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Yokoi R, Motoshita M, Matsuda T, Itsubo N. Country-Specific External Costs of Abiotic Resource Use Based on User Cost Model in Life Cycle Impact Assessment. Environ Sci Technol 2024. [PMID: 38670542 DOI: 10.1021/acs.est.4c00100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Abiotic resources are indispensable in society, but there are concerns regarding their depletion, scarcity, and increasing prices, resulting in potential economic damage in the future. To address these concerns, it is effective to consider the external costs of resource use. Although resource availability is different among mining sites, and local conditions are relevant in assessing resource scarcity, previous studies have assessed external costs and potential impacts of abiotic resource use globally. This study provides country-specific characterization factors (CFs) of abiotic resource use in life cycle impact assessment based on the user cost model, which represents the external costs of abiotic resource use to reflect country-specific resource scarcity. We demonstrate considerable variations in the CFs depending on the mining country, suggesting that the choice of mining country can affect external costs. The global external cost of abiotic resource use in 2020 was estimated at 1.9 trillion $, with a major contribution from the extraction of fossil fuels in the United States. Historical trends of the CFs and relevant parameters showed temporal fluctuations, emphasizing the importance of regularly updating the data underlying the calculation of the CFs. Country-level assessments of the external costs of resource use can contribute to discussions on the responsibilities of consuming countries by incorporating material footprint studies.
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Affiliation(s)
- Ryosuke Yokoi
- Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology (AIST), 16-1 Onogawa, Tsukuba 305-8569, Japan
| | - Masaharu Motoshita
- Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology (AIST), 16-1 Onogawa, Tsukuba 305-8569, Japan
| | - Takeshi Matsuda
- Pacific Power Co., Ltd., 3-22 Kandanishikicho, Chiyoda, Tokyo 101-0054, Japan
| | - Norihiro Itsubo
- Faculty of Science and Engineering, Waseda University, 3-4-1 Okubo Shinjuku-ku, Tokyo 169-8050, Japan
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de Silva NL, Dissanayake H, Kalra S, Meeran K, Somasundaram NP, Jayasena CN. Global Barriers to Accessing Off-Patent Endocrine Therapies: A Renaissance of the Orphan Disease? J Clin Endocrinol Metab 2024; 109:e1379-e1388. [PMID: 37846800 PMCID: PMC11031238 DOI: 10.1210/clinem/dgad610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/18/2023]
Abstract
CONTEXT Clinical endocrinology encompasses many diseases requiring long-term drug therapy. Prohibitive pricing of some endocrine drugs classified as essential by the World Health Organization has created suboptimal care of patients with endocrine disorders. EVIDENCE ACQUISITION This review is based on evidence obtained from several databases and search engines including PubMed, Google, and Google Scholar; reference searches; manual searching for web pages of international regulatory bodies; and the authors' experience from different healthcare settings. EVIDENCE SYNTHESIS After the expiry of a patent, generic versions with the opportunity for increased availability and a price reduction are expected. There are access barriers worldwide for many off-patent endocrine drugs. The high price is the main issue for several medicines including insulin, hydrocortisone, testosterone, and gonadotropins. This is caused by several factors including the market monopoly due to the lack of registered generics or suppliers limiting the benefit of competition and a complex supply chain. Additionally, the lack of some medicines has been concerning due to market factors such as the relatively small number of patients, making it less attractive for the manufacturers. Commissioning of nonprofit manufacturers and state manufacturing as well as strict price control measures could alleviate this situation. CONCLUSION Lack of availability and disproportionate price inflation affecting essential off-patent endocrine therapies is common due to several interrelated factors. Global collaboration among healthcare organizations with the support of policymaking bodies might be needed to mitigate this.
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Affiliation(s)
- Nipun Lakshitha de Silva
- Department of Clinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana 10390, Sri Lanka
| | - Harsha Dissanayake
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana 132001, India
- University Centre for Research and Development, Chandigarh University, Mohali 140413, India
| | - Karim Meeran
- Department of Metabolism, Digestion and Reproduction, Imperial College, W12 0NN, London, UK
| | | | - Channa N Jayasena
- Department of Metabolism, Digestion and Reproduction, Imperial College, W12 0NN, London, UK
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Limenh LW. Availability of Dispensing and Storage Facilities at Public and Community Pharmacies at Bahir Dar and Gondar Towns. Risk Manag Healthc Policy 2024; 17:865-875. [PMID: 38617595 PMCID: PMC11015837 DOI: 10.2147/rmhp.s454187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/04/2024] [Indexed: 04/16/2024] Open
Abstract
Background The availability of various facilities that aid in providing expected services is necessary for the practice of pharmacy, which aims to make the best use of medications and other healthcare products and services. Therefore, the aim of this study was to assess the availability of dispensing and storage facilities at public and community pharmacies in Bahir Dar and Gondar towns. Methods In Gondar and Bahir Dar towns' public and private pharmacies, a facility-based cross-sectional study was conducted from July 2023 to September 2023. All pharmacy areas that were open during data collection were included in the study. The frequency and percentage were calculated using descriptive statistics. Results From 239 pharmacies, 208 (87.0%) of them were open during data collection, and they are included in the study. The water supply and dispensing counter were available in the dispensing area in 79.3% and 60.1% of instances, respectively. They also had adequate room for storage (92.8%), dispensing (92.8%), and receiving (95.7%) of medicines. Additionally, about 98.1% of the facilities had shaded, ventilated, and dry areas. A therapeutic order was the most often used method (59.6%) for medication organization. Merely 1.9% of participants did not employ a strategy to arrange their medications. A refrigerator (88.0%), a refrigerator thermometer (91.3%), a spoon or spatula (81.3%), a separate storage facility (74.5%), a cold room (68.8%), a lockable cabinet (90.9%), a tablet counter (69.2%), and a fire extinguisher (safety device) (88%) were among the various storage equipment the majority of the pharmacies in the survey had. Nonetheless, air conditioning was absent from the majority (53.4%) of pharmacy facilities. Conclusion Few pharmacies need to make improvements to their facilities in order to encourage convenient drug storage and dispensing practices, even though the majority of the pharmacies surveyed had all the necessary equipment and infrastructure. In addition to initiating the pharmacies to provide good practices of dispensing and storage, facility-focused initiation and regulation should be obtained to ensure full availability of the facilities.
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Affiliation(s)
- Liknaw Workie Limenh
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Robbins RC, Singer RS, Innes GK, Plummer PJ, Apley MD, Gaunt PS, Papich MG, Granick J, Marshall ES, Smith DR, Frey E, Cervantes HM, Beaudoin AL, Canon AJ, Brookshire C, Buckley M, Whaley J, Schnabel L, Costin M. Animal drug shortages limit veterinary therapeutic options and introduce artifacts in antimicrobial sales reporting. J Am Vet Med Assoc 2024; 262:576-579. [PMID: 38171090 DOI: 10.2460/javma.23.10.0603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
Supply chain issues disrupt veterinary care and cause downstream consequences that alter the practice of veterinary medicine. Antimicrobials are just 1 class of pharmaceuticals that have been impacted by supply chain issues over the last couple of years. Since February 2021, 2 sponsors/manufacturers of penicillin products have reported shortages in the active pharmaceutical ingredient. With the release of the 2021 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals by the FDA, a key finding was a 19% decrease in penicillin sales and distribution from 2020 to 2021. Herein, we provide our clinicians' professional perspective regarding how drug shortages, specifically that of penicillin, might contribute to misconstrued patterns in antimicrobial use and what can be done by veterinarians and the FDA to minimize the impact of an antimicrobial drug shortage on animal health and well-being.
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Darrah T, Herbert S, Chambers T. A thematic analysis of alcohol and alcohol-related harm across health and social policy in Aotearoa New Zealand. Aust N Z J Public Health 2024; 48:100143. [PMID: 38626567 DOI: 10.1016/j.anzjph.2024.100143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVE This study aims to: 1) explore how alcohol and alcohol harm are framed in New Zealand national policy, strategy, and action plan documents; and 2) examine how these documents align with the WHO SAFER framework. METHODS Keyword searches across government websites and Google were conducted in January 2021. Inclusion and exclusion criteria were applied to all identified documents, resulting in 22 being included for analysis in this study. An inductive and deductive thematic analysis of those documents was performed. RESULTS Our inductive thematic analysis identified three themes, of which one is detailed in this study: 'Location of responsibility for addressing alcohol harms' with a focus on individuals and non-specific government agencies. Thematic results from the deductive analysis found that the most consistently referenced SAFER policies included brief interventions (68% of documents), followed by drink driving measures (45%), alcohol marketing (36%), alcohol availability (27%), and alcohol price (23%). The conversion rate from a document mentioning a SAFER framework policy area to making specific policy recommendations was usually less than or around 50%. CONCLUSIONS The lack of alignment between New Zealand alcohol policy and the SAFER framework can be partially attributable to the absence of an updated national alcohol strategy (NAS). An updated NAS should identify responsible agencies, create a systematic monitoring and evaluation mechanism, and be consistent with the WHO SAFER framework. IMPLICATIONS FOR PUBLIC HEALTH The analysis supports the need to update a national alcohol strategy to guide alcohol policy development.
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Affiliation(s)
- Tayla Darrah
- Department of Public Health, University of Otago, Wellington, New Zealand.
| | | | - Timothy Chambers
- University of Canterbury, Ngāi Tahu Research Centre, Christchurch, New Zealand
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Kebede S, Brazier E, Freeman AM, Muwonge TR, Choi JY, de Waal R, Poda A, Cesar C, Munyaneza A, Kasozi C, Pasayan MKU, Althoff KN, Shongo A, Low N, Ekouevi D, Veloso VG, Ross J. Preexposure prophylaxis availability among health facilities participating in the global International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. AIDS 2024; 38:751-756. [PMID: 38133656 PMCID: PMC10939841 DOI: 10.1097/qad.0000000000003824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND While recognized as a key HIV prevention strategy, preexposure prophylaxis (PrEP) availability and accessibility are not well documented globally. We aimed to describe PrEP drug registration status and the availability of PrEP services across HIV care sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium. METHODS We used country-level PrEP drug registration status from the AIDS Vaccine Advocacy Coalition and data from IeDEA surveys conducted in 2014, 2017 and 2020 among participating HIV clinics in seven global regions. We used descriptive statistics to assess PrEP availability across IeDEA sites serving adult patients in 2020 and examined trends in PrEP availability among sites that responded to all three surveys. RESULTS Of 199 sites that completed the 2020 survey, PrEP was available in 161 (81%). PrEP availability was highest at sites in North America (29/30; 97%) and East Africa (70/74; 95%) and lowest at sites in Central (10/20; 50%) and West Africa (1/6; 17%). PrEP availability was higher among sites in countries where PrEP was officially registered (146/161; 91%) than where it was not (14/32; 44%). Availability was higher at health centers (109/120; 90%) and district hospitals (14/16; 88%) compared to regional/teaching hospitals (36/63). Among the 94 sites that responded to all three surveys, PrEP availability increased from 47% in 2014 to 60% in 2017 and 76% in 2020. CONCLUSION PrEP availability has substantially increased since 2014 and is now available at most IeDEA sites. However, PrEP service provision varies markedly across global regions.
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Affiliation(s)
- Samuel Kebede
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Ellen Brazier
- Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | | | | | - Jun Yong Choi
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Renee de Waal
- Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | - Armel Poda
- Hôpital de Jour, Service des Maladies Infectieuses, CHU Sourô Sanou, Bobo-Dioulasso, Burkina Faso
| | | | | | | | | | - Keri N Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alisho Shongo
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Nicola Low
- Institute of Social and Preventive Medicine, Bern, Switzerland
| | | | - Valdiléa G. Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Rio de Janerio, Brazil
| | - Jonathan Ross
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
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Yu Y, Zhong M, Quan C, Ma C. Treatment access and satisfaction on disease-modifying therapies of neuromyelitis optica spectrum disorder patients in China: a cross-sectional survey. Ther Adv Neurol Disord 2024; 17:17562864241239105. [PMID: 38525489 PMCID: PMC10960978 DOI: 10.1177/17562864241239105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/14/2024] [Indexed: 03/26/2024] Open
Abstract
Background Neuromyelitis optica spectrum disorder (NMOSD) is a rare and debilitating disease that has become more widely recognized in China. Legislative measures have been implemented by the government to improve treatment access for rare diseases. Objectives To investigate the diagnostic journey, treatment status, treatment accessibility, and treatment satisfaction of the NMOSD patients on disease-modifying therapies (DMTs) in China. Design A patient online survey. Methods This cross-sectional online survey was conducted between November 2022 and January 2023. Patients over 18 years old and diagnosed with NMOSD were included. The questionnaire consisted of five sections covering demographics, diagnostic and treatment experiences, DMTs availability, cost and affordability, and treatment satisfaction using the Treatment Satisfaction Questionnaire for Medication (version II). Patient opinions and demands were also collected at the end of the survey. Results A total of 375 patients diagnosed with NMOSD were recruited, of which 321 patients used DMTs. It required 1.22 ± 3.22 years and 3.58 ± 4.24 hospital visits for a definitive diagnosis. One-third of the patients still needed to travel for over 2 h to access DMTs. The total treatment expenditure was estimated to be CNY 59,827.00 (USD 8315.95) a year. Drug expenses alone accounted for 52.22% of the average annual household income. The most common challenges perceived were the inability to afford treatment and a lack of effective options. No significant difference was found in treatment satisfaction among DMTs, except that rituximab scored lowest in convenience compared to other DMTs. Patients' age and travel time required to obtain medications were negatively associated with global treatment satisfaction. Conclusion In China, patients with NMOSD face challenges in obtaining proper treatment due to diagnostic difficulties, distant medication access, and high costs. Policies should prioritize improving disease education and alleviating financial burdens for the patients.
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Affiliation(s)
- Yue Yu
- Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China
- Huashan Rare Disease Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Mingkang Zhong
- Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China
| | - Chao Quan
- Department of Neurology, National Center for Neurological Disorders, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai 200040, China
- Huashan Rare Disease Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Chunlai Ma
- Department of Pharmacy, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai 200040, China
- Huashan Rare Disease Center, Huashan Hospital, Fudan University, Shanghai, China
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Iversen AM, Hansen MB, Münster M, Kristensen B, Ellermann-Eriksen S. Hand hygiene compliance in nursing home wards - the effect of increased accessibility of alcohol-based hand rub. J Hosp Infect 2024:S0195-6701(24)00097-5. [PMID: 38521416 DOI: 10.1016/j.jhin.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Elderly nursing home (NH) residents are vulnerable to infections due to age, weakened immune system and comorbidities. Furthermore, microorganisms are easily transmitted in shared facilities. Hand hygiene (HH) is considered one of the most important measures to prevent transmission. We determined the effect of increased accessibility to alcohol-based hand rub (ABHR) in NH wards by monitoring HH compliance (HHC) among healthcare workers (HCWs). METHODS An 11-month intervention study was conducted in a Danish six-ward NH. Data were collected using an automatic hand hygiene monitoring system (AHHMS). After a baseline period, one extra ABHR dispenser was placed in each of the 150 apartments. We compared baseline HHC with the HHC during an immediate intervention period and a long-term intervention period. RESULTS We included 159 HCWs. The AHHMS registered 341,078 HH opportunities. Overall baseline HHC was 31% (95% CI: 30-32). A significant +18% absolute immediate effect (first five months) (95% CI: 17-19; p<0.0001) and +13 percentage points (95% CI: 11, 14; p<0.0001) long-term effect (another four months) were recorded. HCWs working day shifts and short-term employees had a higher baseline HHC than HCWs working evening/night shifts. However, HCWs working night shifts achieved the greatest long-term effect with a mean +27 percentage point difference (p<0.0001). CONCLUSIONS Placing an additional ABHR dispenser strategically within staff workflow significantly increased HHC among HCWs, showcasing a noteworthy effect. The study is the first to report the effect on NH dispenser accessibility as a single intervention and demonstrate a significant unmet potential.
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Affiliation(s)
- Anne-Mette Iversen
- Department of Oncology, Aarhus University Hospital and Aarhus University, Denmark.
| | | | | | - Brian Kristensen
- National Centre of Infection Control. Statens Serum Institut, Copenhagen, Denmark
| | - Svend Ellermann-Eriksen
- Department of Clinical Microbiology, Aarhus University Hospital and Aarhus University, Denmark
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Ruan WY, Chen HY, Cai HP, Wang XL, Zhao ZG. Real-world data for the availability of pediatric medicines in Chinese hospitals: a multi-center survey and analysis. Front Pharmacol 2024; 15:1283068. [PMID: 38420200 PMCID: PMC10899465 DOI: 10.3389/fphar.2024.1283068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Aim: No information exists on the availability of pediatric medicines in China. This study aimed to access the availability of different types of pediatric medicine and determine their ratio in medical institution drug catalogs. Methods: Based on drug instructions, an expert meeting method was used to divide pediatric medicines into five categories: child-specific medicine (CSM), co-use medicine for adults and children (CMAC), other pediatric medicines (OCM), off-label medicine use (OMU), and non-child medicine (NM). Results: A total of 60 hospitals nationwide participated in this survey, namely, 20 children's hospitals (C-hosp), 14 maternal and child healthcare hospitals (MCHC-hosp), and 26 general hospitals (G-hosp). The average number of drug catalogs in G-hosp was significantly higher than that in C-hosp and MCHC-hosp. CSM accounted for 9.77% of the C-hosp catalog, 7.12% of the MCHC-hosp catalog, and 1% of the G-hosp catalog. The availability rate of CMAC was 49.63% in C-hosp and 40.87% and 31% in MCHC-hosp and G-hosp, respectively. The proportion of OCM in C-hosp (27.28%) was higher than that in MCHC-hosp (13.4%) and G-hosp (5%). The OMU occupied ratio in C-hosp, MCHC-hosp, and G-hosp is not negligible, which was 12.06%, 8.7%, and 10% respectively. The proportion of NM in C-hosp was almost negligible but was 29.91% and 53% in MCHC-hosp and G-hosp, respectively. Compared to the CSM and CMAC listed in China, the share of CSM in C-hosp was close to 40%, which was much higher than that of G-hosp and MCHC-hosp. In contrast, the share of CMAC in G-hosp was nearly 30%, which was significantly higher than that in C-hosp and MCHC-hosp. Health insurance covers most of these five types of pediatric medicines, with the proportion of insured medicines reaching close to 80% in C-hosp and approximately 85% in MCHC-hosp and G-hosp. Discussion: The availability of specific medicines suitable for use in children is generally low, and even CSM in specialized hospitals such as C-hosp cannot meet the relatively high accessibility level of WHO evaluation standards. Policies and measures should be implemented to boost the research and development of pediatric medicines, as well as supplement safety information lacking in instruction manuals.
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Affiliation(s)
- Wen-Yi Ruan
- Anhui Provincial Children's Hospital, Department of Clinical Pharmacy, Hefei, China
| | - Hui-Ying Chen
- Anhui Provincial Children's Hospital, Department of Clinical Pharmacy, Hefei, China
| | - He-Ping Cai
- Anhui Provincial Children's Hospital, Department of Clinical Pharmacy, Hefei, China
| | - Xiao-Ling Wang
- National Center for Children's Health, Department of Pharmacy, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Zhi-Gang Zhao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Lule F, Rajab K, Banzimana S, Asingizwe D. Assessing determinants of the availability of HIV tracer commodities in health facilities in Wakiso District, Uganda. J Pharm Policy Pract 2024; 17:2306846. [PMID: 38333575 PMCID: PMC10851790 DOI: 10.1080/20523211.2024.2306846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Background HIV/AIDS commodity stock-outs are still rampant in most African Countries causing treatment interruption, antiretroviral resistance, treatment failure, morbidity and mortality. Therefore, this study aimed at assessing the determinants of the availability of HIV Tracer Commodities in Health Facilities in Wakiso District, Uganda. Methods A descriptive cross-sectional design was conducted in 42 Health Facilities [HFs] offering HIV/AIDs services in Wakiso District, Uganda. Semi-structured questionnaire adapted from the Anti-Retroviral Therapy Supervision Performance and Recognition Strategy [ART SPARS] tool Version 2.0 | 2018111 was used to collect data. Results The majority of the HFs 28 [67%] had all the seven tracer commodities on the day of the visit. The majority of the HFs 33 [78.6%] were using Manual stock management tools that were fully updated. The availability of HIV tracer commodities was high in facilities that made timely ordering [AOR: 2.538, 95% CI: 2.126-3.304, p-value = 0.003] while the use of manual LMIS alone at the facility [AOR: 0.623, 95% CI: 0.131-0.958, p-value = 0.002] was associated with low availability. Conclusion This study indicated that 67% of health facilities visited had all HIV Tracer commodities on the day of the visit. ART commodity management should be computerised and orders made on time to ensure the availability of commodities.
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Affiliation(s)
- Falisy Lule
- EAC Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Kalid Rajab
- School of Pharmacy, College of Health Science, Makerere University, Kampala, Uganda
| | - Stany Banzimana
- EAC Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Domina Asingizwe
- EAC Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Rafi S, Anjum SM, Usman M, Nawaz HA, Chaudhry M, Babar ZUD, Rasheed H. Availability of Access, Watch, and Reserve groups of essential antibiotics: a cross-sectional survey. Front Public Health 2024; 11:1251434. [PMID: 38239798 PMCID: PMC10794303 DOI: 10.3389/fpubh.2023.1251434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/22/2023] [Indexed: 01/22/2024] Open
Abstract
Background Lower-middle income countries face drastic challenges in Access to essential medicines. Data regarding Pakistan is scarce with no comprehensive study in this regard. The objectives of the study are to document and compare public and private sector availability of all essential antibiotics as well as to conduct a comparison among the AWaRe groups. Methods The study analyzed 103 essential antibiotics comprising 51 Access, 29 Watch, 6 Reserve, and 17 anti-tuberculosis drugs from 15th August to 10th September 2020 in Lahore, Pakistan. It included on-spot physical availability and availability trend surveys. The survey sites included five public tertiary care hospitals with one as anchor and four randomly selected. Their hospital pharmacies and one randomly selected private retail pharmacy from the vicinity each hospital comprised the ten sampling sites. Percentage availability for each antibiotic was categorized as high (>80%), fairly high (50-80%), low (30-<50%), very low (<30->0%), and not available (0%). Results The mean percentage on-spot availability was 23.76% ± 5.19 (14-25%) for public facilities and 59.20% ± 4.45 (54-66%) for private sector retail pharmacies. The overall percentage of available essential antibiotics varied significantly (p** < 0.001) in public and private sector sampling sites. Except for the Watch group, all other groups showed the mode of 0% availability. A significant difference (p**** < 0.00001) was seen in percentage availability by Access, Watch, Reserve, and anti-TB-all groups of essential antibiotics. The availability trend survey revealed a list of 18 medicines as 'as never been available', and five medicines were 'not available for 5 years or more than 5 years.' Fourteen medicines as 'never been heard.' Conclusion Non-availability of essential medicines is a significant public health challenge at public-sector facilities in Pakistan. It was observed that a number of essential antibiotics were not available in both public and private sectors. A number of corrective strategies are required. This includes the engagement of stakeholder and government bodies. This can help to improve supply chain barriers.
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Affiliation(s)
- Sunaina Rafi
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Syed Muneeb Anjum
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Usman
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Hafiz Awais Nawaz
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Mamoona Chaudhry
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, University of Huddersfield, Huddersfield, United Kingdom
| | - Huma Rasheed
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
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12
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Porembka JH, Arjmandi FK, Hyde K, Xi Y, Zaidi SF, Lee RK. Next Level of Care Protocols in Radiology: Improving Patient Access to Care. J Am Coll Radiol 2024; 21:19-26. [PMID: 37939812 DOI: 10.1016/j.jacr.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/26/2023] [Accepted: 11/03/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE To introduce a novel next level of care (NLC) protocol used in our breast imaging practice to bypass additional imaging and image-guided biopsy orders and to examine the impact of NLC on breast biopsy wait times compared with thyroid biopsy wait times, which do not use NLC. METHODS Our institutional review board deemed this retrospective analysis to be exempt. NLC was implemented for breast imaging in late 2014. Two 6-month periods before and after the COVID-19 shutdown were sampled and compiled. Data were queried from departmental database and electronic health record for all breast and thyroid biopsies during this time. Time to biopsy (TTB) was defined as the number of days from the diagnostic imaging evaluation recommending the biopsy to the completion of the biopsy. To determine the effect of NLC, TTB was compared between breast and thyroid biopsies. RESULTS Of the 1,114 breast biopsies and 154 thyroid biopsies included, the mean TTB was 9 days (95% confidence interval 8.4-9.3) for breast and 23 days (95% confidence interval 20.5-25.0) for thyroid. There was a 61% reduction in the mean TTB for patients in the breast group compared with patients in the thyroid group. The effect of the NLC was comparable among different races and ethnicities in the breast group, but a significantly higher mean TTB (24% higher, P = .025) was observed for thyroid biopsies in Black patients compared with thyroid biopsies in Hispanic patients. CONCLUSION NLC protocol facilitates imaging evaluations and reduces the time interval to image-guided biopsies.
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Affiliation(s)
- Jessica H Porembka
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas; and Vice Chair of Strategy and Quality, Quality Assurance Medical Director, Parkland Radiology, Dallas, Texas.
| | - Firouzeh K Arjmandi
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas; and Assistant Quality Assurance Medical Director, Parkland Radiology, Dallas, Texas
| | - Katherine Hyde
- Department of Radiology, University of Texas Southwestern Medical Center, Quality Assurance Specialist, Dallas, Texas
| | - Yin Xi
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Syed F Zaidi
- Office of the Chief Medical Officer, Operations and Integration, Radiology Partners, Inc, El Segundo, California; and Chair, ACR Patient and Family-Centered Care Population Health Management Committee
| | - Ryan K Lee
- Chair, Department of Radiology, Jefferson Einstein Hospital, Jefferson Einstein Montgomery Hospital, Philadelphia, Pennsylvania; and Chair, ACR Patient and Family-Centered Care Population Health Management Committee
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Traoré F, Omolo M, Beal T, Nordhagen S, Codjia P, Kiige L, Kamudoni P, Arimi C, Kirogo V, Ortenzi F, Wouabe ED. Modelling policies to improve affordability and consumption of nutritious foods for complementary feeding in Kenya. Matern Child Nutr 2024; 20 Suppl 3:e13519. [PMID: 38204288 PMCID: PMC10782137 DOI: 10.1111/mcn.13519] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/09/2023] [Accepted: 03/23/2023] [Indexed: 01/12/2024]
Abstract
In Kenya 26% of children under age 5 experience stunted growth, 4% are wasted and 11% are underweight. In pregnant women, the prevalence of iron deficiency is 36% and iron-deficiency anaemia prevalence is 26%. Previous studies have identified affordability as a key barrier to the intake of nutrients, particularly from animal-source foods (ASFs). Thus, this study analyzes to what extent the affordability of ASF in Kenya can be improved. It focuses on four ASFs: eggs, milk, chicken and beef. Using a computable general equilibrium model, three policy simulations were undertaken to establish the impact of potential changes on nutritious ASF availability and affordability: a 20% increase in total factor productivity (TFP) for the four products; a 20% TFP increase plus a 25% reduction in trade and transportation margins; and a 20% TFP increase for ASF and maize (a key input in animal feed). Simulations suggest increasing the productivity of the four ASF products would increase their availability and lower consumer prices (up to 17% lower). Household consumption of the four commodities would increase, resulting in improved household dietary diversity. Rural households would gain more compared with urban households. Poor households (the lowest 40%) would register larger welfare (Equivalent Variation) gains than other households in both urban and rural areas. The richest 20% of the population would neither lose nor gain following the policy changes. Reducing transportation costs and trade margins and increasing maize productivity could further reduce the price of ASFs through lower production costs and increased consumption.
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Affiliation(s)
| | - Miriam Omolo
- The African Policy Research InstituteNairobiKenya
| | - Ty Beal
- Global Alliance for Improved NutritionWashingtonDistrict of ColumbiaUSA
| | | | | | | | | | | | | | | | - Eric Djimeu Wouabe
- Global Alliance for Improved NutritionWashingtonDistrict of ColumbiaUSA
- Present address:
Results for DevelopmentWashingtonDistrict of ColumbiaUSA
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Shukar S, Anjum R, Zhang J, Babar ZUD, Mobeen I, Yang C. Anticancer medicines in Pakistan: An analysis of essential medicines lists. J Oncol Pharm Pract 2024; 30:46-54. [PMID: 37006130 DOI: 10.1177/10781552231167809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
OBJECTIVE The lack of anticancer drugs for curative and supportive purposes is the critical reason for the low survival rate in low-and-middle-income countries. This study aims to analyze whether the National Essential Medicines List (NEML) and Registered Essential Medicines List (REML) are in concordance with the World Health Organization (WHO) Essential Medicines List (EML) and whether the formularies prevalent in the country are parallel to each other and to the NEML. METHOD An observational study design was used in which antineoplastic drugs from the 2021 NEML and REML were compared with 2021 WHO EML to evaluate their availability in Pakistan. Market access was determined. Moreover, the formularies of six different hospital types were compared with each other and with the NEML, and REML to estimate the availability within hospitals. RESULTS There were 66 anticancer drugs in 2021 WHO EML and all were found in Pakistan's 2021 NEML but only 48 drugs (73%) were found in the REML. Hydroxycarbamide and dasatinib were two registered drugs absent in all hospitals' formularies. The market access for anticancer medicines was 73% (48 of 66). Semigovernment hospital (86%) has the highest availability, followed by the government hospital (80%). All the hospitals have unregistered drugs including bortezomib, lenalidomide, and mesna. CONCLUSION Pakistan's NEML adopts WHO EML abruptly but all medicines are not registered. The hospitals are trying their best to increase availability but optimum drug regulations to revise NEML based on the country's requirements and emphasizing registration of anticancer medicines are needed to improve the country's availability of antineoplastic agents.
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Affiliation(s)
- Sundus Shukar
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China
| | - Rehan Anjum
- Department of Pharmacy, Shifa International Hospitals, Islamabad, Pakistan
| | - Jinwei Zhang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, West Yorkshire, UK
| | - Iqra Mobeen
- Department of Pharmacy, Samaa Fertilization Center Jumeriah, Dubai, United Arab Emirates
| | - Caijun Yang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China
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15
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Rotimi K, Fagbemi B, Itiola AJ, Ibinaiye T, Aidenagbon A, Dabes C, Biambo AA, Iwegbu A, Onabajo S, Oguoma C, Oresanya O. Private sector availability and affordability of under 5 malaria health commodities in selected states in Nigeria and the Federal Capital Territory. J Pharm Policy Pract 2023; 17:2294024. [PMID: 38223355 PMCID: PMC10783550 DOI: 10.1080/20523211.2023.2294024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
Background To guarantee uninterrupted service delivery, quality-assured products must be affordable and continuously available across all sectors, including the private sector, which provides more than 60% of healthcare services in Nigeria. We investigated the private sector availability and affordability of under 5 malaria commodities to establish the level of access in this sector. Methods We surveyed patent medicine and pharmacy stores across seven states in Nigeria and the Federal Capital Territory to establish the availability and affordability of selected malaria commodities for children under 5 years. Availability was measured as the percentage of visited outlets with the product of interest on the day of visit, while affordability was assessed by establishing if it cost more than a day's wage for the least-paid government worker to purchase a full course of malaria diagnostic test and/or medication. Results Artemisinin-based antimalarials for uncomplicated and severe malaria were the most available commodities. SPAQ1 and SPAQ2 used for seasonal malaria chemoprevention campaign were surprisingly also available in some outlets. However, only about half (48.3% and 53.3%) of the surveyed outlets had stock of artemether/lumefantrine (AL1) and artesunate injection, respectively. The median price of surveyed products ranged from USD (United States Dollars) 0.38 to USD 2.17 per treatment/test. Except for amodiaquine tablet and artemether injection, which cost less, all other originator brands cost the same or more than the lowest-priced generic. Antimalarial products were affordable as their median prices were not more than a day's wage for the least-paid government worker. However, when the cost of testing and treatment with artemisinin-based combination therapies (ACTs) was assessed, testing and treatment with dihydroartemisinin/piperaquine were unaffordable as the they cost more than 1.5 times the daily wage of the least-paid government worker. Conclusion The overall private sector availability of under-five malaria commodities in surveyed locations was suboptimal. Also, testing and treatment with recommended ACTs were not affordable for all surveyed products. These findings suggest the need for interventions to improve access to affordable under-five malaria commodities.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sarah Onabajo
- National Agency for Food and Drug Administration and Control, Lagos, Nigeria
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Deressa HD, Abuye H, Adinew A, Ali MK, Kebede T, Habte BM. Access to Essential Medicines for Diabetes Care: Availability, Price, and Affordability in Central Ethiopia. Res Sq 2023:rs.3.rs-3694051. [PMID: 38106116 PMCID: PMC10723550 DOI: 10.21203/rs.3.rs-3694051/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Background Diabetes is a major global public health burden. Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines (EMs) which is a challenge especially in low-and-middle-income countries such as Ethiopia. Methods A cross-sectional study was conducted in 60 selected public and private medicine outlets in central Ethiopia from January to February 2022 using the World Health Organization/Health Action International (WHO/HAI) standard tool to assess access to EMs. We included EMs that lower glucose, blood pressure, and cholesterol as these are all critical for diabetes care. Availability was determined as the percentage of surveyed outlets per sector in which the selected lowest-priced generic (LPG) and originator brand (OB) products were found. The number of days' wages required by the lowest paid government worker (LPGW) to purchase a one month's supply of medicines was used to measure affordability while median price was determined to assess patient price and price markup difference between public procurement and retail prices. Results Across all facilities, availability of LPG and OB medicines were 34.6% and 2.5% respectively. Only two glucose-lowering (glibenclamide 5mg, metformin 500mg) and two blood pressure-lowering medications (nifedipine 20mg and hydrochlorothiazide 25mg) surpassed the WHO's target of 80% availability. The median price based on the least measurable unit of LPG diabetes EMs was 1.6 ETB (0.033 USD) in public and 4.65 ETB (0.095 USD) in private outlets, respectively. The cost of one month's supply of diabetes EMs was equivalent to 0.3 to 3.1 days wages in public and 1.0 to 11.0 days wages in private outlets, respectively, for a typical LPGW. Thus, 58.8% and 84.6% of LPG diabetes EMs included in the price analysis were unaffordable in private and public outlets, respectively. Conclusion There are big gaps in availability and affordability of EMs used for diabetes in central Ethiopia. Relevant stakeholders should work to improve access to EMs.
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Affiliation(s)
- Hachalu Dugasa Deressa
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Habtamu Abuye
- Department of Pharmacy, College of Medicine and Health Sciences, Wachemo University, Hossaena, Ethiopia
| | - Alemayehu Adinew
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mohammed K Ali
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA
| | - Tedla Kebede
- School of Medicine, College of Health Sciences, Addis Ababa University
| | - Bruck Messele Habte
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Jakobson DJ, Bashkin O, Kalatskaya V, Veinberg H, Chernoguz E, Nesi V, Levy C, Sherer Y. Challenging Organizational Factors Associated With Admission Delay to Intensive Care Unit-A Novel Quality Indicator. J Intensive Care Med 2023; 38:1121-1126. [PMID: 37403372 DOI: 10.1177/08850666231183899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
BACKGROUND Delays in admitting patients to the intensive care unit (ICU) can defer the timely initiation of life-sustaining therapies and invasive monitoring, jeopardizing the success of the treatment. Nevertheless, the availability of research on interventions that reduce or minimize admission delays is limited. OBJECTIVES The current study aimed to assess the factors related to delays in admission times of critically ill patients transferred to the ICU. METHODS A software was designed to follow-up, compare and measure the defined intervals of the time to admission, implemented at the ICU for 6 months. Measurements included 5 time intervals, referral department, and work shift at admission. Data from 1004 patients admitted to the ICU between July 2017 and January 2020 were analyzed in a retrospective observational study. RESULTS Precisely, 53.9% of total patients were referred from the hospital emergency department, and 44% were admitted during the evening shift. Significant differences were found in time intervals between shifts, showing the morning round had the longer total admission time (median: 67.8 min). Analysis showed that admission time was longer at times of full capacity compared to times of available bed (mean: 56.4 and 40.2 min, respectively; U = 68,722, p < .05). Findings demonstrated a significant shortening of time to admission after implementing a new time monitoring software by the Institutional Quality Control Commission (U = 5072, p < .001). CONCLUSIONS Our study opens doors for potential studies on applying effective initiatives in critical care settings to improve patient care and outcomes. Additionally, it generates new insights regarding how clinicians and nursing teams can jointly develop and promote multidisciplinary interventions in intensive care work environments.
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Affiliation(s)
- Daniel J Jakobson
- Intensive Care Department, Barzilai University Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | | | - Halel Veinberg
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Evgeny Chernoguz
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
- Quality Department, Barzilai University Medical Center, Ashkelon, Israel
| | - Vicky Nesi
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
- Quality Department, Barzilai University Medical Center, Ashkelon, Israel
| | - Chezy Levy
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
- Hospital Direction Department, Barzilai University Medical Center, Ashkelon, Israel
| | - Yaniv Sherer
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
- Hospital Direction Department, Barzilai University Medical Center, Ashkelon, Israel
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Farrell P, Bogard J, Thow AM, Boylan S, Johnson E, Tutuo J. Food price and availability in Solomon Islands during COVID-19: A food environment survey. Nutr Health 2023; 29:611-619. [PMID: 37365874 PMCID: PMC10293874 DOI: 10.1177/02601060231183592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Background: In Solomon Islands, the retail food environment is an important food source, for instance, the dominant source of fresh fruit and vegetables for urban consumers is open markets. The effects of COVID-19 mitigation measures (such as restriction of human movement and border closures) in early 2020 placed food security at risk in many parts of the community. Of particular concern was the risk of price gouging in an already price-sensitive market. Aims: The study aimed to provide rapid and policy-relevant information on the pricing of foods in the urban food environment in Solomon Islands in the context of the unfolding COVID-19 pandemic. Methods: A vendor survey was conducted in July to August 2020 and repeated in July 2021 using a survey tool that collected information on type, quantity, and price of food on offer. Findings: We found price reductions among the majority of fresh fruit and non-starchy vegetables available. A trend of rising prices was reported for some other commodities, such as fresh locally caught fish. Conclusion: Our findings highlight the impact of 'schocks to the system' on food prices as a potential barrier or enabler to consumption of fresh foods purchased from urban areas - an important finding in a price sensitive market. The survey design was successful in collecting pricing data from the retail food environment during a time of external 'shock to the system'. Our approach is applicable to other settings needing a rapid survey of the external food environment.
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Affiliation(s)
- Penny Farrell
- Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Jessica Bogard
- Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Sinead Boylan
- Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Eveleigh, NSW, Australia
| | - Ellen Johnson
- Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
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Özler G, Işik O. Prices, availability and affordability of selected essential medicines for chronic diseases in Türkiye. East Mediterr Health J 2023; 26:850-860. [PMID: 38279880 DOI: 10.26719/emhj.23.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/25/2023] [Indexed: 01/29/2024]
Abstract
Background Fair access to essential medicines is a significant parameter in fulfilling the right to basic health. Aim We investigated the availability, prices and affordability of essential medicines for chronic diseases in Ankara, Türkiye. Methods We used the procedures outlined in the WHO and Health Action International guidelines for measuring prices, availability, affordability, and price components of medicines. The sample consisted of 334 (14%) of the 2354 pharmacies in Ankara, and 24 essential medicines for cardiovascular diseases, diabetes, chronic respiratory diseases, and palliative care, adopted from the WHO Model List of Essential Medicines (2021). We collected the data in 2021 using a questionnaire administered through face-to-face survey and analysed the data using SPSS version 22. Results The findings showed that 15 medicines (62.5% of the selected medicines) met the 80% availability target set by WHO, while 9 did not. The original medicines were more readily available than the generic ones. Among the original medicines, furosemide (10.11) and acetylsalicylic acid (9.26) had the highest median price ratios. The generic medicines seemed to be more affordable than original medicines. Glibenclamide, budesonide, gliclazide, and diazepam had low availability and were sold at higher prices than their international reference prices. Conclusion This research highlights priority areas of action to improve access to affordable medicines for chronic diseases in Ankara, Türkiye.
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Affiliation(s)
- Gökçen Özler
- Department of Health Management, Faculty of Health Sciences, Ankara University, Ankara, Türkiye
| | - Oğuz Işik
- Department of Health Management, Faculty of Economics and Administrative Sciences, Hacettepe University, Ankara, Türkiye
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Ishutin AA, Stupak VS, Zolotareva LS, Feduleeva ES. [The satisfaction of parents with quality of palliative care rendered to their children]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2023; 31:1360-1365. [PMID: 38142336 DOI: 10.32687/0869-866x-2023-31-6-1360-1365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/30/2023] [Indexed: 12/25/2023]
Abstract
The pediatric palliative care (PC) is the physical, mental and spiritual care of children as well as support of their family members. The purpose of the study - to investigate satisfaction of parents of children with severe refractory diseases with availability and quality of PC in the Moscow region. The prospective cohort study was carried out using sociological survey in 2020-2021 on the basis of the "Moscow Oblast Hospice (for children)". The survey involved 300 people (63.7% of total number of patients). The most common symptoms were shortness of breath (41.8%), impaired concentration (36.4%) and constipation (36.4%). The most common psychological symptoms were anxiety (29.1%) and sleep disorders (17.8%). The parents rated availability of PC at 7.0 (5.0; 8.0) points out of 10.0, territorial accessibility of PC at 7.0 (5.0; 8.0) points, the quality of PC received at 8.0 (6.0; 9.0) points. Almost two-thirds of respondents rated volume of PC provided as limited and only 31.0% as sufficient. The number of palliative beds in hospitals was assessed by 71.7% as limited, and by 17.0% as sufficient. According to respondents, PC provision service requires, first of all, improvement of funding (80.2%) and organization of new hospices (55.7%). The majority of children received medical assistance (99.3%). Only 23.7% received psychological, 12.2% pedagogical, 24.5% social and 4.3% legal support. The research, identification of needs, targeted care based on individual approach can support children and their family members, reduce discomfort and suffering. Support of children receiving PC and their families are key components of qualitative and affordable PC in pediatrics.
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Affiliation(s)
- A A Ishutin
- The State Autonomous Health Care Institution of the Moscow Oblast "The Moscow Oblast Hospice (for children)", 1452032, Domodedovo, Russia
- The Federal State Budget Institution "The Central Research Institute for Health Organization and Informatics" of Minzdrav of Russia, 127254, Moscow, Russia
| | - V S Stupak
- The Federal State Budget Institution "The Central Research Institute for Health Organization and Informatics" of Minzdrav of Russia, 127254, Moscow, Russia
| | - L S Zolotareva
- The State Autonomous Health Care Institution of the Moscow Oblast "The Moscow Oblast Hospice (for children)", 1452032, Domodedovo, Russia,
| | - E S Feduleeva
- The State Autonomous Health Care Institution of the Moscow Oblast "The Moscow Oblast Hospice (for children)", 1452032, Domodedovo, Russia
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Temech EC, Said O, Endalik G, Demilew YM, Belay MA, Kassie TD, Dessie AM. Adequacy of iodized salt and its associated factors among households in the Bahir Dar Zuria district, Northwest Ethiopia, 2022. Front Nutr 2023; 10:1215613. [PMID: 37964937 PMCID: PMC10641846 DOI: 10.3389/fnut.2023.1215613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/29/2023] [Indexed: 11/16/2023] Open
Abstract
Background The inadequacy of iodine in salt is the a contributing factor behind lack of awareness and poor economic performance in developing countries. To address the issue of iodine deficiency, universal salt iodization has been implemented globally. Nevertheless, it is imperative to closely monitor the sufficiency of iodine in salts to achieve its intended objective at the household level in the Bahir Dar Zuria district. Objective To assess the adequacy of iodized salt and its associated factors among households in the Bahir Dar Zuria district, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted from May to June 2022 among households in Bahir Dar Zuria district. The data were gathered from 825 households that were chosen using a multistage sampling process. Iodometric titration was used to assess the amount of iodine in salt. The data were gathered using a structured questionnaire that was administered by an interviewer. For data entry and analysis, EpiData version 3.01 and SPSS version 25.0 were used, respectively. To evaluate the association between explanatory factors and the outcome variable, binary logistic regression was conducted, and significance was determined at alpha 0.05. Result This study analyzed a total of 825 households. Of these, only 384 [46.5, 95% CI, 43.5-50.5%] households had adequately iodized salt at home. Age increase of 1 year [AOR = 1.04, 95% CI = 1.02-1.06], being an urban resident [AOR = 3.18, 95% CI = 1.84-5.48], diploma and above educational attainment [AOR = 3.74, 95% CI = 1.99-7.02], checking salt by asking the seller [AOR = 2.21, 95% CI = 1.26-3.88], storing salts in closed containers [AOR = 1.57, 95% CI = 1.13-2.19], and storing salts in a dry and cool area [AOR = 2.72, 95% CI =1.37-5.42] were associated with the adequacy of iodized salt at the household level. Conclusion and recommendation The percentage of households in the district (46.5%) that had enough iodized salt in their homes is still extremely low and falls short of the targeted level for the country. At the household level, adequate iodized salt was found to be associated with age, place of residence, level of education, checking salt iodization while purchasing, place of salt storage, and cover use for salt containers. Therefore, increasing the accessibility of iodized salt at the household level is essential.
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Affiliation(s)
| | - Oumer Said
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Genete Endalik
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yeshalem Mulugeta Demilew
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mahider Awoke Belay
- Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
| | - Tadele Derbew Kassie
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Anteneh Mengist Dessie
- Department of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
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Russell AM, Browne M, Hing N, Rockloff M, Newall P, Dowling NA, Merkouris S, King DL, Stevens M, Salonen AH, Breen H, Greer N, Thorne HB, Visintin T, Rawat V, Woo L. Electronic gaming machine accessibility and gambling problems: A natural policy experiment. J Behav Addict 2023; 12:721-732. [PMID: 37594879 PMCID: PMC10562817 DOI: 10.1556/2006.2023.00044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/18/2023] [Accepted: 07/28/2023] [Indexed: 08/20/2023] Open
Abstract
Background Electronic gaming machines (EGMs) are one of the most harmful forms of gambling at an individual level. It is unclear whether restriction of EGM functions and accessibility results in meaningful reductions in population-level gambling harm. Methods A natural policy experiment using a large (N = 15,000) national dataset weighted to standard population variables was employed to compare estimates of gambling problems between Australian residents in Western Australia (WA), where EGMs are restricted to one venue and have different structural features, to residents in other Australian jurisdictions where EGMs are widely accessible in casinos, hotels and clubs. Accessibility of other gambling forms is similar across jurisdictions. Results Gambling participation was higher in WA, but EGM participation was approximately half that of the rest of Australia. Aggregate gambling problems and harm were about one-third lower in WA, and self-reported attribution of harm from EGMs by gamblers and affected others was 2.7× and 4× lower, respectively. Mediation analyses found that less frequent EGM use in WA accounted for the vast majority of the discrepancy in gambling problems (indirect path = -0.055, 95% CI -0.071; -0.038). Moderation analyses found that EGMs are the form most strongly associated with problems, and the strength of this relationship did not differ significantly across jurisdictions. Discussion Lower harm from gambling in WA is attributable to restricted accessibility of EGMs, rather than different structural features. There appears to be little transfer of problems to other gambling forms. These results suggest that restricting the accessibility of EGMs substantially reduces gambling harm.
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Affiliation(s)
- Alex M.T. Russell
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 400 Kent St, Sydney, NSW 2000, Australia
| | - Matthew Browne
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 6 University Dr, Branyan, QLD 4670, Australia
| | - Nerilee Hing
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 6 University Dr, Branyan, QLD 4670, Australia
| | - Matthew Rockloff
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 6 University Dr, Branyan, QLD 4670, Australia
| | - Philip Newall
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 400 Kent St, Sydney, NSW 2000, Australia
| | - Nicki A. Dowling
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125, Australia
| | - Stephanie Merkouris
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125, Australia
| | - Daniel L. King
- College of Education, Psychology, & Social Work, Flinders University, Sturt Rd, Bedford Park, SA 5042, Australia
| | | | - Anne H. Salonen
- Finnish Institute for Health and Welfare, Health and Well-Being Promotion Unit, Mannerheimintie 166, Helsinki, Finland
| | - Helen Breen
- Faculty of Business, Law and Arts, Southern Cross University, Military Rd, East Lismore, NSW 2480, Australia
| | - Nancy Greer
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 120 Spencer St, Melbourne, VIC 3000, Australia
| | - Hannah B. Thorne
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Appleton Institute, 44 Greenhill Rd, Wayville, SA 5000, Australia
| | - Tess Visintin
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Appleton Institute, 44 Greenhill Rd, Wayville, SA 5000, Australia
| | - Vijay Rawat
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 120 Spencer St, Melbourne, VIC 3000, Australia
| | - Linda Woo
- Independent Consultant, Southport, QLD 4215, Australia
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Wharton MK, Islam S, García-Ramírez G, Treffers R, Thomas S, Lipperman-Kreda S. Lesbian, Gay, Bisexual, Queer, Questioning and Transgender, Nonbinary, Genderqueer, and Gender Questioning Adult Alcohol Use Outcomes Associated with State Alcohol-Related Laws During the Coronavirus Pandemic in the United States. LGBT Health 2023; 10:526-534. [PMID: 37252781 PMCID: PMC10552143 DOI: 10.1089/lgbt.2022.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Purpose: We assessed how COVID-19-related alcohol sales policies influenced alcohol use behaviors during the pandemic for U.S. adults of diverse sexual (lesbian, gay, bisexual, queer, questioning [LGBQ]) and gender identities (transgender, nonbinary, genderqueer, and gender questioning [T/NB/GQ]). Methods: Time-specific, state-level, restaurant, bar, and off-premise alcohol policy data were collected from the National Institute on Alcohol Abuse and Alcoholism-sponsored Alcohol Policy Information System and merged with the 2020 Behavioral Risk Factor Surveillance System survey data. Treatments included bar, restaurant, and delivery alcohol sales policies. Outcomes included past 30-day drinking frequency, quantity, and heavy episodic drinking (HED). We fitted negative binomial regression models for all outcomes, clustered standard errors by state and used sample weights. We also controlled for seasonality, state Alcohol Policy Scale scores, pre-/postpandemic time period, and included demographic control variables in our cross-sectional analyses. Results: The sample included 10,505 adults identifying as LGBQ and 809 as T/NB/GQ from 32 states. Restaurant and bar closures were associated with less alcohol use for LGBQ respondents. Outdoor-only policies at bars were also associated with significantly less quantity of use and HED for T/NB/GQ adults in the sample. Off-premise home delivery was associated with greater quantity of use for LGBQ respondents and less frequency for T/NB/GQ respondents. Conclusion: The COVID-19-related alcohol sales policy changes offer an opportunity to better understand alcohol policy and availability's influence on drinking behaviors among sexual and gender-diverse populations in the United States.
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Affiliation(s)
- M. Kristina Wharton
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California, USA
- Department of Community Health Sciences, Health and Social Behavior, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Sabrina Islam
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California, USA
- Department of Community Health Sciences, Health and Social Behavior, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Grisel García-Ramírez
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California, USA
| | - Ryan Treffers
- Pacific Institute for Research and Evaluation, National Capital Region Center, Beltsville, Maryland, USA
| | - Sue Thomas
- Pacific Institute for Research and Evaluation, National Capital Region Center, Beltsville, Maryland, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California, USA
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24
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Bayle A, Bonastre J, Chaltiel D, Latino N, Rouleau E, Peters S, Galotti M, Bricalli G, Besse B, Giuliani R. ESMO study on the availability and accessibility of biomolecular technologies in oncology in Europe. Ann Oncol 2023; 34:934-945. [PMID: 37406812 DOI: 10.1016/j.annonc.2023.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Access to biomolecular technologies has become an essential requirement to ensure optimal and timely treatment of patients with cancer. This study sought to provide a comprehensive overview of the availability and accessibility of biomolecular technologies to patients, the status of their use and prescription, barriers to access, and potential economic issues related to cost and reimbursement. MATERIALS AND METHODS A total of 201 field reporters from 48 European countries submitted data through an electronic survey tool between July and December 2021. The survey methodology mirrored that from previous ESMO studies addressing the availability and accessibility of antineoplastic medicines, in Europe and worldwide. The preliminary data were posted on the ESMO website for open peer-review, and amendments were incorporated into the final report. RESULTS Overall, basic single-gene techniques are widely available, whereas access to advanced biomolecular technologies, including large next-generation sequencing panels and complete genomic profiles, is highly heterogeneous. In most countries, advanced biomolecular technologies remain largely inaccessible in clinical practice, are limited to clinical trials or basic research, and associated with progressively increasing cost as the technique becomes more advanced. Differences also exist regarding national sequencing initiatives or molecular tumour boards. The most important barriers to multiple versus single-gene sequencing techniques are the reimbursement of the test (59% versus 24%), and the availability of a suitable medicine, either through reimbursement of treatment (48% versus 30%), off-label treatment (52% versus 35%), or clinical trial enrolment (53% versus 39%). CONCLUSIONS Cost and availability of both treatment and test are the two main factors limiting patients' access to advanced biomolecular technologies and as a consequence to innovative anticancer strategies. In the era of precision medicine, tackling the accessibility to biomolecular technologies is a key step to reduce inequalities to transformative cancer care.
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Affiliation(s)
- A Bayle
- Drug Development Department (DITEP), Gustave Roussy - Cancer Campus, Villejuif; Université Paris Saclay, Université Paris-Sud, Faculté de Médicine, Le Kremlin Bicêtre, Paris; Bureau Biostatistique et Epidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif; INSERM, Université Paris-Saclay, CESP U1018 Oncostat, Labelisé Ligue Contre le Cancer, Villejuif, France; European Society for Medical Oncology (ESMO), Lugano, Switzerland.
| | - J Bonastre
- Bureau Biostatistique et Epidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif; INSERM, Université Paris-Saclay, CESP U1018 Oncostat, Labelisé Ligue Contre le Cancer, Villejuif, France
| | - D Chaltiel
- Bureau Biostatistique et Epidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif; INSERM, Université Paris-Saclay, CESP U1018 Oncostat, Labelisé Ligue Contre le Cancer, Villejuif, France
| | - N Latino
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - E Rouleau
- Department of Medical Biology and Pathology, Tumor Genetic Lab, Gustave Roussy, Villejuif; INSERM UMR 981, Gustave Roussy, Villejuif, France
| | - S Peters
- European Society for Medical Oncology (ESMO), Lugano, Switzerland; Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Galotti
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Bricalli
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - B Besse
- Université Paris Saclay, Université Paris-Sud, Faculté de Médicine, Le Kremlin Bicêtre, Paris; Paris-Saclay University, Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - R Giuliani
- European Society for Medical Oncology (ESMO), Lugano, Switzerland; Guy's and St Thomas NHS Foundation Trust, London, UK
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25
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Umer A, Mohammed H, Yazie B, Angaw DA, Gonete TZ, Endehabtu BF, Tilahun B, Jisso M, Tamiso A, Assesfa NA, Alemayehu A, Fikre R, Mizana BA, Dessie K, Sime H, Abera M, Mecha M, Yesuf EA, Gurmu KK, Kebede M. Assessment of Availability of Tracer Drugs and Basic Diagnostics at Public Primary Health Care Facilities in Ethiopia During COVID-19 Pandemic. Ethiop J Health Sci 2023; 33:135-142. [PMID: 38352669 PMCID: PMC10859737 DOI: 10.4314/ejhs.v33i2.7s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/09/2023] [Indexed: 02/16/2024] Open
Abstract
Background The emergence of COVID-19 pandemic has disrupted the supply chain and stock of medicines and drugs across the globe. Tracer drugs are essential medicines that address the population's priority health problems. Thus, this study aimed to assess availability of tracer drugs and basic diagnostics at public primary health care facilities in Ethiopia. Methods Facility based cross-sectional study was employed in four regions and one city administration. The primary health care units (PHCUs) were purposively selected in consultation with respective regional health bureaus. Finally, 16 hospitals, 92 health centers and 344 health posts were included. This study adopted WHO's tool that was being used to rapidly assess the capacity of health facilities to maintain the provision of essential health services during the COVID-19. Descriptive analysis was done using frequency and percentage, and results were presented. Results The overall mean availability of tracer drugs in PHCUs was 77.6%. Only 2.8% of PHCUs have all tracer drugs. The mean availability of basic diagnostic at national level was 86.6% in PHUs except health posts where it was less. Health facilities with all basic diagnostic services was 53.7%. Of the total 344 health posts assessed, 71% were providing diagnostic testing for malaria using either laboratory equipment or rapid diagnostic test (RDT) while 43% provide urine test for the pregnancy. Conclusion This study shows availability of all tracer drugs in PHCUs in Ethiopia was extremely low. There was regional variation in availability of tracer drugs and basic diagnostics. It is very crucial to increase availability of tracer drugs and diagnostics. Drugs and diagnostic materials should be supplied according to the capacity and location of health facilities.
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Affiliation(s)
- Abdurezak Umer
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Hussen Mohammed
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Bekele Yazie
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Dessie Abebaw Angaw
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Tajebew Zayede Gonete
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Berhanu Fikadie Endehabtu
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Binyam Tilahun
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Meskerem Jisso
- Hawassa University, College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Alemu Tamiso
- Hawassa University, College of Medicine and Health Sciences, Hawassa, Ethiopia
| | | | - Akalewold Alemayehu
- Hawassa University, College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Rekiku Fikre
- Hawassa University, College of Medicine and Health Sciences, Hawassa, Ethiopia
| | | | - Kassahun Dessie
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Habtamu Sime
- Jimma University, Institute of Health, Jimma, Ethiopia
| | | | | | | | - Kassu Ketema Gurmu
- World Health Organization-Ethiopia, Health System Strengthening Unit, Addis Ababa, Ethiopia
| | - Mesfin Kebede
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
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Mangalampalli S, Karri GR, Gupta A, Chakrabarti T, Nallamala SH, Chakrabarti P, Unhelkar B, Margala M. Fault-Tolerant Trust-Based Task Scheduling Algorithm Using Harris Hawks Optimization in Cloud Computing. Sensors (Basel) 2023; 23:8009. [PMID: 37766066 PMCID: PMC10534848 DOI: 10.3390/s23188009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/21/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023]
Abstract
Cloud computing is a distributed computing model which renders services for cloud users around the world. These services need to be rendered to customers with high availability and fault tolerance, but there are still chances of having single-point failures in the cloud paradigm, and one challenge to cloud providers is effectively scheduling tasks to avoid failures and acquire the trust of their cloud services by users. This research proposes a fault-tolerant trust-based task scheduling algorithm in which we carefully schedule tasks within precise virtual machines by calculating priorities for tasks and VMs. Harris hawks optimization was used as a methodology to design our scheduler. We used Cloudsim as a simulating tool for our entire experiment. For the entire simulation, we used synthetic fabricated data with different distributions and real-time supercomputer worklogs. Finally, we evaluated the proposed approach (FTTATS) with state-of-the-art approaches, i.e., ACO, PSO, and GA. From the simulation results, our proposed FTTATS greatly minimizes the makespan for ACO, PSO and GA algorithms by 24.3%, 33.31%, and 29.03%, respectively. The rate of failures for ACO, PSO, and GA were minimized by 65.31%, 65.4%, and 60.44%, respectively. Trust-based SLA parameters improved, i.e., availability improved for ACO, PSO, and GA by 33.38%, 35.71%, and 28.24%, respectively. The success rate improved for ACO, PSO, and GA by 52.69%, 39.41%, and 38.45%, respectively. Turnaround efficiency was minimized for ACO, PSO, and GA by 51.8%, 47.2%, and 33.6%, respectively.
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Affiliation(s)
- Sudheer Mangalampalli
- School of Computer Science and Engineering, VIT-AP University, Amaravati 522237, India;
| | - Ganesh Reddy Karri
- School of Computer Science and Engineering, VIT-AP University, Amaravati 522237, India;
| | - Amit Gupta
- Department of ECE, Nalla Malla Reddy Engineering College, Hyderabad 500088, India;
| | - Tulika Chakrabarti
- Department of Chemistry, Sir Padampat Singhania University, Udaipur 313601, India;
| | | | - Prasun Chakrabarti
- Department of Computer Science and Engineering, Sir Padampat Singhania University, Udaipur 313601, India
| | - Bhuvan Unhelkar
- Muma School of Business, University of South Florida, Sarasota-Manatee, FL 33620, USA;
| | - Martin Margala
- School of Computing and Informatics, University of Louisiana at Lafayette, Lafayette, LA 70504, USA;
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Tan L, Ni Y, Xie Y, Zhang W, Zhao J, Xiao Q, Lu J, Pan Q, Li C, Xu B. Next-generation meat preservation: integrating nano-natural substances to tackle hurdles and opportunities. Crit Rev Food Sci Nutr 2023:1-24. [PMID: 37702757 DOI: 10.1080/10408398.2023.2256013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
The increasing global meat demand raises concerns regarding the spoilage of meat caused by microbial invasion and oxidative decomposition. Natural substances, as a gift from nature to humanity, possess broad-spectrum bioactivity and have been utilized for meat preservation. However, their limited stability, solubility, and availability hinder their further development. To address this predicament, advanced organic nanocarriers provide an effective shelter for the formation of nano-natural substances (NNS). This review comprehensively presents various natural substances derived from plants, animals, and microorganisms, along with the challenges they face. Subsequently, the potential of organic nanocarriers is explored, highlighting their distinct features and applicability, in addressing these challenges. The review methodically examines the application of NNS in meat preservation, with a focus on their pathways of action and preservation mechanisms. Furthermore, the outlook and future trends for NNS applications in meat preservation are concluded. The theory and practice summary of NNS is expected to serve as a catalyst for advancements that enhance meat security, promote human health, and contribute to sustainable development.
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Affiliation(s)
- Lijun Tan
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
| | - Yongsheng Ni
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
| | - Yong Xie
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
| | - Wendi Zhang
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
| | - Jinsong Zhao
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
| | - Qing Xiao
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
| | - Jingnan Lu
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
| | - Qiong Pan
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
| | - Cong Li
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
| | - Baocai Xu
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, China
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Masrie A, Shawel S, Tamire A, Mandefro M, Gebru T, Seboka Ergiba M, Getachew M. Implementation Evaluation of HIV/AIDS Voluntary Counseling and Testing (VCT) Service at Public Health Facilities of Akaki Kality Sub-City, Addis Ababa, Ethiopia. HIV AIDS (Auckl) 2023; 15:503-518. [PMID: 37691691 PMCID: PMC10488598 DOI: 10.2147/hiv.s422516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023] Open
Abstract
Background Voluntary Counseling and Testing (VCT) is widely acknowledged globally as an effective method for preventing and treating HIV/AIDS. It allows people to understand their HIV status, make informed choices about getting tested for it, evaluate their personal risk of contracting HIV, and create plans to reduce that risk. The study aimed to evaluate the process of VCT services in public health facilities of Akaki Kality sub-city, Addis Ababa, Ethiopia. Methods and Materials A case study evaluation design with a mixed method was employed from May 12 to June 12, 2021. A total of 244 clients were interviewed during the study period. Furthermore, 12 direct observations, a review of documents from the past six months to the study period, and 12 key informant interviews were conducted. Quantitative data were entered into Epi data 4.6 and exported to SPSS version 25 for analysis. Univariate analysis was done and presented in tables and texts. Qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall service implementation process was measured on the basis of pre-determined judgmental criteria. Results The overall level of VCT service implementation was 83.84%, to which the availability of resources (84.8%), compliance of service providers with the national guidelines (85.38%), and client satisfaction (76.93%) contributed. One facility had stock-outs of test kits in the last three months, and all VCT counseling and testing rooms lacked audio-visual privacy. Supportive supervision, the use of IEC materials during counseling, linking all HIV-positive clients to treatment and care services, and sending complete reports were practiced in a way that needs some improvement. Conclusion Overall, the service implementation was deemed satisfactory, but further action is required to improve resource availability, ensure provider compliance with national guidelines, and enhance the status of the service. In addition, the Woreda Health Office and Addis Abeba Health Bureau should regularly supervise and provide feedback.
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Affiliation(s)
- Awoke Masrie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Samrawit Shawel
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Aklilu Tamire
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Miheret Mandefro
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilaye Gebru
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Meskerem Seboka Ergiba
- Department of Health Policy and Management, Public Health Faculty, Institute of Health Jimma University, Jimma, Oromia, Ethiopia
| | - Muluneh Getachew
- Department of Health Policy and Management, Public Health Faculty, Institute of Health Jimma University, Jimma, Oromia, Ethiopia
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29
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Balharith M, Alghalyini B, Al-Mansour K, Tantawy MH, Alonezi MA, Almasud A, Zaidi ARZ. Physical accessibility, availability, financial affordability, and acceptability of mobile health clinics in remote areas of Saudi Arabia. J Family Med Prim Care 2023; 12:1947-1956. [PMID: 38024907 PMCID: PMC10657046 DOI: 10.4103/jfmpc.jfmpc_567_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/04/2023] [Accepted: 06/01/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Access to primary healthcare (PHC) services is a significant concern, especially for those living in remote areas. Mobile health clinics (MHCs) are a model widely used to enhance access to healthcare in rural areas. In Saudi Arabia, the Ministry of Health has launched mobile clinics to facilitate access to PHC and increase access to healthcare. This study aims to assess the accessibility of MHCs in rural areas of Saudi Arabia measuring four dimensions of access from the patient's perspective: physical accessibility, availability, financial affordability, and acceptability. Methods A quantitative cross-sectional survey in the form of an interviewer-administered questionnaire was performed on patients who attended mobile clinics between August and October 2020. All these people have been targeted to be interviewed as a nonprobability sample. Data was collected through a survey filled out by the interviewer. Results Five hundred participants were interviewed in nine mobile clinics in the nine cities of the Kingdom. The majority were men (82.4%) and from Makkah city (13.6%) and 94.2% of the participants were Saudi nationals. In total, 98.3% of the respondents were satisfied with the overall mobile clinic services and 11.4% of the participants had difficulties with the mobile clinics' work schedules. There was a positive correlation between access to mobile clinics and satisfaction. Conclusions The mobile clinics in rural and remote areas in Saudi Arabia during the study period were accessible to the respondents and met patient satisfaction. Most participants accept the work schedule for mobile clinics. However, it requires further improvements to meet all access dimensions of the study.
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Affiliation(s)
- Manea Balharith
- Family and Community Medicine Department, Alfaisal University, Riyadh, Saudi Arabia
| | - Baraa Alghalyini
- Family and Community Medicine Department, Alfaisal University, Riyadh, Saudi Arabia
| | - Khalid Al-Mansour
- Department of Social Studies, College of Arts, King Saud University, Riyadh, Saudi Arabia
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30
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Aregay A, O'Connor M, Stow J, Ayers N, Lee S. Perceptions of Barriers to Using Opioid Analgesics: A Mixed Methods Study. Palliat Med Rep 2023; 4:249-256. [PMID: 37771937 PMCID: PMC10523405 DOI: 10.1089/pmr.2023.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 09/30/2023] Open
Abstract
Background Availability and accessibility of opioids are a worldwide problem. In low-resource settings, such as Ethiopia, access to opioids is either limited or nonexistent and legally restricted in health care settings. This study aimed to identify barriers for the availability and accessibility of opioids in Ethiopian rural and regional health care settings. Methods A mixed-method case study design was used. A total of 220 nurses from primary, secondary, and tertiary health care settings were invited to participate in a survey of knowledge and practice. For the qualitative interview, 38 participants were recruited from educational facilities, health services, and the community across a region. Results Barriers in availability and accessibility of opioid analgesics were expressing pain considered as a sign of weakness, lack of knowledge, side effect concerns about prescribing morphine, only doctors being authorized to prescribe morphine, lack of foreign currency to import morphine ingredients, and inequity in accessing morphine in hospitals and none in rural health care settings. Conclusion The findings of this study indicate that opioids, particularly morphine, were not consistently available and accessible to all patients in need. Health professionals lacked knowledge about opioids. Strengthening the existing pain-free initiatives and improving the type, dose, and supply of morphine could help reduce needless suffering and enhance access to essential pain medicines for those in need.
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Affiliation(s)
- Atsede Aregay
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
- School of Nursing, Mekelle University, Tigray, Ethiopia
| | - Margaret O'Connor
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- Department of Palliative Care, Melbourne City Mission Palliative Care, Melbourne, Victoria, Australia
| | - Jill Stow
- Department of Perioperative Medicine, St Vincent's Private Hospital, Melbourne, Victoria, Australia
| | - Nicola Ayers
- School of Nursing, BPP University, London, United Kingdom
| | - Susan Lee
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
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Paganini S, Meier E, Terhorst Y, Wurst R, Hohberg V, Schultchen D, Strahler J, Wursthorn M, Baumeister H, Messner EM. Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics. JMIR Mhealth Uhealth 2023; 11:e42415. [PMID: 37642999 PMCID: PMC10498318 DOI: 10.2196/42415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/06/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Chronic stress poses risks for physical and mental well-being. Stress management interventions have been shown to be effective, and stress management apps (SMAs) might help to transfer strategies into everyday life. OBJECTIVE This review aims to provide a comprehensive overview of the quality and characteristics of SMAs to give potential users or health professionals a guideline when searching for SMAs in common app stores. METHODS SMAs were identified with a systematic search in the European Google Play Store and Apple App Store. SMAs were screened and checked according to the inclusion criteria. General characteristics and quality were assessed by 2 independent raters using the German Mobile Application Rating Scale (MARS-G). The MARS-G assesses quality (range 1 to 5) on the following four dimensions: (1) engagement, (2) functionality, (3) esthetics, and (4) information. In addition, the theory-based stress management strategies, evidence base, long-term availability, and common characteristics of the 5 top-rated SMAs were assessed and derived. RESULTS Of 2044 identified apps, 121 SMAs were included. Frequently implemented strategies (also in the 5 top-rated SMAs) were psychoeducation, breathing, and mindfulness, as well as the use of monitoring and reminder functions. Of the 121 SMAs, 111 (91.7%) provided a privacy policy, but only 44 (36.4%) required an active confirmation of informed consent. Data sharing with third parties was disclosed in only 14.0% (17/121) of the SMAs. The average quality of the included apps was above the cutoff score of 3.5 (mean 3.59, SD 0.50). The MARS-G dimensions yielded values above this cutoff score (functionality: mean 4.14, SD 0.47; esthetics: mean 3.76, SD 0.73) and below this score (information: mean 3.42, SD 0.46; engagement: mean 3.05, SD 0.78). Most theory-based stress management strategies were regenerative stress management strategies. The evidence base for 9.1% (11/121) of the SMAs could be identified, indicating significant group differences in several variables (eg, stress or depressive symptoms) in favor of SMAs. Moreover, 38.0% (46/121) of the SMAs were no longer available after a 2-year period. CONCLUSIONS The moderate information quality, scarce evidence base, constraints in data privacy and security features, and high volatility of SMAs pose challenges for users, health professionals, and researchers. However, owing to the scalability of SMAs and the few but promising results regarding their effectiveness, they have a high potential to reach and help a broad audience. For a holistic stress management approach, SMAs could benefit from a broader repertoire of strategies, such as more instrumental and mental stress management strategies. The common characteristics of SMAs with top-rated quality can be used as guidance for potential users and health professionals, but owing to the high volatility of SMAs, enhanced evaluation frameworks are needed.
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Affiliation(s)
- Sarah Paganini
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Evelyn Meier
- University of Education Freiburg, Freiburg, Germany
| | - Yannik Terhorst
- Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Ramona Wurst
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Vivien Hohberg
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Dana Schultchen
- Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - Jana Strahler
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Max Wursthorn
- Department of Public and Nonprofit Management, University of Freiburg, Freiburg, Germany
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Chungchunlam SMS, Moughan PJ. Comparative bio availability of vitamins in human foods sourced from animals and plants. Crit Rev Food Sci Nutr 2023:1-36. [PMID: 37522617 DOI: 10.1080/10408398.2023.2241541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Vitamins are essential components of enzyme systems involved in normal growth and function. The quantitative estimation of the proportion of dietary vitamins, that is in a form available for utilization by the human body, is limited and fragmentary. This review provides the current state of knowledge on the bioavailability of thirteen vitamins and choline, to evaluate whether there are differences in vitamin bioavailability when human foods are sourced from animals or plants. The bioavailability of naturally occurring choline, vitamin D, vitamin E, and vitamin K in food awaits further studies. Animal-sourced foods are the almost exclusive natural sources of dietary vitamin B-12 (65% bioavailable) and preformed vitamin A retinol (74% bioavailable), and contain highly bioavailable biotin (89%), folate (67%), niacin (67%), pantothenic acid (80%), riboflavin (61%), thiamin (82%), and vitamin B-6 (83%). Plant-based foods are the main natural sources of vitamin C (76% bioavailable), provitamin A carotenoid β-carotene (15.6% bioavailable), riboflavin (65% bioavailable), thiamin (81% bioavailable), and vitamin K (16.5% bioavailable). The overview of studies showed that in general, vitamins in foods originating from animals are more bioavailable than vitamins in foods sourced from plants.
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Affiliation(s)
| | - Paul J Moughan
- Riddet Institute, Massey University, Palmerston North, New Zealand
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Sánchez DIR, Vogler S. Shortages of Medicines to Treat COVID-19 Symptoms during the First Wave and Fourth Wave: Analysis of Notifications Reported to Registers in Austria, Italy, and Spain. Pharmacy (Basel) 2023; 11:120. [PMID: 37489351 PMCID: PMC10366777 DOI: 10.3390/pharmacy11040120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
The study aimed to investigate medicine shortages of critical relevance in the pandemic. A total of 487 active substances for the treatment of COVID-19-related symptoms and therapeutically similar medicines were reviewed as to whether or not a shortage had been notified in Austria, Italy, and Spain for February 2020, March 2020, April 2020 (first wave of the pandemic), and, in comparison, in November 2021 (fourth wave). Publicly accessible shortage registers managed by the national regulatory authorities were consulted. For 48 active substances, a shortage was notified for at least one of the study months, mostly March and April 2020. Out of these 48 active substances, 30 had been explicitly recommended as COVID-19 therapy options. A total of 71% of the active substances with notified shortage concerned medicines labeled as essential by the World Health Organization. During the first wave, Spain and Italy had higher numbers of shortage notifications for the product sample, in terms of active substances as well as medicine presentations, than Austria. In November 2021, the number of shortage notifications for the studied substances reached lower levels in Austria and Spain. The study showed an increase in shortage notifications for COVID-19-relevant medicines in the first months of the pandemic.
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Affiliation(s)
| | - Sabine Vogler
- WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Gesundheit Österreich (GÖG/Austrian National Public Health Institute), 1010 Vienna, Austria
- Department of Health Care Management, Technische Universität Berlin, 10623 Berlin, Germany
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Zhang S, Ding R, Chen S, Meng X, Jianchao L, Wang DW, Hu D. Availability and trend of dissemination of cardiac rehabilitation in China: report from the multicenter national registration platform between 2012 and 2021. Front Cardiovasc Med 2023; 10:1210068. [PMID: 37404729 PMCID: PMC10315840 DOI: 10.3389/fcvm.2023.1210068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
The study aimed to evaluate the current status of cardiac rehabilitation programs in China by registering and tracking patients undergoing CR programs in the database. Data were extracted from the online registry platform of the China Society of Cardiopulmonary Prevention and Rehabilitation from February 2012 to December 2021. Overall, data on 19,896 patients with cardiovascular diseases (CVDs) from 159 hospitals in 34 provinces of China were extracted. From a time point of view, the number of patients who had undergone CR and institutions that perform CR showed the first decline in 2009 and then increased until 2021. From a geographic point of view, the degree of participation varied greatly among regions, most of which were concentrated in eastern parts of China. A higher population of patients who underwent CR were male, aged less than 60 years, with low-a risk for coronary heart disease (CHD), and tended to choose the hospital-based CR program among all cases registered in the database. The top three diseases in the patients who participated in CR were CHD, hypertension, and metabolic syndrome (MS). Centers with CR were more likely to be tertiary-level hospitals. After adjusting for baseline values, there were significant differences in post-CR exercise capacity among the three groups (home-based CR group, hospital-based CR group, and hybrid CR group), which were in favor of the hybrid CR group compared with other groups. The underutilization of CR is a global issue, not just in China. Despite the number of CR programs showing an increasing trend in the past years, CR in China is still in the preliminary stage of development. Furthermore, the participation of CR in China shows wide diversity across geography, disease, age, sex, risk stratification, and hospital-level factors. These findings reinforce the importance of the implementation of effective measures to improve the participation, enrollment in, and uptake of cardiac rehabilitation.
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Affiliation(s)
- Sisi Zhang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongjing Ding
- Department of Rehabilitation, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Sikun Chen
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Xiaoping Meng
- Department of Cardiology and Cardiac Rehabilitation, The Affiliated Hospital of Traditional Chinese Medicine, Changchun, China
| | - Li Jianchao
- School of Engineering Medicine, Beijing Advanced Innovation for Biomedical Engineering, Beihang University, Beijing, China
| | - Dao Wen Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dayi Hu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Yenet A, Nibret G, Tegegne BA. Challenges to the Availability and Affordability of Essential Medicines in African Countries: A Scoping Review. Clinicoecon Outcomes Res 2023; 15:443-458. [PMID: 37332489 PMCID: PMC10276598 DOI: 10.2147/ceor.s413546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction The availability and affordability of safe, effective, accessible, and high-quality essential medicines is a critical benchmark for achieving the right to good health, and it is also one of the goals of the global health development agenda. To that end, it is critical to conduct rigorous studies to identify the major challenges confronting developing countries, particularly those in Africa. Objective The purpose of this review was to identify the major challenges that Africans face in obtaining reasonably priced and readily available essential medicines. Methods Generally the Boolean operators "AND" and "OR" were employed. Making progress also involves using duplicate checks, field definitions, and comparisons of articles and criteria. The analysis included all English-language papers published in any African country between 2005 and 2022, depending on the year of publication. The technique searches electronic databases for key phrases related to essential medication availability and affordability, such as PubMed, Web of Science, Scopus, Science Direct, Plos Medicine, and Google Scholar. Results A total of 91 articles; by using search engines and handpicking including duplicates, were primarily searched. The electronic database search earned 78 articles while only eleven studies met the criteria for review and were reviewed of which 5 (50%) were from East African countries. Inadequate human resources, financial constraints, high cost of available medications on the market, poor inventory management, manual consumption forecasting, inefficiencies in drug registration, and trade-related aspects of intellectual property rights agreement regulations are all obstacles to the availability of essential medicines in African nations. Conclusion This review revealed that in Africa, the availability and affordability of essential medicines face numerous challenges. The primary challenge, according to the review research, is a lack of adequate financing to pay for an appropriate set of essential medications, which account for a significant portion of household spending.
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Affiliation(s)
- Aderaw Yenet
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getinet Nibret
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Bantayehu Addis Tegegne
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Umanath S, Barrett TE, Kim S, Walsh CA, Coane JH. Older adults recover more marginal knowledge and use feedback more effectively than younger adults: evidence using "I don't know" vs. "I don't remember" for general knowledge questions. Front Psychol 2023; 14:1145278. [PMID: 37325736 PMCID: PMC10264585 DOI: 10.3389/fpsyg.2023.1145278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/02/2023] [Indexed: 06/17/2023] Open
Abstract
Through three experiments, we examined older and younger adults' metacognitive ability to distinguish between what is not stored in the knowledge base versus merely inaccessible. Difficult materials were selected to test this ability when retrieval failures were very frequent. Of particular interest was the influence of feedback (and lack thereof) in potential new learning and recovery of marginal knowledge across age groups. Participants answered short-answer general knowledge questions, responding "I do not know" (DK) or "I do not remember" (DR) when retrieval failed. After DKs, performance on a subsequent multiple-choice (Exp. 1) and short-answer test following correct-answer feedback (Exp. 2) was lower than after DRs, supporting self-reported not remembering reflects failures of accessibility whereas not knowing captures a lack of availability. Yet, older adults showed a tendency to answer more DK questions correctly on the final tests than younger adults. Experiment 3 was a replication and extension of Experiment 2 including two groups of online participants in which one group was not provided correct answer feedback during the initial short-answer test. This allowed us to examine the degree to which any new learning and recovery of access to marginal knowledge was occurring across the age groups. Together, the findings indicate that (1) metacognitive awareness regarding underlying causes of retrieval failures is maintained across different distributions of knowledge accessibility, (2) older adults use correct answer feedback more effectively than younger adults, and (3) in the absence of feedback, older adults spontaneously recover marginal knowledge.
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Affiliation(s)
- Sharda Umanath
- Department of Psychological Science, Claremont McKenna College, Claremont, CA, United States
| | - Talia E. Barrett
- Department of Psychology, Colby College, Waterville, ME, United States
| | - Stacy Kim
- Department of Psychology, Colby College, Waterville, ME, United States
| | - Cole A. Walsh
- Department of Psychology, Colby College, Waterville, ME, United States
| | - Jennifer H. Coane
- Department of Psychology, Colby College, Waterville, ME, United States
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Ma Y, Peng J, Yao X, Feng L, Shi X, Jiang M. Access to anticancer medicines in public hospitals of Northwestern China. Front Public Health 2023; 11:1182617. [PMID: 37275477 PMCID: PMC10235455 DOI: 10.3389/fpubh.2023.1182617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
Objective We aimed to evaluate the accessibility of anticancer medicines in public hospitals of Shaanxi, a representative province of Northwestern China. Methods Thirty-one anticancer medicines were investigated in 146 designated public hospitals in 10 cities of Shaanxi Province. We used medicine procurement data from the Shaanxi Drug Centralized Purchasing Platform during 2019-2021. Primary outcomes included the availability, drug utilization, and affordability of anticancer medicines. Results The mean availability of 31 anticancer medicines increased significantly from 5.45% in 2019 to 14.72% in 2021. The mean availability of nationally negotiated medicines was significantly lower than that of Class B medicines (8.72% vs. 12.85%, p = 0.048), whilst the availability of injectable medicines was significantly greater than that of oral medicines (13.66% vs. 8.77%, p = 0.007). In 2019-2021, the annual mean amount purchased increased significantly from CNY 6.51 million to CNY 18.56 million (p = 0.007). The mean defined daily doses of 31 medicines significantly rose from 225.50 to 1019.50 (p = 0.008) whereas their defined daily drug cost significantly decreased from CNY 551.15 to CNY 404.50 (p < 0.001). The percentage of catastrophic health expenditure decreased from 71.0 to 51.65% and from 90.30 to 80.60% for urban and rural residents, respectively. The affordability of nationally negotiated medicines was significantly lower than that of Class B medicines (p = 0.032), and the affordability of injectable medicines had no significant difference compared to that of oral medicines (p = 0.124) for both urban and rural residents. Conclusion The accessibility of anticancer medicines improved dramatically in public hospitals of Northwestern China during the period 2019-2021.
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Affiliation(s)
- Yue Ma
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
| | - Jin Peng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
| | - Xuelin Yao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
| | - Liuxin Feng
- Department of Pharmacy, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xinke Shi
- Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
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Gobiņa I, Isajeva L, Spriņģe L, Vrobļevska E, Pelne A, Mārtiņsone U, Lange S. A narrative review of alcohol control policies in Latvia between 1990 and 2020. Drug Alcohol Rev 2023; 42:946-959. [PMID: 36974381 PMCID: PMC10897783 DOI: 10.1111/dar.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/29/2023]
Abstract
ISSUES Latvia has one of the highest alcohol per capita consumption in Europe. This study provides a narrative review of all evidence-based population-level alcohol control policies implemented in Latvia during the past 30 years. APPROACH A review of country-level alcohol control policies implemented in Latvia between 1990 and 2020 was conducted. The World Health Organization's "best buys" and other recommended interventions for alcohol control were used to guide the search. KEY FINDINGS Alcohol control policies in Latvia have evolved significantly over the last three decades. The most changes to alcohol control policy occurred in the transitional period between regaining independence in 1991 and joining the European Union in 2004. A number of significant alcohol control policies have been implemented to reduce alcohol availability and affordability, to restrict alcohol marketing and to counter drunk-driving. However, since 2010, when an increasing trend of alcohol consumption was observed, there has been a reluctance to pursue national public health policy actions to reduce alcohol consumption, and few adjustments to legislation to increase alcohol control have been made. IMPLICATIONS Despite the progress in alcohol control, Latvia still has considerable potential for strengthening alcohol control to reduce the high levels of alcohol consumption. CONCLUSION Although several alcohol control policies have been established in Latvia, many of the planned activities to limit alcohol intake and related harm have not been executed. Public health goals rather than political and economic incentives should be prioritised to reduce high levels of alcohol consumption in Latvia.
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Affiliation(s)
- Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Laura Isajeva
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
| | - Lauma Spriņģe
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
| | - Elīna Vrobļevska
- Department of Political Science, Riga Stradiņš University, Riga, Latvia
| | - Aija Pelne
- Addiction Monitoring Unit, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - Una Mārtiņsone
- Addiction Monitoring Unit, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Tejesh S, Sj N. An Assessment of the Availability of Essential Medicines in Gadag Taluk, Karnataka: A Study of Primary Health Centers. Cureus 2023; 15:e39341. [PMID: 37378139 PMCID: PMC10292169 DOI: 10.7759/cureus.39341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Background Essential medicines are those that meet the priority healthcare needs of most of the population and are included in the 2030 Agenda for Sustainable Development. The national list of essential medicines should be tailored to the specific needs of each nation and should always be accessible at reasonable prices and with guaranteed quality. Methods A cross-sectional study was done to assess the availability of essential medicines in primary health centers (PHCs) in Gadag Taluk. The data for the assessment of availability was collected using a checklist, which was prepared after reviewing the Karnataka list of essential medicines, surgical items, and miscellaneous items from 2021 to 2022 for PHCs. The sampling design was a universal sample of all 15 PHCs, as per health management information system data, to assess the availability of essential medicine in PHCs. Results Results indicate that the availability of essential medicines in 15 PHCs in Gadag Taluk is 74.20%. The availability of anti-allergic drugs and drugs used in anaphylaxis was around 88%, whereas the availability of antidiabetic drugs and non-steroidal anti-inflammatory drugs was 86.88% and 86.66%, respectively. All other categories of drugs are available above 50%, except ophthalmic and ear, nose, and throat drugs. Conclusion The public sector should be strengthened by making sure that patients have access to free essential medicines and that essential medications are always available. This would help patients spend less money out of their own pockets and move India closer to achieving universal healthcare.
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Affiliation(s)
- S Tejesh
- School of Environmental Science, Public Health and Sanitation Management, Karnataka State Rural Development and Panchayat Raj University, Gadag, IND
| | - Nagaveni Sj
- School of Environmental Science, Public Health and Sanitation Management, Karnataka State Rural Development and Panchayat Raj University, Gadag, IND
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Zhang M, Zou K, Liu Z, Liu D, Wang X, Shi Y, Chen Z, Cheng X, Lang B, Li H, Zeng L, Tang Y, Zhao S, Jiang Y, Choonara I, Zhang L. Availability of essential medicines, progress and regional distribution in China: a systematic review and meta-analysis. Front Public Health 2023; 11:1149838. [PMID: 37181691 PMCID: PMC10167309 DOI: 10.3389/fpubh.2023.1149838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/06/2023] [Indexed: 05/16/2023] Open
Abstract
Background Essential medicines are the backbone of healthcare and meet the priority healthcare needs of the population. However, approximately one-third of the global population does not have access to essential medicines. Although China formulated essential medicine policies in 2009, the progress of availability of essential medicines and regional variations remains unknown. Therefore, this study was conducted to evaluate the availability of essential medicines, their progress, and regional distribution in China in the last decade. Methods We searched eight databases from their inception to February 2022, relevant websites, and reference lists of included studies. Two reviewers selected studies, extracted data, and evaluated the risk of bias independently. Meta-analyses were performed to quantify the availability of essential medicines, their progress, and regional distribution. Results Overall 36 cross-sectional studies conducted from 2009 to 2019 were included, with regional data for 14 provinces. The availability of essential medicines in 2015-2019 [28.1%, 95% confidence interval (CI): 26.4-29.9%] was similar to that in 2009-2014 (29.4%, 95% CI: 27.5-31.3%); lower in the Western region (19.8%, 95% CI: 18.1-21.5%) than Eastern (33.8%, 95% CI: 31.6-36.1%) and Central region (34.5%, 95% CI: 30.6-38.5%); very low for 8 Anatomical Therapeutic Chemical (ATC) categories (57.1%), and low for 5 categories (35.7%) among all ATC groups. Conclusion The availability of essential medicines in China is low compared with the World Health Organization goal, has not changed much in the last decade, is unequal across regions, and lacks data for half of provinces. For policy-making, the monitoring system of the availability of essential medicines is to be strengthened to enable long-term surveillance, especially in provinces where the data has been missing. Meanwhile, Joint efforts from all stakeholders are warranted to improve the availability of essential medicines in China toward the universal health coverage target. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=315267, identifier: PROSPERO CRD42022315267.
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Affiliation(s)
- Miao Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Kun Zou
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Zheng Liu
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Dan Liu
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Xiuli Wang
- Healthcare Evaluation and Organizational Analysis (HEOA) Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuqing Shi
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Zhe Chen
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Xiao Cheng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Bingchen Lang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Hailong Li
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Linan Zeng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Yong Tang
- School of Economics, Sichuan University, Chengdu, China
| | - Shaoyang Zhao
- School of Economics, Sichuan University, Chengdu, China
| | - Yongmu Jiang
- School of Economics, Sichuan University, Chengdu, China
| | - Imti Choonara
- Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Derby, United Kingdom
| | - Lingli Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- National Medical Products Administration (NMPA) Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Pulungan AB, de Beaufort C, Ratnasari AF, Puteri HA, Lewis-Watts L, Bhutta ZA. Availability and access to pediatric diabetes care: a global descriptive study. Clin Pediatr Endocrinol 2023; 32:137-146. [PMID: 37362165 PMCID: PMC10288289 DOI: 10.1297/cpe.2023-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 03/27/2023] [Indexed: 06/28/2023] Open
Abstract
A decade since the discovery of insulin, the increasing prevalence of type 1 diabetes mellitus (T1DM) has underscored the prevailing inequalities in the provision of essential care for T1DM worldwide. However, the details on the availability of insulin types and associated medical devices remain unclear. A cross-sectional electronic survey was distributed across a global network of pediatric societies under the umbrella of the International Pediatric Association (IPA). Access to and availability of pediatric diabetes care were investigated using standardized questions. Responses from 25 of 132 pediatric societies across six regions were included. Pediatric endocrinologists typically manage T1DM together with pediatricians or adult endocrinologists. Nonetheless, 24% of the respondents reported pediatricians to be the sole healthcare professionals. According to the respondents, the patients were either partially or completely responsible for payments of insulin (40%), A1C (24%), C-peptide (28%), and antibody testing for diagnosis (28%). Government support is generally available for insulin, but this was merely 20% for insulin pumps and 12% for continuous glucose monitors. There are considerable disparities in the access, availability, and affordability of diabetes testing, medications, and support between countries with significant out-of-pocket payments for care. Country- and region-specific improvements to national programs are necessary to achieve optimal pediatric diabetes care globally.
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Affiliation(s)
- Aman B Pulungan
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- International Pediatric Association (IPA)
- NCD Child
- International Society for Pediatric and Adolescent Diabetes (ISPAD)
| | - Carine de Beaufort
- International Society for Pediatric and Adolescent Diabetes (ISPAD)
- Diabetes & Endocrine Care Clinique Pe ´diatrique (DECCP), Clinique Pédiatrique/Centre Hospitalier (CH) de Luxembourg, Luxembourg, Luxembourg
- Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-Belval, Luxembourg
| | | | - Helena A Puteri
- Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Laura Lewis-Watts
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- International Pediatric Association (IPA)
- NCD Child
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
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42
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Auclair J, Turcotte P, Gagnon C, Peyrot C, Wilkinson KJ, Gagné F. Form-Dependent Toxicity of Silver Nanomaterials in Rainbow Trout Gills. Nanomaterials (Basel) 2023; 13:1356. [PMID: 37110941 PMCID: PMC10142066 DOI: 10.3390/nano13081356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
The toxicity of the form of nanoparticles is presently not well understood. The purpose of this study consists in comparing the toxicity of various forms of silver nanoparticles (nAg) in juvenile rainbow trout Oncorhynchus mykiss. Juveniles were exposed to various forms of polyvinyl-coated nAg of similar size for 96 h at 15 °C. After the exposure period, the gills were isolated and analyzed for Ag uptake/distribution, oxidative stress, glucose metabolism, and genotoxicity. Higher levels of Ag were detected in gills in fish exposed to dissolved Ag followed by spherical, cubic, and prismatic nAg. Size-exclusion chromatography of gill fractions revealed that the dissolution of nAg was observed for all forms of nAg where prismatic nAg released more important levels of Ag in the protein pool as in fish exposed to dissolved Ag as well. The aggregation of nAg was more important for cubic nAg in respect of the other forms of nAg. The data revealed that lipid peroxidation was closely associated with protein aggregation and viscosity. Biomarkers revealed changes in lipid/oxidative stress and genotoxicity, which were related to the loss of protein aggregation and inflammation (NO2 levels), respectively. In general, the observed effects were found for all forms of nAg where the effects from prismatic nAg were generally higher than for spherical and cubic nAg. The strong relationship between genotoxicity and inflammation response suggests the participation of the immune system in the observed responses of juvenile fish gills.
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Affiliation(s)
- Joëlle Auclair
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Montreal, QC H2Y 2E7, Canada; (J.A.)
| | - Patrice Turcotte
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Montreal, QC H2Y 2E7, Canada; (J.A.)
| | - Christian Gagnon
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Montreal, QC H2Y 2E7, Canada; (J.A.)
| | - Caroline Peyrot
- Chemistry Department, Montréal University, Montreal, QC H3C 3J7, Canada
| | | | - François Gagné
- Aquatic Contaminants Research Division, Environment and Climate Change Canada, Montreal, QC H2Y 2E7, Canada; (J.A.)
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Denberu BF, Belina M, Demissie M, Abera N, Medhin G, Teklu AM, Kelemu M, Alemayehu YK. The Quality of Logistics Management Information System and the Availability of Tracer Drugs at Health Posts in Rural Ethiopia: A Mixed-Method Study. Ethiop J Health Sci 2023; 33:25-36. [PMID: 38362470 PMCID: PMC10866295 DOI: 10.4314/ejhs.v33i1.4s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 01/24/2023] [Indexed: 02/17/2024] Open
Abstract
Background Proper implementation of the logistics management information system (LMIS) would facilitate access to essential pharmaceutical products. It also prevents wastage at health posts. The aim of this study was to assess the implementation of the LMIS and the availability of tracer drugs at health posts in rural Ethiopia. Methods We employed a cross-sectional descriptive design with a mixed-method approach. The data used for this paper was collected from March to May 2019 as part of the National HEP assessment. The study involved 343 health posts randomly selected from nine regions of Ethiopia. Women's Development Army members and household heads participated in the qualitative study (i.e. in FGD and KII). The quantitative data were exported from Open Data Kit (ODK) to Stata 15.1 for statistical analysis, and the qualitative data were entered into NVivo 12 and analyzed using thematic content analysis. Results Of the health posts, 59.4% had a space for storing drugs; less than half (41.9%; 95% confidence interval (CI) [36%, 48%]) had a functioning refrigerator. The mean percentage of the availability of selected tracer drugs at health posts was 59.6%, with a 95% CI (58.9%, 60.3%). Bin cards were available at 43% (95% CI [40%, 46%]) of health posts, and among these, only 27.5% of the health posts adequately used the bin cards. Conclusion The absence and poor use of LMIS tools was observed at health posts. Proper implementation of the LMIS has the potential to improve the availability of essential drugs that, in turn, improve health post level delivery of health services.
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Affiliation(s)
| | - Merga Belina
- Addis Ababa University, Department of Statistics
| | - Mekdes Demissie
- Centre for Innovative Drug Development and Therapeutic Studies for Africa (CDT-Africa), College of Health Science, Addis Ababa University
- College of Health and Medical Sciences, Haramaya University, Ethiopia
| | | | - Girmay Medhin
- MERQ Consultancy PLC, Addis Ababa, Ethiopia
- Addis Ababa University, Aklilu Lemma Institute of Pathobiology
| | | | - Melody Kelemu
- International Institute for Primary Health Care-Ethiopia (IIfPHC-E)
| | - Yibeltal Kiflie Alemayehu
- MERQ Consultancy PLC, Addis Ababa, Ethiopia
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
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Shi Y, Zhang L, Fu J, Shao R, Yan J. An Analysis of Accessibility of Representative Psychotropic Medicine From the World Health Organization Model List of Essential Medicines in Developing Countries With Different Income Levels. Value Health 2023; 26:528-535. [PMID: 36442833 DOI: 10.1016/j.jval.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/30/2022] [Accepted: 11/16/2022] [Indexed: 05/06/2023]
Abstract
OBJECTIVES The objective of this study was to analyze the accessibility of psychotropic medicine in developing countries based on the availability, price, and affordability indicators to create international evidence to guide the development of policies on the accessibility of medicines. METHODS This study included 5 types of psychotropic medicines listed in the 22nd edition of the World Health Organization Model List of Essential Medicines published by the World Health Organization in 2021. Derived from 84 surveys in 59 countries, this study summarizes the availability, price, and affordability of originator branded drugs (OBs) and lowest-price generic drugs (LPGs) in the public and private sectors and compares them based on income levels in different countries. RESULTS The average availability of psychotropic medicine was 45% in low- and lower-middle-income countries (LLMICs) compared with 49% in high- and upper-middle-income countries (HUMICs) whereas the availability of LPGs was higher than that of OBs in all country groups. The average patient price for OBs and LPGs was 94.0 and 23.2, respectively, and the overall patient price of psychotropic medicine in LLMICs was higher than that in HUMICs. The affordability of psychotropic medicine in LLMICs was lower than that in HUMICs. CONCLUSIONS Psychotropic medicines in lower-middle-income countries have lower availability, a higher average patient price, and lower average affordability than in HUMICs, which requires lower-middle-income countries to take effective and various measures to improve the accessibility of psychotropic medicine.
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Affiliation(s)
- Yangfan Shi
- School of International Business, China Pharmaceutical University, Nanjing, Jiangsu, People's Republic of China; The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing, Jiangsu, People's Republic of China
| | - Lingli Zhang
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Jianan Fu
- School of International Business, China Pharmaceutical University, Nanjing, Jiangsu, People's Republic of China; The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing, Jiangsu, People's Republic of China
| | - Rong Shao
- School of International Business, China Pharmaceutical University, Nanjing, Jiangsu, People's Republic of China; The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing, Jiangsu, People's Republic of China
| | - Jianzhou Yan
- School of International Business, China Pharmaceutical University, Nanjing, Jiangsu, People's Republic of China; The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing, Jiangsu, People's Republic of China.
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45
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Schindler RM, Isaac MS, Dolansky E, Adams GC. Anxiety, Cognitive Availability, and the Talisman Effect of Insurance. Pers Soc Psychol Bull 2023; 49:642-656. [PMID: 35227122 DOI: 10.1177/01461672221077791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Across four experiments (N = 1,923), this research provides converging evidence of a talisman effect of insurance-consumers who have an insurance policy feel that the covered mishap is less likely to occur. Although such an effect has previously been proposed, empirical evidence for it is limited, in part because the talisman effect has often been conflated with a related but distinct magical-thinking phenomenon, the tempting-fate effect. By disentangling these two effects, we are better able to isolate the talisman effect and show that it is a robust phenomenon in its own right. We also provide support for a mechanism underlying the talisman effect: Insurance reduces anxiety and repetitious thoughts related to the mishap; with fewer thoughts about the mishap, its cognitive availability is lower and so it seems less likely to occur.
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Affiliation(s)
| | | | | | - Grant C Adams
- Faulkner Automotive Group, Feasterville-Trevose, PA, USA
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46
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Wang R, Li Y, Yu J, Zhou J, Yu F, Zhang YY, Jiang YL. [ Availability of Se-rich Arable Land in High Geological Background Area and Suggestions for Zoning]. Huan Jing Ke Xue 2023; 44:1727-1734. [PMID: 36922233 DOI: 10.13227/j.hjkx.202205159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
In order to promote the results of land quality geochemical surveys to serve the development of characteristic land resources and realize the safe utilization of Se-rich resources in high geological background areas, Wuli Town, Qianjiang District, Chongqing City were taken as the research object to evaluate the Se-rich level and heavy metal content of soil crops and carry out research on Se-rich cultivated area division and the availability method system in the high geological background area, in order to improve the utilization efficiency of Se-rich resources and provide ideas for the safe utilization of Se-rich resources in high geological background areas. The results showed that the soil and crops in the study area were rich in Se and had the potential to develop Se-rich resources, but some samples had the problem of excessive Cd. Soil pH was a key factor affecting the content of Se and Cd in crops, and alkaline conditions were conducive to the safe utilization of Se-rich resources. The areas of Class A-E (A:selenium-enriched arable land, B:crops that were not selenium-enriched but were safe, C:crops that were selenium-enriched but unsafe, D:crops that were not selenium-enriched and unsafe, and E:soil selenium content less than the selenium-enriched threshold and soil heavy metals not exceeding the standard)cultivated land were 0.72, 0.75, 0.28, 0.13, and 0.56 km2, respectively. It is recommended to develop safe and Se-rich resources in the distribution area of Class A cultivated land and to carry out soil acidification conditioning and low-accumulation crops in the distribution area of Class C and D cultivated land; other agronomic measures should be taken to reduce the risk of excessive heavy metals in crops and strengthen the protection of cultivated land in the region to prevent the input of new pollutants.
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Affiliation(s)
- Rui Wang
- Southeast Sichuan Geological Group, Chongqing Bureau of Geology and Minerals Exploration, Chongqing 400038, China.,Chongqing Key Laboratory of Land Quality Geological Survey, Chongqing 400038, China
| | - Yu Li
- Southeast Sichuan Geological Group, Chongqing Bureau of Geology and Minerals Exploration, Chongqing 400038, China.,Chongqing Key Laboratory of Land Quality Geological Survey, Chongqing 400038, China
| | - Jing Yu
- Southeast Sichuan Geological Group, Chongqing Bureau of Geology and Minerals Exploration, Chongqing 400038, China
| | - Jiao Zhou
- Southeast Sichuan Geological Group, Chongqing Bureau of Geology and Minerals Exploration, Chongqing 400038, China.,Chongqing Key Laboratory of Land Quality Geological Survey, Chongqing 400038, China
| | - Fei Yu
- Southeast Sichuan Geological Group, Chongqing Bureau of Geology and Minerals Exploration, Chongqing 400038, China.,Chongqing Key Laboratory of Land Quality Geological Survey, Chongqing 400038, China
| | - Yun-Yi Zhang
- Southeast Sichuan Geological Group, Chongqing Bureau of Geology and Minerals Exploration, Chongqing 400038, China.,Chongqing Key Laboratory of Land Quality Geological Survey, Chongqing 400038, China
| | - Yu-Lian Jiang
- Southeast Sichuan Geological Group, Chongqing Bureau of Geology and Minerals Exploration, Chongqing 400038, China.,Chongqing Key Laboratory of Land Quality Geological Survey, Chongqing 400038, China
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Rehm J, Lange S, Gobiņa I, Janik-Koncewicz K, Miščikienė L, Reile R, Stoppel R, Tran A, Ferreira-Borges C, Jasilionis D, Jiang H, Kim KV, Manthey J, Neufeld M, Petkevičienė J, Radišauskas R, Room R, Liutkutė-Gumarov V, Zatoński WA, Štelemėkas M. Classifying alcohol control policies enacted between 2000 and 2020 in Poland and the Baltic countries to model potential impact. Addiction 2023; 118:449-458. [PMID: 36471145 PMCID: PMC10884981 DOI: 10.1111/add.16102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
AIMS The study's aim is to identify and classify the most important alcohol control policies in the Baltic countries (Estonia, Latvia and Lithuania) and Poland between 2000 and 2020. METHODS Policy analysis of Baltic countries and Poland, predicting potential policy impact on alcohol consumption, all-cause mortality and alcohol-attributable hospitalizations was discussed. RESULTS All Baltic countries implemented stringent availability restrictions on off-premises trading hours and different degrees of taxation increases to reduce the affordability of alcoholic beverages, as well as various degrees of bans on alcohol marketing. In contrast, Poland implemented few excise taxation increases or availability restrictions and, in fact, reduced stipulations on prior marketing bans. CONCLUSIONS This classification of alcohol control policies in the Baltic countries and Poland provides a basis for future modeling of the impact of implementing effective alcohol control policies (Baltic countries), as well as the effects of loosening such policies (Poland).
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Affiliation(s)
- Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Shannon Lange
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Kinga Janik-Koncewicz
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska, Nadarzyn, Poland
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rainer Reile
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department for Epidemiology and Biostatistics, National institute for Health Development, Tallinn, Estonia
| | - Relika Stoppel
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Economics, University of Potsdam, Potsdam, Germany
| | - Alexander Tran
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | | | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany
- Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - Huan Jiang
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kawon Victoria Kim
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Maria Neufeld
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Vaida Liutkutė-Gumarov
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Witold A Zatoński
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska, Nadarzyn, Poland
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Tafere TZ, Aschalew AY, Tsehay CT, Gebremedhin T. Process Evaluation of Facility Delivery Services in Northwest Ethiopia: In the Case of Public Health Centers. Int J Womens Health 2023; 15:235-253. [PMID: 36816457 PMCID: PMC9936882 DOI: 10.2147/ijwh.s388153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/03/2023] [Indexed: 02/15/2023] Open
Abstract
Background Even if giving birth at health facility is vital for both the mothers and their newborns, the coverage of institutional delivery in Ethiopia is very low (50%). In that regard, several studies have shown the possible factors of low delivery service uptake from the patients' side, but evidences on delivery services at the health centers are meagre. This study aimed to evaluate the process of delivery services in public health centers of northwest Ethiopia. Methods A case study evaluation design with an embedded mixed-method was used to evaluate institutional delivery in public health centers of Gondar city. Dimensions from the access (availability, accommodation, and acceptability) and implementation fidelity (compliance) frameworks were used. A total of 363 mothers, 32 document reviews, 32 direct observations, and 17 key informants were included. The qualitative data were transcribed, translated, coded, and analysed using a thematic analysis approach. The overall process of institutional delivery services was measured based on pre-determined judgmental criteria. Results The overall facility delivery process was 75.1%, judged by availability (78.5%), compliance (70.6%), accommodation (68.8%), and acceptability (80.2%) of services. Essential medicines in some of the health centers were stockout, insufficient delivery rooms and inadequate training of health workers on obstetric and newborn care were observed. Using partograph and examining vulval-perineal region for possible laceration during intrapartum period were less practiced. Residence (AOR: 0.13, 95% CI: 0.06-0.30), ANC 1 to 3 visits (AOR: 2.65, 95% CI: 1.05-6.74) and ANC4+ (AOR: 5.57, 95% CI: 2.09, 14.84) were factors affected acceptability of delivery services. Conclusion Major constraints were in the accommodation of delivery services which needs a holistic effort from all stakeholders. Therefore, implementors with other stakeholders shall improve delivery rooms, facilitate training, and provide parenteral drugs as part of the obstetric and newborn care to improve the facility delivery services in Ethiopia.
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Affiliation(s)
- Tesfahun Zemene Tafere
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Correspondence: Tesfahun Zemene Tafere, Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia, Email
| | - Andualem Yalew Aschalew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chalie Tadie Tsehay
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsegaye Gebremedhin
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Horgan D, Hamdi Y, Lal JA, Nyawira T, Meyer S, Kondji D, Francisco NM, De Guzman R, Paul A, Bernard B, Reddy Nallamalla K, Park WY, Triapthi V, Tripathi R, Johns A, Singh MP, Phipps ME, Dube F, Rasheed HMA, Kozaric M, Pinto JA, Doral Stefani S, Aponte Rueda ME, Fujita Alarcon R, Barrera-Saldana HA. Framework for Adoption of Next-Generation Sequencing (NGS) Globally in the Oncology Area. Healthcare (Basel) 2023; 11:healthcare11030431. [PMID: 36767006 PMCID: PMC9914369 DOI: 10.3390/healthcare11030431] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Radical new possibilities of improved treatment of cancer are on offer from an advanced medical technology already demonstrating its significance: next-generation sequencing (NGS). This refined testing provides unprecedentedly precise diagnoses and permits the use of focused and highly personalized treatments. However, across regions globally, many cancer patients will continue to be denied the benefits of NGS as long as some of the yawning gaps in its implementation remain unattended. The challenges at the regional and national levels are linked because putting the solutions into effect is highly dependent on cooperation between regional- and national-level cooperation, which could be hindered by shortfalls in interpretation or understanding. The aim of the paper was to define and explore the necessary conditions for NGS and make recommendations for effective implementation based on extensive exchanges with policy makers and stakeholders. As a result, the European Alliance for Personalised Medicine (EAPM) developed a maturity framework structured around demand-side and supply-side issues to enable interested stakeholders in different countries to self-evaluate according to a common matrix. A questionnaire was designed to identify the current status of NGS implementation, and it was submitted to different experts in different institutions globally. This revealed significant variability in the different aspects of NGS uptake. Within different regions globally, to ensure those conditions are right, this can be improved by linking efforts made at the national level, where patients have needs and where care is delivered, and at the global level, where major policy initiatives in the health field are underway or in preparation, many of which offer direct or indirect pathways for building those conditions. In addition, in a period when consensus is still incomplete and catching up is needed at a political level to ensure rational allocation of resources-even within individual countries-to enable the best ways to make the necessary provisions for NGS, a key recommendation is to examine where closer links between national and regional actions could complement, support, and mutually reinforce efforts to improve the situation for patients.
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Affiliation(s)
- Denis Horgan
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
- Correspondence:
| | - Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
- Laboratory of Human and Experimental Pathology, Institut Pasteur de Tunis, Tunis 1002, Tunisia
| | - Jonathan A. Lal
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
- Department of Genetics and Cell Biology, GROW School of Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Institute for Public Health Genomics, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Teresia Nyawira
- National Commission for Science, Technology and Innovation in Kenya (NACOSTI), Nairobi 00100, Kenya
| | | | - Dominique Kondji
- Health & Development Communication, Building Capacity for Better Health in Africa, Yaounde P.O. Box 2032, Cameroon
| | - Ngiambudulu M. Francisco
- Grupo de Investigação Microbiana e Imunológica, Instituto Nacional de Investigação em Saúde (National Institute for Health Research), Luanda 3635, Angola
| | - Roselle De Guzman
- Oncology and Pain Management Section, Manila Central University—Filemon D. Tanchoco Medical Foundation Hospital, Caloocan 1400, Philippines
| | - Anupriya Paul
- Department of Mathematics and Statistics, Faculty of Science, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Branka Bernard
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
- Mediterranean Institute for Life Sciences, 21000 Split, Croatia
| | | | - Woong-Yang Park
- Samsung Medical Center, Samsung Genome Institute, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Vijay Triapthi
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Ravikant Tripathi
- Department Health Government of India, Ministry of Labor, New Delhi 110001, India
| | - Amber Johns
- Cancer Division, Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney 2010, Australia
| | - Mohan P. Singh
- Center of Biotechnology, University of Allahabad, Allahabad 211002, India
| | - Maude E. Phipps
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | - France Dube
- Precision Medicine and Breast Cancer Department, Astra Zeneca, 1800 Concord Pike, Wilmington, DE 19803, USA
| | | | - Marta Kozaric
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
| | - Joseph A. Pinto
- Center for Basic and Translational Research, Auna Ideas, Lima 15036, Peru
| | | | | | - Ricardo Fujita Alarcon
- Centro de Genética y Biología Molecular, Universidad de San Martín de Porres, Lima 15024, Peru
| | - Hugo A. Barrera-Saldana
- Innbiogem SC/Vitagenesis SA at National Laboratory for Services of Research, Development, and Innovation for the Pharma and Biotech Industries (LANSEIDI) of CONACyT Vitaxentrum Group, Monterrey 64630, Mexico
- Schools of Medicine and Biology, Autonomous University of Nuevo Leon, Monterrey 66451, Mexico
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Jiang H, Tran A, Petkevičienė J, Štelemėkas M, Lange S, Rehm J. Are restrictions in sales hours of alcohol associated with fewer emergency room visits in Lithuania? An interrupted time-series analysis. Drug Alcohol Rev 2023; 42:487-494. [PMID: 36514305 PMCID: PMC9898194 DOI: 10.1111/dar.13584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION On 1 January 2018, an amendment to the alcohol control law was introduced in Lithuania which, among other changes, reduced trading hours for alcoholic beverages by 4 h for weekdays and Saturdays, and by 9 h for Sundays. The objective of the current study was to quantify the potential association of this law with the numbers and types of emergency room (ER) visits in Lithuania, in general and specifically for Sundays, for all ER visits, for injury-related ER visits and specifically for alcohol poisoning as a 100% alcohol-attributable cause. METHODS Sex-stratified time-series analysis-based models for the period 2016-2019 were used to test for associations and for potential alternative explanations (e.g., the increase in minimum legal drinking age, which occurred at the same time). RESULTS Overall, while the reduction in sales hours for both sexes was associated with slight increases in all types and in injury-related ER visits on a weekly basis, the association with ER visits for alcohol poisoning was in the opposite direction for men in all models. Specifically, among men, it was associated with an approximate decrease of 20% of alcohol poisoning-related ER visits on Sundays and an approximate decrease of 12% of alcohol poisoning-related ER visits for all seven weekdays. DISCUSSION AND CONCLUSIONS As predicted, restrictions on availability were associated with marked reductions in ER visits for alcohol poisoning in men. However, contrary to expectations, there were no overall reductions in overall ER visits, nor reductions in injury-related ER visits.
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Affiliation(s)
- Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Dalla Lana School of Public Health, Health Sciences Building, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181 Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181 Kaunas, Lithuania
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181 Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181 Kaunas, Lithuania
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 3M1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T 1R8, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Dalla Lana School of Public Health, Health Sciences Building, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 3M1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T 1R8, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, Ontario, M5S 1A8, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, 81-95 Roc Boronat St., 08005, Barcelona, Spain
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, b. 2, Moscow, 119991, Russian Federation
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