOR 8.41, 95% CI 7.30 to 9.68) compared with work from upper-middle income sub-Saharan African countries, with <5 authors (aOR 14.46, 95% CI 12.81 to 16.35) than >10 authors, and was less common in articles published in French (aOR 0.60, 95% CI 0.41 to 0.85) than English. CONCLUSIONS Authorship parasitism was common in articles reporting research conducted in sub-Saharan Africa. There were reliable predictors of authorship parasitism. Investigators and institutions in high-income countries, as well as funding agencies and journals should promote research from sub-Saharan Africa, including its publication, in a collaborative and equitable manner.
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Affiliation(s)
- Chris A Rees
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Division of Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Mohsin Ali
- Divison of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rodrick Kisenge
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Readon C Ideh
- Department of Pediatrics, John F. Kennedy Medical Center, Monrovia, Liberia
| | - Stephanie J Sirna
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Carl D Britto
- Boston Combined Residency Program, Boston, Massachusetts, USA
| | | | - Michelle Niescierenko
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Christopher P Duggan
- Center for Nutrition, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
- Departments of Nutrition and Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Karim P Manji
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Ranganathan P, Chinnaswamy G, Sengar M, Gadgil D, Thiagarajan S, Bhargava B, Booth CM, Buyse M, Chopra S, Frampton C, Gopal S, Grant N, Krailo M, Langley R, Mathur P, Paoletti X, Parmar M, Purushotham A, Pyle D, Rajaraman P, Stockler MR, Sullivan R, Swaminathan S, Tannock I, Trimble E, Badwe RA, Pramesh CS. The International Collaboration for Research methods Development in Oncology (CReDO) workshops: shaping the future of global oncology research. Lancet Oncol 2021; 22:e369-e376. [PMID: 34216541 PMCID: PMC8328959 DOI: 10.1016/s1470-2045(21)00077-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 02/07/2023]
Abstract
Low-income and middle-income countries (LMICs) have a disproportionately high burden of cancer and cancer mortality. The unique barriers to optimum cancer care in these regions necessitate context-specific research. The conduct of research in LMICs has several challenges, not least of which is a paucity of formal training in research methods. Building capacity by training early career researchers is essential to improve research output and cancer outcomes in LMICs. The International Collaboration for Research methods Development in Oncology (CReDO) workshop is an initiative by the Tata Memorial Centre and the National Cancer Grid of India to address gaps in research training and increase capacity in oncology research. Since 2015, there have been five CReDO workshops, which have trained more than 250 oncologists from India and other countries in clinical research methods and protocol development. Participants from all oncology and allied fields were represented at these workshops. Protocols developed included clinical trials, comparative effectiveness studies, health services research, and observational studies, and many of these protocols were particularly relevant to cancer management in LMICs. A follow-up of these participants in 2020 elicited an 88% response rate and showed that 42% of participants had made progress with their CReDO protocols, and 73% had initiated other research protocols and published papers. In this Policy Review, we describe the challenges to research in LMICs, as well as the evolution, structure, and impact of CReDO and other similar workshops on global oncology research.
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Affiliation(s)
- Priya Ranganathan
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
| | - Girish Chinnaswamy
- Division of Paediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Manju Sengar
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Durga Gadgil
- Research Administration Council, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Shivakumar Thiagarajan
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | | | - Christopher M Booth
- Departments of Oncology and Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Marc Buyse
- International Drug Development Institute, Louvain-la-Neuve, Belgium; Data Science Institute, Hasselt University, Diepenbeek, Belgium
| | | | - Chris Frampton
- Departments of Medicine and Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Satish Gopal
- Center for Global Health, National Cancer Institute, Rockville, MD, USA
| | | | - Mark Krailo
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ruth Langley
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - Prashant Mathur
- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Xavier Paoletti
- University of Versailles Saint-Quentin-en-Yvelines, Versailles, France; Department of Biostatistics, Institut Curie, Saint-Cloud, France; Department of Statistics for Precision Medicine, INSERM U900, Paris, France
| | - Mahesh Parmar
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - Arnie Purushotham
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Douglas Pyle
- American Society of Clinical Oncology, Alexandria, VA, USA
| | - Preetha Rajaraman
- US Department of Health and Human Services, Washington, DC, USA; US Embassy, New Delhi, India
| | - Martin R Stockler
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | | | | | - Ian Tannock
- Division of Medical Oncology, Princess Margaret Cancer Centre and University of Toronto, Toronto, ON, Canada
| | - Edward Trimble
- Office of the Director, National Cancer Institute, NIH, US Department of Health and Human Services, Washington, DC, USA
| | - Rajendra A Badwe
- Departments of Administration and Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - C S Pramesh
- Departments of Administration and Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Mulder N, Zass L, Hamdi Y, Othman H, Panji S, Allali I, Fakim YJ. African Global Representation in Biomedical Sciences. Annu Rev Biomed Data Sci 2021; 4:57-81. [PMID: 34465182 DOI: 10.1146/annurev-biodatasci-102920-112550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
African populations are diverse in their ethnicity, language, culture, and genetics. Although plagued by high disease burdens, until recently the continent has largely been excluded from biomedical studies. Along with limitations in research and clinical infrastructure, human capacity, and funding, this omission has resulted in an underrepresentation of African data and disadvantaged African scientists. This review interrogates the relative abundance of biomedical data from Africa, primarily in genomics and other omics. The visibility of African science through publications is also discussed. A challenge encountered in this review is the relative lack of annotation of data on their geographical or population origin, with African countries represented as a single group. In addition to the abovementioned limitations,the global representation of African data may also be attributed to the hesitation to deposit data in public repositories. Whatever the reason, the disparity should be addressed, as African data have enormous value for scientists in Africa and globally.
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Affiliation(s)
- Nicola Mulder
- Computational Biology Division, Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; .,Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-AFRICA), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - Lyndon Zass
- Computational Biology Division, Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
| | - Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics and Laboratory of Human and Experimental Pathology, Institut Pasteur de Tunis, University of Tunis El Manar, 1002 Tunis, Tunisia
| | - Houcemeddine Othman
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Sumir Panji
- Computational Biology Division, Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
| | - Imane Allali
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, and Genomic Center of Human Pathologies, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, 1014 Rabat, Morocco
| | - Yasmina Jaufeerally Fakim
- Biotechnology Unit, Department of Agricultural and Food Science, Faculty of Agriculture, University of Mauritius, Réduit 80837, Mauritius
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Rodin G, Ntizimira C, Sullivan R. Biomedicine and the soul of medicine: optimising the balance. Lancet Oncol 2021; 22:907-909. [PMID: 34197742 DOI: 10.1016/s1470-2045(21)00271-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Gary Rodin
- Global Institute of Psychosocial, Palliative, and End-of-Life Care, UHN Cancer Experience, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2C1, Canada.
| | | | - Richard Sullivan
- Institute of Cancer Policy, School of Cancer Sciences, King's College London, London, UK
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Merriman R, Galizia I, Tanaka S, Sheffel A, Buse K, Hawkes S. The gender and geography of publishing: a review of sex/gender reporting and author representation in leading general medical and global health journals. BMJ Glob Health 2021; 6:bmjgh-2021-005672. [PMID: 33986001 PMCID: PMC8118011 DOI: 10.1136/bmjgh-2021-005672] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/17/2021] [Accepted: 04/17/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction Diverse gender and geographical representation matters in research. We aimed to review medical and global health journals’ sex/gender reporting, and the gender and geography of authorship. Methods 542 research and non-research articles from 14 selected journals were reviewed using a retrospective survey design. Paper screening and systematic data extraction was conducted with descriptive statistics and regression analyses calculated from the coded data. Outcome measures were journal characteristics, the extent to which published articles met sex/gender reporting guidelines, plus author gender and location of their affiliated institution. Results Five of the fourteen journals explicitly encourage sex/gender analysis in their author instructions, but this did not lead to increased sex/gender reporting beyond the gender of study participants (OR=3.69; p=0.000 (CI 1.79 to 7.60)). Just over half of research articles presented some level of sex/gender analysis, while 40% mentioned sex/gender in their discussion. Articles with women first and last authors were 2.4 times more likely to discuss sex/gender than articles with men in those positions (p=0.035 (CI 1.062 to 5.348)). First and last authors from high-income countries (HICs) were 19 times as prevalent as authors from low-income countries; and women from low-income and middle-income countries were at a disadvantage in terms of the impact factor of the journals they published in. Conclusion Global health and medical research fails to consistently apply a sex/gender lens and remains largely the preserve of authors in HIC. Collaborative partnerships and funding support are needed to promote gender-sensitive research and dismantle historical power dynamics in authorship.
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Affiliation(s)
| | - Ilaria Galizia
- Global Health 50/50, London, UK.,C&H Mental Health Medical Adult, East London NHS Foundation Trust, London, UK
| | | | - Ashley Sheffel
- Global Health 50/50, London, UK.,Department of International Health, Johns Hopkins Bloomberg School of Public Health Center for Teaching and Learning, Baltimore, Maryland, USA
| | - Kent Buse
- Global Health 50/50, London, UK.,Director, Healthier Societies Program, the George Institute for Global Health, Newtown, New South Wales, Australia
| | - Sarah Hawkes
- Global Health 50/50, London, UK .,Institute for Global Health, University College London, London, UK
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20
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Dimitris MC, Gittings M, King NB. How global is global health research? A large-scale analysis of trends in authorship. BMJ Glob Health 2021; 6:bmjgh-2020-003758. [PMID: 33500263 PMCID: PMC7843301 DOI: 10.1136/bmjgh-2020-003758] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/18/2020] [Accepted: 12/19/2020] [Indexed: 12/11/2022] Open
Abstract
Many have called for greater inclusion of researchers from low- and middle-income countries (LMICs) in the conduct of global health research, yet the extent to which this occurs is unclear. Prior studies are journal-, subject-, or region-specific, largely rely on manual review, and yield varying estimates not amenable to broad evaluation of the literature. We conducted a large-scale investigation of the contribution of LMIC-affiliated researchers to published global health research and examined whether this contribution differed over time. We searched titles, abstracts, and keywords for the names of countries ever classified as low-, lower middle-, or upper middle-income by the World Bank, and limited our search to items published from 2000 to 2017 in health science-related journals. Publication metadata were obtained from Elsevier/Scopus and analysed in statistical software. We calculated proportions of publications with any, first, and last authors affiliated with any LMIC as well as the same LMIC(s) identified in the title/abstract/keywords, and stratified analyses by year, country, and countries’ most common income status. We analysed 786 779 publications and found that 86.0% included at least one LMIC-affiliated author, while 77.2% and 71.2% had an LMIC-affiliated first or last author, respectively; however, analagous proportions were only 58.7%, 36.8%, and 29.1% among 100 687 publications about low-income countries. Proportions of publications with LMIC-affiliated authors increased over time, yet this observation was driven by high research activity and representation among upper middle-income countries. Between-country variation in representation was observed, even within income status categories. We invite comment regarding these findings, particularly from voices underrepresented in this field.
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Affiliation(s)
- Michelle C Dimitris
- Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Matthew Gittings
- School of Computer Science, McGill University, Montreal, Quebec, Canada
| | - Nicholas B King
- Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.,Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
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Logiou C, Tiffreau V, Allart E, Thevenon A. Negligible increase in the low-income countries' contribution to the physical and rehabilitation medicine literature. Ann Phys Rehabil Med 2021; 64:101494. [PMID: 33571684 DOI: 10.1016/j.rehab.2021.101494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 11/29/2022]
Affiliation(s)
- C Logiou
- Pôle RRSS, CHU Lille, F-59000, Lille, France
| | - V Tiffreau
- Pôle RRSS, CHU Lille, F-59000, Lille, France; EA 7369URePPS, Université de Lille, F-59000 Lille, France
| | - E Allart
- Pôle RRSS, CHU Lille, F-59000, Lille, France; INSERM UMR-S-1172, CHU Lille, F-59000 Lille, France
| | - A Thevenon
- Pôle RRSS, CHU Lille, F-59000, Lille, France; EA 7369URePPS, Université de Lille, F-59000 Lille, France.
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22
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Zhang M, Li X. Focuses and trends of the studies on pediatric palliative care:A bibliometric analysis from 2004 to 2018. Int J Nurs Sci 2021; 8:5-14. [PMID: 33575439 PMCID: PMC7859508 DOI: 10.1016/j.ijnss.2020.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/10/2020] [Accepted: 11/26/2020] [Indexed: 10/25/2022] Open
Abstract
Objectives To investigate the focuses and trends of the studies on pediatric palliative care (PPC) and provide directions for future research. Methods Relevant papers about PPC published from 2004 to 2018 were analyzed using bibliometric analysis methods, including co-word analysis, biclustering analysis, and strategic diagram analysis. The included papers were divided into three groups based on the publication time, including 2004-2008, 2009-2013, and 2014-2018. Results A total of 1132 papers were published between 2004 and 2018, and there were 293 papers published between 2004 and 2008, 396 between 2009 and 2013, and 443 between 2014 and 2018. There were 42 high-frequency MeSH terms/MeSH subheadings in papers published between 2004 and 2018, including 12 between 2004 and 2008, 13 between 2009 and 2013, and 17 between 2014 and 2018. Conclusion Studies on PPC were making progress, with the increasing number, expanding scope, and uneven global distribution. Integration palliative care into pediatrics, cancer treatments in pediatric oncology, education methods on PPC, and establishment of professional teams were the major themes during 2004-2008, then the themes changed into establishing interventions to enhance the quality of life of the patients and parents, building professional-family relationship, and investigating attitude of health personnel in PPC during 2009-2013 and subsequently turned into communication skills, end-of-life decision making, and guidelines making on PPC during 2014-2018. Underdeveloped and protential themes including effective approaches to deal with the ethical dilemmas, training programs on communication skills, family support and guideline making are worth studying in the future.
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Affiliation(s)
- Miao Zhang
- School of Nursing, China Medical University, Shenyang, Liaoning, China
| | - Xiaohan Li
- School of Nursing, China Medical University, Shenyang, Liaoning, China
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23
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Laabar TD, Saunders C, Auret K, Johnson CE. Palliative care needs among patients with advanced illnesses in Bhutan. BMC Palliat Care 2021; 20:8. [PMID: 33422058 PMCID: PMC7797114 DOI: 10.1186/s12904-020-00697-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/15/2020] [Indexed: 02/08/2023] Open
Abstract
Background Palliative care improves the quality of lives of patients and families affected by advanced illnesses through the prevention and relief of suffering. While palliative care is well established in developed countries, it is inadequate or non-existent in most developing countries. Palliative care is an emerging concept in Bhutan, a tiny Himalayan Kingdom. A small community palliative care service is available in the national referral hospital with three dedicated inpatient palliative care beds. This study explored the needs for palliative care among patients diagnosed with advanced illnesses and is a component of a larger project aimed to inform a suitable palliative care model for the country. Methods This is a cross-sectional descriptive study. A survey, using a structured questionnaire including the EORTC QLQ-C30, was carried out among patients with advanced illness in hospitals, primary care units and communities across the country. Purposeful and snowball sampling strategies were used to recruit study participants. Results Seventy (76%), out of 93 eligible patients, agreed to participate in the survey. Participants reported low to moderate scores on physical, role, emotional, cognitive and social functioning, a moderate score for the global health/ quality of life scale and moderately high (worse) scores in symptoms including fatigue, pain, insomnia, loss of appetite and the financial impact from the disease. Conclusions The symptom burden experienced by patients affected by advanced illnesses demonstrates the need for palliative care in Bhutan. These findings will help inform the development of a public health-focused palliative care model, modified to the Bhutanese context, as recommended by the World Health Organization.
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Affiliation(s)
- Tara Devi Laabar
- Medical School, The University of Western Australia, 35 Stirling Highway, 6009, Perth, Western Australia, Australia. .,Department of Nursing, Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan.
| | - Christobel Saunders
- Medical School, Surgery Division, The University of Western Australia, 35 Stirling Highway, 6009, Perth, Western Australia, Australia
| | - Kirsten Auret
- Rural Clinical School of Western Australia, The University of Western Australia, Science Building M701, 35 Stirling Terrace, 6330, Albany, Western Australia, Australia
| | - Claire E Johnson
- Medical School, The University of Western Australia, 35 Stirling Highway, 6009, Perth, Western Australia, Australia.,Monash Nursing and Midwifery, Monash University, 10 Chancellors Walk, Wellington Road, 3800, Clayton, Victoria, Australia.,Australian Health Services Research Institute (AHSRI), University of Wollongong, Building 234, Innovation Campus, 2522, Sydney, NSW, Australia
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24
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Earl-Royal E, Feltes M, Gisondi MA, Matheson L, Htoo MOT, Walker R. Physicians in Myanmar Provide Palliative Care Despite Limited Training and Low Confidence in Their Abilities. Palliat Med Rep 2020; 1:314-320. [PMID: 34223491 PMCID: PMC8241381 DOI: 10.1089/pmr.2020.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Patients in low-income and middle-income countries (LMICs) have limited access to palliative care providers. In Myanmar, little is known about physician knowledge of or perceptions about palliative care. An assessment of physician practice and capacity to provide palliative care is needed. Objective: Our objective was to identify physician practice patterns, knowledge gaps, and confidence in providing palliative and end-of-life care in Myanmar. Design: This was a cross-sectional survey study. Setting/Subjects: Participants were physicians practicing in Myanmar who attended the Myanmar Emergency Medicine Updates Symposium on November 10 to 11, 2018 in Yangon, Myanmar (n = 89). Measurements: The survey used modified Likert scales to explore four aspects of palliative care practice and training: frequency of patient encounters, confidence in skills, previous training, and perceived importance of formal training. Results: Study participants were young (median age 27 years old); 89% cared for terminally ill patients monthly, yet 94% reported less than two weeks of training in common palliative care domains. Lack of training significantly correlated with lack of confidence in providing care. Priorities for improving palliative care services in Myanmar include better provider training and medication access. Conclusions: Despite limited training and low confidence in providing palliative care, physicians in Myanmar are treating patients with palliative needs on a monthly basis. Future palliative care education and advocacy in Myanmar and other LMICs could focus on physician training to improve end-of-life care, increase physician confidence, and reduce barriers to medication access.
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Affiliation(s)
- Emily Earl-Royal
- Department of Emergency Medicine, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Michelle Feltes
- Department of Emergency Medicine, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Michael A Gisondi
- The Precision Education and Assessment Research Lab, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Loretta Matheson
- Department of Emergency Medicine, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | | | - Rebecca Walker
- Department of Emergency Medicine, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
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25
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Jennings N, Chambaere K, Chamely S, Macpherson CC, Deliens L, Cohen J. Palliative and End-of-Life Care in a Small Caribbean Country: A Mortality Follow-back Study of Home Deaths. J Pain Symptom Manage 2020; 60:1170-1180. [PMID: 32650139 DOI: 10.1016/j.jpainsymman.2020.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/28/2022]
Abstract
CONTEXT Empirical information on circumstances of dying from advanced illness in developing countries remains sparse. Evidence indicates that out-of-hospital end-of-life care can have significant benefits such as increased satisfaction for the patient and caregivers and cost-effective for a health-care system. Services that are aimed to deliver care at private homes may be a good model for low- and middle-income countries or other low-resourced settings. OBJECTIVES To examine specialized, generalist, and informal palliative care provision and to describe the end-of-life care goals and treatments received. METHOD A mortality follow-back study with data obtained from general practitioners certifying a random sample of death certificates of adult decedents who died between March and August 2018. The questionnaire inquired about the characteristics of care and treatment preceding death. RESULTS Three hundred nine questionnaires were mailed, and the response rate was 31% (N = 96), of which 76% were nonsudden deaths. Of these cases, 27.4% received no palliative care, 39.7% received it from a general practitioner, and 6.8% from a specialized palliative care service. Comfort maximization (60.3%) was the main goal of care in the last week of life, and analgesics (53.4%) were the predominant treatment for achieving this goal. In addition, 60.3% received informal palliative care from a family member. CONCLUSION The largest part of end-of-life care at home in Trinidad and Tobago is provided by family members, whereas professional caregivers feature less prominently. To ensure quality in end-of-life care, better access to analgesics is needed, and adequate support and education for family members as well as general practitioners are highly recommended.
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Affiliation(s)
- Nicholas Jennings
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium; St. George's University, Bioethics Department, St. George's Grenada.
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Stacey Chamely
- Independent researcher, San Fernando, Trinidad and Tobago
| | - Cheryl C Macpherson
- Bioethics Division, St. George's University School of Medicine and Windward Islands Research and Education Foundation, St. George's, Grenada
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium; Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
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26
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Jordan RI, Allsop MJ, ElMokhallalati Y, Jackson CE, Edwards HL, Chapman EJ, Deliens L, Bennett MI. Duration of palliative care before death in international routine practice: a systematic review and meta-analysis. BMC Med 2020; 18:368. [PMID: 33239021 PMCID: PMC7690105 DOI: 10.1186/s12916-020-01829-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Early provision of palliative care, at least 3-4 months before death, can improve patient quality of life and reduce burdensome treatments and financial costs. However, there is wide variation in the duration of palliative care received before death reported across the research literature. This study aims to determine the duration of time from initiation of palliative care to death for adults receiving palliative care across the international literature. METHODS We conducted a systematic review and meta-analysis that was registered with PROSPERO (CRD42018094718). Six databases were searched for articles published between Jan 1, 2013, and Dec 31, 2018: MEDLINE, Embase, CINAHL, Global Health, Web of Science and The Cochrane Library, as well undertaking citation list searches. Following PRISMA guidelines, articles were screened using inclusion (any study design reporting duration from initiation to death in adults palliative care services) and exclusion (paediatric/non-English language studies, trials influencing the timing of palliative care) criteria. Quality appraisal was completed using Hawker's criteria and the main outcome was the duration of palliative care (median/mean days from initiation to death). RESULTS One hundred sixty-nine studies from 23 countries were included, involving 11,996,479 patients. Prior to death, the median duration from initiation of palliative care to death was 18.9 days (IQR 0.1), weighted by the number of participants. Significant differences between duration were found by disease type (15 days for cancer vs 6 days for non-cancer conditions), service type (19 days for specialist palliative care unit, 20 days for community/home care, and 6 days for general hospital ward) and development index of countries (18.91 days for very high development vs 34 days for all other levels of development). Forty-three per cent of studies were rated as 'good' quality. Limitations include a preponderance of data from high-income countries, with unclear implications for low- and middle-income countries. CONCLUSIONS Duration of palliative care is much shorter than the 3-4 months of input by a multidisciplinary team necessary in order for the full benefits of palliative care to be realised. Furthermore, the findings highlight inequity in access across patient, service and country characteristics. We welcome more consistent terminology and methodology in the assessment of duration of palliative care from all countries, alongside increased reporting from less-developed settings, to inform benchmarking, service evaluation and quality improvement.
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Affiliation(s)
- Roberta I Jordan
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Matthew J Allsop
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
| | - Yousuf ElMokhallalati
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Catriona E Jackson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Helen L Edwards
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Emma J Chapman
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Luc Deliens
- End-of-Life Care Research Group, Ghent University, Ghent, Belgium.,Vrije Universiteit Brussel, Brussels, Belgium
| | - Michael I Bennett
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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27
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Jennings N, Chambaere K, Cox Macpherson C, Cox KL, Deliens L, Cohen J. Developing and validating a questionnaire for mortality follow-back studies on end-of-life care and decision-making in a resource-poor Caribbean country. BMC Palliat Care 2020; 19:123. [PMID: 32795270 PMCID: PMC7427774 DOI: 10.1186/s12904-020-00630-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 08/06/2020] [Indexed: 12/03/2022] Open
Abstract
Background Palliative and end-of-life care development is hindered by a lack of information about the circumstances surrounding dying in developing and resource-poor countries. Our aims were to develop and obtain face and content validity for a self-administered questionnaire on end-of-life care provision and medical decision-making for use in population-based surveys. Methods Modelled on validated questionnaires from research in developed countries, our questionnaire was adapted to the cultural sensitivity and medico-legal context of Trinidad and Tobago. Two sets of semi-structured face-to-face cognitive interviews were done with a sample of physicians, sampling was purposive. Phase 1 assessed interpretation of the questions, terminology and content of the questionnaire. Phase 2 was tested on a heterogeneous group of physicians to identify and fix problematic questions or recurring issues. Adjustments were made incrementally and re-tested in successive interviews. Results Eighteen physicians were interviewed nationwide. Adaptations to questionnaires used in developed countries included: addition of a definition of palliative care, change of sensitive words like expedited to influenced, adjustments to question formulations, follow-up questions and answer options on medications used were added, the sequence, title and layout were changed and instructions for completion were included at the beginning of the questionnaire. Conclusion A new instrument for assessing and documenting end-of-life care and circumstances of dying in a small, resource-poor Caribbean country was developed and validated, and can be readily used as a mortality follow-back instrument. Our methods and procedures of development can be applied as a guide for similar studies in other small developing countries.
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Affiliation(s)
- Nicholas Jennings
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Ghent University, Laarbeeklaan 103, B-1090, Brussels, Belgium. .,St. George's University, St. George's, Grenada.
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Ghent University, Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - Cheryl Cox Macpherson
- Bioethics Division, St. George's University School of Medicine and Windward Islands Research and Education Foundation, St. George's, Grenada
| | - Karen L Cox
- Palliative Care Unit, Caura Hospital, North Central Regional Health Authority, Caura, Trinidad and Tobago
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Ghent University, Laarbeeklaan 103, B-1090, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Ghent University, Laarbeeklaan 103, B-1090, Brussels, Belgium
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Walshe C, Ahmed F, Preston N. Do journals contribute to the international publication of research in their field? A bibliometric analysis of palliative care journal data. Palliat Med 2020; 34:541-546. [PMID: 31973638 DOI: 10.1177/0269216319897536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Research is important internationally, impacting on health service provision and patient benefit. Journals play an important dissemination role, but there may be geographical bias, potentially affecting access to evidence. AIM To understand if there is a relationship between the continent of journals and that of contributing authors. DESIGN Bibliometric analysis of journal citation report data (June 2018). Odds ratio of association of an author being from region, region of journal publication, publication model and the number of papers. SETTING Journals specialising in palliative care research, with an impact factor above the median impact factor for their most common indexing category. RESULTS Five journals: three published in Europe (Palliative Medicine, BMJ Supportive and Palliative Care, and BMC Palliative Care) and two in North America (Journal of Pain and Symptom Management and Journal of Palliative Medicine). Authors were from 30+ countries, but mostly North America (54.18%) or Europe (27.94%). Preliminary sensitivity tests show that the odds of an author being from a North American institution increase 16.4 times (p < 0.01; 95% confidence interval: 12.9, 20.8) if the region of journal publication is North America. The odds of an author being from a European institution is 14.0 times (p < 0.01; 95% confidence interval: 10.9, 17.9) higher if the region of journal publication is Europe. CONCLUSION Publishers, editors and authors are concentrated in North America or Europe. North American authors are more present in North American journals and European authors in European journals. This polarised approach, if replicated across readerships, may lead to research waste, duplication, and be sub-optimal for healthcare development.
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Affiliation(s)
- Catherine Walshe
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Faraz Ahmed
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Nancy Preston
- Division of Health Research, Lancaster University, Lancaster, UK
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Osman H, Shrestha S, Temin S, Ali ZV, Corvera RA, Ddungu HD, De Lima L, Del Pilar Estevez-Diz M, Ferris FD, Gafer N, Gupta HK, Horton S, Jacob G, Jia R, Lu FL, Mosoiu D, Puchalski C, Seigel C, Soyannwo O, Cleary JF. Palliative Care in the Global Setting: ASCO Resource-Stratified Practice Guideline. J Glob Oncol 2019; 4:1-24. [PMID: 30085844 PMCID: PMC6223509 DOI: 10.1200/jgo.18.00026] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose The purpose of this new resource-stratified guideline is to provide expert guidance to clinicians and policymakers on implementing palliative care of patients with cancer and their caregivers in resource-constrained settings and is intended to complement the Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update of 2016. Methods ASCO convened a multidisciplinary, multinational panel of experts in medical oncology, family medicine, radiation oncology, hematology/oncology, palliative and/or hospice care, pain and/or symptom management, patient advocacy, public health, and health economics. Guideline development involved a systematic literature review, a modified ADAPTE process, and a formal consensus-based process with the Expert Panel and additional experts (consensus ratings group). Results The systematic review included 48 full-text publications regarding palliative care in resource-constrained settings, along with cost-effectiveness analyses; the evidence for many clinical questions was limited. These provided indirect evidence to inform the formal consensus process, which resulted in agreement of ≥ 75% (by consensus ratings group including Expert Panel). Recommendations The recommendations help define the models of care, staffing requirements, and roles and training needs of team members in a variety of resource settings for palliative care. Recommendations also outline the standards for provision of psychosocial support, spiritual care, and opioid analgesics, which can be particularly challenging and often overlooked in resource-constrained settings. Additional information is available at www.asco.org/resource-stratified-guidelines. It is the view of ASCO that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.
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Affiliation(s)
- Hibah Osman
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Sudip Shrestha
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Sarah Temin
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Zipporah V Ali
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Rumalie A Corvera
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Henry D Ddungu
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Liliana De Lima
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Maria Del Pilar Estevez-Diz
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Frank D Ferris
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Nahla Gafer
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Harmala K Gupta
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Susan Horton
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Graciela Jacob
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Ruinuo Jia
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Frank L Lu
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Daniela Mosoiu
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Christina Puchalski
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Carole Seigel
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Olaitan Soyannwo
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - James F Cleary
- Hibah Osman, Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Sudip Shrestha, Nepal Cancer Hospital and Research Center, Lalitpur Submetropolis, Nepal; Sarah Temin, ASCO, Alexandria, VA; Zipporah V. Ali, Kenya Hospices and Palliative Care Association, Nairobi, Kenya; Rumalie A. Corvera, Asian Hospital and Medical Centre, Muntinlupa, Philippines; Henry D. Ddungu, Uganda Cancer Institute and Hutchinson Center Research Institute, Kampala, Uganda; Liliana De Lima, International Association for Hospice and Palliative Care, Houston, TX; Maria Del Pilar Estevez-Diz, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Frank D. Ferris, OhioHealth, Columbus, OH; Nahla Gafer, Radiation and Isotope Center, Khartoum, Sudan; Harmala K. Gupta, CanSupport, New Delhi, India; Susan Horton, University of Waterloo, Waterloo, Ontario, Canada; Graciela Jacob, Instituto Nacional de Cancerología, Buenos Aires, Argentina; Ruinuo Jia, Henan University of Science and Technology, Luoyang, People's Republic of China; Frank L. Lu, National Taiwan University Children's Hospital, Taipei, Republic of China; Daniela Mosoiu, Transylvania University Brasov, Brasov, Romania; Christina Puchalski, George Washington University, Washington, DC; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; Olaitan Soyannwo, University College Hospital Ibadan, Ibadan, Nigeria; and James F. Cleary, University of Wisconsin Carbone Cancer Center, Madison, WI
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30
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Varadaraj V, Ranjit A, Nwadiuko J, Canner J, Diener-West M, Schneider EB, Thyagarajan SP, Shrestha R, Nagarajan N. Towards diaspora-driven research capacity strengthening in low- and middle-income countries: results from India and Nepal. Int Health 2019; 11:221-228. [PMID: 30307506 DOI: 10.1093/inthealth/ihy076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/12/2018] [Accepted: 09/07/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Biomedical research from high-income countries often informs practice and policy in low- and middle-income countries (LMICs) with vastly different socioeconomic and health systems. Engagement of LMIC-based researchers is integral to setting research priorities in the local context. METHODS A program, comprising a research seminar and workshop, and utilizing diaspora health professionals to understand research needs and build research capacity in LMICs, was created and pilot-tested at two institutions in India (65 participants) and Nepal (30 participants). Pre- and post-program surveys were instituted to assess participants' attitudes towards research. RESULTS In the pre-program survey, most participants (India: 76%, Nepal: 100%) perceived research as 'very/extremely important' in their careers. However, a majority felt that finding time (India: 75%, Nepal: 81%) and funding (India: 82%, Nepal: 100%) for research was 'difficult/very difficult'. After the program, 86-91% and 86-100% of participants from India and Nepal, respectively, felt that the various courses were very useful/useful for their research careers. CONCLUSIONS Research is seen as an integral part of educational training and career advancement in LMICs. However, inadequate training, funding and mentorship remain a challenge. Engagement of diaspora health workers may serve as an important avenue for collaborative biomedical research capacity strengthening in LMICs.
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Affiliation(s)
- Varshini Varadaraj
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Anju Ranjit
- Center for Surgery and Public Health, Brigham and Women's Hospital, 1620 Tremont St, Boston, MA, USA
| | - Joseph Nwadiuko
- Department of Medicine, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Joseph Canner
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Marie Diener-West
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - Eric B Schneider
- Department of Surgery, University of Virginia School of Medicine, 1215 Lee St, Charlottesville, VA, USA
| | | | - Rajeev Shrestha
- Departments of Research Development and Medical Education, Kathmandu University, Dhulikhel, Nepal
| | - Neeraja Nagarajan
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
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31
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Mbaye R, Gebeyehu R, Hossmann S, Mbarga N, Bih-Neh E, Eteki L, Thelma OA, Oyerinde A, Kiti G, Mburu Y, Haberer J, Siedner M, Okeke I, Boum Y. Who is telling the story? A systematic review of authorship for infectious disease research conducted in Africa, 1980-2016. BMJ Glob Health 2019; 4:e001855. [PMID: 31750001 PMCID: PMC6830283 DOI: 10.1136/bmjgh-2019-001855] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/23/2019] [Accepted: 09/28/2019] [Indexed: 11/08/2022] Open
Abstract
Introduction Africa contributes little to the biomedical literature despite its high burden of infectious diseases. Global health research partnerships aimed at addressing Africa-endemic disease may be polarised. Therefore, we assessed the contribution of researchers in Africa to research on six infectious diseases. Methods We reviewed publications on HIV and malaria (2013–2016), tuberculosis (2014–2016), salmonellosis, Ebola haemorrhagic fever and Buruli ulcer disease (1980–2016) conducted in Africa and indexed in the PubMed database using Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Papers reporting original research done in Africa with at least one laboratory test performed on biological samples were included. We studied African author proportion and placement per study type, disease, funding, study country and lingua franca. Results We included 1182 of 2871 retrieved articles that met the inclusion criteria. Of these, 1109 (93.2%) had at least one Africa-based author, 552 (49.8%) had an African first author and 41.3% (n=458) an African last author. Papers on salmonellosis and tuberculosis had a higher proportion of African last authors (p<0.001) compared with the other diseases. Most of African first and last authors had an affiliation from an Anglophone country. HIV, malaria, tuberculosis and Ebola had the most extramurally funded studies (≥70%), but less than 10% of the acknowledged funding was from an African funder. Conclusion African researchers are under-represented in first and last authorship positions in papers published from research done in Africa. This calls for greater investment in capacity building and equitable research partnerships at every level of the global health community.
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Affiliation(s)
- Rose Mbaye
- Department of Epidemiology, University of Rochester, Rochester, New York, USA
| | - Redeat Gebeyehu
- Department of Public Health, Stanford University, Stanford, California, USA
| | | | - Nicole Mbarga
- Department of Public Health, Universite Catholique de l'Afrique Centrale, Yaounde, Cameroon.,Cameroon Mission, Medecins Sans Frontieres, Geneva, Switzerland
| | - Estella Bih-Neh
- Department of Public Health, University of Buea, Buea, Cameroon
| | | | | | - Abiodun Oyerinde
- Department of Microbiology, University of Ibadan, Ibadan, Nigeria
| | - Gift Kiti
- Department of Public Health, University of California Berkeley, Berkeley, California, USA
| | | | - Jessica Haberer
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark Siedner
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Iruka Okeke
- Department of Microbiology, University of Ibadan, Ibadan, Nigeria
| | - Yap Boum
- Epicentre, Yaounde, Centre, Cameroon.,Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda
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Rees CA, Keating EM, Dearden KA, Haq H, Robison JA, Kazembe PN, Bourgeois FT, Niescierenko M. Importance of authorship and inappropriate authorship assignment in paediatric research in low‐ and middle‐income countries. Trop Med Int Health 2019; 24:1229-1242. [DOI: 10.1111/tmi.13295] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Chris A. Rees
- Division of Emergency Medicine, Boston Children's Hospital Harvard Medical School Boston MA USA
| | - Elizabeth M. Keating
- Division of Pediatric Emergency Medicine University of Utah Salt Lake City UT USA
| | | | - Heather Haq
- Department of Pediatrics Baylor College of Medicine Houston TX USA
| | - Jeff A. Robison
- Division of Pediatric Emergency Medicine University of Utah Salt Lake City UT USA
| | - Peter N. Kazembe
- Baylor College of Medicine Children’s Foundation Malawi Lilongwe Malawi
| | - Florence T. Bourgeois
- Division of Emergency Medicine, Boston Children's Hospital Harvard Medical School Boston MA USA
| | - Michelle Niescierenko
- Division of Emergency Medicine, Boston Children's Hospital Harvard Medical School Boston MA USA
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Arias N, Garralda E, De Lima L, Rhee JY, Centeno C. Global Palliative Care and Cross-National Comparison: How Is Palliative Care Development Assessed? J Palliat Med 2019; 22:580-590. [DOI: 10.1089/jpm.2018.0510] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Natalia Arias
- ATLANTES Research Program, Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Eduardo Garralda
- ATLANTES Research Program, Institute for Culture and Society, University of Navarra, Pamplona, Spain
- IdiSNA (Instituto de Investigación Sanitaria de Navarra/Institute of Health Research of Navarra), Pamplona, Spain
| | - Liliana De Lima
- International Association for Hospice and Palliative Care, Houston, Texas
| | - John Y. Rhee
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Carlos Centeno
- ATLANTES Research Program, Institute for Culture and Society, University of Navarra, Pamplona, Spain
- IdiSNA (Instituto de Investigación Sanitaria de Navarra/Institute of Health Research of Navarra), Pamplona, Spain
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Doherty ME, Power L, Rahman R, Ferdous L, Akter KM, Quadir SS, Sharmin S, Evans E, Khan F. The Psychosocial and Spiritual Experiences of Patients with Advanced Incurable Illness in Bangladesh: A Cross-Sectional Observational Study. Indian J Palliat Care 2019; 25:487-493. [PMID: 31673200 PMCID: PMC6812416 DOI: 10.4103/ijpc.ijpc_113_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context The psychosocial and spiritual needs of individuals with life-limiting conditions in low- or middle-income countries have not been well described. Understanding these needs is important to providing holistic palliative care. Aim This study aims to better understand the psychosocial and spiritual needs and supports of patients with advanced, incurable illness in Bangladesh. Subjects and Methods Individuals with advanced incurable illnesses (advanced cancer and HIV/AIDS) from a wide geographical distribution across Bangladesh were interviewed about their health status, emotional and spiritual experiences with their illness, coping and support systems, and greatest needs and fears. Results We interviewed 221 individuals with incurable cancer (82%) or HIV/AIDS (18%). Self-reported health status was poor or very poor for 48%, and 44% reported feeling unhappy all of the time. The majority (61%) rated their current level of unhappiness as 10/10. Spouses (50%), children (15%), and parents (13%) were the most common caregivers. Money and medical care were equally the most common needs (46%). Participants' greatest fears were for the future of their children (38%), being in pain (29%), and dying (28%). Conclusions There is a significant burden of psychosocial and spiritual concerns among patients with advanced incurable illness in Bangladesh, with sadness being very frequent and of high intensity. Family and friends provide significant emotional and practical support to patients who are seriously ill, but very few patients access any professional support for these concerns.
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Affiliation(s)
- Megan E Doherty
- Department of Pediatrics, Faculty of Medicine, University of Ottawa and Roger Neilson House, Ottawa, Canada.,Children's Hospital of Eastern Ontario, Ottawa, Canada
| | | | - Rubayet Rahman
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Lailatul Ferdous
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Kazi M Akter
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sayeda Sharmin Quadir
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sadia Sharmin
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Emily Evans
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Farzana Khan
- Fasiuddin Khan Research Foundation, Dhaka, Bangladesh
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Osman H, Shrestha S, Temin S, Ali ZV, Cleary JF. Palliative Care in the Global Setting: ASCO Resource-Stratified Practice Guideline Summary. J Oncol Pract 2018; 14:431-436. [DOI: 10.1200/jop.18.00087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Hibah Osman
- Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Nepal Cancer Hospital and Research Center, Lalitpur, Nepal; ASCO, Alexandria, VA; Kenya Hospices and Palliative Care Association, Nairobi, Kenya; and University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Sudip Shrestha
- Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Nepal Cancer Hospital and Research Center, Lalitpur, Nepal; ASCO, Alexandria, VA; Kenya Hospices and Palliative Care Association, Nairobi, Kenya; and University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Sarah Temin
- Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Nepal Cancer Hospital and Research Center, Lalitpur, Nepal; ASCO, Alexandria, VA; Kenya Hospices and Palliative Care Association, Nairobi, Kenya; and University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Zipporah V. Ali
- Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Nepal Cancer Hospital and Research Center, Lalitpur, Nepal; ASCO, Alexandria, VA; Kenya Hospices and Palliative Care Association, Nairobi, Kenya; and University of Wisconsin Carbone Cancer Center, Madison, WI
| | - James F. Cleary
- Balsam-Lebanese Center for Palliative Care, American University of Beirut Medical Center, Beirut, Lebanon; Nepal Cancer Hospital and Research Center, Lalitpur, Nepal; ASCO, Alexandria, VA; Kenya Hospices and Palliative Care Association, Nairobi, Kenya; and University of Wisconsin Carbone Cancer Center, Madison, WI
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Liu CJ, Yeh TC, Hsu SH, Chu CM, Liu CK, Chen M, Huang SJ. Bibliometric Analysis of Palliative Care-Related Publication Trends During 2001 to 2016. Am J Hosp Palliat Care 2018; 35:1280-1286. [DOI: 10.1177/1049909118773751] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The scientific contributions (publications) and international influence (citations) from authors providing the palliative care (PC)-related literature has a limited number of bibliometric reports. We aimed to analyze PC-related literature using the Institute for Scientific Information Web of Science (WoS) database. Methods: WoS database was used to retrieve publications with the following key words with title: “palliative care” OR “End of Life care” OR “terminal care.”. The statistical analysis of the documents published during 2001 to 2016 was performed. The quantity and quality of research were assessed by the number of total publications and citation analysis. In addition, we also analyzed whether there were possible correlations between publication and socioeconomic factors. Results: The total research output was 6273 articles for PC. There was a 3-fold increase in the number of publications during the period and strong correlation between the year and number of PC-related publications ( R2 = .96). The United States took a leading position in PC research (2448, 39.0%). The highest average citations was reported for the Norway (21.8). Australia had gained the highest productive ability in PC research (24.9 of articles per million populations). The annual impact factor rose progressively with time and increased 1.13 to 2.24 from 2003 to 2016. The number of publications correlated with gross domestic product ( r = .74; P < .001). Conclusion: The United States and United Kingdom contributed most of the publications, but some East Asian countries also had a great performance. According to the socioeconomic factors, the publication capacity of top 20 countries is correlated with their economic scale.
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Affiliation(s)
- Chia-Jen Liu
- Superintendent Office, Taipei City Hospital, Taipei City, Taiwan
- Graduate Institute of Business Administration, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Te-Chun Yeh
- Academy of Humanities and Innovation, Taipei City Hospital, Taipei City, Taiwan
| | - Su-Hsuan Hsu
- Center of R/D in Community Based Palliative Care, Taipei City Hospital, Taipei City, Taiwan
| | - Chao-Mei Chu
- Development and Planning Center, Taipei City Hospital, Taipei City, Taiwan
| | - Chih-Kuang Liu
- Graduate Institute of Business Administration, Fu-Jen Catholic University, New Taipei City, Taiwan
- Department of Urology, Taipei City Hospital, Taipei City, Taiwan
- College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Mingchih Chen
- Graduate Institute of Business Administration, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Sheng-Jean Huang
- Superintendent Office, Taipei City Hospital, Taipei City, Taiwan
- Department of Surgery, College of Medicine, National Taiwan University, Taipei City, Taiwan
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Campbell J, Buyinza N, Hauser J. Perspective on Care at the End of Life at Hospice Africa Uganda. J Palliat Med 2018; 21:901-906. [PMID: 29649394 DOI: 10.1089/jpm.2017.0472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Since its beginning in 1993, Hospice Africa Uganda (HAU) has become a leader in palliative care in Africa. Despite this, there remains a sparsity of research elucidating the priorities of patients in their care at the end of life. This study aimed to identify those priorities in three groups: patients with life-limiting illness, their caregivers, and their healthcare providers at HAU, and thus to identify differences in what these groups find important in the last month of life. METHODS A Likert scale survey of 31 statements regarding end-of-life care was administered to 46 patients, 51 caregivers, and 25 healthcare providers at HAU in Kampala, Uganda and satellite locations. ANALYSIS Variations in the responses of the groups were analyzed using the Kruskal-Wallis test of variance. RESULTS Twelve of 31 items were significantly different, and frequency data were examined. Differences were found in categories of symptom management, future planning, and in preferred place of death. Of anxiety, pain, and shortness of breath (SOB), only control of SOB was widely agreed on as important by patients, although providers unanimously wanted to control symptoms. Many subjects in all groups found that funeral arrangements should be deferred. Most patients and caregivers felt as if dying in the hospital was preferable, whereas providers felt that home care was preferable. CONCLUSION This study tells us that patients, caregivers, and healthcare providers often have different ideas concerning what is important in end-of-life care, differences that are unique to this population.
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Affiliation(s)
- Joshua Campbell
- 1 Departments of Hospital Medicine and Medical Education, Northwestern University Feinberg School of Medicine , Chicago, Illinois
| | - Nasur Buyinza
- 2 Department Institute of Hospice and Palliative Care in Africa, Hospice Africa Uganda, Kampala, Uganda
| | - Joshua Hauser
- 1 Departments of Hospital Medicine and Medical Education, Northwestern University Feinberg School of Medicine , Chicago, Illinois
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Shabnam J, Ahmad N, Quadir SS, Biswas FN, Timm HU. 24/7 palliative care telephone consultation service in Bangladesh: A descriptive mixed method study – They know that we are with them. PROGRESS IN PALLIATIVE CARE 2018. [DOI: 10.1080/09699260.2018.1461479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jahan Shabnam
- REHPA – Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Copenhagen, Denmark
| | - Nezamuddin Ahmad
- Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sayeda Sharmin Quadir
- Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Fazle-noor Biswas
- Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Helle Ussing Timm
- REHPA – Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Copenhagen, Denmark
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Jennings N, Chambaere K, Macpherson CC, Deliens L, Cohen J. Main themes, barriers, and solutions to palliative and end-of-life care in the English-speaking Caribbean: a scoping review. Rev Panam Salud Publica 2018; 42:e15. [PMID: 31093044 PMCID: PMC6385807 DOI: 10.26633/rpsp.2018.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 08/09/2017] [Indexed: 11/24/2022] Open
Abstract
Objectives To identify common themes documented in the literature on palliative and end-of-life care in English-speaking Caribbean small island developing states (SIDS), and to describe barriers, improvement strategies, and suggested ways forward. Methods In 2015, we conducted a systematic scoping review of relevant literature identified through the MEDLINE and Web of Science databases. We supplemented that with searches of other electronic and hard-copy sources to map key concepts and summarize themes. Results Primary data and other literature from and about English-speaking Caribbean nations are relatively scarce. The available literature offers an overview of the existing situation in the region and explores why palliative and end-of-life care is limited there. This review identified barriers in five main areas recurring across this literature: i) culture and attitudes of health care providers, patients, and those close to them towards terminal illness and death; ii) opioid availability and use; iii) limited development of palliative care services; iv) unmet palliative care needs; and v) limited research on palliative or end-of-life care. Conclusions Our analysis helps to document the need for palliative and end-of-life care in Caribbean SIDS and highlights suggestions for moving forward with related practice, policy, and research.
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Affiliation(s)
- Nicholas Jennings
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Cheryl C Macpherson
- Bioethics Department, St. George's University School of Medicine and Windward Islands Research and Education Foundation, St. George's, Grenada
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
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Rees CA, Lukolyo H, Keating EM, Dearden KA, Luboga SA, Schutze GE, Kazembe PN. Authorship in paediatric research conducted in low- and middle-income countries: parity or parasitism? Trop Med Int Health 2017; 22:1362-1370. [DOI: 10.1111/tmi.12966] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Chris A. Rees
- Division of Emergency Medicine; Boston Children's Hospital; Harvard Medical School; Boston USA
| | - Heather Lukolyo
- Department of Pediatrics; Baylor College of Medicine; Houston USA
- Baylor College of Medicine Children's Foundation Uganda; Kampala Uganda
| | - Elizabeth M. Keating
- Department of Pediatrics; Baylor College of Medicine; Houston USA
- Baylor College of Medicine Children's Foundation Lesotho; Maseru Lesotho
| | | | | | | | - Peter N. Kazembe
- Department of Pediatrics; Baylor College of Medicine; Houston USA
- Baylor College of Medicine Children's Foundation Malawi; Lilongwe Malawi
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Clark D, Inbadas H, Colburn B, Forrest C, Richards N, Whitelaw S, Zaman S. Interventions at the end of life - a taxonomy for 'overlapping consensus'. Wellcome Open Res 2017; 2:7. [PMID: 28261674 PMCID: PMC5336190 DOI: 10.12688/wellcomeopenres.10722.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Context: Around the world there is increasing interest in end of life issues. An unprecedented number of people dying in future decades will put new strains on families, communities, services and governments. It will also have implications for representations of death and dying within society and for the overall orientation of health and social care. What interventions are emerging in the face of these challenges? Methods: We conceptualize a comprehensive taxonomy of interventions, defined as 'organized responses to end of life issues'. Findings: We classify the range of end of life interventions into 10 substantive categories: policy, advocacy, educational, ethico-legal, service, clinical, research, cultural, intangible, self-determined. We distinguish between two empirical aspects of any end of life intervention: the 'locus' refers to the space or spaces in which it is situated; the 'focus' captures its distinct character and purpose. We also contend that end of life interventions can be seen conceptually in two ways - as 'frames' (organized responses that primarily construct a shared understanding of an end of life issue) or as 'instruments' (organized responses that assume a shared understanding and then move to act in that context). Conclusions: Our taxonomy opens up the debate about end of life interventions in new ways to provide protagonists, activists, policy makers, clinicians, researchers and educators with a comprehensive framework in which to place their endeavours and more effectively to assess their efficacy. Following the inspiration of political philosopher John Rawls, we seek to foster an 'overlapping consensus' on how interventions at the end of life can be construed, understood and assessed.
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Affiliation(s)
- David Clark
- School of Interdisciplinary Studies, University of Glasgow, Glasgow, UK
| | - Hamilton Inbadas
- School of Interdisciplinary Studies, University of Glasgow, Glasgow, UK
| | - Ben Colburn
- School of Humanities, University of Glasgow, Glasgow, UK
| | - Catriona Forrest
- School of Interdisciplinary Studies, University of Glasgow, Glasgow, UK
| | - Naomi Richards
- School of Interdisciplinary Studies, University of Glasgow, Glasgow, UK
| | - Sandy Whitelaw
- School of Interdisciplinary Studies, University of Glasgow, Glasgow, UK
| | - Shahaduz Zaman
- School of Interdisciplinary Studies, University of Glasgow, Glasgow, UK
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Zaman S, Inbadas H, Whitelaw A, Clark D. Common or multiple futures for end of life care around the world? Ideas from the 'waiting room of history'. Soc Sci Med 2017; 172:72-79. [PMID: 27894008 PMCID: PMC5224187 DOI: 10.1016/j.socscimed.2016.11.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 11/04/2016] [Accepted: 11/07/2016] [Indexed: 11/28/2022]
Abstract
Around the world there is growing interest in the manner in which care is delivered to people at the end of life. However, there is little unanimity on what constitutes a 'good death' and the appropriate societal responses to the issue of delivering culturally relevant and sustainable forms of end of life care in different settings are not subjects of broad agreement. In this critical conceptual paper we focus on the emerging narratives of global palliative care and offer an assessment of their implications. We relate this to calls to improve end of life care across jurisdictions and settings, attempts to map and grade the development of palliative care provision, and to the emergence of a widely recognised global 'quality of death index'. We consider an alternative approach to framing this debate, drawn from a subaltern and post-colonial studies perspective and suggest that adopting a truly global perspective will require acceptance of the plurality of past and present local problems and issues relating to end of life care, as well as the plural possibilities of how they might be overcome. In that context, we would not aim to universalise or privilege one particular global future for end of life care. Instead of homogenising end of life interventions, we seek to be open to multiple futures for the care of the dying.
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Affiliation(s)
- Shahaduz Zaman
- School of Interdisciplinary Studies, The University of Glasgow, Crichton University Campus, Dumfries, DG1 4ZL, Scotland, UK.
| | - Hamilton Inbadas
- School of Interdisciplinary Studies, The University of Glasgow, Crichton University Campus, Dumfries, DG1 4ZL, Scotland, UK.
| | - Alexander Whitelaw
- School of Interdisciplinary Studies, The University of Glasgow, Crichton University Campus, Dumfries, DG1 4ZL, Scotland, UK.
| | - David Clark
- School of Interdisciplinary Studies, The University of Glasgow, Crichton University Campus, Dumfries, DG1 4ZL, Scotland, UK.
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Clark J, Gardiner C, Barnes A. International palliative care research in the context of global development: a systematic mapping review. BMJ Support Palliat Care 2016; 8:7-18. [DOI: 10.1136/bmjspcare-2015-001008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 05/17/2016] [Accepted: 07/14/2016] [Indexed: 01/18/2023]
Abstract
ContextAn increasing amount of health policy is formulated at global level. At this global level, palliative care has attracted support primarily from normative institutions (WHO), not funding agencies. To attract greater global attention from policymakers, it has been argued that an international approach to research is required. However, the extent to which an international approach is being undertaken is unknown.ObjectivesTo systematically identify and thematically synthesise all international palliative care research, defined as research involving two or more countries, or focused on the global level.MethodsFive bibliographic databases (CINAHL, Cochrane Library, ASSIA, Web of Knowledge, Psychinfo) were searched for journal articles relevant to international and global palliative care and end-of-life care. Data were extracted using a piloted extraction form and findings were synthesised.Results184 studies were included, published across 75 different academic journals. Research emanates from and focuses on all world regions and there is increasing focus on the global level. Thematically, there is a high focus on Evaluation (n=53) and views of Stakeholders (n=38). The review revealed a predominantly observational research approach and few interventional studies were identified.ConclusionsInternational palliative care research is a relatively new, but growing field. However, many gaps in the evidence base remain and palliative care research continues to take place outside broader discourses of international development. The relative absence of interventional research demonstrating the effectiveness and cost-effectiveness of palliative care risks limiting the tools with which advocates can engage with international policymakers on this topic.
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Zafar W, Hafeez H, Jamshed A, Shah MA, Quader A, Yusuf MA. Preferences regarding disclosure of prognosis and end-of-life care: A survey of cancer patients with advanced disease in a lower-middle-income country. Palliat Med 2016; 30:661-73. [PMID: 26769733 DOI: 10.1177/0269216315625810] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Cancer patients' preferences regarding disclosure of prognosis and end-of-life care remain under-reported from low- and middle-income countries where cancer poses an increasing demand on scarce healthcare resources. A better knowledge of these preferences can help in achievement of shared treatment goals. AIM To survey preferences of adult cancer patients regarding disclosure of prognosis and end-of-life care DESIGN A multidimensional questionnaire was developed to survey consecutively sampled patients. A fifth of the participants completed a repeat survey 3 months later. SETTING/PARTICIPANTS Adult patients at a specialist cancer center in Pakistan. RESULTS In total, 520 patients were surveyed initially (participation rate 98.6%) and 100 completed the repeat survey. Three in five respondents wanted a healthcare provider to give them detailed information about their prognosis and life expectancy. Those who wanted information withheld were significantly more likely to be female, to have a lower socioeconomic status, or to have lung cancer. Only two in five patients agreed that they wanted to die at home and more than 90% wanted all possible care till end-of-life. Yet, a little over half also agreed that they did not wish to be placed on a ventilator. In rank ordering preferences about end-of-life, respondents ranked "religious wellbeing" as the highest and "avoiding inappropriate prolongation of dying" as the lowest of six options. CONCLUSION A majority of adult cancer patients surveyed in this study wanted a truthful disclosure about their disease prognosis and expressed a preference for hospital-based care at end-of-life. Healthcare providers should find ways to tailor prognostic information to patients' expressed information needs.
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Affiliation(s)
- Waleed Zafar
- Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | - Haroon Hafeez
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | - Arif Jamshed
- Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | - Mazhar Ali Shah
- Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | - Ainul Quader
- Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | - M Aasim Yusuf
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
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Alsirafy SA, Abd El-Aal HH, Farag DE, Radwan RH, El-Sherief WA, Fawzy R. High Symptom Burden Among Patients With Newly Diagnosed Incurable Cancer in a Developing Country. J Pain Symptom Manage 2016; 51:e1-5. [PMID: 27033159 DOI: 10.1016/j.jpainsymman.2016.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 02/02/2016] [Accepted: 02/18/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Samy A Alsirafy
- Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt.
| | - Hesham H Abd El-Aal
- Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Dina E Farag
- Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Riham H Radwan
- Palliative Medicine Unit and Department of Clinical Oncology, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Wessam A El-Sherief
- Palliative Medicine Unit and Department of Clinical Oncology, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Radwa Fawzy
- Department of Clinical Oncology, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
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Hannon B, Zimmermann C, Knaul FM, Powell RA, Mwangi-Powell FN, Rodin G. Provision of Palliative Care in Low- and Middle-Income Countries: Overcoming Obstacles for Effective Treatment Delivery. J Clin Oncol 2016; 34:62-8. [DOI: 10.1200/jco.2015.62.1615] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Despite being declared a basic human right, access to adult and pediatric palliative care for millions of individuals in need in low- and middle-income countries (LMICs) continues to be limited or absent. The requirement to make palliative care available to patients with cancer is increasingly urgent because global cancer case prevalence is anticipated to double over the next two decades. Fifty percent of these cancers are expected to occur in LMICs, where mortality figures are disproportionately greater as a result of late detection of disease and insufficient access to appropriate treatment options. Notable initiatives in many LMICs have greatly improved access to palliative care. These can serve as development models for service scale-up in these regions, based on rigorous evaluation in the context of specific health systems. However, a multipronged public health approach is needed to fulfill the humane and ethical obligation to make palliative care universally available. This includes health policy that supports the integration of palliative care and investment in systems of health care delivery; changes in legislation and regulation that inappropriately restrict access to opioid medications for individuals with life-limiting illnesses; education and training of health professionals; development of a methodologically rigorous data and research base specific to LMICs that encompasses health systems and clinical care; and shifts in societal and health professional attitudes to palliative and end-of-life care. International partnerships are valuable to achieve these goals, particularly in education and research, but leadership and health systems stewardship within LMICs are critical factors that will drive and implement change.
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Affiliation(s)
- Breffni Hannon
- Breffni Hannon, Camilla Zimmermann, and Gary Rodin, Princess Margaret Cancer Centre, University Health Network; and University of Toronto, Toronto, Ontario, Canada; Felicia M. Knaul, Harvard Global Equity Initiative and Harvard Medical School, Boston, MA; Richard A. Powell, Independent Global Health Researcher; Faith N. Mwangi-Powell, University Research Company, Nairobi, Kenya
| | - Camilla Zimmermann
- Breffni Hannon, Camilla Zimmermann, and Gary Rodin, Princess Margaret Cancer Centre, University Health Network; and University of Toronto, Toronto, Ontario, Canada; Felicia M. Knaul, Harvard Global Equity Initiative and Harvard Medical School, Boston, MA; Richard A. Powell, Independent Global Health Researcher; Faith N. Mwangi-Powell, University Research Company, Nairobi, Kenya
| | - Felicia M. Knaul
- Breffni Hannon, Camilla Zimmermann, and Gary Rodin, Princess Margaret Cancer Centre, University Health Network; and University of Toronto, Toronto, Ontario, Canada; Felicia M. Knaul, Harvard Global Equity Initiative and Harvard Medical School, Boston, MA; Richard A. Powell, Independent Global Health Researcher; Faith N. Mwangi-Powell, University Research Company, Nairobi, Kenya
| | - Richard A. Powell
- Breffni Hannon, Camilla Zimmermann, and Gary Rodin, Princess Margaret Cancer Centre, University Health Network; and University of Toronto, Toronto, Ontario, Canada; Felicia M. Knaul, Harvard Global Equity Initiative and Harvard Medical School, Boston, MA; Richard A. Powell, Independent Global Health Researcher; Faith N. Mwangi-Powell, University Research Company, Nairobi, Kenya
| | - Faith N. Mwangi-Powell
- Breffni Hannon, Camilla Zimmermann, and Gary Rodin, Princess Margaret Cancer Centre, University Health Network; and University of Toronto, Toronto, Ontario, Canada; Felicia M. Knaul, Harvard Global Equity Initiative and Harvard Medical School, Boston, MA; Richard A. Powell, Independent Global Health Researcher; Faith N. Mwangi-Powell, University Research Company, Nairobi, Kenya
| | - Gary Rodin
- Breffni Hannon, Camilla Zimmermann, and Gary Rodin, Princess Margaret Cancer Centre, University Health Network; and University of Toronto, Toronto, Ontario, Canada; Felicia M. Knaul, Harvard Global Equity Initiative and Harvard Medical School, Boston, MA; Richard A. Powell, Independent Global Health Researcher; Faith N. Mwangi-Powell, University Research Company, Nairobi, Kenya
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Ekeroma AJ, Kenealy T, Shulruf B, McCowan LME, Hill A. Building reproductive health research and audit capacity and activity in the Pacific Islands (BRRACAP) study: methods, rationale and baseline results. BMC MEDICAL EDUCATION 2014; 14:121. [PMID: 24947243 PMCID: PMC4069343 DOI: 10.1186/1472-6920-14-121] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 06/12/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Clinical research and audit in reproductive health is essential to improve reproductive health outcomes and to address the Millennium Development Goals 4 and 5. Research training, mentoring and a supportive participatory research environment have been shown to increase research activity and capacity in low to middle income countries (LMIC). This paper details the methods, rationale and baseline findings of a research program aimed at increasing clinical research activity and audit in the six Pacific Islands of Fiji, Samoa, Tonga, Vanuatu, Cook Islands and the Solomon Islands. METHOD Twenty-eight clinician participants were selected by the five Ministries of Health and the Fiji National University to undergo a research capacity building program which includes a research workshop and mentoring support to perform research and audit as teams in their country. Data on the participants' characteristics, knowledge and experiences were collected from structured interviews, questionnaires, focus groups, and an online survey. The interviews and the two focus groups were audio-recorded and all replies were analysed in a thematic framework. RESULTS The 28 participants included 9 nurses/midwives, 17 medical doctors of whom 8 were specialists in reproductive health and 2 other health workers. Most (24, 86%) were required to perform research as part of their employment and yet 17 (61%) were not confident in writing a research proposal, 13 (46%) could not use an electronic spreadsheet and the same number had not analysed quantitative data. The limited environmental enablers contributed to poor capacity with only 11 (46%) having access to a library, 10 (42%) receiving management support and 6 (25%) having access to an experienced researcher. Barriers to research that affected more than 70% of the participants were time constraints, poor coordination, no funding and a lack of skills. CONCLUSION Building a research capacity program appropriate for the diversity of Pacific clinicians required research evidence and collaborative effort of key stakeholders in the Pacific Islands and the region. The participants had limited research knowledge, skills and experience and would require individualized training and continuous intensive mentorship to realize their potential as clinician researchers for their services in the Pacific.
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Affiliation(s)
- Alec J Ekeroma
- South Auckland Clinical Campus, University of Auckland, Middlemore Hospital, Auckland, New Zealand
| | - Tim Kenealy
- South Auckland Clinical Campus, University of Auckland, Middlemore Hospital, Auckland, New Zealand
| | - Boaz Shulruf
- Office of Medical Education, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Lesley ME McCowan
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Andrew Hill
- South Auckland Clinical Campus, University of Auckland, Middlemore Hospital, Auckland, New Zealand
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Powell RA, Harding R, Namisango E, Katabira E, Gwyther L, Radbruch L, Murray SA, El-Ansary M, Leng M, Ajayi IO, Blanchard C, Kariuki H, Kasirye I, Namukwaya E, Gafer N, Casarett D, Atieno M, Mwangi-Powell FN. Palliative care research in Africa: consensus building for a prioritized agenda. J Pain Symptom Manage 2014; 47:315-24. [PMID: 23870840 DOI: 10.1016/j.jpainsymman.2013.03.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 03/20/2013] [Accepted: 03/29/2013] [Indexed: 11/20/2022]
Abstract
CONTEXT Palliative care research in Africa is in its relative infancy, with dedicated financial support extremely limited. Therefore, setting research priorities to optimize use of limited resources is imperative. OBJECTIVES To develop a prioritized research agenda for palliative care in Africa. METHODS We used a two-stage process involving palliative care professionals and researchers: 1) generation of an initial topic list at a consultative workshop of experts and 2) prioritization of that list using a consensus development process, the nominal group technique. RESULTS Phase 1: 41 topics were generated across five groups, with several topics nominated in more than one group. Phase 2: 16 topics and three broad thematic areas were identified. The two most prioritized topics within each of the three themes were the following: Theme 1: patient, family, and volunteers-1) care outcomes and the impact of palliative care as perceived by patients and caregivers and 2) palliative care needs of children; Theme 2: health providers-1) impact of palliative care training on care and practice and 2) integration of palliative care and antiretroviral therapy services; and Theme 3: health systems-1) palliative care needs assessments at the micro-, meso-, and macro-levels and 2) integration of palliative care into health systems and educational curricula. CONCLUSION Consensus-based palliative care topics determined by the study can assist researchers in optimizing limited research capacities by focusing on these prioritized areas. Subsequent to the identification and publication of the research agenda, concrete steps will be undertaken by the African Palliative Care Research Network and other partners to help implement it.
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Affiliation(s)
| | - Richard Harding
- King's College London, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, London, United Kingdom; Palliative Medicine Programme, Department of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Eve Namisango
- African Palliative Care Association, Kampala, Uganda
| | - Elly Katabira
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Liz Gwyther
- Division of Family Medicine, School of Public Health University of Cape Town, Cape Town, South Africa
| | - Lukas Radbruch
- Department of Palliative Medicine, University of Bonn, Bonn, Germany; Palliative Care Centre, Malteser Hospital Bonn/Rhein-Sieg, Bonn, Germany
| | - Scott A Murray
- Primary Palliative Care Research Group, General Practice Section, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Maged El-Ansary
- Anesthesia Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mhoira Leng
- Makerere Palliative Care Unit, Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ike O Ajayi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria; Centre for Palliative Care, Ibadan, Nigeria
| | - Charmaine Blanchard
- Gauteng Centre of Excellence for Palliative Care, Chris Hani Baragwanath Academic Hospital and University of Witwatersrand, Johannesburg, South Africa
| | - Helen Kariuki
- Department of Medical Physiology, University of Nairobi, Kenya
| | | | - Elizabeth Namukwaya
- Makerere Palliative Care Unit, Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Nahla Gafer
- Palliative Care Unit, Radiation and Isotope Centre, Khartoum, Sudan
| | - David Casarett
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Cleary J, Ddungu H, Distelhorst SR, Ripamonti C, Rodin GM, Bushnaq MA, Clegg-Lamptey JN, Connor SR, Diwani MB, Eniu A, Harford JB, Kumar S, Rajagopal MR, Thompson B, Gralow JR, Anderson BO. Supportive and palliative care for metastatic breast cancer: resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement. Breast 2013; 22:616-27. [PMID: 23972474 DOI: 10.1016/j.breast.2013.07.052] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 07/23/2013] [Indexed: 12/25/2022] Open
Abstract
Many women diagnosed with breast cancer in low- and middle-income countries (LMICs) present with advanced-stage disease. While cure is not a realistic outcome, site-specific interventions, supportive care, and palliative care can achieve meaningful outcomes and improve quality of life. As part of the 5th Breast Health Global Initiative (BHGI) Global Summit, an expert international panel identified thirteen key resource recommendations for supportive and palliative care for metastatic breast cancer. The recommendations are presented in three resource-stratified tables: health system resource allocations, resource allocations for organ-based metastatic breast cancer, and resource allocations for palliative care. These tables illustrate how health systems can provide supportive and palliative care services for patients at a basic level of available resources, and incrementally add services as more resources become available. The health systems table includes health professional education, patient and family education, palliative care models, and diagnostic testing. The metastatic disease management table provides recommendations for supportive care for bone, brain, liver, lung, and skin metastases as well as bowel obstruction. The third table includes the palliative care recommendations: pain management, and psychosocial and spiritual aspects of care. The panel considered pain management a priority at a basic level of resource allocation and emphasized the need for morphine to be easily available in LMICs. Regular pain assessments and the proper use of pharmacologic and non-pharmacologic interventions are recommended. Basic-level resources for psychosocial and spiritual aspects of care include health professional and patient and family education, as well as patient support, including community-based peer support.
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Affiliation(s)
- James Cleary
- University of Wisconsin Comprehensive Cancer Center, Madison, WI, USA
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Jones AC, Geneau R. Assessing research activity on priority interventions for non-communicable disease prevention in low- and middle-income countries: a bibliometric analysis. Glob Health Action 2012; 5:1-13. [PMID: 22944364 PMCID: PMC3427597 DOI: 10.3402/gha.v5i0.18847] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 07/26/2012] [Accepted: 07/27/2012] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Action is urgently needed to curb the rising rates of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) and reduce the resulting social and economic burdens. There is global evidence about the most cost-effective interventions for addressing the main NCD risk factors such as tobacco use, unhealthy diets, physical inactivity, and alcohol misuse. However, it is unknown how much research is focused on informing the local adoption and implementation of these interventions. OBJECTIVE To assess the degree of research activity on NCD priority interventions in LMICs by using bibliometric analysis to quantify the number of relevant peer-reviewed scientific publications. METHODS A multidisciplinary, multi-lingual journal database was searched for articles on NCD priority interventions. The interventions examined emphasise population-wide, policy, regulation, and legislation approaches. The publication timeframe searched was the year 2000-2011. Of the 11,211 articles yielded, 525 met the inclusion criteria. RESULTS Over the 12-year period, the number of articles published increased overall but differed substantially between regions: Latin America & Caribbean had the highest (127) and Middle East & North Africa had the lowest (11). Of the risk factor groups, 'tobacco control' led in publications, with 'healthy diets and physical activity' and 'reducing harmful alcohol use' in second and third place. Though half the publications had a first author from a high-income country institutional affiliation, developing country authorship had increased in recent years. CONCLUSIONS While rising global attention to NCDs has likely produced an increase in peer-reviewed publications on NCDs in LMICs, publication rates directly related to cost-effective interventions are still very low, suggesting either limited local research activity or limited opportunities for LMIC researchers to publish on these issues. More research is needed on high-priority interventions and research funders should re-examine if intervention research is enough of a funding priority.
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Affiliation(s)
- Amanda C Jones
- Non-Communicable Disease Prevention, International Development Research Centre, 150 Kent Street, Ottawa, ON, Canada.
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