PubMed · 12911066
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Paul Rousseau. Physician crying.. https://doi.org/10.1177/104990910302000401
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Currently, there is a "divide" between cancer survivorship initiatives and minority participation. The level of participation is nearly nonexistent in many cancer support and control initiatives. Cancer survivorship resources that facilitate access to treatment, psychosocial interventions, clinical trials, and research are key components to eliminating this divide. Differences in cancer results among minority populations are caused by several factors, including biologic reactions to environmental activities, socioeconomic status, perceived beliefs and notions of medical professionals, a lack of resources to participate in cancer support groups, and having personal contact with cancer survivors. Health professionals, advocates, and researchers hold the key to opening more opportunities for the improvement of cancer survivorship among minorities. The belief that "one size fits all" is unrealistic. These beliefs can influence participation in innovative clinical trials, decisions about treatment, emotional responses, and social support relationships. To help ensure participation in these programs, researchers and health workers must understand the role of social and psychosocial implications and results of the assessment, strategies, and sustainability that must be included in the development stage of any cancer support and survivorship initiatives. For this article, the authors examined mechanisms that can be used by cancer-control researchers and program staff to limit the divide between cancer survivorship initiatives and minority participation. They identified three strategies that must be used to address this divide effectively: the inclusion of minorities in clinical trials, intervention studies, treatment, and research programs; the development of culturally sensitive environments; and the ability to sustain minority participation. In summary, cancer survivorship includes many components that are developed individually and collectively to formulate sound strategies for including minorities in cancer-control initiatives. These programs should go beyond basic support groups and should include research studies, clinical trials, and alternative treatments for increasing cancer survival rates and quality of life among minorities. The divide can be addressed only through a proactive initiative that brings cancer survivorship initiatives and minority communities together in full partnership.
OBJECTIVE: To assess the potential effect of educational intervention on episiotomy practice. STUDY DESIGN: A survey of the attitude of obstetrical caregivers toward episiotomy was conducted among obstetricians and midwives in the three public hospitals in Haifa. Data regarding episiotomy rates was collected for the years 2001-2003. At the beginning of 2002, lectures on the risks and benefits of episiotomy were given in two hospitals. Episiotomy rates before and after the lecture were compared. RESULTS: A significant and lasting reduction in episiotomy rates was observed in the two hospitals where lectures were given. There were no clinically significant and consistent changes in the episiotomy practices in the third hospital. CONCLUSION: Education may play an important role in changing common medical practices, as in episiotomy. It was clearly shown that our beliefs are not always up to date. We call for periodic reassessment of all medical procedures, as common and accepted as they are.
PURPOSE: Epilepsy is common in underresourced countries, where most people with epilepsy do not take antiepileptic drugs (AEDs). This underutilization, referred to as the treatment gap, was investigated in Kilifi, Kenya, by exploring the sociocultural context in which children with epilepsy and their families live. This study focused particularly on what effect attitudes and practices might have on service utilization, particularly the use of AEDs. METHODS: Attitudes and practices toward children with epilepsy were examined using qualitative data collection methods, namely, interviews, focus group discussions, group activities, and observations. These were carried out with children diagnosed as having active epilepsy, their parents, their grandparents, and health care personnel. RESULTS: The responses illustrate both positive and negative attitudes, underpinning a wide variety of practices toward children with epilepsy. They also indicate the use of several types of services that vary between the traditional, medical, educational, and religious. The choice of these services was affected by different socioeconomic factors, the complex interrelationship of which offers some explanation for the underutilization of AEDs. CONCLUSIONS: The treatment gap may be explained by a "health versus sickness" model, accounting for families' health-seeking behavior in relation to their perception of cause and treatment. In this model, occasional convulsions associated with fever in younger children are placed in the "health sphere," making recommendations of regular and continued medication illogical for what is perceived to be a healthy child. When seizures persist beyond a certain age, the child is placed in the "sickness sphere," meaning that the child is incurable and treatment attempts are futile. Better levels of understanding and information sharing among children with epilepsy, their families, and health care personnel are required to improve use of medical services. Possible interventions include community-based services and health education programs for the community and service providers.