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3.
Asian Pac J Cancer Prev ; 23(1): 71-77, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35092373

RESUMO

OBJECTIVE: Cancer is the third leading cause of death in Iran. Todays, caregiving to patients with cancer is shifting towards home based care, and home care needs from a caregiver's perspective can help improve the patient care. This qualitative study aimed to examine the home care needs of cancer patients from the perspective of home care nurses. METHODS: This is a qualitative descriptive study carried out at home care centers in the northwest of Iran. A total of 15 participants were recruited through purposive sampling and underwent face-to-face semi-structured interviews. Data were analyzed through Conventional content analysis method in MAXQDA software.  Measures of trustworthiness were established throughout the study using Lincoln and Guba's (1985) criteria (dependability, credibility, transferability, and confirmability). RESULTS: Data analysis resulted in the extraction of four main categories including physical needs (pain relief, gastrointestinal problems including nausea and anorexia and nutritional problems, lethargy, wound care), psychological support (need for hope and emotional support), educational needs (need for information and self-care) and financial support (service insurance coverage, charity support). To promote these patients home care, insurance coverage of nursing home care services was emphasized by the participants. CONCLUSION: Various aspects of cancer patients home care needs were identified. Interdisciplinary home-based palliative care collaboration is needed to address their physical, psychological, and moral needs.


Assuntos
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Serviços de Assistência Domiciliar , Neoplasias/enfermagem , Enfermeiras e Enfermeiros/psicologia , Cuidados Paliativos/psicologia , Adulto , Feminino , Apoio Financeiro , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Manejo da Dor , Pesquisa Qualitativa , Apoio Social
4.
Asian Pac J Cancer Prev ; 22(S2): 89-96, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780143

RESUMO

One of the important factors contributing to tobacco epidemic is tobacco advertising, promotion, and sponsorship (TAPS). TAPS is employed by tobacco industry to increase demand for its products, often through targeting specific groups or market segments. The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) recommends implementation of comprehensive bans on TAPS as part of an effective set of tobacco control policies. Article 13 of the WHO FCTC and its guidelines mandate a comprehensive ban on all TAPS. Besides, TAPS ban is one of the MPOWER strategy and is included in the 'Best Buys' for effective tobacco control. However, many countries, especially low-income and middle-income countries, primarily implement only partial TAPS bans, allowing the tobacco industry to directly or indirectly advertise and promote its products via multiple media. This review article analyzes the current state of affairs in respect of TAPS in India and Indonesia, the two of the largest countries in the WHO South-East Asia Region of the world, and discusses the way forward to address the identified gaps in TAPS ban policy formulation and implementation focusing on strengthening its compliance and enforcement at the country level.


Assuntos
Publicidade/legislação & jurisprudência , Política Pública , Prevenção do Hábito de Fumar/legislação & jurisprudência , Indústria do Tabaco/legislação & jurisprudência , Produtos do Tabaco/legislação & jurisprudência , Apoio Financeiro , Implementação de Plano de Saúde , Humanos , Índia , Indonésia , Organização Mundial da Saúde
8.
Bull Cancer ; 108(12S): S10-S19, 2021 Dec.
Artigo em Francês | MEDLINE | ID: mdl-34247762

RESUMO

Hematopoietic cell transplantation (HCT) is the curative treatment for many malignant and non-malignant blood disorders and some solid cancers. However, transplant procedures are considered tertiary level care requiring a high degree of technicality and expertise and generating very high costs for hospital structures in developing countries as well as for patients without health insurance. During the 11th annual harmonization workshops of the francophone Society of bone marrow transplantation and cellular therapy (SFGM-TC), a designated working group reviewed the literature in order to elaborate unified guidelines, for developing the transplant activity in emerging countries. Access to infrastructure must comply with international standards and therefore requires a hospital system already in place, capable of accommodating and supporting the HCT activity. In addition, the commitment of the state and the establishment for the financing of the project seems essential.


Assuntos
Países em Desenvolvimento , Transplante de Células-Tronco Hematopoéticas , Desenvolvimento de Programas , Fatores Etários , Aloenxertos , Autoenxertos , Características Culturais , Países em Desenvolvimento/economia , Apoio Financeiro , Transplante de Células-Tronco Hematopoéticas/economia , Transplante de Células-Tronco Hematopoéticas/normas , Hospitais Especializados/organização & administração , Hospitais Especializados/normas , Humanos , Pessoas sem Cobertura de Seguro de Saúde , Equipe de Assistência ao Paciente/organização & administração , Equipe de Assistência ao Paciente/normas , Qualidade da Assistência à Saúde , Sociedades Médicas , Fatores Socioeconômicos , Atenção Terciária à Saúde/economia , Condicionamento Pré-Transplante/métodos , Condicionamento Pré-Transplante/normas
10.
Ir J Med Sci ; 190(4): 1355-1361, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33409845

RESUMO

BACKGROUND: Crowdfunding is the internet practice of funding a project or person by requesting online monetary donations from people. We set out to analyse the current non-US GoFundMe cancer pages in order to get deeper understanding of this unregulated activity. METHODS: We identified 150 non-US GoFundMe webpages between November 2019 and January 2020. Data collected included clinicopathological details such as age, gender, cancer type and stage of the disease along with other parameters. RESULTS: Of 150 pages reviewed, 83% requestors were adults, 64% were female and the median age was 33 years (2-60). The majority of requestors had brain cancer, followed by breast cancer and ovarian cancer. The median amount of money requested was €48,205 (€1171-€588,759). The majority of pages were from the UK (59%) and Ireland (16%). Financial support for cancer patients was the largest group identified (25%). Requests for immunotherapy were the second most common (21%) followed by alternative therapies (19%) and funding for anticancer drug not financed by specific health system but approved elsewhere (12%). The largest amount of money requested was for immunotherapy (median €187,064). CONCLUSION: Our GoFundMe analysis has identified that crowdfunding platforms are predominantly used for requesting financial support, but worryingly, a large proportion are requesting immunotherapy for unlicensed indications and alternative therapies with no evidence. Future efforts to improve patient education, and possibly online donation page regulation, are required to better manage this route of cancer funding.


Assuntos
Neoplasias Encefálicas , Crowdsourcing , Adulto , Feminino , Apoio Financeiro , Humanos , Imunoterapia , Irlanda
12.
Otolaryngol Head Neck Surg ; 165(2): 375-380, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33400633

RESUMO

OBJECTIVE: To determine if there is an association between authors' financial conflict of interest and published position on clinical use of hypoglossal nerve stimulation for obstructive sleep apnea. STUDY DESIGN: Retrospective cross-sectional analysis. SETTING: International roster of authors and articles analyzed. METHODS: A Google Scholar search was performed for editorials and reviews citing the 2014 New England Journal of Medicine article on hypoglossal nerve stimulation for obstructive sleep apnea. Included articles were coded as favorable or neutral. Conflict of interest was recorded as declared by the authors in these articles and as independently searched in the Open Payments registry. RESULTS: Sixteen articles from 45 independent authors were analyzed. Nine articles by authors were coded as favorable. Among authors of articles with favorable views, 16 (59%) had a financial conflict of interest with the manufacturer of the hypoglossal nerve stimulator device, as opposed to only 1 of 21 (5%) authors of neutral/unfavorable articles. When we included only authors to whom payments could be identified or excluded on Open Payments, 16 of 20 (80%; 95% CI, 62%-98%) authors of favorable articles had a financial conflict, while 1 of 10 (10%; 95% CI, 0%-29.6%) of neutral/unfavorable articles did (P = .004). CONCLUSION: Our study demonstrates an association between published position on hypoglossal nerve stimulator use and financial conflict with the device manufacturer. Several undeclared conflicts were also found, suggesting a role for independent search for conflicts during the review process.


Assuntos
Conflito de Interesses/economia , Terapia por Estimulação Elétrica , Apoio Financeiro/ética , Nervo Hipoglosso , Síndromes da Apneia do Sono/terapia , Estudos Transversais , Humanos , Estudos Retrospectivos
13.
J Vasc Surg ; 73(2): 675-681, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32535153

RESUMO

OBJECTIVE: Financial relationships between vascular surgeons and industry are essential to the development and adoption of innovative technology. However, these relationships may establish competing interests. Our objective was to describe publicly available financial transactions between industry and academic vascular surgeons. METHODS: Academic vascular surgeons were identified and characterized on the basis of publicly available data correlated with Accreditation Council for Graduate Medical Education and Association of American Medical Colleges data to identify academic practice settings. Vascular surgeons were linked to Open Payments data for 2017 as reported by the Centers for Medicare & Medicaid Services. Univariate and nonparametric tests were used for analysis. RESULTS: Of 1158 academic vascular surgeons identified, 997 (86%) received industry payments totaling $8,548,034. Overall, the median of total payments received was $814 (interquartile range [IQR], $124-$2863). The top paid decile of vascular surgeons received $29,645 (IQR, $16,128-$61,701). Payments to the top decile accounted for 81% of all payments. Payments did not vary by academic rank but did vary by sex, with male vascular surgeons (n = 954) receiving $889 (IQR, $146-$3217) vs female vascular surgeons (n = 204) receiving $467 (IQR, $87-$1533; P = .002). By leadership role, division chiefs received the highest median payment amount ($1571; IQR, $368-$11,281) compared with department chairs ($424; IQR, $56-$2698) and vascular surgeons without leadership role ($769; IQR, $117-$2592; P = .002). Differences in payments were also seen on the basis of U.S. census region: Northeast, $571 (IQR, $90-2462); Midwest, $590 (IQR, $75-$2364); South, $1085 (IQR, $241-$3405); and West, $1044 (IQR, $161-$4887; P = .001). The most common categories of payments were food and beverage (paid to 85% of all vascular surgeons), travel and lodging (35%), and consulting fees (13%). Among the top decile of vascular surgeons, median payments exceeded $10,000 for three categories: consulting fees, compensation, and honoraria. Payments were made by 178 distinct entities with median total payments of $286 (IQR, $70-$6285). The three top entities paid a total of $5,004,061, which accounted for 59% of all payments. Payments from at least one of the top three entities reached 76% of vascular surgeons. CONCLUSIONS: Most academic vascular surgeons receive publicly reported industry payments that are paid by a limited number of entities, typically for food and beverage or travel and lodging. The top 10% of vascular surgeons received higher median payment amounts, totaling 81% of all industry payments. Vascular surgeons should be aware of publicly reported payment information and the potential for conflicts of interest.


Assuntos
Apoio Financeiro , Doações , Setor de Assistência à Saúde/tendências , Cirurgiões/tendências , Procedimentos Cirúrgicos Vasculares/tendências , Centers for Medicare and Medicaid Services, U.S. , Conflito de Interesses/economia , Revelação , Feminino , Setor de Assistência à Saúde/economia , Humanos , Masculino , Estudos Retrospectivos , Cirurgiões/economia , Estados Unidos , Procedimentos Cirúrgicos Vasculares/economia
14.
R I Med J (2013) ; 103(9): 41-46, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33126788

RESUMO

The COVID-19 pandemic has exacerbated the effects of existing health disparities throughout the United States. While Hispanic/Latino individuals account for only 16% of the Rhode Island (RI) population, Rhode Island Department of Health (RIDOH) data show that 45% of COVID-19 cases and 36% of individuals who have been hospitalized identify as Hispanic/Latino. Clínica Esperanza/Hope Clinic (CEHC) mobilized a comprehensive effort to offer telehealth visits, health education and accessible, walk-up COVID-19 testing for low-income, uninsured and Spanish-speaking individuals living in Rhode Island. With support from CEHC volunteers, the City of Providence, the State of Rhode Island, and local foundations, CEHC has administered 1,649 individual COVID-19 tests as of October 2020. The overall COVID-19 test positivity rate at CEHC was 23%, peaking in April at 48%. Additionally, CEHC has distributed more than 1,600 meal boxes to patients experiencing food insecurity, provided emergency financial resources, while rapidly scaling up healthcare services for the increasing numbers of uninsured individuals in RI.


Assuntos
Instituições de Assistência Ambulatorial , Infecções por Coronavirus/diagnóstico , Apoio Financeiro , Abastecimento de Alimentos , Educação em Saúde , Pessoas sem Cobertura de Seguro de Saúde , Pneumonia Viral/diagnóstico , Telemedicina , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico , Feminino , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Rhode Island , SARS-CoV-2 , Populações Vulneráveis , Adulto Jovem
15.
J Natl Compr Canc Netw ; 18(10): 1366-1373, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33022646

RESUMO

BACKGROUND: Few studies have engaged patients and caregivers in interventions to alleviate financial hardship. We collaborated with Consumer Education and Training Services (CENTS), Patient Advocate Foundation (PAF), and Family Reach (FR) to assess the feasibility of enrolling patient-caregiver dyads in a program that provides financial counseling, insurance navigation, and assistance with medical and cost of living expenses. METHODS: Patients with solid tumors aged ≥18 years and their primary caregiver received a financial education video, monthly contact with a CENTS counselor and PAF case manager for 6 months, and referral to FR for help with unpaid cost of living bills (eg, transportation or housing). Patient financial hardship and caregiver burden were measured using the Comprehensive Score for Financial Toxicity-Patient-Reported Outcomes (COST-PRO) and Caregiver Strain Index (CSI) measures, respectively, at baseline and follow-up. RESULTS: Thirty patients (median age, 59.5 years; 40% commercially insured) and 18 caregivers (67% spouses) consented (78% dyad participation rate). Many participants faced cancer-related financial hardships prior to enrollment, such as work change or loss (45% of patients; 39% of caregivers) and debt (64% of patients); 39% of caregivers reported high levels of financial burden at enrollment. Subjects received $11,000 in assistance (mean, $772 per household); 66% of subjects with income ≤$50,000 received cost-of-living assistance. COST-PRO and CSI scores did not change significantly. CONCLUSIONS: Patient-caregiver dyads were willing to participate in a financial navigation program that addresses various financial issues, particularly cost of living expenses in lower income participants. Future work should address financial concerns at diagnosis and determine whether doing so improves patient and caregiver outcomes.


Assuntos
Cuidadores , Efeitos Psicossociais da Doença , Gastos em Saúde , Neoplasias , Adulto , Escolaridade , Apoio Financeiro , Humanos , Pessoa de Meia-Idade , Neoplasias/economia , Neoplasias/terapia , Projetos Piloto
17.
PLoS One ; 15(6): e0235021, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32579571

RESUMO

BACKGROUND: Many patient organisations collaborate with drug companies, resulting in concerns about commercial agendas influencing patient advocacy. We contribute to an international body of knowledge on patient organisation-industry relations by considering payments reported in the industry's centralised 'collaboration database' in Sweden. We also investigate possible commercial motives behind the funding by assessing its association with drug commercialisation. METHODS: Our primary data source were 1,337 payment reports from 2014-2018. After extraction and coding, we analysed the data descriptively, calculating the number, value and distribution of payments for various units of analysis, e.g. individual companies, diseases and payment goals. The association between drug commercialisation and patient organisation funding was assessed by, first, the concordance between leading companies marketing drugs in specific diseases and their funding of corresponding patient organisations and, second, the correlation between new drugs in broader condition areas and payments to corresponding patient organisations. RESULTS: 46 companies reported paying €6,449.224 (median €2,411; IQR €1,024-4,569) to 77 patient organisations, but ten companies provided 67% of the funding. Small payments dominated, many of which covered costs of events organised by patient organisations. An association existed between drug commercialisation and industry funding. Companies supported patient organisations in diseases linked to their drug portfolios, with the top 3 condition areas in terms of funding-cancer; endocrine, nutritional and metabolic disorders; and infectious and parasitic disorders-accounting for 63% of new drugs and 56% of the funding. CONCLUSION: This study reveals close and widespread ties between patient organisations and drug companies. A relatively few number of companies dominated the funding landscape by supporting patient organisations in disease areas linked to their drug portfolios. This commercially motivated funding may contribute to inequalities in resource and influence between patient organisations. The association between drug commercialisation and industry funding is also worrying because of the therapeutic uncertainty of many new drugs. Our analysis benefited from the existence of a centralised database of payments-which should be adopted by other countries too-but databases should be downloadable in an analysable format to permit efficient and independent analysis.


Assuntos
Indústria Farmacêutica/economia , Apoio Financeiro , Defesa do Paciente/economia , Preparações Farmacêuticas/economia , Conflito de Interesses , Estudos Transversais , Custos de Medicamentos , Humanos , Marketing/economia , Organizações/economia , Organizações/ética , Defesa do Paciente/ética , Suécia
19.
Artigo em Chinês | MEDLINE | ID: mdl-32306676

RESUMO

Objective: To understand the situation supported by the National Natural Science Foundation in the field of occupational diseases (H2402) in China, so as to provide a reference basis for the application and research of scientific researchers in the field of occupational diseases in China. Methods: The information system of scientific and technological achievements was used to search the financial support of the National Natural Science Foundation of China (NSFC) in the field of occupational diseases from 2010 to 2019. Results: From 2010 to 2019, a total of 55 projects were funded under the Occupational Disease code (H2402) , with a total funding of 22.33 million yuan, of which 30 were supported by the Youth Science Foundation, 20 by the Youth Science Foundation and 5 by the Regional Science Foundation. Thirty five items of the research projects focused on pneumoconiosis and other respiratory diseases which accounted for 63.64 per cent. Forty one items of scientific research projects are supported by domestic institutions of higher learning which accounted for 74.55 per cent. Conclusion: The research support of the National Natural Science Foundation of China to the field of occupational diseases (H2402) has increased steadily, but the support of different research directions and supporting units is not balanced. It is suggested that departments concerned strengthen guidance and support for the applicants in less developed areas and weak research directions of the projects in the National Natural Science Foundation.


Assuntos
Apoio Financeiro , Fundações , Disciplinas das Ciências Naturais , Doenças Profissionais , China , Humanos
20.
Int J Tuberc Lung Dis ; 24(2): 180-188, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32127102

RESUMO

BACKGROUND: The study was conducted in BRAC-administered areas of the Bangladesh National Tuberculosis (TB) Programme (42 of 64 districts). According to the 2013-2017 financial support scheme, direct costs due to TB diagnosis were reimbursed among economically disadvantaged people with presumptive smear-negative pulmonary (PTB) and extrapulmonary TB (EPTB).OBJECTIVE: To describe the implementation of the scheme and associated changes in case notification.DESIGN: This was a descriptive study involving programme data.RESULTS: Between 2013 and 2017, persons reimbursed reduced from 125 680 to 88 763, and the case detection ratio increased from 18% to 24%. The number of patients with presumptive EPTB who were reimbursed decreased from 5024 to 3484. More than 95% were reimbursed for chest radiograph, fine-needle aspiration cytology and biopsy. However, large numbers of ancillary investigations were also reimbursed. During 2013-2017, the observed national quarterly new smear-negative PTB case notification rates (CNRs) were significantly higher than the forecasted CNRs (based on CNR trends during 2008-2012). New EPTB and all form TB CNRs increased but not significantly.CONCLUSION: Implementation of the financial support scheme was accompanied by a significant improvement in new, smear-negative PTB notification. The absence of a comparison arm was a key limitation, but comparison was not possible as the scheme was implemented in all districts.


Assuntos
Tuberculose , Bangladesh/epidemiologia , Apoio Financeiro , Humanos , Tuberculose/diagnóstico , Tuberculose/epidemiologia
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