Orphan, Orphanage

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Management of orphanages and its implication on the educational performance of orphaned learners in kisauni sub-county, Mombasa County (Kenya)

Management of orphanages and its implication on the educational performance of orphaned learners in kisauni sub-county, Mombasa County (Kenya)

Literature review is important in research as Koshy (2005) states that it can enhance one’s understanding of the issues associated with the topic and it can also help one sharpen the focus of his/her study as such efforts will help one gain insights into the topic as well as guide him/her in the pursuit of fruitful activities. In this chapter, the literature reviewed on orphanage management and its implication on the educational performance of orphans is presented. It also presents the source material used by the researcher: journal articles, books and internet information which the researcher retrieved using search engines like Google, google scholar and Bing. The keywords used in the search include: orphan, orphanage management, orphans in Kenya, teaching or educating orphans, behavior of orphans in orphanages, performance of orphans in schools and provision of basic needs to orphans.
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Incidence and risk factors of Blastocystis infection in an orphanage in Bangkok, Thailand

Incidence and risk factors of Blastocystis infection in an orphanage in Bangkok, Thailand

In this study, Blastocystis sp. was identified using both direct wet smears and stool culture. Short term in vitro cultivation is considered to be a diagnostic method with a high sensitivity for the detection of Blastocystis sp. [20]. The incidence rate of Blastocystis infection was 1.8/100 person-months in this setting, which was low compared with a previous study in children at an older age group [21]. The prevalences of Blastocystis carriage in orphans at each time point varied from 7.2% to 27.4%. The highest prevalence was shown at the begin- ning of the study, and then gradually decreased after the time of follow up. This might be due to the notification of the first finding. Additional interventions that occurred during early 2004 to prevent transmission of parasitological infections included health education and the cleaning of clothes and bedding accessories using autoclave heat treatment. Since Blastocystis is not a host-specific organism, transmission from human-to- human and animal-to-human could have occurred [22,23]. It is indicated that the orphans acquired Blasto- cystis infection in this orphanage since no newly- enrolled orphans were infected by Blastocystis at the enrollment. In this orphanage, zoonotic transmission was unlikely to have occurred since no pets were allowed to be raised in this community setting. Water contamination has been identified as a method of trans- mission [16,18,24]. In this orphanage, filtered water was supplied from the same source to be used as drinking water in every room. Because significant differences of Blastocystis infection were found among different
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Child mental health in Jordanian orphanages: effect of placement change on behavior and caregiving

Child mental health in Jordanian orphanages: effect of placement change on behavior and caregiving

There is evidence that the increased problems evinced by older youth in care are not just a result of the quality of care in these settings, but also of the children’s experi- ence of change and placement disruption as they age through and out of the system [7,20,21]. In older youth in Jordanian institutions, we found the number of prior placement moves to be an important predictor of mental health and wellbeing [7]. The younger children in this sample have not experienced as large a number of tran- sitions at this point in their care trajectory, but the de- sign of age-triggered moves in the orphanage system and the children’s awareness of when these changes will hap- pen allowed us to explore both their adjustment to past change and anticipatory effects of upcoming changes. We find evidence of adjustment effects to change with regard to internalizing behavior, such that as the time in- creases since the child last moved we see decreases in internalizing behaviors. The opposite effect was found for externalizing disorder, such that as the length of time counts down until the child’s next move we see an asso- ciated increase in externalizing behaviors, highlighting the anticipatory effects of upcoming placement change.
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The Orphanage at Schuyler Mansion

The Orphanage at Schuyler Mansion

Doll parts, toy tea set fragments, and other toys were excavated from the late 19th-century through early 20th-century occupation layers at the Schuyler Mansion S[r]

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Emergent Voices from an Orphanage School in Belize, Central America

Emergent Voices from an Orphanage School in Belize, Central America

Miss Marcelle: ―The Liberty Children‘s Learning Centre. continues to be welcomed by the community and this was[r]

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A Re engineered  Prototype for Child Immunization in India Supplemented with ICT

A Re engineered Prototype for Child Immunization in India Supplemented with ICT

Step1: The private/ Government health centre will invoke the infant registration module and parent or guardian or owner of the orphanage (in case the child is an orphan) will provide their Aadhar number provided by government of India for the initiation of infant registration process.

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Orphan Care

Orphan Care

In this article I make an attempt to examine the different causes and types of orphanage and try to seek answers to the problems of and challenges to orphan care caused by our contemporary society. Since today’s orphans are the tomorrow’s adults, the topic has significant importance not only on societal, but on political and economic level as well. The idea of orphan care traces back to the broader idea of human security and tightly connected to the rights of children in general. Children constitute one of the most vulnerable groups of people and in case of orphans, factors of vulnerabilities (being woman or part of a minority, having disability) are often multiple. Researchers found that children living in orphanages are much more exposed to all forms of violence. The basic root of the problem is that the institutions cannot provide the emotional and psychological care that children need; therefore, they are easy target for becoming a street child, being exploited workforce, victims of trafficking or prostitution. Apart from the rights provided by the institutional and international background of social and orphan care issues, the personality of the caregiver has particular importance with regard to the assimilation of orphans to the society. An ideal caregiver tries to mitigate the pressure on orphans caused by traditions and social expectations. However, these social impacts may take various forms originating from the specific environment of the domestic culture. The aim is to strengthen the way of communication between children and social workers and to provide the orphans moral and emotional support to build up their own confidence, which is necessary to cope with the life outside the orphanages.
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Resilience As Related To Peer Attachment: A Comparative Study Of Orphan And Non-Orphan Children

Resilience As Related To Peer Attachment: A Comparative Study Of Orphan And Non-Orphan Children

IJSRR, 8(2) April. – June., 2019 Page 2639 than non-orphans. The possible reasons could be that positive, stimulating and enriched environment in the orphanage that is sustained over time contribute to boosting resilience among orphan children. Moreover, higher sense of resilience in orphan children as compared to their non-orphan counterparts mainly develops due to development of close and warm social bonds and friendships with peers in orphanages.

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Resilience As Related To Peer Attachment: A Comparative Study Of Orphan And Non-Orphan Children

Resilience As Related To Peer Attachment: A Comparative Study Of Orphan And Non-Orphan Children

IJSRR, 8(2) April. – June., 2019 Page 2639 than non-orphans. The possible reasons could be that positive, stimulating and enriched environment in the orphanage that is sustained over time contribute to boosting resilience among orphan children. Moreover, higher sense of resilience in orphan children as compared to their non-orphan counterparts mainly develops due to development of close and warm social bonds and friendships with peers in orphanages.

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IJMSS Vol.05 Issue-06, (June, 2017) ISSN: 2321-1784 International Journal in Management and Social Science (Impact Factor- 6.178)

IJMSS Vol.05 Issue-06, (June, 2017) ISSN: 2321-1784 International Journal in Management and Social Science (Impact Factor- 6.178)

Psychologist have long believed that growing up in an institution like an orphanage stunts children’s mental development but have never had direct evidence to back it up. Previous research shows that the loss of a parent can lead to a series of developmental disadvantages resulting in poor education, such as lags in grade for age and school attendance relative to non-orphans. In contrast, other studies find little negative impact of parental death on child education and instead find that alternative factors such as wealth, age, or the child’s relationship to the head of household are better predictors of education outcomes.
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Ahlawat

Ahlawat

We concluded the study by the following points, as most of the morbidities were higher in children lacking proper personal hygiene, it is important to focus on programs aimed at developing the foundations of personal hygiene. This research further suggested the need for quality health education sessions on personal hygiene as a means of primary prevention of illnesses. To ensure that children adhere to utmost personal cleanliness, regular inspection should be adopted by the orphanage authorities. Children are more receptive to learning and are very likely to adopt healthy behaviours if taught at a younger age. Hence, Teachers may play a leading role in imparting education at a younger age on personal hygiene so that it may go a long way in paving their way for a healthy adulthood.
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The correlation between HTA recommendations and reimbursement status of orphan drugs in Europe

The correlation between HTA recommendations and reimbursement status of orphan drugs in Europe

HTA assessment, which is a tool providing decision makers useful information on clinical efficacy, costs and cost-effectiveness of drugs and let allocate public cover- age on pharmacotherapy which should be reimbursed in the lack of sufficient financial resources; we speculate that in coming years in all EU member states such as- sessment for orphan drugs should be obligatory. On the other hand in some countries (e.g. Poland) some changes of too strict reimbursement requirements for orphan drugs are about to be implemented; currently in Poland tjust the same reimbursement procedures as for drugs used in non-rare diseases have been applied for orphans but probably in coming months a new law will be launched in Poland with a submission of a justifica- tion of the proposed price of orphan drug instead of submitting a full economic analysis. This means that the cost-effectiveness analyses for orphan drugs will no lon- ger be obligatory but clinical analysis as well as budget impact analysis should still be submitted during applica- tion for reimbursement of orphan drugs in Poland. The similar approach to the orphan drugs ’ assessment is ob- served in France – HAS does not examine the economic evidence in a reimbursement process [14]. In Germany there is a lower accepted significance level for p-values in case of assessment of orphan drugs ’ clinical outcomes (when sample size is small) and there is an acceptance of evidence from surrogate endpoints. The economic ana- lysis is not required if the budget impact is less than 50 million euro per annum [4]. Lower levels of evidence are accepted for clinical trials for orphan drugs in Scotland and higher cost per QALY than threshold value for non- orphan drugs is accepted in economic analysis. The flexibility in willingness-to-pay threshold value in case of orphan drugs is also acceptable in Sweden [4].
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Reconciling uncertainty of costs and outcomes with the need for access to orphan medicinal products: a comparative study of managed entry agreements across seven European countries

Reconciling uncertainty of costs and outcomes with the need for access to orphan medicinal products: a comparative study of managed entry agreements across seven European countries

Identified MEAs specific to orphan medicinal products From June 2003 to April 2010, TLV received requests for reimbursement for 30 OMPs. It awarded reimburse- ment to 29, six of which were reimbursed with limita- tions. Only one drug was denied reimbursement [49,50]. Since 2006, five CED schemes were set up by TLV to manage some form of uncertainty surrounding the evi- dence package of new OMPs. Only one is on-going (i.e. everolimus). The main uncertainties that led to the de- velopment of these schemes were (i) the need of real-life data (e.g. adherence to treatment, number of patients treated, drug dosage) and (ii) the need to validate the as- sumptions used in the ex-ante cost-effectiveness model submitted to TLV. According to our taxonomy these are CED schemes ‘only with research’ where all new patients must be treated using the new technology while new data are generated. Timeframe for generating new data ranged between two and three years. TLV was usually not prescriptive as to the outcomes data that it wished to see re-submitted but usually offered informal protocol assistance to manufacturers to develop the data gene- ration plan. In theory, failure to comply with these data requirements may result in delisting. To our knowledge, this has not happened.
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An Update on the Therapeutic Orphan

An Update on the Therapeutic Orphan

Patent expirations and economic forces of the mar- ketplace are leading to an increase in OTC switch of prescription drugs. This presents a new phase in the therapeutic orphan concept if pediatric labeling is not available for these drugs. Concerns include use in children without advice of an intermediary pre- scriber, increase in drug interactions and toxicity, and even wider off-label use for young age groups. Revised OTC drug labeling proposed recently will not ease these concerns. 38 These concerns are deep-

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Pediatric Orphan Drug Indications: 2010–2018

Pediatric Orphan Drug Indications: 2010–2018

drug development and also suggest that additional reforms may be needed to address the remaining unmet need for treatment among children with rare diseases. To achieve this goal, the US Congress recently passed the Research to Accelerate Cures and Equity Act of 2017. 22 Before 2017, the Pediatric Research Equity Act did not require drug manufacturers seeking approval for an adult indication to include children in clinical testing if the disease did not affect children or if the drug had orphan designation. The Research to Accelerate Cures and Equity Act of 2017 amended the Pediatric Research Equity Act to require pediatric testing when a drug intended to treat an adult cancer has a common molecular target in pediatric cancer and additionally eliminated the orphan exemption for TABLE 3 Pediatric Orphan Indications for Drugs Receiving FDA Breakthrough Designation
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Impact of orphan drugs on Latvian budget

Impact of orphan drugs on Latvian budget

Budget impact of orphan drugs is growing, which puts pressure on decision makers. Given current fiscal con- straints and financial uncertainty around orphan drugs, health authorities are increasingly concerned about the growth in orphan drug expenditure and its impact on their limited budgets. On the one hand, budget impact for an individual orphan drug is usually small [12, 13], due to the limited numbers of patients. The majority of orphan drugs have relatively low sales [13], except few high-cost orphan drugs. Though, budget impact for or- phan drugs altogether might be considerable [12, 14]. As a result, the number of studies conducted in this field at the European level is increasing. An early European study showed that orphan medicinal products accounted for 0.7 % and 1 % of total drug budgets in France and the Netherlands in 2004 [9], and it was anticipated to in- crease to 6–8 % by 2010. Another study focused on five European countries with the highest drug expenditures, and found that the average overall impact of orphan drugs was 1.7 % of total drug spending in 2007 [3]. The impact of orphan drugs was predicted to increase from 3.3 % of the total European pharmaceutical market in 2010 to a peak of 4.6 % in 2016 [14]. In Europe, total budget impact of ultra-orphan drugs for non-oncological diseases was estimated to be EUR 20 625 million over 10 years (2012–2021) [15]. In Belgium, orphan drugs represented 1.9 % (EUR 66 million) of total drug ex- penditure in 2008 [16, 17], and it was estimated to grow to about 4 % (EUR 162 million) in 2013. The share of total pharmaceutical expenditure spent on orphan drugs in the Netherlands almost quadrupled, from 1.1 % in 2006 to 4.2 % in 2012 (from EUR 61.2 to 260.4 million) [12]. In 2012, budget impact of orphan medicinal prod- ucts represented 2.5 % of total pharmaceutical market in Sweden and 3.1 % in France [13]. And it was forecasted to grow to 4.1 % in Sweden and 4.9 % in France by 2020. Finally, in Bulgaria, which was a pioneering country in Eastern Europe in adopting a national plan and imple- menting registers for rare diseases, expenditure for out- patient rare disease therapies was around 8 % of the total National Health Insurance Fund’s expenditure for medications in 2012–2014 (about EUR 32 million in 2013) [5].
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Estimating the clinical cost of drug development for orphan versus non-orphan drugs

Estimating the clinical cost of drug development for orphan versus non-orphan drugs

Next, we calculated the average cost per trial, by trial phase, for both groups of drugs. This was the product of the average number patients enrolled and the average cost per patient, again stratified by phase and drug group. For non-orphan drugs, the average clinical trial site-based costs per patient by trial phase was obtained through a publicly available data source in 2013 USD [15]. These per patient costs include costs related to in- vestigator and site (institutional overhead, ethics review), recruitment costs, screening, general trial procedures, materials (drug supply, comparator drugs), efficacy as- sessments (MRIs, CT scans), laboratory procedures (local lab fees, shipping of samples), site-based data management and any site-specific contract research organization costs. We utilized data from a report by EvaluatePharma to calculate the per patient cost for phase 3 trial for orphan drug trials and non-orphan drug trials [16]. These estimates resulted in a ratio of per pa- tient costs for orphan: non-orphan of 2.5:1. Given the similarities in phase 2 and 3 study designs, we assumed that the same ratio for phase 2 trials. The per patient costs for phase 1 trials were assumed to be the same for both orphan and non-orphan groups.
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Copyright in Unpublished Works: 2039 and Orphan Works

Copyright in Unpublished Works: 2039 and Orphan Works

reproduction of works such as 2039 works is permissible under the orphan works exception for CHIs, provided that it is for one of the above specified purposes. Lastly, if an institution wishes to use an orphan or 2039 work for purposes above and beyond that permitted by the European exception, they may apply to the IPO for an orphan works licence, which lasts for seven years, with an option to renew. However, for works which may be hundreds of years old, a subsisting copyright which will continue to exist for the next 24 years is a stringent protection. It means that there are still many procedures to go through before the works can be used, and there are restrictions on the ways in which they can be used. Thus, although the UK government has committed to not utilising the powers laid out in the ERR Act without further consultation, there are several options open to the UK government which should be explored in order to allow greater use of 2039 and orphan works.
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Off-label use of orphan medicinal products: a Belgian qualitative study

Off-label use of orphan medicinal products: a Belgian qualitative study

Background: Off-label use of (orphan) medicinal products for (rare) diseases is quite common but not underpinned by clinical studies to confirm efficacy and safety. No risk-analyses by regulatory agencies are carried out. The objective of this study was to map off-label use of orphan medicinal products in Belgium in terms of attitude towards off-label prescribing, factors influencing off-label prescribing, disclosure of information towards the patient, reporting of off-label use, risks and consequences. Most of the EMA authorized orphan drugs are fully reimbursed in Belgium under
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Does market exclusivity hinder the development of Follow-on Orphan Medicinal Products in Europe?

Does market exclusivity hinder the development of Follow-on Orphan Medicinal Products in Europe?

Significant benefit is justified in the EU by demonstrat- ing an improved efficacy, a better safety or a major con- tribution to patient care. In this study the concept of significant benefit included these three categories. Data regarding the assumptions of significant benefit were collected using sources in the public domain. Firstly, European Public Assessment Reports (EPARs) were con- sulted for follow-on OMPs that were successfully devel- oped and approved in the EU. An EPAR provides information regarding the significant benefit of a follow- on OMP compared to earlier approved OMPs for the same rare disorder. Secondly, Summaries of Opinion were consulted provided that the follow-on OMP obtained an orphan designation after approval of the first OMP for the same rare disorder. Finally, sponsor documents (e.g. sponsor website, annual reports, press releases) were consulted to determine the assumptions of significant benefit of follow-on OMPs that obtained an orphan designation before approval of the first OMP for the same rare disorder. All collected assumptions of significant benefit were compared and mapped using central key words of the mentioned EMA guideline [19] for each of the three categories (for example mechanism of action for improved efficacy, side effects for better safety and way of administration for a major contribu- tion to patient care).
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