Unmet Needs Research Articles

Global Neurosurgery Advocacy

The white paper published by the Lancet Commission put forward surgery as a global health priority. In that paper, their findings showed that 5 billion people in the world do not have access to 'safe, affordable surgical and anesthesia services when needed,' and this inequity is more evident in lower- and middle-income countries (LMICs). These deficits are even more profound in surgical subspecialties such as neurosurgery. The paper "Global Neurosurgery: The Unmet Needs," published in 2016, addresses the system-level thinking and programs required to address the needs of neurosurgical care in lower resource settings. Neurosurgeons need to have influence, presence, and leadership role in advocating for the surgical system strengthening worldwide as it is estimated that there are 5 million emergency and essential neurosurgery neurosurgical services currently unmet, especially in LMICs. Thus, in 2019, the World Federation of Neurosurgical Societies (WFNS) established the Global Neurosurgery Committee (GNC), an ad hoc committee dedicated to organizing and furthering global neurosurgical efforts. The Committee is co-chaired by Kee B. Park, MD, MPH from the United States, and Abdessamad El Ouahabi, MD from Morocco. The body of the GNC was the Committee of 22 neurosurgeons from 19 countries; the Secretariat Team primarily managed internal GNC operations with support from the later-added Junior Committee, both of which were international medical students and trainees. One of the objectives of this Committee is to promote advocacy efforts for neurosurgical care within universal healthcare coverage. This paper explores the fifth "ADVOCATE" objective, including its significance, the GNC's efforts, and progress toward executing its defining targets.

The Role of Neurosurgeons in Policy Development: Addressing Unmet Neurosurgical Needs in Low-and-Middle Income Countries

Introduction: Global Neurosurgical (GNS) publications can be classified into two broad categories: 1) clinical research and 2) public health research. To date, most papers and manuscripts have been clinical in nature. However, over the past 5 years, the focus of GNS manuscripts have changed dramatically. A recent scoping review identified public health-oriented GNS manuscripts from 1999 to 2019 and categorized them by the WHO’s six Health System domains (service delivery, workforce, infrastructure, financing, information management, and governance). The objectives of this follow-up study include: 1) updating the literature search done in the scoping review and 2) discussing the importance of comprehensive policy recommendations.
 Methods: We searched three databases – PubMed/MEDLINE, CINAHL, and EMBASE – for GNS literature published from June 2019 (the end of previous search date) to December 2020. Afterwards, a title & abstract screening was conducted.
 Results: A total of 246 references were found across the three aforementioned databases. After the title & abstract screening, 68 GNS manuscripts were identified. Although a full-text review was not conducted, this cursory search supports the notion that the GNS community is now shifting towards a more holistic, health systems-oriented approach.
 One limitation to this search method is the exclusion of commentaries and policy briefs that discussed governance within GNS. For example, the study excluded the Comprehensive Policy Recommendations that have been released by the Program for Global Surgery and Social Change (PGSSC). The first set of recommendations were about head and spine injuries. The second set of recommendations – published at the end of 2021 – focused on policy related to the management of Spina Bifida and Hydrocephalus.
 Discussion: The Comprehensive Policy Recommendations clearly highlight how neurosurgeons can influence policy development and implementation. While these publications are a step forward, it is not enough. Moving ahead, the GNS community should: 1) widely disseminate the document to all, 2) selectively distribute the document to Ministries of Health, and 3) conduct more policy-focused research. To adequately address the unmet neurosurgical needs in LMICs, collaboration is paramount. It is time for neurosurgeons to think beyond the operating room.

A Novel Method to Optimize Drug Delivery for Parenteral Products Involving New Therapies and Unmet Needs.

Healthcare trends continue to move from hospital to home and many targeted therapies and precision medicines are now being designed to be self-administered by patients or delivered in a home setting. In the case of long acting injectables and bio-therapeutics, the importance of optimal drug/biologic-device combination in terms of user needs becomes critical for successful clinical outcomes. The risk especially increases for novel therapies due to unknowns and uncertainties surrounding new formulation flow behavior, delivery methods, new injection sites and therapeutic optimization. Other risk factors include patient tolerability and acceptability. The success of the clinical outcome is now dependent on the optimal delivery in these situations for a consistent pharmacokinetics (PK) response. In addition, the complexity of formulations and challenging delivery needs have brought to light some of the limitations of existing legacy device technology, which may not be suited for these novel applications. The formulation itself may not be an exact fit to deliver with existing standard device technologies and may need to be designed to deliver the specific formulation appropriately. Formulations may have to be optimized both for delivery and for the therapeutic outcome creating many iterative development cycles. Rapid development of the therapies requires simultaneous development of drug and device and thus the importance of early-stage characterization. We present a novel integrated approach that includes drug delivery optimization via an autoinjector simulator in pre-clinical and clinical studies to assess the PK performance and potential to establish path to device early on and reduce time to the clinic.

Unmet Needs in Geriatric Oncology.

Nikhil PathiIndia's population is aging, with the number of people aged 60 and over projected to reach 340 million by 2050. This is expected to lead to an increase in the number of older adults with cancer. Geriatric oncology is a rapidly growing field in India that is facing several challenges. Some of these include inadequate access to cancer screening and early detection programs in elderly, leading to late diagnoses and poor outcomes, lack of specialized geriatric oncology services, cancer-specific treatment guidelines and protocols in elderly, limited availability of treatment options due to accessibility, finances and other logistic issues, lack of trained healthcare professionals with expertise in geriatric oncology, lack of awareness, and access to early integrated palliative care services. There are several challenges faced by elderly in this journey like financial dependency, social isolation, difficulty in transportation to healthcare for treatments, and psychosocial aspects attributed to cancer. Awareness about availability of resources, patient assistance programs to reduce financial burdens, education campaigns, use of telemedicine and telehealth services to bypass transportation issues in remote and underserved areas, and integration of geriatric oncology into mainstream oncology services might be some solutions. Additionally, there is a need for more research on the unique characteristics and needs of older cancer patients in India, as well as the development of culturally appropriate interventions to address these needs. Development of India-specific geriatric assessment scales encompassing medical, psychosocial, and functional problems in elderly identifies areas of vulnerability. A multidisciplinary team-based decision-making is required at various levels. There is a need for increased investment in geriatric oncology research, training, and integrated palliative care services in India. Geriatric oncology is slowly being recognized as a separate subspeciality and more geriatric oncology centers and clinics are being set up in major cities in India that should be the way forward.

(976) Assessment of Clinical Practices and Unmet Needs in Chronic Thromboembolic Pulmonary Hypertension (CTEPH) - A Global Cross-Sectional Scientific Survey (CLARITY)

(976) Assessment of Clinical Practices and Unmet Needs in Chronic Thromboembolic Pulmonary Hypertension (CTEPH) - A Global Cross-Sectional Scientific Survey (CLARITY)

Unmet Needs for Comprehensive Sexuality Education: A Qualitative Study Among Secondary School Students in Western Kenya

The aim of this qualitative study was to explore desired ways to deliver comprehensive sexuality education (CSE) and topics, among secondary school students in a low-resource setting in Western Kenya. One school (n = 440) has received 8–9-h CSE intervention, while the other school (n = 496) served as a control. After one-year follow-up the students were asked (one open-ended question) to suggest desired topics of CSE, with a response rate of 93% (n = 867). The following topics were suggested by the students: abortion, contraception, sexual rights, abstinence and STI/HIV, and preferred CSE delivery means were school-based teaching, online resources and social media, community-based elements or trusted individuals. The students who had not received the intervention were more in favor of an abstinence-only approach and demonstrated more negative attitudes toward abortion.

CORR Insights®: Association of Unmet Social Needs With Level of Capability in People With Persistent Knee Pain.

1Sports Medicine Specialist, OrthoVirginia, Richmond, VA, USA K. Owusu-Akyaw, OrthoVirginia, 7858 Shrader Road, Richmond, VA 23294, USA, Email: [email protected] This CORR Insights® is a commentary on the article “Association of Unmet Social Needs With Level of Capability in People With Persistent Knee Pain” by Lin and colleagues available at: DOI: 10.1097/CORR.0000000000002554. The author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writer, and do not reflect the opinion or policy of CORR® or The Association of Bone and Joint Surgeons®.

The Singapore Experience With Uncontrolled Gout: Unmet Needs in the Management of Patients.

Gout is the most common type of inflammatory arthritis, and its impact on cardiovascular health and quality of life is often underestimated. The prevalence and incidence of gout are increasing globally. Further, ischemic heart disease (IHD) and chronic kidney disease (CKD) are prevalent in gout patients. Some unmet needs for gout management include physicians' low initiation rate of urate-lowering therapy (ULT) and poor treatment adherence in patients with gout. There is also a lack of randomized controlled trials that establish safe doses of acute and long-term treatment for gout, particularly in patients with IHD and stage 4 CKD and above (including end-stage renal failure).Furthermore, there is also a lack of studies showing optimal serum uric acid (SUA) target and validated clinical outcome measures, including disease activity and remission criteria for gout tailored to treat-to-target approaches and the high cost of newer gout medications. The causal relationship between asymptomatic hyperuricemia or gout with comorbidities such as IHD and CKD has yet to be fully elucidated. There is a pressing need for collaborative international efforts to address the overall suboptimal management of gout.

Is It Possible to Notice the Unmet Non-Medical Needs among Cancer Patients? Application of the Needs Evaluation Questionnaire in Men with Lung Cancer.

Lung cancer is the most common cause of cancer death worldwide. It is the most frequently diagnosed cancer in men. Lung cancer causes not only physical symptoms related to the disease itself and its treatment but also numerous mental, social and spiritual problems. The aim of the study was to assess non-medical needs among male lung cancer patients during oncological treatment. The study was conducted on a group of 160 men (mean age 67 years) treated for lung cancer from June 2022 until November 2022 in 5 oncological centers in Poland. The Needs Evaluation Questionnaire (NEQ) was used. The NEQ explores five areas of patients' needs: informative, connected with assistance/care, relational, material and psycho-emotional support. All participants (except one) expressed some unmet non-medical needs (mean and median 11). Male lung cancer patients indicated informative needs most frequently. There were no significant differences between expressed unmet needs based on age, place of residence, professional activity or marital status. The NEQ seems to be a proper instrument to explore the non-medical needs of cancer patients. Adequate measures to address the unmet needs of lung cancer patients could contribute to an improved quality of life.

Social Support and Unmet Needs for Personal Assistance Among Community-Dwelling U.S. Chinese Older Adults: Does the Source of Support Matter?

ABSTRACT This study examines the relationship between social support sources and unmet needs among U.S. Chinese older adults. Data were from the Population Study of Chinese Elderly in Chicago. Unmet needs were assessed by indexes of activities of daily living (ADL) and instrumental activities of daily living (IADL). Three specific sources of social support (spouse, family members, and friends) were included. Multivariable logistic regression models were conducted. Approximately 17% of the 3,157 respondents reported having unmet ADL/IADL needs. U.S. Chinese older adults with less overall social support were more likely to have unmet ADL needs (odds ratio [OR]=0.91, 95% CI=0.83-0.99) and IADL needs (OR=0.84, 95% CI=0.81-0.88). Family and friend support were associated with a lower likelihood of having unmet ADL needs. Support from spouse, family, and friends was associated with a lower likelihood of having unmet IADL needs. The findings highlight the importance of informal social support in addressing unmet needs .

Health related unmet needs of community dwelling older adults: a nationwide representative descriptive study in Korea.

South Korea has no official geriatric specialties or subspecialties. Moreover, studies on the unmet needs related to geriatric health problems in older Korean adults are scarce. Therefore, we investigated the unmet needs regarding geriatric health problems among older Korean adults. This cross-sectional study included 411 Korean adults aged ≥70 years. We constructed a questionnaire for a field survey that comprised 21 items to understand the geriatric challenges related to the participants' physicians and the necessity for geriatric physicians to resolve participants' health problems. We used unweighted numbers (weighted frequency) or mean ± standard deviation to describe the characteristics of the study participants for categorical and continuous variables, respectively. This study included a total of 411 men and women. The mean age was 77.6 ± 5.9 years. Among the participants, 88.6% had one or more chronic diseases (mean number of chronic diseases, 2.0 ± 1.3. 32.8) Of the participants, 32.8% said that their physicians did not spend enough time addressing their problems and only 24.3% felt that their physicians understood geriatric problems well. Of these, 76.2% (n=313) said that geriatricians were required to fulfill their unmet healthcare needs. The participants reported the need for help from a geriatrician, although most of the participants consulted regular physicians about their health problems. Geriatricians need to improve health services for older adults.

Clinical Unmet Needs and Treatment Patterns of Paediatric Psoriasis Patients: A Real-World Evidence Study in Spain

Background and objectiveReal-world evidence of paediatric psoriasis (PsO) is lacking in Spain. The purpose of this study was to identify physician-reported disease burden and current treatment patterns in a real-world paediatric PsO patient cohort in Spain. This will enhance our understanding of the disease and contribute to the development of regional guidelines. Material and methodThis retrospective analysis of a cross-sectional market research survey assessed the clinical unmet needs and treatment patterns in patients with paediatric PsO in Spain, as reported by their primary care and specialist physicians, using data collected as part of the Adelphi Real World Paediatric PsO Disease-Specific Program (DSP™) between February and October 2020. ResultsSurvey data from 57 treating physicians were included (71.9% [N=41] dermatologists, 17.6% [N=10] general practitioners/primary care physicians, and 10.5% [N=6] paediatricians); the final analysis included 378 patients. At sampling, 84.1% (318/378) of patients had mild disease, 15.3% (58/378) had moderate disease and 0.5% (2/378) had severe disease. Retrospectively reported physician-judged severity at the time of PsO diagnosis recorded 41.8% (158/378) of patients with mild disease, 51.3% (194/378) with moderate disease and 6.9% (26/378) with severe disease. Overall, 89.3% (335/375) of patients were currently receiving topical PsO therapy, while 8.8% (33/375), 10.4% (39/375) and 14.9% (56/375) of patients were currently receiving phototherapy, conventional systemics and biologics, respectively. ConclusionsThese real-world data reflect the current burden and treatment landscape of paediatric PsO in Spain. The management of patients with paediatric PsO could be improved by further educating healthcare professionals and developing regional guidelines.

Unmet Needs and Receipt of Supportive Care Services in Head and Neck Cancer Patients Prior to Oncologic Treatment: A Prospective, Cross-Sectional Pilot Study.

To characterize the supportive care (SC) needs and receipt of SC services among head and neck cancer (HNC) patients prior to oncologic treatment and to explore the influence of social determinants of health on these outcomes. Newly diagnosed HNC patients were surveyed via telephone prior to oncologic treatment between 10/2019 and 1/2021 using a prospective, cross-sectional, bi-institutional, pilot study design. The primary study outcome was unmet SC needs (Supportive Care Needs Survey-Short Form34 [SCNS-SF34]). Hospital type (university- vs county safety-net) was explored as an exposure. Descriptive statistics were performed using STATA16 (College Station, TX). Among 158 potentially eligible patients, 129 were successfully contacted, 78 met the study criteria, and 50 completed the survey. The mean age was 61, 58% exhibited clinical stage III-IV disease, and 68% and 32% were treated at the university and county safety-net hospital, respectively. Patients were surveyed a median of 20 days after their first oncology visit and 17 days prior to initiation of oncology treatment. They had a median of 24 total needs (11 were met and 13 were unmet) and preferred to see a median of 4 SC services but received care from none. County safety-net patients had comparatively more unmet needs than university patients (14.5 vs 11.5, P = .04). Pretreatment HNC patients at a bi-institutional academic medical center report a high number of unmet SC needs with corollary poor receipt of available SC services. Novel interventions to address this significant gap in care are needed.

Impact of Unmet Social Needs, Scarcity, and Future Discounting on Adherence to Treatment in Children With Asthma: Protocol for a Prospective Cohort Study

Asthma is one of the most prevalent chronic diseases of childhood and disproportionately affects children with lower socioeconomic status. Controller medications such as inhaled corticosteroids significantly reduce asthma exacerbations and improve symptoms. However, a large proportion of children still have poor asthma control, in part owing to suboptimal adherence. Financial barriers contribute to hindering adherence, as do behavioral factors related to low income. For example, unmet social needs for food, lodging, and childcare may create stress and worry in parents, negatively influencing medication adherence. These needs are also cognitively taxing and force families to focus on immediate needs, leading to scarcity and heightening future discounting; thus, there is the tendency to attribute greater value to the present than to the future in making decisions. In this project, we will investigate the relationship between unmet social needs, scarcity, and future discounting as well as their predictive power over time on medication adherence in children with asthma. This 12-month prospective observational cohort study will recruit 200 families of children aged 2 to 17 years at the Asthma Clinic of the Centre Hospitalier Universitaire Sainte-Justine, a tertiary care pediatric hospital in Montreal, Canada. The primary outcome will be adherence to controller medication, measured using the proportion of prescribed days covered during follow-up. Exploratory outcomes will include health care use. The main independent variables will be unmet social needs, scarcity, and future discounting, measured using validated instruments. These variables will be measured at recruitment as well as at 6- and 12-month follow-ups. Covariates will include sociodemographics, disease and treatment characteristics, and parental stress. Primary analysis will compare adherence to controller medication, measured using the proportion of prescribed days covered, between families with versus those without unmet social needs during the study period using multivariate linear regression. The research activities of this study began in December 2021. Participant enrollment and data collection began in August 2022 and are expected to continue until September 2024. This project will allow the documentation of the impact of unmet social needs, scarcity, and future discounting on adherence in children with asthma using robust metrics of adherence and validated measures of scarcity and future discounting. If the relationship between unmet social needs, behavioral factors, and adherence is supported by our findings, this will suggest the potential for novel targets for integrated social care interventions to improve adherence to controller medication and reduce risk across the life course for vulnerable children with asthma. ClinicalTrials.gov NCT05278000; https://clinicaltrials.gov/ct2/show/NCT05278000. PRR1-10.2196/37318.

Abstract P4-05-01: Cancer-Related Distress and Unmet Needs Among Triple Negative Breast Cancer Patients: Findings from the Cancer Experience Registry

Abstract Background: Cancer patients and survivors experience distress related to physical, psychological, social and financial concerns. Individuals diagnosed with triple negative breast cancer (TNBC) may be at increased risk of distress due to the aggressive nature of the illness and high rates of recurrence. The aim of the present study was to describe how TNBC patients characterize cancer-related distress and concerns and identify factors associated with distress. Methods: Cancer Support Community’s Cancer Experience Registry® (CER) is an online research initiative examining the physical, emotional, practical, and financial impact of cancer. The CER measures cancer-related distress using CancerSupportSource™ (CSS), a 25-item validated distress screening tool in which participants rate their level of concern (0=Not at all; 4=Very seriously) across five key domains: (1) emotional well-being (EWB; 8 items, α=.91); (2) symptom burden and impact (SYM; 8 items, α=.90); (3) body image and healthy lifestyle (BHL; 4 items, α=.80); (4) healthcare team communication (HCC; 2 items, α=.74); (5) relationships and intimacy (REL; 2 items, α=.71). CSS subscale scores were calculated as the average item rating. For item analysis, the proportion indicating moderate to very serious concern was reported. From January 2015 to August 2021, a total of 195 US residents with a history of TNBC took part in the CER and completed CSS. Multiple linear regression analysis was used to estimate the relationships between CSS subscales and socio-demographic variables (age, low-income status, employment status) and clinical history (time since diagnosis, advanced or metastatic disease, and currently receiving treatment). Results: The sample was 82% Non-Hispanic White, 7% Non-Hispanic Black, 5% Hispanic, and 7% Non-Hispanic other/multiracial. 17% reported annual household income <$40K. 44% was employed full-time, 12% part-time, 18% retired, and 24% unemployed due to disability or other reason. Mean age was 53 (SD=10) years; 11% were < 40 years. 14% of participants were < 1 year of cancer diagnosis, 27% 1 to < 2 years, 34% 2 to < 5 years, and 25% ≥5 years. 41% were currently receiving treatment, and 27% were diagnosed with advanced or metastatic disease. The mean distress subscale score was highest for concerns about BHL (1.61), followed by EWB (1.29), SYM (1.27), REL (1.04), and HCC (0.83). With regard to concerns about BHL, over half were moderately to very seriously concerned with eating and nutrition (55%) and exercise (55%). Regarding EWB, the items of greatest distress were worrying about the future (53%) and worrying about family (39%). For SYM, over half (53%) were concerned about thinking clearly, and 49% were concerned about fatigue. Participants reported moderate to very serious concern about intimacy, sexual function, and/or fertility (36%) and relationships (22%). Regarding HCC, 24% reported concern related to treatment decisions, while 22% reported concern about communicating with their doctor. In multivariate analysis, time since diagnosis was inversely associated with concerns about EWB (B=-0.03, p=.030), such that distress was higher closer to diagnosis. TNBC patients with advanced or metastatic disease status had significantly higher distress related to SYM (B=0.40, p=.009) and HCC (B=0.61, p=.001). Younger age was associated with concerns about BHL (B=-0.02, p=.011) and REL (B=-0.02, p=.006). Finally, unemployment was associated with higher distress related to EWB (B=0.57, p=.001), SYM (B=0.63, p<.001), BHL (B=0.42, p=0.03), and REL (B=0.70, p<.001). Conclusions: In this sample, average levels indicated slight distress across multiple domains. Many TNBC patients reported concerns that were physical and future-oriented, highlighting critical areas of unmet need. Factors of less time since cancer diagnosis, advanced/metastatic disease, younger age, and unemployment were predictors of higher levels of distress. Citation Format: Caroline Lawrence, Erica E. Fortune, Heather Badt, Kara Doughtie, Madyson L. Popalis, Melissa F. Miller. Cancer-Related Distress and Unmet Needs Among Triple Negative Breast Cancer Patients: Findings from the Cancer Experience Registry [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-05-01.

Alopecia Areata: Burden of Disease, Approach to Treatment, and Current Unmet Needs.

Alopecia areata is an autoimmune hair loss disorder with variations in distribution, duration, and severity. The disease is chronic and often follows an unpredictable course, frequently leading to stress and anxiety for those who suffer from it. Throughout the years more knowledge has been gained regarding pathogenesis, diagnostic tools, impact on quality of life, as well as treatment strategies for alopecia areata. However, challenges in treating and alleviating the burden of disease remain. In this article, we discuss updates regarding the pathogenesis and treatment of alopecia areata and highlight unmet needs of the condition, including a review of limitations of current treatments, accessibility to management strategies, and the need for disease awareness and advocacy.

Congenital Athymia: Unmet Needs and Practical Guidance.

Inborn errors of thymic stromal cell development and function which are associated with congenital athymia result in life-threatening immunodeficiency with susceptibility to infections and autoimmunity. Athymic patients can be treated by thymus transplantation using cultured donor thymus tissue. Outcomes in patients treated at Duke University Medical Center and Great Ormond Street Hospital (GOSH) over the past three decades have shown that sufficient T-cell immunity can be recovered to clear and prevent infections, but post-treatment autoimmune manifestations are relatively common. Whilst thymus transplantation offers the chance of long-term survival, significant challenges remain to optimise the outcomes for the patients. In this review, we will discuss unmet needs and offer practical guidance based on the experience of the European Thymus Transplantation programme at GOSH. Newborn screening (NBS) for severe combined immunodeficiency (SCID) and routine use of next-generation sequencing (NGS) platforms have improved early recognition of congenital athymia and increasing numbers of patients are being referred for thymus transplantation. Nevertheless, there remain delays in diagnosis, in particular when the cause is genetically undefined, and treatment accessibility needs to be improved. The majority of athymic patients have syndromic features with acute and chronic complex health issues, requiring life-long multidisciplinary and multicentre collaboration to optimise their medical and social care. Comprehensive follow up after thymus transplantation including monitoring of immunological results, management of co-morbidities and patient and family quality-of-life experience, is vital to understanding long-term outcomes for this rare cohort of patients. Alongside translational research into improving strategies for thymus replacement therapy, patient-focused clinical research will facilitate the design of strategies to improve the overall care for athymic patients.

Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic.

Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic.

Examining Unmet Needs in a Brain Injury Sample referred to RF: A Cross-Ethnic Comparison

Examining Unmet Needs in a Brain Injury Sample referred to RF: A Cross-Ethnic Comparison

Unmet Needs in Complicated Urinary Tract Infections: Challenges, Recommendations, and Emerging Treatment Pathways.

While urinary tract infections (UTIs) are one of the most common types of infections globally, the wide variety of presentations and of severity of disease can make it difficult to manage. The definition for uncomplicated UTIs (uUTIs) is generally regarded as UTIs in healthy, non-pregnant women whereas all other UTIs are considered complicated. There is, however, a lack of consensus definition of complicated UTIs (cUTIs), leading to global differences in management. In addition, the patients who develop complicated UTIs generally have other comorbidities that warrant more urgent intervention. One of the biggest challenges in treating cUTIs is the rise of antimicrobial resistance (AMR). While there have been recent drug approvals for new antibiotic to treat these resistant organisms, a multidisciplinary approach, including regulatory frameworks, provider education and public awareness campaigns, is crucial to limiting unnecessary treatments for asymptomatic bacteriuria (ASB) and uUTIs that can ultimately lead to more severe infections.