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US children with special health care needs and ethnic discrimination: results from multivariate modeling

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World Journal of Pediatrics 2019年第2期15卷 182-189页

作者： Guillermo Montes St.John Fisher College Alesi 106C3690 East Ave.RochesterNY 14618USA Children's Institute Inc. RochesterNYUSA

Background To determine the prevalence of parent-reported ethnic/racial discrimination,and to determine if children with special health care needs are more likely to experience ethnic discrimination than other children who have similar family income,age,sex,race,parental education and Hispanic ethnicity.Methods Using the National Survey of Children's Health 2011-2012 (n =95,677),ethnic discrimination was measured by two questions that asked 'was child ever treated or judged unfairly because of his/her race or ethnic group?' and if so,how often it occurred in the last 12 months prior to the survey.Results An estimated 3 million US children aged 0-17 years have experienced parent-reported ethnic discrimination (1.4% White,9.1% Black,9.9% other race,4.7% Hispanic).The likelihood to experience ethnic discrimination is much higher for Black and other race children,compared to White children.Children with special health care needs were two times more likely to experience ethnic discrimination frequently in the 12 months prior to the survey than comparable children in terms of age,sex,race,family income,parental education,and social capital.Higher family income did not prevent the exposure to ethnic discrimination but was associated with fewer instances.Conclusions Theoretical frameworks,such as social determinants of health,must account for the bidirectional nature of the relationship between health and ethnic discrimination.Pediatric care must assess if ethnic discrimination has occurred and whether trauma-informed approaches are needed.

关键词： Children with special health care needs Ethnic discrimination United States

Assessment of orthotic needs in Iranian veterans with ankle and foot disorders

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Military Medical Research 2018年第3期5卷 222-230页

作者： Kamiar Ghoseiri Mostafa Allami Mohammad Reza Soroush Department of Orthotics and Prosthetics School of Rehabilitation SciencesHamadan University of Medical SciencesShahid Fahmideh AveHamadanIran Janbazan Medical and Engineering Research Center (JMERC) Farrokh AveVelenjakTehranIran

Background: War-related traumas can lead to orthopedic and neurological disorders in victims. However, the scope of such disorders may expand months or even years after the trauma. Orthotic treatment as a rehabilitation process aims to enable people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological, and social functional levels. This study aimed to investigate the rate of using orthoses among Iranian veterans with neuromuscular and skeletal disorders of the ankle and foot. Furthermore, the priorities of orthotic treatment in those veterans were explored.Methods: This qualitative study was a national health needs assessment conducted in 11 provinces of Iran during 2011–2016. A stakeholder research group was established to survey the veterans in respect to their demographic variables, activities of daily living, current health conditions, and rate of using orthoses.Results: Overall, 907 of the 1124 veteran participants completed the survey(response rate: 80.7%). Most of the veterans were men(97.7%), and their age and disability rate were 52.07±8.13 years and 31.92%±14.93%, respectively. Nearly 42% of the veterans had experience in using orthoses on a daily and weekly basis. As physical ambulation was the main problematic activity in veterans, most of them were using medical shoes and foot orthoses. Nearly 37% of veterans were in need of some type of lower limb orthoses on the contralateral side to compensate for their hip inequality. In sequential order, the most in need orthoses for veterans were foot orthoses(n=538), medical shoes(n=447), lower limb orthoses on the contralateral side(n=320), spinal orthoses(n=273), and upper limb orthoses(n=86).Conclusion: In spite of the high demands for orthoses among Iranian veterans with ankle and foot disorders, the use of orthoses is insufficient. Hence, there is a discrepancy between the current rate of orthoses use and its ideal situation, and more resources should be provided for service providers to be able to serve vet

关键词： needs assessment Orthotic devices Veterans Ankle Foot War-related injuries

China needs long-term solutions for African Swine Fever

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Science Bulletin 2019年第20期64卷 1469-1471页

作者： Jun Zhao Zhaohai Bai Lin Ma Key Laboratory of Agricultural Water Resources Hebei Key Laboratory of Soil EcologyCenter for Agricultural Resources ResearchInstitute of Genetic and Developmental BiologyChinese Academy of SciencesShijiazhuang 050021China School of Social and Public Administration East China University of Science and TechnologyShanghai 200237China

African Swine Fever(ASF)has received a lot of public concerns in and outside of China(1)Currently,more than 1 million head of pigs have been culled,and the stocking number of fattening pigs and sows has been reported reduced by more than 20%(Fig.1a,b),and the price of pork has been increased by around 30%compared with the same period in 2018(Fig.1c).ASF in China has also had a significant impact on the world meat market,due to its huge contribution to global pig production.

关键词： pro China needs long-term solutions for African Swine Fever ASF

Inflammatory bowel disease patient profiles are related to specific information needs: A nationwide survey

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World Journal of Gastroenterology 2019年第30期25卷 4246-4260页

作者： Saleh Daher Tawfik Khoury Ariel Benson John R Walker Oded Hammerman Ron Kedem Timna Naftali Rami Eliakim Ofer Ben-Bassat Charles N Bernstein Eran Israeli Institute of Gastroenterology and Liver Diseases Hadassah-Hebrew University Medical CenterJerusalem 91120Israel Department of Gastroenterology Galilee Medical CenterFaculty of Medicine in the GalileeBar-Ilan UniversityNahariya 22100Israel IBD Clinical and Research Centre University of ManitobaWinnipegMB R3E3P4Canada Research Branch IDF Medical CorpsTel-HashomerRamat Gan 52630Israel Institute of Gastroenterology Meir Medical CenterKfar-saba 4428164Israel Sackler School of Medicine Tel-Aviv UniversityTel-Aviv 6997801Israel Institute of Gastroenterology Sheba Medical CenterRamat-Gan 52630Israel Institute of Gastroenterology Rabin Medical CenterPetach-Tikva 49100Israel

BACKGROUND Inflammatory bowel diseases(IBD) is a heterogenous, lifelong disease, with an unpredictable and potentially progressive course, that may impose negative psychosocial impact on patients.While informed patients with chronic illness have improved adherence and outcomes, previous research showed that the majority of IBD patients receive insufficient information regarding their disease.The large heterogeneity of IBD and the wide range of information topics makes a one-size fits all knowledge resource overwhelming and cumbersome.We hypothesized that different patient profiles may have different and specific information needs, the identification of which will allow building personalized computer-based information resources in the future.AIM To evaluate the scope of disease-related knowledge among IBD patients and determine whether different patient profiles drive unique information needs.METHODS We conducted a nationwide survey addressing hospital-based IBD clinics.A Total of 571 patients completed a 28-item questionnaire, rating the amount of information received at time of diagnosis and the importance of information, as perceived by participants, for a newly diagnosed patient, and for the participants themselves, at current time.We performed an exploratory factor analysis of the crude responses aiming to create a number of representative knowledge domains(factors), and analyzed the responses of a set of 15 real-life patient profiles generated by the study team.RESULTS Participants gave low ratings for the amount of information received at disease onset(averaging 0.9/5) and high ratings for importance, both for the newly diagnosed patients(mean 4.2/5) and for the participants themselves at current time(mean 3.5/5).Factor analysis grouped responses into six informationdomains.The responses of selected profiles, compared with the rest of the participants, yielded significant associations(defined as a difference in rating of >0.5 points with a P < 0.05).Patients with active disease showed a higher interest in w

关键词： Inflammatory bowel diseases Information needs Patient education Knowledge resources Patient profiles

Challenges and needs for China to eliminate rabies

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Infectious Diseases of Poverty 2013年第1期2卷 178-187页

作者： Wenwu Yin Jie Dong Changchun Tu John Edwards Fusheng Guo Hang Zhou Hongjie Yu Sirenda Vong Division of Infectious Diseases Chinese Center for Disease Control and PreventionBeijingChina Key Laboratory of Surveillance and Early-warning on Infectious Disease Chinese Center for Disease Control and PreventionBeijingChina World Health Organization Country OfficeBeijingChina OIE Reference Laboratory for Rabies Institute of Military VeterinaryAcademy of Military Medical SciencesChangchunChina Food and Agriculture Organization BeijingChina National Institute for viral disease control and prevention Chinese Center for Disease Control and PreventionBeijingChina

In China,rabies is a significant public health concern where dogs remain the main reservoir of disease transmission to humans;rabies-related mortality ranks second in the world.We compiled all published articles and official documents on rabies in China's Mainland to examine challenges and needs to eliminate rabies in the country.The Chinese authorities have identified rabies as a priority,recognized rabies control in dogs as key to control rabies in humans and required intersectoral collaborations.Efforts have been made to respond effectively to the latest re-emergence of rabies,which peaked in 2007 with>3,300 cases.Despite these outcomes and the increasing volume of publications and regulations in the recent years,our review points to some major information gaps to improve rabies control activities and envisage elimination program.An emphasis on laboratory or pathogen-associated and basic epidemiology research in the literature has contrasted with the absence of information to monitor various systems in humans and animals(e.***.quality of surveillance,response and post-exposure prophylaxis).Information is also lacking to appropriately inform policymakers(e.***.economic disease burden,impact of policies)and assist program managers(e.***.comprehensive and strategic guidance for cost-effective prevention and control activities,public education and dog population management).In conclusion,strategic planning is needed to provide a sense of direction,demonstrate feasibility of elimination in China,and develop a research agenda,addressing country’s operational needs and constraints.The planning should be a multisectoral effort.

关键词： Rabies Elimination China needs Challenges Review

needs and Opportunities for Information in Patients with Metastatic Breast Cancer Attending a Tertiary Hospital in Tanzania—A Qualitative Study

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Advances in Breast Cancer Research 2023年第3期12卷 63-76页

作者： Nazima Dharsee Kisa Mwakatobe Mary Haule Queen Tarimo Mohammed Mbwana Ocean Road Cancer Institute Dar es Salaam Tanzania Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania Shujaa Cancer Foundation Dar es Salaam Tanzania

Background: The majority of breast cancer patients in Tanzania present with advanced disease, and a significant proportion has metastatic breast cancer (MBC) on presentation or develops it during the course of their follow-up. With few treatment options to choose from, such patients often benefit from empathic support and access to information to help them make treatment decisions based on their individual circumstances and needs. Patients with MBC have been shown to present with unique physical, social and psychological needs that require additional time, counselling and availability of health care providers in addition to the routine options available to other patients. In resource-limited settings, the needs of such patients are often unknown and unaddressed, which adds to the anxiety associated with the diagnosis and its treatment. Materials and methods: This descriptive qualitative study was conducted using 3 focus group discussions with a total of 17 participants with metastatic breast cancer (MBC) attending Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Participants were purposively selected for the study from outpatient clinics and inpatient wards. A semi-structured FGD guide was used to moderate discussions and analysis was done using a thematic approach. Results: The median age of participants was 51 (range 33 - 81 years) with an average of 4 months (range 1 - 12 months) from diagnosis of BC to the interview. 4 (24%) were diagnosed with MBC on first presentation (denovo). Participants spoke about the importance of accurate BC-related information in allowing timely referral and treatment both in the community and within the health system. They recognized the role of mass and social media in increasing awareness about BC and identified myths surrounding cancer treatment especially mastectomy. Correct and timely information at points of care, through media platforms and via ambassadors/patient support groups was perceived as a means to avoiding delays and securing early and effective treatment. Co

关键词： Metastatic Breast Cancer Information needs Qualitative

Ophthalmic community perception of new medication needs

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International Journal of Ophthalmology(English edition) 2018年第5期11卷 848-851页

作者： William C.Stewart Jeanette A.Stewart Lindsay A.Nelson PRN PharmaFarm LLC

AIM：To survey ophthalmologists（who have participated previously in clinical research） and ophthalmic industry professionals（who have been involved in ocular research and development） to indicate perceived needs for new pharmaceuticals in various ophthalmic subspecialties.METHODS：A prospective,industry-based survey was sent to ophthalmologists and ophthalmic industry professionals about the perceived needs for new pharmaceutical products.RESULTS：This survey was sent to 559 ophthalmic pharma professionals and ophthalmologists.We received 82（15%） responses.The results showed that the most commonly perceived need for new pharmaceuticals were dry and wet age-related macular degeneration,glaucoma,diabetic macular edema and dry eye.There was a statistical difference found between response groups（P〈0.0001）.Respondents indicated they would express their commitment to a new product they perceived as needed by recommending to colleagues（63%）,prescribing（60%）,participating as principle investigator in a related clinical trial（52%）,advising the company（52%）,lecturing on behalf of the product（43%）,investing in the product（38%）,taking no action（7%） or obtain a position in the company（1%）.CONCLUSION：Ophthalmic pharma professionals and ophthalmologists perceive the greatest need for new medicines in ophthalmology to be in dry and wet agerelated macular degeneration,glaucoma,diabetic macular edema and dry eye.

关键词： ophthalmic ophthalmology ocular eye disease pharmaceuticals start-up development needs medication therapies future new treatments

Study on Community Care needs and Influencing Factors of the Urban Elderly in Shandong Province, China

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Journal of Biosciences and Medicines 2022年第10期10卷 231-242页

作者： Yuqing Mi Wei Li Yunfeng Tang Xiang Wang Sheng Luo School of Public Health Weifang Medical University Weifang China Personnel Department Weifang Medical University Weifang China School of Management Weifang Medical University Weifang China

Objective: To understand community care needs of the urban elderly in Shandong Province. To analysis the influencing factors and community care needs of the urban elderly in Shandong Province. Methods: Shandong Province was divided into four levels according to the level of economic development, multi-stage stratified cluster random sampling method was used. Each city collected the old aged 60 years or older served by 5 community health service centers. A total of 3390 questionnaires were distributed, the recovery rate was 100%, it had 3363 effective questionnaires, and an effective rate was 99.20%. SPSS17.0 software was used for univariate and multivariate analysis. Results: Analysis results show that, the influencing factors of community care needs of health promotion dimension have medical time (t = 3.239, P = 0.001) and EQ-5D score (t = 9.104, P - 6.239, P - 17.276, P - 3.762, P - 8.341, P Conclusions: Community care needs of the urban elderly in Shandong Province are at a medium level and have many influencing factors, the scores of each dimension from high to low are health promotion, disease care and disease prevention. In community nursing work, we should meet the care needs of the elderly, we need to enhance elderly self-care and safety awareness and promote the physical and mental health of the elderly.

关键词： The Elderly Community Care needs Influencing Factors

Prioritizing the efforts:lived experiences of family when taking care of people with cancer

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Frontiers of Nursing 2023年第3期10卷 315-322页

作者： Titan Ligita Merry Andriani Hazwani Hazwani Ersy Aprilya Fransiska Shafira Aulya Department of Medical Surgical Nursing School of NursingTanjungpura UniversityPontianakWest Kalimantan 78124Indonesia Department of Chemotherapy Doctor Soedarso General HospitalPontianakWest Kalimantan 78124Indonesia

Objective:Cancer has one of the highest disease mortality rates.Families are very important in the treatment of people with cancer.By using a phenomenological design,this study aimed to explore the experience of families in caring for a person with cancer and to identify the needs of these families.Methods:First,eight interviews were under taken with family members selected through a purposive sampling method.Then,another three interviews were conducted for data validation.The collected data were analyzed using the framework method of analysis.Results:The core theme,“Prioritizing the efforts:Being aware of the best we could do for our family,”reflected family’s experiences of caring for a person with cancer and was underpinned by five themes:“Decisions to make,”“Keeping up the good support,”“Acknowledging the others’contributions,”“Assisting my family to alleviate the disease,”and“Adapting to the current situation.”Conclusions:The results suggest that building mutual trust and communication between family and healthcare professionals is vital in decision-making for people with cancer.Family may also work with the person in fulfilling their needs,without disregarding the needs of the family.When suppor ting the needs of people with diabetes,the family requires appropriate information,and thus,healthcare professionals wisely select which information can help the family make a decision regarding the treatment.After administering the treatment and providing information for people with cancer and their family,asking for feedback is required for evaluation.

关键词： cancer decision-making family needs phenomenology priority treatment