bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of life and associated factors among chronic kidney disease patients at Zewditu Memorial and Tikur Anbessa Specialised Hospitals, Ethiopia: a cross-sectional study design
Authors: Berhe Teshome , Tegegne Gobezie T , Berha Alemseged Beyene 
Published: June 2023

IntroductionChronic kidney disease (CKD) is associated with significant morbidity, mortality, healthcare cost and reduced health-related quality of life (HRQoL). This study aimed to assess HRQoL and associated factors among patients with CKD at both Zewditu Memorial and Tikur Anbessa Specialised Hospitals, Ethiopia.MethodA cross-sectional study design was performed. All patients who visited the renal clinics in both hospitals from March to July 2019 were targeted, and data were collected using interviews and medical records. HRQoL was assessed using the Kidney Disease and Quality of Life-36 tool. Normality assessment was done for HRQoL subscales. Descriptive statistics, logistic regression, t-test and one-way analysis of variance were performed.ResultA total of 300 patients with CKD were included. Around 62% of them were in either stage 3 or 4 CKD. The mean domain scores of physical component summary (PCS), mental component summary (MCS), burden of kidney disease, effect of kidney disease and symptoms and problems of kidney disease (SPKD) subscales were 50.4, 59.5, 63.1, 74.6 and 80.4, respectively. The lowest HRQoL was seen in the PCS scale, while the highest was in SPKD. In addition, the study revealed that a lower level of education, elevated serum creatinine and a history of smoking were significantly associated with poor PCS score. Further, the presence of three or more comorbidities, CKD-related complications and a lower haemoglobin level were significantly associated with poor MCS.ConclusionThe overall mean scores of PCS and MCS were low, below the standard level. Level of education, serum creatinine and smoking history were significantly associated with PCS, while the presence of comorbidity, complications and haemoglobin level were significantly associated with MCS. Stakeholders working on CKD management should design a relevant strategy targeting patients, patients’ care providers and healthcare professionals to improve HRQoL of patients.
Objectives and outcomes of patient-driven innovations published in peer-reviewed journals: a qualitative analysis of publications included in a scoping review
Authors: Dahlberg Marie , Lek Madelen , Malmqvist Castillo Moa , Bylund Ami , Hasson Henna , Riggare Sara , Reinius Maria , Wannheden Carolina 
Published: June 2023

ObjectivesThe aim of this study was to gain a deeper understanding of the objectives and outcomes of patient-driven innovations that have been published in the scientific literature, focusing on (A) the unmet needs that patient-driven innovations address and (B) the outcomes for patients and healthcare that have been reported.MethodsWe performed an inductive qualitative content analysis of scientific publications that were included in a scoping review of patient-driven innovations, previously published by our research group. The review was limited to English language publications in peer-reviewed journals, published in the years 2008–2020.ResultsIn total, 83 publications covering 21 patient-driven innovations were included in the analysis. Most of the innovations were developed for use on an individual or community level without healthcare involvement. We created three categories of unmet needs that were addressed by these innovations: access to self-care support tools, open sharing of information and knowledge, and patient agency in self-care and healthcare decisions. Eighteen (22%) publications reported outcomes of patient-driven innovations. We created two categories of outcomes: impact on self-care, and impact on peer interaction and healthcare collaboration.ConclusionsThe patient-driven innovations illustrated a diversity of innovative approaches to facilitate patients’ and informal caregivers’ daily lives, interactions with peers and collaborations with healthcare. As our findings indicate, patients and informal caregivers are central stakeholders in driving healthcare development and research forward to meet the needs that matter to patients and informal caregivers. However, only few studies reported on outcomes of patient-driven innovations. To support wider implementation, more evaluation studies are needed, as well as research into regulatory approval processes, dissemination and governance of patient-driven innovations.
Short-term Endpoints for Cancer Screening Trials: Does Tumor Subtype Matter?
Authors: Owens Lukas , Gogebakan Kemal Caglar , Menon Usha , Gulati Roman , Weiss Noel S. , Etzioni Ruth 
Published: June 2023

Abstract
Multicancer early detection tests are precipitating a reexamination of potential short-term endpoints for cancer screening trials. A reduction in advanced stage incidence is a prime candidate, and stage-shift models that substitute early-stage for late-stage survival have been used to predict mortality reduction due to screening. However, standard stage-shift models often ignore prognostic subtypes, effectively implying that cancers detected early also have an associated subtype shift. To illustrate the differences between mortality predictions from stage-shift models that ignore versus preserve prognostic subtype, we use ovarian cancer partitioned by histologic subtype and prostate cancer partitioned by grade. We infer general conditions under which stage-shift models that preserve prognostic subtype are likely to predict mortality reductions that differ from those that ignore subtype and examine the implications for short-term endpoints based on stage in cancer screening trials.
Abstract 10: Availability and Access to Hospital-Based Breast Cancer Early Detection and Diagnostic Services in Ghana
Authors: Price Matthew , Rositch Anne , Dedey Florence , Tounkara Mamadou , Brownson Kirstyn , Price Raymond , Sutherland Edward Kofi 
Published: June 2023

Abstract
Purpose: Breast Cancer in Ghana is the leading type of cancer and second most common cause of cancer related death. Five-year survival in Ghana has been cited at 40-48% with most cases being stage 3 or 4 at diagnosis. Robust access to early detection and diagnostic services can lead to earlier stages of diagnosis and improved survival. The purpose of this study was to evaluate the early detection and diagnostic services available at hospital facilities nationwide in Ghana and to characterize geographic access.
Methods: Trained research assistants administered a cross-sectional survey to all hospitals in Ghana from November 2020 to October 2021. Early detection and diagnostic services were characterized as having Basic, Core, or Enhanced services as per in the National Comprehensive Cancer Network (NCCN) framework for resource stratification. Availability of services were defined as available greater than 80% of the time, available less than 80%, or not at all. Results were analyzed for descriptive statistics in STATA.
Results: 328 of 346 hospitals completed the survey. Of the 328 hospitals, 2 (1%) met NCCN Basic criteria alone, 11 (3%) of the hospitals met NCCN Core criteria, and none met NCCN Enhanced criteria. When including hospitals who offer services less than 80% of the year for varying circumstances, 3 (1%) met NCCN Basic criteria, 20 (6%) met NCCN Core criteria, and none met NCCN Enhanced criteria. Mammography was offered at 21 (6%) of the hospitals, 17 (5%) of which were available more than 80% of the year. Mapping and population data to estimate the percentage of population within various distances to hospital-based breast cancer early detection and diagnostic services will be done using Ghana 2021 census data in ArcGIS.
Conclusion: Hospital based services for breast cancer early detection and diagnosis in Ghana are available but sparse. Many hospitals offer fragmented aspects of care outlined by the NCCN framework, but there are only a limited number of hospitals who offer the full spectrum of services. Understanding of current availability, and geographical distribution of services, provides a framework for potential targeted expansion or identification of alternative healthcare delivery models.
Citation Format: Matthew Price, Anne Rositch, Florence Dedey, Mamadou Tounkara, Kirstyn Brownson, Raymond Price, Edward Kofi Sutherland. Availability and Access to Hospital-Based Breast Cancer Early Detection and Diagnostic Services in Ghana [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 10.
Abstract 13: Barriers to Diagnostic Follow-Up for Women With a Suspicious Clinical Breast Examination at the Primary Health Center in Uttar Pradesh State in India: A Qualitative Study
Authors: Liebermann Erica , Usmanova Gulnoza , Akhtar Nadeem , Agrawal Shivani , Patwardhan Vaibhav , Bhamare Parag , Kumar Somesh 
Published: June 2023

Abstract
Purpose: The purpose of this study was to understand key barriers to diagnostic follow-up for women with a suspicious clinical breast examination (CBE) at the primary care level in Uttar Pradesh (UP) state in India. We also explored acceptability of the use of mHealth strategies to address barriers to CBE follow up for women.
Methods: We conducted 28 in-depth individual interviews with key stakeholders involved in the Breast Health Initiative in Lucknow district, UP. Primary health facilities in rural and urban settings were purposively selected based on the number of CBE screening exams conducted in the last year and the number of women with a suspicious CBE identified. We interviewed six women with a suspicious CBE at the primary health facility who did not have diagnostic follow-up, six community health workers (ASHAs), six healthcare providers from primary health facilities and four district or state-level health decisionmakers. Interviews were audio-recorded and transcribed verbatim. Coding and thematic analysis will proceed once translation of the full dataset of transcripts is complete.
Results: Preliminary analyses of qualitative interviews found that cancer stigma and fear are significant barriers to both breast screening and follow-up of an abnormal CBE. Male providers and long waits at the district hospital are barriers to completing confirmatory diagnostic exams. Providers maintain that, despite community education and outreach efforts by ASHAs, lack of awareness of breast cancer and the importance of follow-up for abnormal CBE remains a barrier to early detection.
Conclusion: Knowledge barriers, cultural barriers, and health system barriers challenge women’s ability to follow recommendations for diagnostic follow-up of an abnormal CBE in Uttar Pradesh, India. Multi-level strategies are needed to address these barriers. Our findings will help inform the content and approach of an mHealth patient navigation strategy that could include patient education, reminders, patient tracking, and care coordination.
Citation Format: Erica Liebermann, Gulnoza Usmanova, Nadeem Akhtar, Shivani Agrawal, Vaibhav Patwardhan, Parag Bhamare, Somesh Kumar. Barriers to Diagnostic Follow-Up for Women With a Suspicious Clinical Breast Examination at the Primary Health Center in Uttar Pradesh State in India: A Qualitative Study [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 13.
Abstract 14: Barriers to Effective Safe Handling of Chemotherapeutic Drugs Among Healthcare Workers in Vietnam: Needs Assessment by Electronic Survey
Authors: Nguyen Cham , Abramovitz Linda , Nguyen Kim Lien , Truong Bao , Hermiston Michelle 
Published: June 2023

Abstract
Purpose: To identify barriers and facilitators of effective safe handling of chemotherapeutic drugs among healthcare workers in hospitals across Vietnam.
Methods: We used Qualtrics to design a 45-question structured questionnaire in English and Vietnamese survey to assess the safe handling of chemotherapeutic drugs. This questionnaire was distributed as an anonymous online survey through the e-mail listserv of the Vietnam Pediatric Oncology Association in August 2022. Survey instruments included years of practice, types of prior training, knowledge, personal practice, and organizational factors. Respondents were asked whether they used specific personal protective equipment (PPE) in the steps of preparation, administration, and disposal of chemotherapeutic drugs.
Results: The survey was distributed to 310 healthcare workers at 14 children’s hospitals. Sixty-two healthcare workers from 13 hospitals completed the survey (response rate 20%). Among those who completed the survey, diverse occupations were represented (39 nurses, 21 physicians, and 2 pharmacists). Forty-six had received prior training in the safe handling of chemotherapeutic drugs, and 25 had longer than ten years of practice. Forty-two workers reported involvement in the administration of chemotherapy, and 17 reported wearing chemotherapy gloves (compliant group) while 25 wore other types of gloves or no gloves at all (non-compliant group). Thirty-six workers (86%) reported the availability of chemotherapy gloves, and 38 (90%) were aware that not all gloves provide the same level of protection. In the compliant group, 71% (n = 12) were aware of institutional policies at their workplaces, while only 36% of the non-compliant group (n = 9) reported awareness of the institutional policies. When stratified according to the availability of institutional policy, long years of practice were more common in the compliant group.
Conclusion: Overall, respondents reported having supplies of gloves and knowledge of glove use. Those who used chemotherapy gloves were generally aware of institutional policies and had longer years of practice. The next step will involve reviewing institutional policy at each institution and studying how long years of practice influence the practice of safe handling.
Citation Format: Cham Nguyen, Linda Abramovitz, Kim Lien Nguyen, Bao Truong, Michelle Hermiston. Barriers to Effective Safe Handling of Chemotherapeutic Drugs Among Healthcare Workers in Vietnam: Needs Assessment by Electronic Survey [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 14.
Abstract 33: Epidemiology, Diagnosis, and Outcomes of Pediatric Burkitt Lymphoma Patients Treated at Bugando Medical Centre in Mwanza, Tanzania
Authors: Chapman Hutton , Ntemi Paul S. , Kamanga Jacqueline , Paschal Judith , Kashaigili Heronima J. , Schroeder Kristin 
Published: June 2023

Abstract
Purpose: Despite the significant improvement in outcomes over the last few decades for the treatment of pediatric Burkitt lymphoma, outcomes in sub-Saharan Africa remain poor, with an approximately 50% survival rate. This disparity is likely multifactorial and significant work remains to improve these outcomes in low resource settings. As a first step in attempting to improve these disparate outcomes at our hospital, Bugando Medical Centre (BMC), in Mwanza, Tanzania, we aim to improve the understanding of the presentation, diagnosis, and outcomes with the current standard of care therapy at our site. We propose that a better understanding of the current nature of care for these patients at our site will allow for more informed future interventions aimed at improving outcomes.
Methods: Historical patient data were abstracted for pediatric patients with a diagnosis of Burkitt lymphoma treated at BMC from 2016-2022. Patients’ initial presentations (e.g. site of disease), means of diagnosis, treatment completion rate, and outcomes (if available) were analyzed.
Results: Data were available on 109 patients with a diagnosis of Burkitt lymphoma between 2016-2022. Patients were on average 7.7 years old at presentation. We observed a 2:1 male to female ratio. We observed a significant proportion of abdominal disease with 58.7% presenting with abdominal disease (either alone or in combination) at initial diagnosis. There were 91% of patients who were deemed INCTR ‘high risk’ at diagnosis. There was a notable improvement in the percent of patients diagnosed with a biopsy with 46% in 2016 and 100% in 2022. Outcomes were poor but were difficult to assess with clarity due to a high rate of abandonment. Within those limitations, we observed a 1-year overall survival, of patients through 2021 with known outcomes, of 50.2% and a 1-year event free survival of 34.1% (including abandoment as an event).
Conclusion: Overall, in our patients we note epidemiology consistent with known data for endemic Burkitt lymphoma. Our patient population includes a significant proportion of abdominal and/or high-risk disease. We demonstrate overall poor outcomes with a high degree of treatment abandonment. These data suggest that improvement in treatment efficacy and treatment adherence may improve outcomes.
Citation Format: Hutton Chapman, Paul S. Ntemi, Jacqueline Kamanga, Judith Paschal, Heronima J. Kashaigili, Kristin Schroeder. Epidemiology, Diagnosis, and Outcomes of Pediatric Burkitt Lymphoma Patients Treated at Bugando Medical Centre in Mwanza, Tanzania [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 33.
Abstract 45: How Did States Adapt Their Cancer Control Plan During the COVID-19 Pandemic?
Authors: Semprini Jason 
Published: June 2023

Abstract
Purpose: The COVID-19 pandemic upended the delivery of cancer services across the care continuum. In the United States, the federalist system of governance led to health policy changes by federal, state, and local jurisdictions. At the intersection of these levels of government are state cancer control plans. Funded by the federal government, state cancer control plans are developed by state health departments in collaboration with healthcare providers, public health agencies, and community organizations. By outlining specific strategies for addressing cancer in the state, these plans serve a critical role during a public health emergency. This policy analysis aims to understand how states updated their cancer control plan as a response to COVID-19.
Methods: This qualitative policy analysis began by reviewing the cancer control plans of all 50 states and the District of Columbia. The inclusion criteria required that each plan be updated after March 2020 and included language related to “COVID”. These plans were then analyzed for COVID-19 related adaptations along three themes: 1) cancer care continuum, 2) service delivery, 2) population health and equity.
Results: Among the 51 cancer plans analyzed, seven plans met the inclusion criteria (IL, IA, ME, NV, NC, UT, VT). Three states (IL, IA, ME) adapted their plans to increase cancer screenings, two plans to increase clinical trials (IA, ME), and one plan each targeted increased treatment (NC) and prevention activities (NV). Three states identified telehealth as a priority for service delivery (IL, NV, UT), but only two (IL, UT) identified telehealth equity as a barrier. Two states (IA, NC) prioritized addressing workforce shortage and disruptions caused by the pandemic. Health insurance loss and public health investments were also identified as service delivery concerns. Two states (IL, IA) acknowledged the role of social determinants of health exacerbating COVID-19 and cancer inequalities. Food insecurity (NV, UT) and job loss (ME, NV, UT) were also components of equity within these plans. Utah explicitly acknowledged the role of racism and gender as related to the disparate impact of COVID-19 on cancer care.
Conclusion: This analysis highlighted how states adapted their cancer control plans in response to COVID-19 and may inform ongoing policy debate. Continued policy surveillance and evaluation could ensure that cancer patients receive timely, appropriate care during public health emergencies.
Citation Format: Jason Semprini. How Did States Adapt Their Cancer Control Plan During the COVID-19 Pandemic? [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 45.
Abstract 50: Impact of the COVID-19 Pandemic on Breast Cancer Treatments in the Brazilian Public System
Authors: da Silva Laura Tibola Marques , Barreto Pedro Antonio Paludo Menna , Beltramo Luiza Seixas de Sá , Lech Gabriele Eckerdt , Azambuja Fernando , de Andrade Rafaela , Alberti Arthur Minas , Silveira Pedro Arthur Zimmer , Kieling Lucas 
Published: June 2023

Abstract
Purpose: To evaluate the impact of the COVID-19 pandemic on breast cancer treatments performed in Brazil, by the Unified Health System (SUS).
Methods: Data were obtained from the DATASUS database, provided by the Ministry of Health, from 2017 to 2021. The codes C50 (Malignant breast neoplasm) and D05 (Carcinoma in situ of the breast) were used. The therapeutic modality included surgery, chemotherapy, radiotherapy and/or both as a form of treatment. Statistical analysis was performed using linear regression with a 95% confidence interval.
Results: The number of treatments for breast cancer performed in the years 2017, 2018 and 2019 was 26,335, 39,339 and 43,271, respectively. The analysis between year and number of treatments performed showed progressive growth. In 2020, impacted by the pandemic, the number of treatments was 40,934, a value 22.63% below the forecast (52,911.09) and 14.14% below the lower confidence limit (47,677.58) estimated for the year by regression. In 2021, 43,265 treatments were performed.
Conclusion: The number of treatments performed for breast cancer by the SUS, which had shown relative growth until 2019, declined in the year affected by the COVID-19 pandemic. One of the possible associated factors was the greater focus of hospital services on the prevention and treatment of the disease triggered by the virus. In addition, the immunosuppression of patients with breast cancer in treatments such as chemotherapy and radiotherapy, associated with the higher age group epidemiologically associated with the pathology, may have corroborated a higher mortality due to COVID-19. The underdiagnosis of cancer as a result of the pandemic should also be a relevant factor for future studies, since, in 2021, the number of treatments performed returned to the pre-pandemic value observed, which may characterize the resumption of cancer diagnosis and treatment services.
Citation Format: Laura Tibola Marques da Silva, Pedro Antonio Paludo Menna Barreto, Luiza Seixas de Sá Beltramo, Gabriele Eckerdt Lech, Fernando Azambuja, Rafaela de Andrade, Arthur Minas Alberti, Pedro Arthur Zimmer Silveira, Lucas Kieling. Impact of the COVID-19 Pandemic on Breast Cancer Treatments in the Brazilian Public System [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 50.