Mast Cell Diseases in Practice and Research: Issues and Perspectives Raised by Patients and Their Recommendations to the Scientific Community and Beyond.

BACKGROUND: Since 2010, patients and physicians have collaborated to understand unmet needs of patients with mast cell diseases, incorporating mastocytosis and mast cell activation disorders, which include mast cell activation syndromes. OBJECTIVE: This Open Innovation in Science project aims to expand understanding of the needs of patients affected by mast cell diseases, and encourage global communication among patient advocacy groups, physicians, researchers, industry, and government. A major aim is to support the scientific community's efforts to improve diagnosis, management, therapy, and patients' quality of life by addressing unmet needs. METHODS: In collaboration with mast cell disease specialists, 13 patient advocacy groups from 12 countries and regions developed lists of top patient needs. A core team of leaders from patient advocacy groups collected and analyzed the data and proposed possible actions to address patient needs. RESULTS: Findings identified similarities and differences among participating countries in unmet needs between patients with mastocytosis and those with mast cell activation syndromes. Issues emphasized struggles relating to the nature and rarity of mast cell diseases, their impact on quality of life, the diagnostic process, access to appropriate care, more effective treatment, and the need for research. CONCLUSIONS: Solutions vary across countries because situations differ, in particular regarding the existence of and access to centers of excellence and reference centers. Multifaceted mast cell activation syndrome barriers necessitate innovative approaches to improve access to appropriate care. The outcomes of this project should greatly support scientists and clinicians in their efforts to improve diagnosis, management, and treatment of patients with mastocytosis and mast cell activation disorders.

Does Location of Practice or Religiosity Predict Negative Physician Attitudes or Beliefs Toward LGB+ Individuals?

The purpose of this study is to extend the Sabin et al's. (Am J Public Health 105(9):1831-1841, 2015. https://doi.org/10.2105/AJPH.2015.302631) findings to examine the extent to which religiosity and/or geographic region is predictive of negative attitudes or beliefs toward lesbian, gay, bisexual, and asexual (LGB+) individuals. Secondary data from the Sexuality Implicit Association Test were analyzed. Data included only participants from 2013 to 2015 who identified "Healthcare - Diagnosing and Treating Practitioners" as their occupation (n = 1376). The results of a factorial ANOVA revealed significant group differences accounting for 22.4% of the variance in attitudes toward LGB+ individuals. Religiosity was a significant factor in determining negative attitudes toward LGB+ individuals. However, the study was underpowered (5.8%) to detect an effect of geographic location in determining negative attitudes toward LGB+ individuals. It is important to validate a tool that can adequately measure the common assumptions associated with both religion and geographic region. Additionally, medical educators need to learn how to recognize and address negative attitudes among their students.

Impact of school health management committees on health services delivery in Ghana: A national level assessment.

OBJECTIVES: To examine the prevalence, determinants, and impact of local school health management committees on implementation of minimum-recommended school health services delivery among basic and secondary schools in Ghana. METHODS: National level cross-sectional data from the first-ever assessment of Ghana Global-School Health Policies and Practices Survey was utilized. Complex sample analyses were used to quantify school-level implementation of recommended minimum package for health services delivery. RESULTS: Of 307 schools, 98% were basic and government run, and 33% offered at least half of the recommended health service delivery areas measured. Schools with a school health management committee (53%) were 4.8 (95% CI = 3.23-5.18) times as likely to offer at least 50% of the minimum health services package than schools that did not. CONCLUSIONS: There is significant deficit concerning delivery of school health services in schools across Ghana. However, school health management committees positively impact implementation of health service delivery. POLICY IMPLICATIONS: School health management committees provide a significant impact on delivery of school health services; thus, it is recommended that policy makers and programmers place greater emphasis on the value and need for these advisory boards in all Ghanaian schools.