bluuebunny/crossref_metadata_2025 huggingface dataset:
After a Sharp Decline in HPV Vaccine Rates From 87% to 50%, Irish Health Experts, Politicians and NGOs Joined Forces To Turn The Tide, Helping to Increase Vaccination by 11%. This Is How We Did It
Authors: Buggy D.
Published: September 2018

Background and context: Just three years ago, in 2015, HPV vaccination uptake in Ireland was running at 87%. The school-based program was going well, and thousands of girls had completed a two-dose vaccination course which will significantly reduce their risk of cervical cancer and other HPV-related diseases. This was achieved with limited public health messaging. Then an online campaign to undermine the vaccine began to gather momentum. A small number of stories surfaced on social media claiming links between the timing of the vaccination campaigns and the subsequent development of illnesses. The campaign against the vaccine went viral on social media, local radio - and, in November 2015, on a commercial television station - fear began to trump science. In the summer of 2016, when preliminary figures showed uptake had hit 50%, the Irish Cancer Society commenced a campaign to take decisive action. Aim: To reverse the decline in HPV vaccine and restore uptake to previous levels above 80%. Strategy/Tactics: For health campaigners, such as the Irish Cancer Society, the problem of falling HPV vaccine uptake was a perplexing one. The society had pushed hard for the introduction of the HPV vaccine which commenced in 2011. To address the problem the Irish Cancer Society developed an advocacy campaign which eventually led to the establishment of the HPV Vaccination Alliance, a large group of leading health, children and women's groups, with the aim of ensuring that the public saw a broad coalition standing up for the vaccine. The Alliance has simple and consistent messages - including the fact that 40 women will die each year as a result of parents opting out of the vaccination program. Work was done to ensure that politicians were strongly supportive of the vaccine including political briefings with politicians who had previously sought to question its effectiveness. Young women with cervical cancer endorsed the campaign. The Minister for Health strongly endorsed the vaccine. The credibility of support groups for those with reported side effects of the vaccine was undermined by highlighting their links with national and international antivaccine activists as well as highlighting their repeated refusal to answer questions about where they spent money raised from the general public. Outcomes: Figures show uptake of the vaccine has increased to 61% in 2017 - up from 50% in 2016. What was learned: Not enough was done to support the initial implementation of the vaccine which created an information vacuum and under informed vaccination teams. The answer was a classic example of good public health advocacy in action demonstrating the power of alliances delivering consistent, clear and simple messaging.
Predictors of Cervical Cancer Screening Amongst Women Aged 25 - 49 in Botswana: A Pilot Study
Authors: Koyabe B.
Published: September 2018

Background: Cervical cancer is the fourth leading type of cancer in women worldwide (World Health Organization, 2015, Joshi et al, 2015). According to McFarland (2009) cervical cancer is the most common cancer leading to mortality and mobility among women in Botswana. Health Statistics Botswana (1995) noted that cervical cancer incidents continue to rise each year. It is even direr to have higher mortality and mobility among women in Botswana happening among a population that the HIV incidence and/or prevalence are humanly high. It is therefore crucial for developing countries like Botswana to take action just like the developed countries to determine the factors that predict screening for cervical cancer behaviors among Batswana women. These factors will be used to inform the design of the intervention that will lower the burden and associated morbidity and mortality of cervical cancer in Botswana. Aim: The major aim of this pilot study was to identify factors among Batswana women in going for screening for cervical cancer. The specific aims were to identify the norms and beliefs that influence cervical cancer screening among women in Botswana aged 25-49 years thus to identifying the attitudes, behavioral intentions, subjective norms, social norms, perceived power, and perceived behavioral control about cervical cancer screening among women aged 25-49 years in Botswana. Methods: In this research study, a qualitative research paradigm research approach was used to understand people's attitudes, behavioral intentions, subjective norms, social norms, perceived power, and perceived behavioral control. The study was guided by the theory of reasoned action (TRA) and its extension the theory of planned behavior (TPB) and the social cognitive theory to conduct this elicitation phase. The study was then informed by this elicitation phase to design and administer, as the quantitative phase, the survey instrument to determine the predictors for going for cervical cancer screening among women in Botswana aged 25-49 years. This instrument was administered to 115 women among the targeted population at Mochudi and Moshupa. Results: Results of this study will reveal the knowledge about cervical cancer, the behavioral beliefs, normative beliefs and control beliefs held by Batswana women that contribute to their actions to go or not to go for cervical cancer screening. Conclusion: The findings will be used to design the intervention that will target to promote the going of cervical cancer screening among women aged 25-49 years in Botswana.
Coordination of Care Within a Mobile Palliative Care Team and Organization of a Continuing Education Program for Health Professionals in Palliative Care
Authors: Kananga A. Mubeneshayi
Published: September 2018

Background: In DR Congo (DRC), many cancer patients in the terminal phase of their condition have minimal access to palliative care. There is a combined effect of poverty, the deterioration of the health system and the absence of a well-defined national policy on palliative care. Patients are for the most part abandoned to the care of inexperienced family members. Founded in 2009, Palliafamilli aims to improve the quality of life of patients requiring palliative care in the DRC by providing visits and care for patients, by striving to increase access to palliative care in the region and by informing, raising awareness and mobilizing key national stakeholders. In September 2018, Palliafamilli will launch a mobile palliative care team (MPCT) in partnership with the general hospital of Ndjili in Kinshasa. The MPCT is an interdisciplinary team consisting of physicians, nurses, a psychologist and a project manager; all experienced in accompaniment, symptom management and palliative emergency. It has a consultancy role for professionals, patients and their caregivers. Aim: Through a African Cancer Fellowship award, I will visit a mobile team of palliative care from CHRU Besançon, France, for one month in May 2018 to gain experience in designing and implementing best practices for a mobile palliative care team. Methods: I will work closely with the mobile palliative care team of the Besançon Regional Hospital Center to gain experience regarding the coordination and care administration of palliative care within a mobile team. I will also learn about the different programs of continuing education for health professionals, make comparisons and adapt the programs to the reality of DR Congo. Results: With a view to promoting access to palliative care patients, I intend to learn from the host organization the best practices that they apply to overcome communication difficulties with the patient and their relatives which can constitute delays to access to adequate care. This delay is more marked for patients suffering from cancer because the evolution of their pathology is unpredictable. The main barriers are the insufficient knowledge of patients' needs and the opportunities offered by palliative care. Upon my return, I will adapt the best practices learned in France to the DRC context during the launch of the new mobile palliative care team. Conclusion: In Congo, a cross-cutting approach is required to provide patients with palliative care and pain relief, as resources are limited, many people are in need of care, and there are few nurses and doctors empowered to provide care. An effective approach is to involve community or volunteer caregivers supervised by health professionals, and Palliafamilli is successful due in its multidisciplinary and multisectoral approach, with adaptation to cultural, social and economic specificities and its integration with existing health systems, focusing on primary health care and community and home care.
Assessment of Anxiety and Depression Among Breast Cancer Patients in Ghana
Authors: Kyei K.A.
Published: September 2018

Background: Cancer of the breast happens to be one of the most important diseases worldwide and in Ghana, accounts for the highest referral at the study site. The treatment of breast cancer has evolved over the years offering patients high rates of survival. What is missing in the literature are studies that focus on determining levels of depression and anxiety and how this assessment will impact treatment outcome for breast cancer patients undergoing radiotherapy. Hence, recognizing a better understanding in this study will promote positive social change in three different ways. First, it will serve the cancer population especially patients undergoing breast cancer treatment to manage depression and anxiety. Second, it will enhance efforts for coping and finally increase the overall quality of life of these patients undergoing treatment. Aim: This study aims to find various interventions for depression and anxiety among breast cancer patients in Ghana. Methods: The author used a mixed method design to gather both quantitative and qualitative data. The qualitative data were an interview with selected working participants whiles the quantitative data were a nonprobabilistic approach using a structured questionnaire. This mixed method was a triangulation that described how the interviews supported and confirmed the responses from the patient participants. There was an evaluation of the relationships with a combination of two modified scales, Patient Health Questionnaire (PHQ) and Depression Anxiety Stress Scale (DASS). The sample consisted of 100 patients between the ages of 20-89, and six professionals with a minimum of five years' work experience. Results: Findings of this study indicated the need intervene through counseling and education on behalf of patients in Ghana as they undergo breast cancer treatment. Age and monthly income of patients were statistically significant in predicting the anxiety and depression among the patients. The R (0.397) value was less than 0.5, which depicted that the alternate hypothesis could be accepted. The independent variables significantly predicted the anxiety and depression. Conclusion: The study illustrates a need to understand how breast cancer patients in Ghana go through treatment with the high impact of anxiety and depression with treatment which affects total well-being and life after treatment. Although interventions and management should be available to breast cancer patients with anxiety and depression undergoing treatment of their coping with the burden of the disease, a striking improvement in the survival of patients could be achieved when proper systems are put in place by the Ministry of Health and the government.
Getting Ireland Moving for World Cancer Day 2018
Authors: Lyng A. , McCarthy T. , Glynn R. , Guiry R. , Shields M. , Bonas F.
Published: September 2018

Background and context: World Cancer Day (WCD) aims to increase awareness and empower individuals to reduce their risk of cancer. Each year in Ireland approximately 800 new cancer cases and 300 cancer deaths are due to obesity. Aim: For WCD the Irish National Cancer Control Program (NCCP) aimed to increase public awareness of the risk of cancer due to obesity and the protective link with physical activity. Behavioral action was encouraged by partnering with parkrun ( www.parkrun.ie , a national free running event) to encourage participants to bring a friend and spread the cancer prevention message. Strategy/Tactics: A single overarching message was established: bring a friend to parkrun on the 3rd February for World Cancer Day. Two target audiences were identified: - General public watching Operation Transformation a national interactive TV program supporting weight loss and encouraging health behaviors - parkrun participants. Program/Policy process: Campaign activities were planned in conjunction with parkrun and HSE communications: - Digital assets designed - Press release issued to local and national media - Partner pack with key messages, social assets, campaign activity and supporting evidence disseminated to statutory bodies, NGOs and charities - NCCP cancer expert feature on Operation Transformation - Social media campaign @HSELive and @parkrunIE - Articles in parkrun newsletter prior to WCD - Announcements at parkrun events around the country prior to WCD - Communication to health service staff. Outcomes: On the 3rd February 10,169 individuals participated in parkrun, coordinated by 1153 volunteers. Cancer prevention and survivorship articles were published in 3 parkrun newsletters. #WorldCancerDay posts reached 39,000 on parkrun Facebook and 33,700 on parkrun Twitter. HSE paid Facebook posts reached 375,861 with a high level of engagement. Unpaid posts reached 5458. Tweets issued had a total reach of over 280,000. Parkrun directors provided the following feedback: “I think it was a great success - the engagement on social media both through parkrun Ireland and through the local event social media was brilliant.” “I think all the local events had at least one post on #WorldCancerDay during that time and most had had more and the feedback was uniformly positive, a couple of the parkruns (notably Dundalk parkrun) invited local cancer support groups to the event as well and in Dundalk´s case they actually gave a little talk before the event which was well received.” What was learned: - Inclusion of digital images for partners to share on social media was an integral element of the partner pack. - Straightforward message with a call to action built on an existing initiative with a broad reach across the country. - At the time of the campaign there was a large amount of national media coverage of Operation Transformation, impacting on space for media coverage. In the future consider a more local approach.
Mouth Self-Examination (MSE) As a Screening Tool for Oral Potentially Malignant Disorders Among a High-Risk Indigenous Population With a Low Socioeconomic Status
Authors: Razak I.A. , Ghani W.M.N. , Doss J.G. , Ramanathan A. , Tahir Z. , Ridzuan N.A. , Edgar S. , Zain R.B.
Published: September 2018

Background: Oral cancer can be preceded by a group of conditions termed oral potentially malignant disorders (OPMDs). Oral cancers are associated with a 5-year survival of less than 50%, largely attributed to diagnoses at advanced stages. As pain associated with oral cancer manifests only at late stages, delay in detection often occurs. Screening has been found to aid in detection at an early stage, however it is only feasible if targeted toward high risk individuals. Mouth self-examination (MSE) is a relatively quick, inexpensive and simple to perform method of screening. Aim: To evaluate the efficacy of MSE as a screening tool for detection of oral mucosal lesions and OPMDs in a high risk indigenous population with a high prevalence of tobacco and betel quid chewing habit. Methods: Two villages were selected as the sampling frame based on prevalence of tobacco and betel quid chewing habit. Respondents were asked to check their mouth for presence of lesion or abnormalities. Education on oral cancer, including MSE was provided. Subsequently, respondents were asked to perform MSE. Finally, a comprehensive oral examination (COE) was done by a specialist and the presence of oral mucosal lesions was recorded. Results: Almost 64.5% of respondents exhibited high levels of difficulty and low mucosal visualization and retracting ability, whereas 3.0% demonstrated high attention level when performing MSE. Prevalence of oral mucosal lesions was 59.0%, whereas the prevalence of oral potentially malignant disorders (OPMDs) was 9.0%. Detection of oral lesions by respondents using MSE was lower than detection by the gold standard. Sensitivity and specificity of MSE for detection of all types of lesions were 8.6% and 95.0% respectively. When analyzing each lesion type separately, MSE was found to be most sensitive in detection of swellings (10.0%), and most specific in identifying red lesions (100.0%). For detection of OPMDs, MSE yielded a high specificity of 98.9%, with an accuracy rate of 91.8%. Conclusion: MSE is a potentially good screening tool for OPMDs and oral cancer; however, awareness level of the public on oral cancer and its associated signs and symptoms needs to be improved.
Integrating Cervical Cancer Screening and Syndromic Management of Sexually Transmitted Infections in Resource-Limited Settings in India
Authors: Bhise M. , Dhanu A. , Apte K. , Rahman A. , Huang Y.
Published: September 2018

Background: In India, annually, there are more than 120,000 women diagnosed with cervical cancer and more than half of them die of the disease. The link between cervical cancer and high-risk type of human papilloma virus (HPV) is well-established. In addition to this, low-risk type HPV can lead to sexually transmitted infections (STIs). It is believed that 6% of Indian adult population is affected by one or more STIs. However, due to geographical and socioeconomic barriers, rural and poor women do not always have access to updated sexual and reproductive health (SRH) information and relevant services, resulting in the delay of treatment. To address these challenges and to strengthen the existing health system, Family Planning Association of India (FPA India), a national level voluntary organization, integrated cervical cancer and STIs services into a 2-year project and delivered it in urban slums and rural areas. Aim: To evaluate the impact of integrated cervical cancer and STIs services in the resource-limited settings in India. Methods: FPA India implemented the integrated package through six branch health facilities to raise people's awareness and build institutional capacity for the screening of women. All detailed process is summarized in Fig 1. Data, such as the number of cervical cancer screening and syndromic treatment, was collected. Results: More than 14,000 people were reached and 14 service providers including midlevel providers were trained. The number of services significantly improved in the selected 6 branches and in all branches of FPA India. The numbers for syndromic treatment of STIs almost doubled in the selected 6 branches and showed a 50% rise in all the branches. The number of cervical cancer screenings was 2938 and 9862, before and after the project, respectively in the selected 6 branches. The progress nearly doubled at the whole association level. Additionally, in this project, the progress of visual inspection of the cervix with acetic acid (VIA) and Lugol´s iodine (VILI) was remarkable whether in 6 selected branches or in all branches. At the end of project implementation, VIA/VILI accounted for 90% of all cervical cancer screenings. Data are summarized in Table 1. Conclusion: This study presents FPA India's operational experience in carrying out integrated cervical cancer and STIs services, in urban slums and rural areas. This project reaffirms that raising people's awareness and building institutional capacity are core approaches to deliver certain SRH information and services as well as achieve better SRH outcomes. The shift from Papanicolaou test to VIA/VILI may be related to VIA/VILI's sensitivity, quick results and affordability. However, more studies are needed to explain this change.[Figure: see text][Table: see text]
My Alma: A Digital App Supporting Metastatic Breast Cancer Patients in Greece
Authors: Mitsi C. , Tzintziropoulou E. , Panagiotopoulou L.
Published: September 2018

Background: Current research has shown that women with MBC patients feel ashamed and isolated. In Greece, “Alma Zois”, as a patient group, has made several attempts to provide support, but with a moderate success. Nevertheless, MBC patients have unmet needs that consist of better information and knowledge about MBC, better support for physical and emotional impact of MBC and better quality of life. Especially when it comes to younger women, these needs seem to be less covered. The development of a specially designed digital application (app) will cover the gap between support services and MBC patients by embracing the digital era in a country where 66% of the population uses smartphones. Aim: The development of the app aims at: 1) providing useful information about metastatic breast cancer, 2) reaching out to MBC patients, 3) improving the quality of life, 4) increasing healthy behaviors, and 5) increasing compliance. Methods: The project “My Alma App” is designed according to three major pillars: 1) Awareness, 2) Support 3) Communication. The 1st part AWARENESS includes: information about MBC. Calendar - Daily record of healthy behaviors (walking, nutrition, etc.). The 2nd part SUPPORT includes: 1) Psychological advice provided by psycho-oncologists, 2) Emotional-meter: issue the daily question “How are you feeling today?” and based on the patient's answer, the app can provide multiple suggestions/call to action. The 3rd part COMMUNICATION includes: personalized motivation, calendar with reminders of medication, therapies and events that might be of interest according to each patient's profile. Results: To achieve the best quality for the project: 1) A technical development of the app is been held, 2) The app will be tested by a group of patients as a pilot study and 3) Updates and improvements based on users feedback (metastatic breast cancer patients) and latest scientific data will be made. After the official launch, a short satisfaction survey will be addressed to every registered user. Finally, to motivate patients to use the app, a special social media campaign about the app will be launched. Conclusion: It is expected that the app will provide to MBC patients ways and methods to deal with the emotional challenges, distress and ways to improve their daily activities and their quality of life. Upon the end of the launch of the app, it is expected that a number of 500 Stage III and IV breast cancer patients will start using the app. The number of people who will download the app, the data provided by app users and the ratings and answers on “emotion-meter” during a period of time will be indexes of impact of the project to the MBC community in Greece.
Economic Burden of Esophageal Cancer on Esophageal Cancer Patients and Their Perceived Threat for Discontinuation Under Treatment and Follow-Up Patients Attending Tikur Anbesa Hospital, Oncology Department
Authors: Tuamay B.
Published: September 2018

Background: The cancer esophageal is one of the deadly malignant in the world. Ethiopia is the country with a higher esophageal cancer incidence. Esophageal cancer has been severely affecting the economically disfranchised counties like Ethiopia. Aim: The overall aim of the study was to explore the economic burden of esophageal cancer on esophageal cancer patients and their perceived threat for discontinuation under treatment and follow up patients attending Tikur Anbesa Hospital, Oncology Department. Methods: In-depth interviews were carried out with purposively selected esophageal cancer patients attending Tikur Anbesa Hospital, Oncology Department. A total of 10 in-depth interviews were done. The numbers of interviewees were determined by information saturation. The interviews were conducted using semistructured interview guide. All in-depth interviews were taped. Data were translated in to English, and then coded using Open Code software version 4.0. Finally thematic analyses were used as a method of analysis. Results: Squatty of awareness on causes for esophageal cancer infection was claimed by the patients. Moreover, both lack of knowledge on the typical symptom of the disease and information in the presence of treatment were scrutinized. Patients oftentimes had claimed traditional remedies as their primary preference for their treatment. Esophageal cancer was perceived as the most fatal disease than any other cancer types by the patients. Fees for medical care and other nonmedical expenses were beyond their capacity. The referral system along with the private facilities fees made patients economically deprived. Public health facilities were lacked necessary drugs and diagnostic materials as a result they were exploited by private health facilities. Majority of the participants were not sure about their continuation under their follow-ups due to future financial constraints and sought government support. Conclusion: Lack of knowledge about the causes for esophageal cancer infection was critical observed. Patients were at risk for their continuation with their treatment and follow-up. The care for esophageal cancer needs several specialists and expertise and this has led for costs unaffordability to the patients.
Self-Mouth Mirror Examination: A Boon to Tobacco-Related Potentially Malignant Lesions and Oral Cancer
Authors: Hazarey V. , Deshmukh A.
Published: September 2018

Background and context: The tobacco related potentially malignant disorders and oral cancer occupies the major burden of diseases caused by smokeless and smoking tobacco in general in southeast Asia and in particular India. The major challenge is due to lack of awareness about ill effects of tobacco especially in rural India. Community awareness is adopted as a measure to reduce mortality and morbidity of oral cancer and also other cancers caused by tobacco. In developing countries like India, the problem is magnified because of low literacy levels and lack of logistics and IEC material. The qualified human resource especially professionals to assist is also another road block. Intervention is designed to create awareness about ill effects of tobacco through a simplified IEC pictorial brochure called Self-Mouth Mirror Examination (SELFMEE). Aim: To aware public about ill effects of tobacco and how to notice the disorders caused at early stages. Capacity building of dental and paramedical and nursing workers toward tobacco control. Strategy/Tactics: Young dental and medical professional and paramedical workers such as nursing students and ancillary workers were trained to educate public about self-mouth mirror examination. Thus spreading awareness against tobacco and promoting health by counseling and treatment of diseases diagnosed. Program/Policy process: Village constituency of a elected legislative member from rural India (katol) was considered to implement policy of SELFMEE. 75,000 homes coming under the ten primary health centers were surveyed nearly covering 200,000 population. The procedure was explained through visual demonstration of brochure. Sign and symptoms were explained and the sensitized populations was screened at primary health centers. Outcomes: 5100 citizens reported to have complaints which were examined by young dental and medical professionals mainly residents. 900 citizens were found to have oral diseases. Majority of the 800 showed the signs and symptoms of a potentially malignant disorder caused by smokeless tobacco and areca nut mixture (gutkha/kharra). Ten oral cancer cases were detected. Eight early cancers were treated at tertiary medical college centers. Two inoperable cases were given palliative treatment. The oral submucous fibrosis cases were advised tobacco and areca quid cessation. What was learned: Mouth mirror examination performed by self-helped tobacco users to observe the ill effects of tobacco habits by themselves thus becoming active partner in tobacco control. The self-motivation to quit habits is effective. Young dental and medical professions were trained in effective cancer control.
Trends in Incidence and Mortality of Female Cancers Among Sri Lankan Women 1995-2010
Authors: Vithana P.V.S.C. , Perera S. , Dheerasinghe D.S.A.F. , Handagiripathira H.M.I. , Mery L. , Bray F.
Published: September 2018

Background: Sri Lanka is facing epidemiologic transition from communicable diseases to noncommunicable diseases in recent decades. Aim: This study analyses the trends in incidence and mortality of all cancers, breast cancer, cervical, ovarian and uterine cancers among Sri Lankan females over 1995-2010. Methods: Cancer incidence was obtained from the published national hospital based cancer registries, Sri Lanka for 1995-2010. Cancer mortality was abstracted from World Health Organization (WHO) database for 1996-2003 and 2006 and Department of Census and Statistics Sri Lanka for 1995 and 2004-2010 where WHO data were not available. Number of new cases and deaths were obtained by five-year age group for all cancers by sex and breast, cervical, ovarian and uterine cancers for females. Particular cancer specific incidence and mortality rates were directly age-standardized to the world population and age standardized rates were calculated for all ages, 20-34, 35-64 and over 64 years. Results: Female, age-standardized rates (ASR) for incidence for all cancers rose from 63.3 to 87.5 per 100 000 population during 1995-2010 and morality increased from 44.5 to 53.5 per 100 000 population over 1995-2010. In spite of having basically similar trends in both sexes, female incidence remained higher and mortality lower than males. Breast cancer was the commonest cancer among females with its incidence and mortality increasing through-out. Cervical cancer incidence increased during 1995- 2000, declined slightly in 2005 and remained stable over 2006-2010. Cervical cancer mortality remained stable over 1995-1999, declined in 1999-2003, increased in a lesser extend throughout 2003-2006 and remained stable during 2007-2010. Ovarian cancer incidence remained stable over 1995-2010 with 35-64 years being highest. Its mortality remained stable over 1995-2000 and declined slightly during 2000-2003 and increased in 2003-2010 with over 64 years being highest. Uterine cancer incidence and mortality increased steadily throughout 1995-2010. For all above mentioned cancers, incidence and mortality in 0-34 years remained low. Conclusion: Increasing trend of cancer incidence and mortality among females over 1995-2010, directs the need of revisiting breast cancer and cervical cancer control program in the country and strengthening awareness and early diagnosis and timely treatment of the other gynecologic cancers.
The Role of Volunteers in Quality Palliative Care Delivery
Authors: Manna A.
Published: September 2018

Introduction: Here in India almost 75% of cancer patient die a sad death of neglect due to lack of awareness about palliative care and low economic level. Surveys in India show that two third of cancer patient do not get proper care during the terminal phase of their life. Palliative care through volunteers can make a significant difference in this respect. Objective: To identify and try to solve, to the extent possible, the main difficulties in giving palliative care to the terminal cancer patients of the area. And evaluate the impact of volunteer's direct care of palliative patients and their families. Methods: Feedback from patients and their relatives regarding the palliative care they receive from nursing home and from volunteers and compare the two. Also feedback from volunteers regarding their positive and negative experience while delivering palliative care service. Then evaluate the data to compare and improve the quality of service. Results: We carried out two studies. One study was undertaken in nursing home palliative care and another was in home setting by volunteers. Both studies were in adult palliative care services. Since January 2015, 496 cases were studied to inquire about their experience in both home based care and nursing home care. Both the studies fulfilled our quality appraisal criteria. One found that those families and patients who received home visits from volunteers were significantly more satisfied. The study highlighted the value of the role of volunteers in better satisfaction of patients and their families. Conclusions: Further research is needed to evaluate the role of volunteers in palliative care and how it can be delivered appropriately and effectively. We also wish to compare our findings with similar studies elsewhere.
Tobacco Addiction: Quitting Smoking Through Systemic Approach
Authors: Algosini J. Bilachi , Aldemir Bilaqui
Published: September 2018

Background: The main reason for carrying out this study was the wish to understand the reasons leading to smoking, the influence of such behavior in people's ways of thinking, as well as methods of quitting. It was necessary to understand that the dependents are more than their beliefs, family, social life, religion, profession, and paradigms. Aim: Smokers who want to quit smoking through their cognitive system transformation. Objectives: The objective of this project was to help patients quit smoking through systemic approach and, consequently, to help them face quitting methods more comfortably and safely and also to avoid relapse. Methods: This project started from a systemic model that is based on the conscience of the essential interrelation and interdependence state of all physical, biologic, psychological, social, and cultural phenomena. Support brief therapy and support group were the resources used during this research. As well as these methods, some patients, assisted by a medical team, underwent drug therapy. Therapeutic techniques (such as verbal techniques; action; creation of contexts; opening to the emerging narratives; paradoxical; structural; strategic; and the problem externalizations) were developed both in support brief therapy and support group. Results: The quantitative results will be presented here to show the effectiveness of the project developed. The most important information is the number of people who interrupted tobacco dependence: 322 (70%) out of 460 quit smoking, of which 186 (58%) were men and 136 (42%) were women. Among the men who quit smoking, 41 were in the support group, 76 were in the support brief therapy, and 69 were in both. Among the women, 43 participated of the group therapy, 48 of the support brief therapy and 45 were in both; 48 men and 25 women took antismoking medication, while 11 men and 2 women used patches. Relapse occurred in 26 out of 322 patients who had quit smoking, 9 out of the 26 restarted therapy, and 6 of them quit smoking. The patients who relapsed, 9 attended the support group (4 men and 5 women), 10 attended the support brief therapy (6 men and 4 women), and 7 attended both (4 men and 3 women). Those who restarted the treatment, 6 were in the support group (2 men and 4 women), 3 were in the support brief therapy (1 man and 2 women), and no one was in both. Among the patients who quit smoking, 2 were in the group work (1 man and 1 woman), 4 were in the individual therapy (1 man and 3 women), and no one was in both. Conclusion: It was possible to verify that quitting smoking through systemic approach is effective, because it gives the individual, immersed in his/her family system, the opportunity to discern all his/her integrated and interdependent aspects (biologic, psychological and social phenomena) and, thus, restructure his/her paradigms and patterns of behavior.
The Larynx Carcinomas in West Serbia
Authors: Majstorovic S. , Majstorovic N.
Published: September 2018

Background: Malignant tumors of the larynx account for 20% of all malignant head and neck tumors, and 45% of all epithelial head and neck tumors, as well as 2% of all malignant tumors. They commonly occur among the population of 50-70 years of age, and quite rarely among the population under 20 years of age, and affect predominantly male population. The larynx is located at the intersection of the respiratory and digestive ducts. It consists of a number of cartilages mutually connected by joints, muscles and connective tissue. Anatomically, clinically and oncologically speaking, the larynx is divided into three sections: supraglottis, glottis and subglottis. The supraglottis tumors dominate over the glottis tumors while the subglottis tumors are the least frequent and occur with approximately 5% of the patients. The larynx carcinomas produce regional metastases on the neck and more distant organs such as the lungs, the liver and the brain. Aim: The survey covers the five-year period, from 2010-2015, during which LMS (laryngomicroscopic procedures) were performed on the patients from municipality of Čačak and West Serbia and results obtained upon the histopathological examination of the biopsy-taken tissues of the above patients. Methods: Diagnosis, estimation of the logically and the extent of tumor are performed according to the following method of operation: 1. Case history 2. Clinical examination 3. Endoscopic examination and RTG examination. Endoscopic methods: 1. Indirect laryngoscopy 2. DSC and LMS (directoscopy and laryngomicroscopy) 3. Fib laryngoscopy 4. ESC (esophagoscopy), due to the tendency of tumor to spread to hypopharynx 5. TBSC (tracheobronchoscopy) 6. Stroboscopy. The essential procedures in the larynx carcinoma therapy are as follows: 1. To assess the locality and extent of the tumor 2. To ascertain the PH with specific histologic paraments (nuclear and histologic graduation) 3. To assess the extent of the tumor in the region. Results: The total of 305 LMS procedures were performed, out of which 225 on male and 80 LMS on female patients. There were 207 (68%) patients with benign lesions and 98 patients (32%) with larynx carcinomas. The larynx carcinoma was found in 90% of the male and 10% of the female patients. The youngest patient aged 26, while the oldest one was 82 years of age. The benign lesions took the forms of polyps, papillomas, hemangiomas and chronic inflammation of the larynx mucous membrane. Conclusion: The exposure of the larynx epithelium to various air pollutants and tobacco smoke especially, causes numerous changes in the organ which may range from harmless acute inflammation to cancerogenic conditions.
Effectiveness of Mass and Small Media Campaigns to Improve Cancer Awareness and Screening Rates in Asia: A Systematic Review
Authors: Schliemann D. , Su T.T. , Paramasivam D. , Donnelly M.
Published: September 2018

Background: Cancer presents an increasing burden for Asian countries and cancer-related deaths have been predicted to increase from 4.1 million in 2008 to 7.5 million in 2030 in Asia. Low-middle income countries are recommended to prioritize public education as a first step toward cancer prevention and early detection. Mass media campaigns have been found to be effective in increasing cancer awareness and screening uptake in western countries as well as cost-effective in reducing morbidity and mortality. A number of studies have used mass and or small media components in Asian countries. Aim: This systematic review aims to deliver an overview of small and mass media campaigns in Asia and to assess their effectiveness in improving cancer awareness. Methods: We searched MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, Cochrane Library, Gray literature and Google Scholar for relevant literature. Furthermore, we hand-search reference lists of relevant reviews and studies and run a search in relevant journals individually. Peer-reviewed studies that were published in the English language before September 2017 and targeted adults aged 18 year or over in Asia, were included. We excluded studies targeting minority populations living abroad as well as studies that included individual or group components in addition to the media components. Results: The search identified 10,676 titles after removal of duplicates. A total of 479 titles were included in the abstract screen and 51 articles were included in the full-text screen. The full-text screen is currently ongoing and the results will be presented at the conference. Conclusion: To our knowledge, this is the first systematic review summarizing the effectiveness of media campaigns to improve cancer awareness in Asia. The full results of the systematic review will be valuable to inform future mass and small media campaigns in Asian countries.
Prospective Assessment of Quality of Life and Quality of Death of Patients With Advanced Cancer
Authors: Surendran V. , Revathy S. , Prasanth G. , Kalpana B.
Published: September 2018

Background: Advanced disease and its treatment contribute to a compromised lifespan of any patient. The treatment in cases of advanced disease is aimed toward managing physical symptoms and providing supportive care, whereas the extent to which the treatment achieves the given purpose, thereby improving the quality of life in India, is underexplored. As advanced cancer patients have a compromised lifespan, the quality of life during their survival will be a major factor that influences their quality of death. Aim: This present study was carried out with the aim of assessing the QoL of patients with advanced cancer, prospectively and exploring the quality of death of those patients who had expired. Methods: A total of 46 patients above 18 years of age, with advanced solid malignancies, after the failure of 1 or more than 1 line of therapy with curative intent were enrolled and were assessed for their QoL and other symptoms for baseline. As patients expired during the phase of the study, only 23 and 12 patients were assessed for the following 2nd and 3rd prospective assessments, respectively. Quality of death was assessed using caregiver ratings of patients' physical and mental distress on a scale of 0-10, for 31 patients, who had expired during the study. Descriptive statistics, t-test, repeated measure of analysis of variance and χ2 test were used for analyzing the data. Results: Patients, irrespective of the site of the diagnosis or the treatment received, were found to be moderately distressed, thus leading to a low global QoL. Although not significantly, the overall distress of the patients has decreased overtime with the mean scores being 6.04, 4.82 and 4.12 during the 1st, 2nd and 3rd assessments, respectively. The pain level of the patients found to differ significantly overtime (F= 4.128; P = 0.049), decreasing during the second assessment and increasing thereafter. A significant reduction in the levels of depression was observed during the prospective assessments (F= 18.293; P = 0.000). Similarly, the concerns about the financial difficulties also decreased eventually (F= 6.563; P = 0.015). The demographics were found to have a significant impact over the physical symptoms namely anxiety, pain, role functioning, fatigue, appetite, nausea and dyspnea. The quality of death analysis revealed a poor physical, whereas moderate psychological health and overall quality of life. The most commonly reported physical sufferings of the patients who had expired, by their caregivers were lack of appetite, pain, immobility and difficulty in breathing, while psychological concerns were anticipation about survival and worsening of physical symptoms. Conclusion: Even with efficient treatment modalities targeted toward managing symptoms during end-of-life, patients with advanced cancers have a compromised quality of life and subsequently compromised quality of death, as a result of their poor physical health.
Gabay Magulang: A Parent-Empowerment Program
Authors: Fernandez A.S.
Published: September 2018

Background and context: Gabay Magulang or Parent Guide is a collaboration between Kythe Foundation Inc. and selected medical students to provide support for and empower parents of children newly diagnosed with cancer. With the guide, parents would be better able to understand and care for their children. Aim: The program has two aims. First, it seeks to inform parents by providing relevant information on childhood cancer and its treatment. Second, the program hopes to develop and empower core Parent Leaders who will take the lead in educating and supporting other parents. Strategy/Tactics: Focus group discussions (FGDs) were conducted with parents of children with cancer to better understand their needs and how best they can be supported. With the information gathered, a draft of the guide was written by the medical students and forwarded first to Kythe staff and then to pediatric hematologists/oncologists for editing. Four pediatric hematologists/oncologists edited the booklet before publishing. From the initial FGDs, a select group of core parents were invited to be Parent Leaders. Four training sessions on the use of the guide were conducted by Kythe. After the training, the Parent Leaders led learning sessions with parents of newly diagnosed children. Program/Policy process: Two programs are run every year with four months for each program. Monthly learning sessions are conducted in the four months by the Parent Leaders using Gabay Magulang (Parent Guide). In these four sessions, Kythe staff are present to provide support and a pediatric oncology fellow or consultant is on hand to either discuss a specific topic or provide answers to questions that arise. Outcomes: There are now four Parent Leaders who actively help in educating and empowering parents of newly diagnosed patients. More of the latter set of parents have expressed an increase in awareness and information of pediatric cancer. Likewise, they have become more involved in their children´s journey and treatment process. A new batch of Parent Leaders are now being chosen. What was learned: Empowering parents to be active partners and advocates in the holistic healing of their children undergoing treatment of cancer is essential. The Gabay Magulang program has published a parent guide, trained Parent Leaders to lead learning sessions and has provided parents with opportunities for better understanding of their children's illness and treatment and answered questions through sessions with a pediatric oncology fellow or consultant.