Resultados de Búsqueda por Autor

1

artículo

Preventing and Treating Pain and Anxiety during Needle-Based Procedures in Children with Cancer in Low- and Middle-Income Countries

Publicado por
McNeil, MJ, Garcia, Quintero, X, Gonzalez, M, Zheng, Y, Ugaz, Olivares, C, Morales, R, Boldrini, E, Rebollo, de, Campos, D, Ferreira, D, Coopasamy, K, Caneba, J, Padernilla, ML, Friedrichsdorf, S, Baker, JN, Friedrich, P

Publicado 2024

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Introduction: Children with cancer experience significant pain and anxiety during needle-based procedures. Undertreated pain in children has long-lasting consequences and reduces the efficacy of subsequent analgesic efforts. A validated quality improvement (QI) intervention, known as the “Children’s Comfort Promise”, includes (1) topical anesthetics, (2) sucrose or breastfeeding for infants, (3) comfort positioning, and (4) distraction techniques, and has been shown to be highly effective in decreasing procedural pain and anxiety in children. However, there is limited data about the adoption, adaptation, and implementation of these interventions in low- and middle-income countries (LMICs). Methods: A QI pilot project utilizing the Model for Improvement of the “Global Comfort Promise” was implemented in four global pediatric cancer hospitals (Lima, Peru; Barretos, Brazil; Pieter...

2

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Retrospective analysis of outcomes for pediatric acute lymphoblastic leukemia in South American centers

Publicado por
Duffy, C, Graetz, DE, Lopez, AMZ, Carrillo, A.K, Job, G, Chen, Y, Devidas, M, Leon, SA, Bonzi, SA, Flores, PC, Torres, LE, Broncano, EH, Jaramillo, SJ, Zelada, MO, Novoa, RR, Samudio, A, Sanchez-Fernandez, G, Villanueva, E, Metzger, ML, Friedrich, P, Jeha, S

Publicado 2023

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Introduction: Acute lymphoblastic Leukemia (ALL) is the most common pediatric malignancy. While the survival rate for childhood ALL exceeds 90% in high-income countries, the estimated survival in low-and middle-income countries ranges from 22-79%, depending on the region and local resources. Methods: This study retrospectively reviewed demographic, biological, and clinical parameters of children under 18 years of age with newly diagnosed ALL presenting between 2013-2017 across five pediatric centers in 4 countries in South America. Survival analyses were estimated using the Kaplan-Meier method. Results: Across the five centers, 752 patients were analyzed (Bolivia [N=9], Ecuador [N=221], Paraguay [N=197], Peru [N=325]) and 92.1% (n=690) patients were diagnosed with B-cell and 7.5% (n= 56) with T-cell ALL. The median age was 5.5 years old (IQR 7.29). At diagnosis, 47.8% of patients were ca...

3

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Exploring treatment decision-making at diagnosis for children with advanced cancer in low- and middle-income countries

Publicado por
Salek, M, Porter, AS, Maradiege, E, Dolendo, MCJ, Figueredo, D, Geriga, F, Gunasekera, S, Kizyma, R, Nguyen, HTK, Nzamu, I, Raza, MR, Rustamova, K, Sari, NM, Rodriguez-Galindo, C, Graetz, D, Bhakta, N, Kaye, EC, Wise, PH, Hunleth, JM, Friedrich, P, Force, L, Baker, JN

Publicado 2024

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Purpose: Global childhood cancer survival outcomes correlate with regional contextual factors, yet upfront treatment decision-making for children with advanced or poor prognosis cancer in low- and middle-income countries (LMICs) is not well understood. This study aimed to (1) characterize the landscape of contextual factors that shape physician decision-making at diagnosis for these children in LMICs and (2) describe physician rationales for if/when to offer treatment with non-curative intent, including how they define “poor prognosis” during treatment decision-making. Methods: An international panel of pediatric oncologists practicing in LMICs participated in two focus groups structured for the collaborative generation of factors influencing treatment decision-making, including consideration of non-curative treatment pathways at diagnosis. Thematic analysis of qualitative data was c...

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Development of the pediatric neuro-oncology services assessment aid: An assessment tool for pediatric neuro-oncology service delivery capacity

Publicado por
Rajagopal, R, Coronado, RD, Hamid, SA, Martin, del, Campo, RN, Boop, F, Bag, A, Reséndiz, AEB, Vasudeva, Bhat, K, Campos, D, Chang, K, Cirt, R, Rahmartani, LD, Foo, JC, Hoveyan, J, Lucas, JT,, Jr, Ngcana, T, Ul, Ain, R, Omran, N, Osorio, DS, Qureshi, BM, Sabin, ND, Schandorf, E, Bankah, P, Dadzie, M-A, Gbadamos, H, Sharafeldin, H, Somathilaka, M, Yang, P, Jean-Jacques, YA, Zhang, A, Salman, Z, Gonzalez, M, Friedrich, P, Rodriguez-Galindo, C, Qaddoumi, I, Moreira, DC

Publicado 2024

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Background. To enhance the quality of care available for children with central nervous system (CNS) tumors across the world, a systematic evaluation of capacity is needed to identify gaps and prioritize interventions.To that end, we created the pediatric neuro-oncology (PNO) resource assessment aid (PANORAMA) tool. Methods. The development of PANORAMA encompassed 3 phases: operationalization, consensus building, and piloting. PANORAMA aimed to capture the elements of the PNO care continuum through domains with weighted assessments reflecting their importance. Responses were ordinally scored to reflect the level of satisfaction. PANORAMA was revised based on feedback at various phases to improve its relevance, usability, and clarity. Results. The operationalization phase identified 14 domains by using 252 questions.The consensus phase involved 15 experts (6 pediatric oncologists, 3 radiat...

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Fortalecimiento de las políticas de salud pública contra el cáncer infantil: logros de Perú en el marco de la Iniciativa Mundial de la OMS contra el Cáncer Infantil

Publicado por
Maradiegue, E, Pascual, C, Vasquez, L, Maza, I, Ugaz, C, Montoya, J, Zapata, A, García, H, Chavez, S, Ordoñez, K, Rossi, J, Diaz, R, Morales, R, Trigoso, V, Ames, R, Celis, E, Barzola, I, Torres, L, Cosme, M, Tarrillo, F, Rojas, N, Santillan, C, Quispe, Y, Palacios, V, Godoy, V, Tello, M, Tarco, D, Wachtel, A, Malaver, E, Diaz, E, Goyburu, M, Perez, V, Talavera, I, Baca, ME, Maza M, Saldaña, L, Holguin, A, Jarquin, M, Loggetto, P, Metzger, M, Friedrich, P, Lam, C, Rodriguez-Galindo, C

Publicado 2023

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Objective. To report the progress in Peru, since June 2019, in the implementation of the World Health Organization Global Initiative for Childhood Cancer using the CureAll framework, which can be replicated in low- and middle-income countries. Methods. A mixed method was used of participatory and documentary evaluation. The participatory evaluation included stakeholders from various government institutions, nonprofit organizations, and international partners. The documentary aspect consisted of a review of data on the regulatory environment, national projects, and interventions implemented. The Ministry of Health engaged more than 150 participants to form working committees, which have developed policy and regulatory documents to strengthen care services. Results. Achievements include a decrease in the national treatment abandonment rate from 18.6% to 8.5%, the approval of the Childhood ...

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Model for regional collaboration: Successful strategy to implement a pediatric early warning system in 36 pediatric oncology centers in Latin America

Publicado por
Agulnik, A, Gonzalez-Ruiz, A, Muniz-Talavera, H, Carrillo, AK, Cárdenas, A, Puerto-Torres, MF, Garza, M, Conde, T, Soberanis-Vasquez, DJ, Méndez-Aceituno, A, Acuña-Aguirre, C, Alfonso, Y, Álvarez-Arellano, SY, Argüello Vargas, D, Batista, R, Blasco Arriaga, EE, Chávez Rios, M, Cuencio Rodríguez, ME, Fing Soto, EA, Gómez-García, W, Guillén Villatoro, RH, Gutiérrez Rivera, MDL, Herrera Almanza, M, Jimenez Antolinez, YV, Juárez Tobias, MS, López Facundo, NA, Martínez Soria, RA, Miller, K, Miralda, S, Morales, R, Negroe Ocampo, N, Osuna, A, Pascual Morales, C, Pérez Fermin, CK, Pérez Alvarado, CM, Pineda, E, Andrés Portilla, C, Rios López, LE, Rivera, J, Sagaón Olivares, AS, Saguay Tacuri, MC, Salas-Mendoza, BT, Solano Picado, I, Soto Chávez, V, Tejocote Romero, I, Tatay, D, Teixeira Costa, J, Villanueva, E, Villegas Pacheco, M, McKay, VR, Metzger, ML, Friedrich, P, Rodriguez-Galindo, C

Publicado 2022

Enlace

Background: Pediatric early warning systems (PEWS) aid in the early identification of deterioration in hospitalized children with cancer however, they are under-used in resource-limited settings. The authors use the knowledge-to-action framework to describe the implementation strategy for Proyecto Escala de Valoracion de Alerta Temprana (EVAT), a multicenter quality-improvement collaborative, to scale-up PEWS in pediatric oncology centers in Latin America. Methods: Proyecto EVAT mentored participating centers through an adaptable implementation strategy to: (1) monitor clinical deterioration in children with cancer, (2) contextually adapt PEWS, (3) assess barriers to using PEWS, (4) pilot and implement PEWS, (5) monitor the use of PEWS, (6) evaluate outcomes, and (7) sustain PEWS. The implementation outcomes assessed included the quality of PEWS use, the time required for implementation,...