A Study on the Structural Transition of the City Area According a Policy in the Castle City Jeonju
In: Journal of the City Planning Institute of Japan, Band 29, Heft 0, S. 229-234
ISSN: 2185-0593
7 Ergebnisse
Sortierung:
In: Journal of the City Planning Institute of Japan, Band 29, Heft 0, S. 229-234
ISSN: 2185-0593
In: Journal of the City Planning Institute of Japan, Band 28, Heft 0, S. 211-216
ISSN: 2185-0593
In: KIEP Research Paper, World Economy Brief(WEB) 23-01
SSRN
In: KIEP Research Paper, 연구보고서(PA) 22-03
SSRN
Background Vietnam has been successful in increasing access to maternal, neonatal, and child health (MNCH) services during last decades; however, little is known about whether the primary MNCH service utilization has been properly utilized under the recent rapid urbanization. We aimed to examine current MNCH service utilization patterns at a district level. Methods The study was conducted qualitatively in a rural district named Quốc Oai. Women who gave a birth within a year and medical staff at various levels participated through 43 individual in-depth interviews and 3 focus group interviews. Results Primary MNCH services were underutilized due to a failure to meet increased quality needs. Most of the mothers preferred private clinics for antenatal care and the district hospital for delivery due to the better service quality of these facilities compared to that of the commune health stations (CHSs). Mothers had few sociocultural barriers to acquiring service information or utilizing services based on their improved standard of living. A financial burden for some services, including caesarian section, still existed for uninsured mothers, while their insured counterparts had relatively few difficulties. Conclusions For the improved macro-efficiency of MNCH systems, the government needs to rearrange human resources and/or merge some CHSs to achieve economies of scale and align with service volume distribution across the different levels. ; This research was financially supported by the JW LEE Center for Global Medicine of Seoul National University College of Medicine, Seoul, South Korea. Vietnam Health System Strengthening project is part of a collaborative project by and JW LEE Center for Global Medicine of Seoul National University College of Medicine, Seoul, South Korea and University of Hanoi, University of Medicine and Pharmacy of Ho Chi Minh City. The funding source had no role in study design, data collection and analysis, interpretation of data, or preparation of the manuscript.
BASE
BACKGROUND AND OBJECTIVES: Presymptomatic testing is available for early diagnosis of hereditary autosomal dominant polycystic kidney disease (ADPKD). However, the complex ethical and psychosocial implications can make decision-making challenging and require an understanding of patients' values, goals and priorities. This study aims to describe patient and caregiver beliefs and expectations regarding presymptomatic testing for ADPKD. DESIGN, SETTING AND PARTICIPANTS: 154 participants (120 patients and 34 caregivers) aged 18 years and over from eight centres in Australia, France and Korea participated in 17 focus groups. Transcripts were analysed thematically. RESULTS: We identified five themes: avoiding financial disadvantage (insecurity in the inability to obtain life insurance, limited work opportunities, financial burden); futility in uncertainty (erratic and diverse manifestations of disease limiting utility, taking preventive actions in vain, daunted by perplexity of results, unaware of risk of inheriting ADPKD); lacking autonomy and support in decisions (overwhelmed by ambiguous information, medicalising family planning, family pressures); seizing control of well-being (gaining confidence in early detection, allowing preparation for the future, reassurance in family resilience); and anticipating impact on quality of life (reassured by lack of symptoms, judging value of life with ADPKD). CONCLUSIONS: For patients with ADPKD, presymptomatic testing provides an opportunity to take ownership of their health through family planning and preventive measures. However, these decisions can be wrought with tensions and uncertainty about prognostic implications, and the psychosocial and financial burden of testing. Healthcare professionals should focus on genetic counselling, mental health and providing education to patients' families to support informed decision-making. Policymakers should consider the cost burden and risk of discrimination when informing government policies. Finally, patients are recommended to ...
BASE
In: Logeman , C , Cho , Y , Sautenet , B , Rangan , G K , Gutman , T , Craig , J , Ong , A , Chapman , A , Ahn , C , Coolican , H , Tze-Wah Kao , J , Gansevoort , R T , Perrone , R , Harris , T , Torres , V , Fowler , K , Pei , Y , Kerr , P , Ryan , J , Johnson , D , Viecelli , A , Geneste , C , Kim , H , Kim , Y , Howell , M , Ju , A , Manera , K E , Teixeira-Pinto , A , Parasivam , G & Tong , A 2020 , ' 'A sword of Damocles' : patient and caregiver beliefs, attitudes and perspectives on presymptomatic testing for autosomal dominant polycystic kidney disease: a focus group study ' , BMJ Open , vol. 10 , no. 10 , e038005 . https://doi.org/10.1136/bmjopen-2020-038005 ; ISSN:2044-6055
BACKGROUND AND OBJECTIVES: Presymptomatic testing is available for early diagnosis of hereditary autosomal dominant polycystic kidney disease (ADPKD). However, the complex ethical and psychosocial implications can make decision-making challenging and require an understanding of patients' values, goals and priorities. This study aims to describe patient and caregiver beliefs and expectations regarding presymptomatic testing for ADPKD. DESIGN, SETTING AND PARTICIPANTS: 154 participants (120 patients and 34 caregivers) aged 18 years and over from eight centres in Australia, France and Korea participated in 17 focus groups. Transcripts were analysed thematically. RESULTS: We identified five themes: avoiding financial disadvantage (insecurity in the inability to obtain life insurance, limited work opportunities, financial burden); futility in uncertainty (erratic and diverse manifestations of disease limiting utility, taking preventive actions in vain, daunted by perplexity of results, unaware of risk of inheriting ADPKD); lacking autonomy and support in decisions (overwhelmed by ambiguous information, medicalising family planning, family pressures); seizing control of well-being (gaining confidence in early detection, allowing preparation for the future, reassurance in family resilience); and anticipating impact on quality of life (reassured by lack of symptoms, judging value of life with ADPKD). CONCLUSIONS: For patients with ADPKD, presymptomatic testing provides an opportunity to take ownership of their health through family planning and preventive measures. However, these decisions can be wrought with tensions and uncertainty about prognostic implications, and the psychosocial and financial burden of testing. Healthcare professionals should focus on genetic counselling, mental health and providing education to patients' families to support informed decision-making. Policymakers should consider the cost burden and risk of discrimination when informing government policies. Finally, patients are recommended to ...
BASE