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Based in narrative phenomenology, this article describes an example of how lived time, self and bodily engagement with the social world intertwine, and how our sense of self develops. We explore this through the life story of a woman who lost weight through surgery in the 1970 s and has fought against her own body, food and eating ever since. Our narrative analysis of interviews, reflective notes and email correspondence disentangled two storylines illuminating paradoxes within this long-term weight loss process. Thea's Medical Weight Narrative From Severely Obese Child to Healthy Adult is her story in context of medicine and obesity treatment and expresses success and control. Thea's Story The Narrative of Fighting Weight is the experiential story, including concrete examples and quotes, highlighting bodily struggles and the inescapable ambiguity of being and having one's body. The two storylines coexist and illuminate paradoxes within the weight loss surgery narrative, connected to meaningful life events and experiences, eating practices and relationships with important others. Surgery was experienced as lifesaving, yet the surgical transformation did not suffice, because it did not influence appetite or, desire for food in the long run. In the medical narrative of transforming the body by repair, a problematic relationship with food did not fit into the plot.
Acute myeloid leukemia (AML) in children remains a challenging disease to cure with suboptimal outcomes particularly when compared to the more common lymphoid leukemias. Recent advances in the genetic characterization of AML have enhanced understanding of individualized patient risk, which has also led to the development of new therapeutic strategies. Here, we review key cytogenetic and molecular features of pediatric AML and how new therapies are being used to improve outcomes.
Recent studies have revealed an increasing number of mutations, including WT1, CBFA2T3-GLIS2, and KAT6A fusions, DEK-NUP214 and NUP98 fusions, and specific KMT2A rearrangements, which are associated with poor outcomes. However, outcomes are starting to improve with the addition of therapies such as gemtuzumab ozogamicin and FLT3 inhibitors, initially developed in adult AML. The combination of advanced risk stratification and ongoing improvements and innovations in treatment strategy will undoubtedly lead to better outcomes for children with AML.
Recent studies have revealed an increasing number of mutations, including WT1, CBFA2T3-GLIS2, and KAT6A fusions, DEK-NUP214 and NUP98 fusions, and specific KMT2A rearrangements, which are associated with poor outcomes. However, outcomes are starting to improve with the addition of therapies such as gemtuzumab ozogamicin and FLT3 inhibitors, initially developed in adult AML. The combination of advanced risk stratification and ongoing improvements and innovations in treatment strategy will undoubtedly lead to better outcomes for children with AML.
Equitable access to essential medicines of maintained efficacy, safety, quality, and cost-effectiveness must be ensured by a well-functioning health system. This study aims to identify the determinants of patients' access to medicines at the primary health care (PHC) level from the perspectives of various(internal and external) stakeholders of the pharmaceutical system.
The study employed both quantitative and qualitative components. Quantitative component applied a descriptive across-sectional design and qualitative component applied anin-depth interview design. It was a health system research conducted at two (PHC) facilities (one urban and the other rural) in Egypt. It inquired upon political, economic, and managerial aspects of the pharmaceutical system utilizing the "Health System Assessment Approach a How-To Manual" and the "WHO operational package for assessing, monitoring and evaluating country pharmaceutical situations."
Analysis of the quantitative data extracted from thecross-sectional compondicine quality in thegovernment health facilities focusing on improving medicine availability and ensuring enough amounts of high-quality drugs. Although there are drug committees in the two studied PHC facilities for demonstrating the prescribing and dispensing policies, yet the system required to enforce these policies is still deficient.
The Percent of medicines dispensed was insufficient in both rural and urban facilities. There is a need to invest in building trust in generic medicine quality in the government health facilities focusing on improving medicine availability and ensuring enough amounts of high-quality drugs. Although there are drug committees in the two studied PHC facilities for demonstrating the prescribing and dispensing policies, yet the system required to enforce these policies is still deficient.Despite the unique nature of ethical issues in a longterm care setting, there is limited help in decision making for nursing home personnel. 2015 the Hospizverband of Upper Austria established a clinical ethic committee to help providing a good quality of decision making in nursing home. Temsirolimus cost A consultation could be asked by the managing nurses of the longterm care institution, by the resident or by relatives of the nursing home residents. Since the start of the ethic committee 24 from 137 nursing homes in Upper Austria asked for a consultation. All consultations came from the personnel of the nursing homes. Beside the nursing team and 1-3 members of the ethic committee, in 75% of the consultations the physician was present. The most often discussed ethical issues were hospital admission (25%), conflicts with relatives of the residents, artificial nutrition (including PEG tube insertion and displacement) and use of restraints. The most underlying illness was dementia (50%). 20% of the residents were competent in their wishes, but none of the involved residents had a written precisely patient decree.Vestibular schwannomas can severely impair the quality of life of patients. Next to impaired hearing function, facial palsy is perceived as particularly disturbing in this context. Varying growth rates of these benign tumors complicate a prediction of functional impairment of cranial nerves. Therefore, a regular update on current therapeutic strategies and alternative treatment options is relevant for both physicians and patients.
