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Sacks, E.; Freeman, P.A.; Sakyi, K.; Jennings, M.C.; Rassekh, B.M.; Gupta, S.; Perry, H.B. |
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Title |
Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 3. neonatal health findings |
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Journal Article |
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Year |
2017 |
Publication  |
Journal of Global Health |
Abbreviated Journal |
J Glob Health |
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Volume |
7 |
Issue |
1 |
Pages |
010903 |
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Abstract |
BACKGROUND: As the number of deaths among children younger than 5 years of age continues to decline globally through programs to address the health of older infants, neonatal mortality is becoming an increasingly large proportion of under-5 deaths. Lack of access to safe delivery care, emergency obstetric care and postnatal care continue to be challenges for reducing neonatal mortality. This article reviews the available evidence regarding the effectiveness of community-based primary health care (CBPHC) and common components of programs aiming to improve health during the first 28 days of life. METHODS: A database comprising evidence of the effectiveness of projects, programs and field research studies (referred to collectively as projects) in improving maternal, neonatal and child health through CBPHC has been assembled and described elsewhere in this series. From this larger database (N = 548), a subset was created from assessments specifically relating to newborn health (N = 93). Assessments were excluded if the primary project beneficiaries were more than 28 days of age, or if the assessment did not identify one of the following outcomes related to neonatal health: changes in knowledge about newborn illness, care seeking for newborn illness, utilization of postnatal care, nutritional status of neonates, neonatal morbidity, or neonatal mortality. Descriptive analyses were conducted based on study type and outcome variables. An equity assessment was also conducted on the articles included in the neonatal subset. RESULTS: There is strong evidence that CBPHC can be effective in improving neonatal health, and we present information about the common characteristics shared by effective programs. For projects that reported on health outcomes, twice as many reported an improvement in neonatal health as did those that reported no effect; only one study demonstrated a negative effect. Of those with the strongest experimental study design, almost three-quarters reported beneficial neonatal health outcomes. Many of the neonatal projects assessed in our database utilized community health workers (CHWs), home visits, and participatory women's groups. Several of the interventions used in these projects focused on health education (recognition of danger signs), and promotion of and support for exclusive breastfeeding (sometimes, but not always, including early breastfeeding). Almost all of the assessments that included a measurable equity component showed that CBPHC produced neonatal health benefits that favored the poorest segment of the project population. However, the studies were quite biased in geographic scope, with more than half conducted in South Asia, and many were pilot studies, rather than projects at scale. CONCLUSIONS: CBPHC can be effectively employed to improve neonatal health in high-mortality, resource-constrained settings. CBPHC is especially important for education and support for pregnant and postpartum mothers and for establishing community-facility linkages to facilitate referrals for obstetrical emergencies; however, the latter will only produce better health outcomes if facilities offer timely, high-quality care. Further research on this topic is needed in Africa and Latin America, as well as in urban and peri-urban areas. Additionally, more assessments are needed of integrated packages of neonatal interventions and of programs at scale. |
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Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA |
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2047-2978 |
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PMID:28685041 |
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Call Number |
ref @ user @ |
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97330 |
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Author |
Blot, S.; Bauer, G.; Fraser, M.; Nleya, M.; Wadham, M. |
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Title |
AIDS Service Organization Access Among African, Caribbean and Other Black Residents of an Average Canadian City |
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Journal Article |
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Year |
2017 |
Publication |
Journal of Immigrant and Minority Health |
Abbreviated Journal |
J Immigr Minor Health |
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Volume |
19 |
Issue |
4 |
Pages |
851-860 |
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Keywords |
African; Black people; Caribbean; Hiv/Aids; Health disparities; Health services research; Immigrant health; Minority health |
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Due to heightened vulnerability to HIV/AIDS, African, Caribbean and Black (ACB) communities are priority groups for prevention and intervention services in Canada. However, it is not clear which factors may affect ACB communities' access to these services. We evaluated access to the local AIDS service organization (ASO) in Middlesex-London by using data from the Black, African and Caribbean Canadian Health Study. Modified Poisson regression was used to obtain prevalence risk ratios for factors associated with three measures of access: familiarity with the ASO, willingness to access, and realized access. In adjusted analyses, older ACB community members were more likely to be familiar with the ASO, willing to access it, and have actually gone there. Canadian-born participants were less likely to have been to the ASO than recent immigrants. These results have implications for reaching specific segments of ACB communities for HIV/AIDS-related services in Canada. |
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Women and HIV/AIDS Initiative, Toronto, ON, Canada |
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1557-1912 |
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PMID:26895153 |
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Call Number |
ref @ user @ |
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97194 |
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Author |
Blot, S.; Bauer, G.; Fraser, M.; Nleya, M.; Wadham, M. |
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Title |
AIDS Service Organization Access Among African, Caribbean and Other Black Residents of an Average Canadian City |
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Journal Article |
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Year |
2017 |
Publication |
Journal of Immigrant and Minority Health |
Abbreviated Journal |
J Immigr Minor Health |
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Volume |
19 |
Issue |
4 |
Pages |
851-860 |
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Keywords |
African; Black people; Caribbean; Hiv/Aids; Health disparities; Health services research; Immigrant health; Minority health |
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Abstract |
Due to heightened vulnerability to HIV/AIDS, African, Caribbean and Black (ACB) communities are priority groups for prevention and intervention services in Canada. However, it is not clear which factors may affect ACB communities' access to these services. We evaluated access to the local AIDS service organization (ASO) in Middlesex-London by using data from the Black, African and Caribbean Canadian Health Study. Modified Poisson regression was used to obtain prevalence risk ratios for factors associated with three measures of access: familiarity with the ASO, willingness to access, and realized access. In adjusted analyses, older ACB community members were more likely to be familiar with the ASO, willing to access it, and have actually gone there. Canadian-born participants were less likely to have been to the ASO than recent immigrants. These results have implications for reaching specific segments of ACB communities for HIV/AIDS-related services in Canada. |
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Women and HIV/AIDS Initiative, Toronto, ON, Canada |
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1557-1912 |
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PMID:26895153 |
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Call Number |
ref @ user @ |
Serial |
97682 |
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Lee, J.W.; Lim, D.H.; Sung, K.W.; Lee, H.J.; Yi, E.S.; Yoo, K.H.; Koo, H.H.; Suh, Y.L.; Shin, H.J. |
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Title |
Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation for High-Grade Gliomas in Children and Adolescents |
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Journal Article |
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Year |
2017 |
Publication |
Journal of Korean Medical Science |
Abbreviated Journal |
J Korean Med Sci |
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32 |
Issue |
2 |
Pages |
195-203 |
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Keywords |
Adolescent; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use; Brain Neoplasms/*drug therapy/mortality/therapy; Carboplatin/administration & dosage; Child; Child, Preschool; Etoposide/administration & dosage; Female; Glioma/*drug therapy/mortality/therapy; Humans; Male; Neoplasm Grading; Remission Induction; Retrospective Studies; Stem Cell Transplantation; Survival Rate; Thiotepa/administration & dosage; Transplantation, Autologous; Treatment Outcome; *Autologous Stem Cell Transplantation; *Brain Tumor; *Children; *High-dose Chemotherapy; *High-grade Glioma |
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With the aim to investigate the outcome of tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT) for high-grade gliomas (HGGs), we retrospectively reviewed the medical records of 30 patients with HGGs (16 glioblastomas, 7 anaplastic astrocytomas, and 7 other HGGs) between 2006 and 2015. Gross or near total resection was possible in 11 patients. Front-line treatment after surgery was radiotherapy (RT) in 14 patients and chemotherapy in the remaining 16 patients including 3 patients less than 3 years of age. Eight of 12 patients who remained progression free and 5 of the remaining 18 patients who experienced progression during induction treatment underwent the first HDCT/auto-SCT with carboplatin + thiotepa + etoposide (CTE) regimen and 11 of them proceeded to the second HDCT/auto-SCT with cyclophosphamide + melphalan (CyM) regimen. One patient died from hepatic veno-occlusive disease (VOD) during the second HDCT/auto-SCT; otherwise, toxicities were manageable. Four patients in complete response (CR) and 3 of 7 patients in partial response (PR) or second PR at the first HDCT/auto-SCT remained event free: however, 2 patients with progressive tumor experienced progression again. The probabilities of 3-year overall survival (OS) after the first HDCT/auto-SCT in 11 patients in CR, PR, or second PR was 58.2% +/- 16.9%. Tumor status at the first HDCT/auto-SCT was the only significant factor for outcome after HDCT/auto-SCT. There was no difference in survival between glioblastoma and other HGGs. This study suggests that the outcome of HGGs in children and adolescents after HDCT/auto-SCT is encouraging if the patient could achieve CR or PR before HDCT/auto-SCT. |
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Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. shinhj@skku.edu |
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1011-8934 |
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PMID:28049229 |
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Call Number |
ref @ user @ |
Serial |
96614 |
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Author |
Rosager, A.M.; Sorensen, M.D.; Dahlrot, R.H.; Boldt, H.B.; Hansen, S.; Lathia, J.D.; Kristensen, B.W. |
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Expression and prognostic value of JAM-A in gliomas |
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Journal Article |
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2017 |
Publication |
Journal of Neuro-Oncology |
Abbreviated Journal |
J Neurooncol |
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Astrocytic brain tumors; Glioma; Junctional adhesion molecule-A; Prognosis; Tumor stem cell |
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Gliomas are among the most lethal cancers, being highly resistant to both chemo- and radiotherapy. The expression of junctional adhesion molecule-A (JAM-A) was recently identified on the surface of stem cell-like brain tumor-initiating cells and suggested to function as a unique glioblastoma niche adhesion factor influencing the tumorigenic potential of brain tumor-initiating cells. We have recently identified high JAM-A expression to be associated with poor outcome in glioblastomas, and our aim was to further investigate the expression of JAM-A in gliomas focusing especially on the prognostic value in WHO grade II and III gliomas. JAM-A protein expression was evaluated by immunohistochemistry and advanced quantitative image analysis with continuous estimates of staining intensity. The JAM-A antibody stained tumor cell membranes and cytoplasm to various extent in different glioma subtypes, and the intensity was higher in glioblastomas than low-grade gliomas. We could not detect an association with overall survival in patients with grade II and III tumors. Double-immunofluorescence stainings in glioblastomas revealed co-expression of JAM-A with CD133, SOX2, nestin, and GFAP in tumor cells as well as some co-expression with the microglial/macrophage marker IBA-1. In conclusion, JAM-A expression was higher in glioblastomas compared to low-grade gliomas and co-localized with recognized stem cell markers suggesting an association of JAM-A with glioma aggressiveness. No significant association between JAM-A expression and overall survival was found in grade II and III gliomas. Further research is needed to determine the function and clinical impact of JAM-A in gliomas. |
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Department of Clinical Research, University of Southern Denmark, Winslowparken 19, 3rd floor, 5000, Odense, Denmark |
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0167-594X |
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PMID:28677106 |
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Call Number |
ref @ user @ |
Serial |
96579 |
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