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Increasing Access (increasing + access)

Distribution by Scientific Domains

Medical Sciences	58%

Selected Abstracts

Increasing access to clinical and educational studies

CANCER, Issue S8 2006
Ronald E. Myers PhD
Abstract In 2001, the National Cancer Institute (NCI) provided funds to support the Increasing Access to Clinical and Educational Studies (ACES) Project of the Thomas Jefferson University, Kimmel Cancer Center in Philadelphia. The ACES Project enabled the Center to engage in the systematic development of approaches for reducing cancer health disparities among African Americans in Philadelphia. This project brought together community partners, clinical partners, cancer prevention and control experts, and staff from an NCI-designated cancer center to develop and implement a community-based outreach education program, a special populations investigator (SPI) training program, and SPI pilot studies in cancer screening and clinical trials participation. At the end of 5 years, the ACES Project had 1) organized a steering committee, expert panel, and a network of community collaborators and clinical partners; 2) implemented a clinical trials education program for community-based nurses, lay health advocates active in community organizations, and health ministries in community churches; 3) mentored 4 SPIs in cancer prevention and control research; 4) completed SPI pilot studies; and 5) leveraged these activities to gain support for cancer health disparities related research. The Project established a successful dialogue between an NCI-designated cancer center and the African American population related to cancer research, and enabled SPIs from the community to adapt evidence-informed interventions for application in cancer prevention and control research. Lessons learned from the Project can guide the implementation of such projects in the future. Cancer 2006. © 2006 American Cancer Society. [source]

Self-Assessed Disability and Self-Rated Health Among Rural Villagers in Peru: A Brief Report

THE JOURNAL OF RURAL HEALTH, Issue 3 2010
James E. Rohrer PhD
Abstract Context: Risks for poor self-rated overall health in rural areas of developing nations have not been thoroughly investigated. Purpose: The objective of this study was to assess potential risk factors for poor self-rated health among rural villagers in Peru. Methods: A door-to-door survey of villagers residing in the Pampas Grande region in Peru, which is in the Andes Mountains, yielded complete data for 337 adults. Findings: Adjusting for age and gender using multiple logistic regression analysis revealed that having self-reported disabilities was inversely and independently related to good self-rated health (OR 0.48 [95% CI, 0.26-0.88]). Joint pain also was related to self-rated health (OR 0.23 [95% CI, 0.13-0.41]). Conclusions: Increasing access to affordable, effective analgesics may reduce this disparity. Health agencies should consider these actions as possible planning priorities for the region. [source]

Unfettered Consumer Access to Affordable Therapies in the Post-TRIPS Era: A Dead-End Journey for Patients?

THE JOURNAL OF WORLD INTELLECTUAL PROPERTY, Issue 3 2010
India Case Studies, Kenya
Increasing access to essential medicines has become an international priority, given the rapid spread of intractable diseases such as HIV/AIDS, tuberculosis and malaria. It follows that the quests to improve the global quality of healthcare and achieve health equity present a challenge for many countries, especially those that have been hard hit by deadly pandemics and whose populations are also still without essential drugs. Consequently, many countries have stepped up efforts to remove the obstacles to the availability and affordability of essential medicines. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) contains flexibilities that can be used as tools for enhancing access to cheap medicines and for controlling drug pricing. However, these flexibilities are not necessarily a panacea and cannot singly solve the problem of limited access to essential medicines. Put differently, cheaper medicines cannot reach the poor without the infrastructure to deliver them. For this to become a reality, commitment on the part of the member countries to adopt comprehensive and cooperative measures to tackle the burdensome barriers that limit access to critical medicines is needed. It is only then that the flexibilities in TRIPS can be optimized and a real difference made in the lives of poor patients across the developing world. [source]

Patents and Access to Antiretroviral Medicines in Vietnam after World Trade Organization Accession

THE JOURNAL OF WORLD INTELLECTUAL PROPERTY, Issue 3-4 2007
Jakkrit Kuanpoth
Antiretroviral (ARV) drugs, where they are accessible, have been shown to prolong the lives and increase the health and well-being of people living with human immunodeficiency virus/acquired immunodeficiency syndrome. In general terms, whether a country is able to provide affordable ARVs to people in need is determined by the pricing structure of the drugs, which is in turn based on the patent environment that regulates them. Increasing access in many developing countries, including Vietnam, requires a thorough understanding of the patent environment and of the legal options that will allow the production and/or importation of affordable treatments. This article provides an analysis of current patent law in Vietnam with regard to the production and importation of pharmaceuticals. It then reviews the current situation of supply of ARVs with regard to pharmaceutical patents and Vietnam's obligations and practices against international agreements. The study concludes by suggesting options for utilizing current law to improve access to ARVs and makes recommendations for the implementation of Vietnamese patent law. [source]

Increasing access to clinical and educational studies

Use of Outpatient Care in Veterans Health Administration and Medicare among Veterans Receiving Primary Care in Community-Based and Hospital Outpatient Clinics

HEALTH SERVICES RESEARCH, Issue 5p1 2010
Chuan-Fen Liu
Objective. To examine differences in use of Veterans Health Administration (VA) and Medicare outpatient services by VA primary care patients. Data Sources/Study Setting. VA administrative and Medicare claims data from 2001 to 2004. Study Design. Retrospective cohort study of outpatient service use by 8,964 community-based and 6,556 hospital-based VA primary care patients. Principal Findings. A significant proportion of VA patients used Medicare-reimbursed primary care (>30 percent) and specialty care (>60 percent), but not mental health care (3,4 percent). Community-based patients had 17 percent fewer VA primary care visits (p<.001), 9 percent more Medicare-reimbursed visits (p<.001), and 6 percent fewer total visits (p<.05) than hospital-based patients. Community-based patients had 22 percent fewer VA specialty care visits (p<.0001) and 21 percent more Medicare-reimbursed specialty care visits (p<.0001) than hospital-based patients, but no difference in total visits (p=.80). Conclusions. Medicare-eligible VA primary care patients followed over 4 consecutive years used significant primary care and specialty care outside of VA. Community-based patients offset decreased VA use with increased service use paid by Medicare, suggesting that increasing access to VA primary care via community clinics may fragment veteran care in unintended ways. Coordination of care between VA and non-VA providers and health care systems is essential to improve the quality and continuity of care. [source]

Characteristics of antepartum and intrapartum eclampsia in the National Maternal and Child Health Center in Cambodia

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2004
Kanal Koum
Abstract Aim:, To measure maternal and perinatal outcome and analyze risk factors for antepartum and intrapartum eclampsia, which is one of main causes of high maternal mortality at the top referral hospital in the Kingdom of Cambodia. Methods:, A hospital-based retrospective study of 164 antepartum and intrapartum eclampsia cases out of 20 449 deliveries. Results:, Overall case,fatality rate was 12%. Rate of stillbirth and low birth weight were 20% and 44%, respectively. Eighty percent of the cases presented signs of severe pre-eclampsia and 27% of the patients who gave birth received cesarean section. Living outside the capital city, teenage pregnancy and twin pregnancy are more frequently associated with eclampsia. Conclusion:, Antepartum and intrapartum eclampsia is associated with severe pre-eclampsia and with poor maternal and perinatal outcome. Recommendations to reduce the burden of eclampsia are promoting and improving quality of antenatal care and health education especially in the third trimester; increasing access to high-quality essential obstetric care; improving the service delivery in rural areas; and monitoring the progress by hospital data. [source]

Explaining race, poverty, and gender disparities in advanced course-taking

JOURNAL OF POLICY ANALYSIS AND MANAGEMENT, Issue 4 2009
Dylan Conger
We use panel data on Florida high school students to examine race, poverty, and gender disparities in advanced course-taking. While white students are more likely to take advanced courses than black and Hispanic students, these disparities are eliminated when we condition on observable pre,high school characteristics. In fact, black and Hispanic students are more likely than observably similar white students to take advanced courses. Controlling for students' pre,high school characteristics substantially reduces poverty gaps, modestly reduces Asian,white gaps, and makes little dent in female,male gaps. Black and Hispanic students attend high schools that increase their likelihood of taking advanced courses relative to observably similar white students; this advantage is largely driven by minorities disproportionately attending magnet schools. Finally, recent federal and state efforts aimed at increasing access to advanced courses to poor and minority students appear to have succeeded in raising the share of students who take advanced courses from 2003 to 2006. However, secular trends (or spillovers of the policies to non-poor, non-minority students) have spurred faster growth for other students, contributing to widening demographic gaps in these years. © 2009 by the Association for Public Policy Analysis and Management. [source]

Databases for outcomes research: what has 10 years of experience taught us?

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 5 2001
Lynn Bosco MD
Abstract This paper describes how the mission of the Agency for Healthcare Research and Quality (AHRQ) is being executed through the many programs that it has developed and implemented. The Evidence-based Practice Center program was developed to provide systematic reviews on common and expensive conditions and health technologies and to ensure that this information is used to improve health care outcomes and costs. The National Guidelines Clearinghouse provides an internet-based source of clinical practice guidelines that are produced by clinical specialty organizations for the primary purpose of improving health care delivery and outcomes. Relevant to this symposium on databases, AHRQ has supported the development of databases to track hospital utilization on a state-by-state basis. The Healthcare Cost and Utilization Project (HCUP) allows comparisons between states and within regions of individual states. New initiatives have been launched to evaluate interventions across systems rather than focusing on the individual patient (Translating Research into Practice,TRIP). The Centers for Education and Research on Therapeutics (CERTs) program was developed to conduct real world evaluations to better understand the benefits and risks of single and combined therapy. Both programs further the mission of the AHRQ to improve the outcomes and quality of health care, with additional focus on the cost-effectiveness, patient safety, and increasing access to care for all. Information on programs developed by the AHRQ is available in more detail at the Agency Web site http://www.ahrq.gov. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Imprinted genes and human disease,

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 3 2010
Rosanna Weksberg
Abstract This issue of Seminars of Medical Genetics features a series of articles on human disorders caused by the dysregulation of imprinted genes. At the outset, there is a review of the general mechanisms by which genomic imprinting is normally regulated followed by an exploration of the clinical and molecular aspects of human imprinting disorders. As we enter an era of bioinformatics and genome-wide analyses with increasing access to high density microarrays and next generation sequencing, it is becoming apparent that the concept of a single mutation or epimutation leading to a disease is outdated. The role of the clinician will become increasingly important, in concert with these molecular advances, in terms of evaluating phenotypic variation to further our understanding of imprinting disorders. Such investigations will benefit children and families as we become better able to define recurrence risk, predict phenotype, and tailor medical management. © 2010 Wiley-Liss, Inc. [source]

Nutrition and Brain Development: Social Policy Implications

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2002
Emily M. Tanner MSc
Undernutrition among young children is widespread in the United States and has a detrimental impact on brain development. This article explores the risks associated with undernutrition and the potential for recovery when diet and the environment improve. Three policy implications are discussed: (a) increasing access to federal food programs, (b) promoting breastfeeding, and (c) working toward reducing child poverty. [source]

Prospects for the Survival of the Navajo Language: A Reconsideration

ANTHROPOLOGY & EDUCATION QUARTERLY, Issue 2 2002
Professor Bernard Spolsky
What is the role of schools in the loss of indigenous languages? A study 25 years ago of prospects for the survival of Navajo placed most of the blame for the spread of English on increasing access to schools. Reconsidering that evidence and recent developments, the central role of the introduction of Western schooling is seen still to be highly relevant. But other factors have worked through the school, the major effect of which has been the ideological acceptance of English. Vernacular literacy, traditional or introduced religion, and political structure all have failed to establish a counterforce. Economic changes also led to new living patterns that, together with improved communication, broke down isolation and supported the threat to the survival of language. This study confirms the importance of seeing language and education in the full social, cultural, religious, and political context recognized by educational anthropology. [source]