Sample records for cancer advocacy changing

  1. Bladder Cancer Advocacy Network (United States)

    ... Grants Bladder Cancer Think Tank Bladder Cancer Research Network Bladder Cancer Genomics Consortium Get Involved Ways to ... us? Who we are The Bladder Cancer Advocacy Network (BCAN) is a community of patients, caregivers, survivors, ...

  2. Advocacy groups for breast cancer patients.


    Waller, M.; Batt, S


    Breast cancer patient advocacy groups emerged in the 1990s to support and empower women with breast cancer. Women with cancer and oncologists tend to have divergent perspectives on how breast cancer prevention should be defined and what the priorities for research should be. As their American counterparts have done, breast cancer patient advocates in Canada are seeking greater participation in decision making with respect to research. To date they have had more input into research policy deci...

  3. Breast cancer advocacy: changing perceptions Abogacía y cáncer de mama: el cambio en las percepciones

    Directory of Open Access Journals (Sweden)

    Ksenia P Koon


    Full Text Available Breast cancer is a significant health burden worldwide. In the United States, the Breast Cancer Advocacy Movement has increased awareness, enhanced dialogue, and provided significant funding opportunities that previously did not exist. Various advocacy programs are beginning to emerge in developing countries in response to the increasing impact breast cancer is having in these regions of the world. This paper discusses the influence of the Breast Cancer Advocacy Movement in the US and proposes a format for working in conjunction with medical experts, political leaders and patient advocates to stimulate discussion and encourage sustainable outcomes in breast cancer internationally.El cáncer de mama es una carga significativa de salud en el mundo. En Estados Unidos, el Movimiento de Abogacía para el Control del Cáncer de Mama ha hecho conciencia, mejorado el diálogo y provisto de oportunidades de financiamiento antes inexistentes. En los países en desarrollo, están emergiendo programas para el combate del cáncer de mama en respuesta al impacto creciente de la enfermedad en estas regiones. Este artículo aborda la influencia del movimiento en Estados Unidos y propone un formato para trabajar en conjunto con expertos en medicina, líderes políticos y defensores de pacientes y estimular la discusión y promoción de resultados sostenibles internacionalmente en cuanto al cáncer de mama.

  4. Climate Change: On Scientists and Advocacy (United States)

    Schmidt, Gavin A.


    Last year, I asked a crowd of a few hundred geoscientists from around the world what positions related to climate science and policy they would be comfortable publicly advocating. I presented a list of recommendations that included increased research funding, greater resources for education, and specific emission reduction technologies. In almost every case, a majority of the audience felt comfortable arguing for them. The only clear exceptions were related to geo-engineering research and nuclear power. I had queried the researchers because the relationship between science and advocacy is marked by many assumptions and little clarity. This despite the fact that the basic question of how scientists can be responsible advocates on issues related to their expertise has been discussed for decades most notably in the case of climate change by the late Stephen Schneider.

  5. Advocacy. (United States)

    Scarr, Margaret, Ed.; Varro, Tim, Ed.


    This theme issue presents art advocacy as a necessary means of bringing art and art education to an elevated status in the elementary secondary curriculum and educational system. Articles include: (1) "Editor's View" (Margaret Scarr); (2) "Art Education: Why Is It Important" (Arts Education Partnership Working Group); (3)…

  6. Prison health advocacy and its changing boundaries. (United States)

    Awofeso, Niyi


    Advocacy is an important tool for translating population health objectives and research findings into policy and practice, as well as for enhancing stakeholder support for programmes and activities with a potential to improve the health of populations. At the inception of modern prisons, health advocacy approaches focused on appealing to humanitarian and religious sentiments of stakeholders to improve the well-being of prisoners. This approach achieved limited results, not least because of persistent apathy of custodial authorities and the public to prisoners' wellbeing. From the mid twentieth century onwards, a constitutional and human rights approach evolved, with courts becoming actively involved in mandating minimum health standards in prisons. Penal populism eroded public support for a judicial recourse to improving prison health services, and encouraged governments to institute procedural barriers to prisoner-initiated litigation. The author proposes an approach premised on public health principles as an appropriate platform to advocate for improvements in prison health services in this era. Such an advocacy platform combines the altruistic goals of the humanitarian and constitutional rights approaches with an appeal to community's self-interest by alerting the public to the social, financial and health implications inherent in released prisoners suffering from major communicable and chronic diseases re-entering the community.

  7. Parent Advocacy: Two Approaches to Change, One Goal (United States)

    O'Hanlon, Elizabeth; Griffin, Amy Tetteh


    The authors describe "top-down" and "bottom-up" models of leadership in the world of advocacy; they became parent advocates after learning that their children had special needs. They argue that change in our communities--and, eventually, in our world--demands that "all" advocates for children with disabilities work together. The authors describe…

  8. Building Knowledge and Advocacy Agendas for Change in the Arab ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Building Knowledge and Advocacy Agendas for Change in the Arab World. As Arab countries continue to ... Transition, uprisings, reforms The Arab world is divided. There are countries in transition facing ... Others, such as Libya, Syria, and Yemen, have had uprisings degenerate into war. Some of their Arab neighbours, ...

  9. Advocacy, support and survivorship in prostate cancer. (United States)

    Dunn, J; Casey, C; Sandoe, D; Hyde, M K; Cheron-Sauer, M-C; Lowe, A; Oliffe, J L; Chambers, S K


    Across Australia, prostate cancer support groups (PCSG) have emerged to fill a gap in psychosocial care for men and their families. However, an understanding of the triggers and influencers of the PCSG movement is absent. We interviewed 21 SG leaders (19 PC survivors, two partners), of whom six also attended a focus group, about motivations, experiences, past and future challenges in founding and leading PCSGs. Thematic analysis identified four global themes: illness experience; enacting a supportive response; forming a national collective and challenges. Leaders described men's feelings of isolation and neglect by the health system as the impetus for PCSGs to form and give/receive mutual help. Negotiating health care systems was an early challenge. National affiliation enabled leaders to build a united voice in the health system and establish a group identity and collective voice. Affiliation was supported by a symbiotic relationship with tensions between independence, affiliation and governance. Future challenges were group sustainability and inclusiveness. Study findings describe how a grassroots PCSG movement arose consistent with an embodied health movement perspective. Health care organisations who seek to leverage these community resources need to be cognisant of SG values and purpose if they are to negotiate effective partnerships that maximise mutual benefit. © 2017 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

  10. Young deafblind adults in action: becoming self-determined change agents through advocacy. (United States)

    Bruce, Susan M; Parker, Amy T


    Six young deafblind adults took a 1-week course on civic engagement and advocacy, which provided the focus for a participatory action research study with a collective case study design. They selected advocacy topics, were briefed on these policy issues, and were paired with experienced mentors for meetings with legislators in Washington, DC. Eight themes were identified from constant comparative and in vivo analysis of classroom discussion notes, interviews, and journals: (a) defining advocacy and advocate, (b) rights and equality, (c) expectations, (d) role of education in change, (e) deafblind expertise, (f) characteristics of effective change agents, (g) advocacy is teamwork, (h) future advocacy. In the classroom, the participants learned about policy issues, communication considerations, and leadership, then applied this knowledge in the legislative arena. Through the advocacy process, they learned to apply their personal strengths as advocates and experienced the importance of teamwork in advocacy.

  11. The effect of advocacy for overcoming stigma on posttraumatic growth: Focusing on childhood cancer survivors. (United States)

    Yi, Hee Jung; Nam, Seok In


    The aim of this study was to investigate both strategies for coping with stigma and the effects of participating in advocacy. The participants were childhood cancer survivors who had been diagnosed before the age of 18 years who had completed treatment. An embedded-design mixed-methods approach was used with 30 interview scripts, and 145 survey results were collected. Coping strategies for the stigma of cancer were "secrecy, avoid stereotypes, and discrimination" and "disclosure of medical history." Participation in advocacy confirmed self-worth, helped in achievement, and promoted social skills. Quantitative analysis showed that greater advocacy participation was associated with higher levels of posttraumatic growth. This study could provide support for advocacy among childhood cancer survivors by demonstrating its positive effects.

  12. Advocacy resource: engaging the media and promoting your cancer program in Africa. (United States)

    Reams, R Renee; Odedina, Folakemi T; Pressey, Shannon


    To address the need for a significant increase in cancer advocacy programs in Africa, the University of Florida (UF), the Prostate Net, and the African Organization for Research and Training in Cancer (AORTIC) co-hosted the first biennial International Workshop on Cancer Advocacy for African Countries (CAAC) on November 29, 2011, one-day prior to AORTIC's 8th International Cancer Conference in Cairo, Egypt. Over 70 African cancer advocates representing about 12 African countries participated in this workshop.The primary goal of the one-day workshop was to inform, educate and empower African cancer advocates to increase the promotion of their cancer programs. The first half of the workshop consisted of five formal PowerPoint presentations focused on the following topics: (a) Understanding Your Community and Assessing your Community Health Assets and Needs; (b) Developing a successful advocacy model for your cancer program; (c) Developing a Relationship with your Elected Officials to Advocate Cancer-related Policies; (d) Engaging the Media and promoting your cancer program; and (e) Developing advocacy plans for sustainability. In this article we summarize the informational content given in the PowerPoint presentation entitled "Engaging the Media and promoting your cancer program". The content given in this article is useful as a how-to guide for both the beginner and the experienced cancer advocate who wants to establish/promote a cancer awareness program.

  13. The future of the cancer prevention workforce: why health literacy, advocacy, and stakeholder collaborations matter. (United States)

    Sulik, Gayle A; Cameron, Carrie; Chamberlain, Robert M


    In considering the role of the cancer prevention workforce in meeting the nation's future health care needs, it is vital to address the considerable gaps in information, communication, training, professional development, roles, and levels of collaboration among diverse disciplines, stakeholders, and constituencies. As part of an October 2009 symposium at The University of Texas MD Anderson Cancer Center entitled "Future Directions in Cancer Prevention and Control: Workforce Implications for Training, Practice, and Policy," the Health Policy and Advocacy Working Group was convened to discuss barriers to closing these gaps. Three major themes emerged from the group's deliberations and are discussed here: (1) the role of critical health literacy and evidence-based collaborations in cancer prevention education, research, and practice; (2) the implications of health advocacy for policy development and clinical and public health practice; and (3) culturally and linguistically appropriate cancer prevention programs and information within advocacy/workforce collaborations. Mechanisms for addressing these gaps are presented.

  14. Self-Advocacy Serious Game in Advanced Cancer (United States)


    Ovarian Cancer Stage III; Ovarian Cancer Stage IV; Breast Cancer Stage IV; Cervical Cancer Stage IIIB; Cervical Cancer Stage IVA; Cervical Cancer Stage IVB; Endometrial Cancer Stage III; Endometrial Cancer Stage IV; Vulvar Cancer, Stage III; Vulvar Cancer, Stage IV; Vaginal Cancer Stage III; Vaginal Cancer Stage IVA; Vaginal Cancer Stage IVB

  15. The process through which an advocacy intervention resulted in positive change for battered women over time. (United States)

    Bybee, Deborah I; Sullivan, Cris M


    A prior experimental evaluation of a community-based advocacy program for women with abusive partners demonstrated positive change in the lives of women even 2 years postintervention (C M. Sullivan & D. I. Bybee, 1999). The current study explored the complex mediational process through which this change occurred, using longitudinal structural equation modeling and formal tests of mediation. As hypothesized, the advocacy intervention first resulted in women successfully obtaining desired community resources and increasing their social support, which enhanced their overall quality of life. This improvement in well-being appeared to serve as a protective factor from subsequent abuse, as women who received the intervention were significantly less likely to be abused at 2-year follow-up compared with women in the control condition. Increased quality of life completely mediated the impact of the advocacy intervention on later reabuse. Discussion places advocacy for women in the context of other efforts that are needed to build an effective community response to preventing intimate violence against women.

  16. Shifting the Culture Around Public Health Advocacy: Training Future Public Health Professionals to Be Effective Agents of Change. (United States)

    Blenner, Sarah R; Lang, Cathy M; Prelip, Michael L


    There is a critical need to build the capacity of our current and future public health workforce and the communities we serve to engage in public health advocacy. Advocacy should be an integral piece of our intervention strategies and public health discourse. Incorporating public health advocacy into public health training, practice, and research serves as a long-term investment for the public's health. Advocacy can achieve systemic change by addressing the social determinants of health. We developed an advocacy training program that embeds students in community-based organizations (CBOs) for 9 months, providing students with experiential education through the application of advocacy skills and CBOs with opportunities to expand and broaden their advocacy efforts. We have three priority populations: graduate students, CBOs serving Los Angeles County, and the broader Los Angeles County community, focusing on vulnerable populations. Our multifaceted approach addresses the necessity of public health advocacy among the health professions. Through changing how we train students and how communities and universities collaborate, we can strengthen the public health workforce and build healthier communities.

  17. Advocacy coalitions, REDD+, and forest governance in Papua New Guinea: how likely is transformational change?

    Directory of Open Access Journals (Sweden)

    Andrea Babon


    Full Text Available Tropical forests in developing countries are increasingly being valued for their role in carbon sequestration. Such interest is reflected in the emergence of international initiatives for Reducing Emissions from Deforestation and Forest Degradation (REDD+. REDD+ requires addressing both tropical forests as complex social-ecological systems and the multiple sectors involved in tropical forest resources, which may necessitate transformational change away from business-as-usual approaches to forest governance. We studied the potential for REDD+ to mobilize an influential coalition of actors promoting transformational change in forest governance in Papua New Guinea (PNG, a leading proponent of REDD+ internationally. Combining policy network approaches with the advocacy coalition framework, we identified four advocacy coalitions in the REDD+ policy domain in PNG and estimated the influence of each coalition. We found the most influential advocacy coalition is promoting the status quo rather than governance reforms capable of reducing deforestations and forest degradation, leading us to suggest that business as usual is the dominant perspective in the REDD+ policy domain in PNG. This may explain why, despite the large amount of REDD+ rhetoric, there has been only modest change in formal policy or practice in PNG to date. However, we did find influential coalitions calling for transformational change. Although these are currently minority coalitions, we identified several pathways through which they could increase their power to realize transformational change

  18. Effective social justice advocacy: a theory-of-change framework for assessing progress. (United States)

    Klugman, Barbara


    This article offers a theory-of-change framework for social justice advocacy. It describes broad outcome categories against which activists, donors and evaluators can assess progress (or lack thereof) in an ongoing manner: changes in organisational capacity, base of support, alliances, data and analysis from a social justice perspective, problem definition and potential policy options, visibility, public norms, and population level impacts. Using these for evaluation enables activists and donors to learn from and rethink their strategies as the political context and/or actors change over time. The paper presents a case study comparing factors that facilitated reproductive rights policy wins during the transition from apartheid to democracy in South Africa and factors that undermined their implementation in the post-apartheid period. It argues that after legal and policy victories had been won, failure to maintain strong organizations and continually rethink strategies contributed to the loss of government focus on and resources for implementation of new policies. By implication, evaluating effectiveness only by an actual policy change does not allow for ongoing learning to ensure appropriate strategies. It also fails to recognise that a policy win can be overturned and needs vigilant monitoring and advocacy for implementation. This means that funding and organising advocacy should seldom be undertaken as a short-term proposition. It also suggests that the building and maintenance of organisational and leadership capacity is as important as any other of the outcome categories in enabling success. Copyright © 2011 Foundation Review. Published by Elsevier Ltd. All rights reserved.

  19. The role of advocacy in occasioning community and organizational change in a medical-legal partnership. (United States)

    Anderson-Carpenter, Kaston D; Collie-Akers, Vicki; Colvin, Jeffrey D; Cronin, Katie


    Health disparities among low-income individuals remain a significant problem. A number of social determinants are associated with adverse health outcomes. Medical-legal partnerships address legal concerns of low-income individuals to improve health and wellness in adults and children. The Medical-Legal Partnership at Legal Aid of Western Missouri provides free direct legal services for patients with legal concerns affecting health. There is limited evidence regarding the association between advocacy-related efforts and changes within both the medical-legal partnership structure and in health-care facilities. Three health-care organizations in Kansas City, MO participated in implementing the medical-legal partnership model between 2007 and 2010. Advocacy efforts conducted by key medical-legal partnership personnel were strongly associated with changes in health-care organizations and within the medical-legal partnership structure. This study extends the current evidence base by examining the types of advocacy efforts required to bring about community and organizational changes.

  20. International Framework for Cancer Patient Advocacy: Empowering Organizations and Patients to Create a National Call to Action on Cancer. (United States)

    Schear, Rebekkah M; Manasco, Leigh; McGoldrick, Devon; Kajana, Kiti; Rosenthal, Lauren; McMikel, Ann; Lins, Nancy


    With the rate of cancer and other noncommunicable diseases (NCDs) growing globally, cancer prevention and control efforts are critical internationally. Moreover, since the 2011 United Nations High-Level Meeting on NCDs, the international health and development community has shifted its awareness to include NCDs as a global health priority, especially in developing countries where mortality rates are disproportionately high. Simultaneously, with the dissemination of the World Cancer Declaration and the evolution of cancer control policies, the international cancer community has recognized the value of engaging patients in reducing the global cancer burden. Cancer advocacy programs that involve patients, survivors, and nongovernmental organizations (NGOs) have increasing opportunities for global impact. We developed a framework over 4 years through implementation of two pilot projects. We created a series of trainings and tools to build the capacity of local NGOs and patients to plan and implement a forum for patients with cancer and to create and disseminate a national call to action. The framework was piloted in South Africa from 2009 to 2011 and Japan from 2012 to 2014, and results were measured through postproject surveys completed by members of the collaborative working group and interviews with the in-country partner. The framework is globally relevant and could be adapted and implemented in low- and middle-income countries to amplify patient voices in the policymaking process, increase grassroots mobilization, and improve health systems and infrastructure through addressing patient needs. With the dominant paradigm of global health in developing countries-which has previously focused on HIV/AIDS, maternal and child health, tuberculosis, and malaria-shifting to adapt to the burgeoning NCD burden, effective patient-centered advocacy frameworks are critical to the success of NCD control.

  1. No-Drop Prosecution in Domestic Violence Cases: Survivor-Defined and Social Change Approaches to Victim Advocacy. (United States)

    Nichols, Andrea J


    The feminist debate on no-drop prosecution is long-standing. However, the ways liberal and radical feminist perspectives inform advocacy in applied settings are limited in the extant research. Drawing from interviews with 26 domestic violence (DV) victim advocates, the current study examines perspectives and practices of victim advocates in no-drop prosecution cases. Two predominate themes emerged-a survivor-defined approach to advocacy emphasizing the individual situations and choices of battered women, and a social change approach focusing on changing the social structures that tolerate violence against women. Findings indicated the relationship between such practices was complex, overlapping, and at times contradictory. While advocates generally supported no-drop prosecution with the goal of social change, survivor-defined approaches superseded social change efforts for a majority of advocates. Survivor-centered advocacy and no-drop prosecution at times conflicted with one another. Advocates described victims' concerns about safety, livelihood, and trauma testifying in court as challenges to the policy, as well as the practice of holding victims in contempt of court and jailing them for not testifying. At the same time, advocates illustrated how survivor-defined advocacy complimented prosecution by addressing women's myriad of needs and concerns related to prosecution. Advocates indicated that victims were more likely to safely participate in prosecution when their individual needs were addressed. Implications for DV victim advocacy are presented. © The Author(s) 2013.

  2. Big Data Sensors of Organic Advocacy: The Case of Leonardo DiCaprio and Climate Change.

    Directory of Open Access Journals (Sweden)

    Eric C Leas

    Full Text Available The strategies that experts have used to share information about social causes have historically been top-down, meaning the most influential messages are believed to come from planned events and campaigns. However, more people are independently engaging with social causes today than ever before, in part because online platforms allow them to instantaneously seek, create, and share information. In some cases this "organic advocacy" may rival or even eclipse top-down strategies. Big data analytics make it possible to rapidly detect public engagement with social causes by analyzing the same platforms from which organic advocacy spreads. To demonstrate this claim we evaluated how Leonardo DiCaprio's 2016 Oscar acceptance speech citing climate change motivated global English language news (Bloomberg Terminal news archives, social media (Twitter postings and information seeking (Google searches about climate change. Despite an insignificant increase in traditional news coverage (54%; 95%CI: -144 to 247, tweets including the terms "climate change" or "global warming" reached record highs, increasing 636% (95%CI: 573-699 with more than 250,000 tweets the day DiCaprio spoke. In practical terms the "DiCaprio effect" surpassed the daily average effect of the 2015 Conference of the Parties (COP and the Earth Day effect by a factor of 3.2 and 5.3, respectively. At the same time, Google searches for "climate change" or "global warming" increased 261% (95%CI, 186-335 and 210% (95%CI 149-272 the day DiCaprio spoke and remained higher for 4 more days, representing 104,190 and 216,490 searches. This increase was 3.8 and 4.3 times larger than the increases observed during COP's daily average or on Earth Day. Searches were closely linked to content from Dicaprio's speech (e.g., "hottest year", as unmentioned content did not have search increases (e.g., "electric car". Because these data are freely available in real time our analytical strategy provides substantial

  3. Big Data Sensors of Organic Advocacy: The Case of Leonardo DiCaprio and Climate Change. (United States)

    Leas, Eric C; Althouse, Benjamin M; Dredze, Mark; Obradovich, Nick; Fowler, James H; Noar, Seth M; Allem, Jon-Patrick; Ayers, John W


    The strategies that experts have used to share information about social causes have historically been top-down, meaning the most influential messages are believed to come from planned events and campaigns. However, more people are independently engaging with social causes today than ever before, in part because online platforms allow them to instantaneously seek, create, and share information. In some cases this "organic advocacy" may rival or even eclipse top-down strategies. Big data analytics make it possible to rapidly detect public engagement with social causes by analyzing the same platforms from which organic advocacy spreads. To demonstrate this claim we evaluated how Leonardo DiCaprio's 2016 Oscar acceptance speech citing climate change motivated global English language news (Bloomberg Terminal news archives), social media (Twitter postings) and information seeking (Google searches) about climate change. Despite an insignificant increase in traditional news coverage (54%; 95%CI: -144 to 247), tweets including the terms "climate change" or "global warming" reached record highs, increasing 636% (95%CI: 573-699) with more than 250,000 tweets the day DiCaprio spoke. In practical terms the "DiCaprio effect" surpassed the daily average effect of the 2015 Conference of the Parties (COP) and the Earth Day effect by a factor of 3.2 and 5.3, respectively. At the same time, Google searches for "climate change" or "global warming" increased 261% (95%CI, 186-335) and 210% (95%CI 149-272) the day DiCaprio spoke and remained higher for 4 more days, representing 104,190 and 216,490 searches. This increase was 3.8 and 4.3 times larger than the increases observed during COP's daily average or on Earth Day. Searches were closely linked to content from Dicaprio's speech (e.g., "hottest year"), as unmentioned content did not have search increases (e.g., "electric car"). Because these data are freely available in real time our analytical strategy provides substantial lead time

  4. Circus monkeys or change agents? Civil society advocacy for HIV/AIDS in adverse policy environments. (United States)

    Spicer, Neil; Harmer, Andrew; Aleshkina, Julia; Bogdan, Daryna; Chkhatarashvili, Ketevan; Murzalieva, Gulgun; Rukhadze, Natia; Samiev, Arnol; Walt, Gill


    This paper explores the factors enabling and undermining civil society efforts to advocate for policy reforms relating to HIV/AIDS and illicit drugs in three countries in Eastern Europe and Central Asia: Georgia, Kyrgyzstan and Ukraine. It examines how political contexts and civil society actors' strengths and weaknesses inhibit or enable advocacy for policy change - issues that are not well understood in relation to specific policy areas such as HIV/AIDS, or particular regions of the world where national policies are believed to be major drivers of the HIV/AIDS epidemic. The study is based on in-depth interviews with representatives of civil society organizations (CSOs) (n = 49) and national level informants including government and development partners (n = 22). Our policy analysis identified a culture of fear derived from concerns for personal safety but also risk of losing donor largesse. Relations between CSOs and government were often acrimonious rather than synergistic, and while we found some evidence of CSO collective action, competition for external funding - in particular for HIV/AIDS grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria was often divisive. Development partners and government tend to construct CSOs as service providers rather than advocates. While some advocacy was tolerated by governments, CSO participation in the policy process was, ultimately, perceived to be tokenistic. This was because there are financial interests in maintaining prohibitionist legislation: efforts to change punitive laws directed at the behaviors of minority groups such as injecting drug users have had limited impact. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Communities of Change, Multi Stakeholder Processes, Lobby & Advocacy : More than 100 years of experience on HBC in Malawi & Zambia!

    NARCIS (Netherlands)

    Vugt, van S.M.; Sloot, H.


    This training of four days focussed on two areas of capacity development of the home-based care (HBC) alliance in Malawi and Zambia: 1. Communities of Change (CoC) concept and practice linked to the Multi Stakeholder Process (MSP), and 2. Lobby & Advocacy (L&A). Since June 2010 Cordaid

  6. The value of advocacy in promoting social change: implementing the new Domestic Violence Act in South Africa. (United States)

    Usdin, S; Christofides, N; Malepe, L; Maker, A


    South Africa's first democratic government passed the Domestic Violence Act (DVA) into law in 1998 as part of local and international commitments to protecting the human rights of women. Although the Act was welcomed as groundbreaking legislation, delays in implementing it led to increasing frustration. This paper describes an advocacy campaign conducted by the Soul City Institute for Health and Development Communication in partnership with the National Network on Violence against Women, to ensure the effective implementation of the DVA. Lessons from the campaign stress the importance of coalition building to draw on diverse strengths, and the use of a combination of advocacy tools, including lobbying, media advocacy and social mobilisation to achieve campaign goals. Given the critical role NGOs dealing with victims/survivors of domestic violence and the justice system played in lobbying for change and drafting the new law, their exclusion from the implementation process was ironic. While many advocacy efforts focus on the development of policy and legislation, ongoing efforts are needed to ensure effective implementation, the commitment of adequate resources and monitoring to identify gaps and propose new solutions. Our experience highlights the important role of policy advocates in connecting the multiple streams at play in the policy and legislative arena.

  7. Southern voices on climate policy choices: Analysis of and lessons learned from civil society advocacy on climate change

    Energy Technology Data Exchange (ETDEWEB)

    Reid, Hannah; Ampomah, Gifty; Prera, Maria Isabel Olazabal; Rabbani, Golam; Zvigadza, Shepard


    This report provides an analysis of the tools and tactics advocacy groups use to influence policy responses to climate change at international, regional, national and sub-national levels. More than 20 climate networks and their member organisations have contributed to the report with their experiences of advocacy on climate change, including over 70 case studies from a wide range of countries - including many of the poorest - in Africa, Asia, Latin America and the Pacific. These advocacy activities primarily target national governments, but also international and regional processes, donors and the private sector. Analyses and case studies show how civil society plays key roles in pushing for new laws, programmes, policies or strategies on climate change, in holding governments to account on their commitments; in identifying the lack of joined-up government responses to climate change; and in ensuring that national policy making does not forget the poor and vulnerable. The report is the first joint product of the Southern Voices Capacity Building Programme, or for short: Southern Voices on Climate Change.

  8. Tobacco control advocacy in the age of social media: using Facebook, Twitter and change. (United States)

    Hefler, Marita; Freeman, Becky; Chapman, Simon


    The tobacco industry's use of social media sites, such as Facebook, is an emerging area of research; however, this is the first study of the potential for social media to advance tobacco control. This paper presents three case studies of using social media for tobacco control advocacy, demonstrates how social media can facilitate direct and effective action, and provides tools and lessons learned for future campaigns.

  9. Rethinking the therapeutic misconception: social justice, patient advocacy, and cancer clinical trial recruitment in the US safety net. (United States)

    Burke, Nancy J


    Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. In the course of two years of ethnographic fieldwork in a safety net hospital, I conducted clinic observations (n=150 clinic days) and in-depth in-person qualitative interviews with patients (n=37) and providers (n=15). I used standard qualitative methods to organize and code resulting fieldnote and interview data. Findings suggest that TM is limited in relevance for the interdisciplinary context of cancer clinical trial recruitment in the safety net setting. Ethnographic data show the value of the discussions that happen prior to the informed consent, those that introduce the idea of participation in research. These preliminary discussions are elemental especially when recruiting underserved and vulnerable patients for clinical trial participation who are often unfamiliar with medical research and how it relates to medical care. Data also highlight the multiple actors involved in research discussions and the ethics of social justice and patient advocacy they mobilize, suggesting that class, inequality, and dependency influence the forms of ethical engagements in public hospital settings. On the ground ethics of social justice and patient advocacy are more relevant than TM as guiding ethical principles in the context of

  10. Media Advocacy. Technical Assistance Packet. (United States)

    Join Together, Boston, MA.

    Media advocacy is an environmental strategy that can be used to support alcohol and other drug prevention and policy development efforts. It helps shift the focus from understanding public health issues as individual problems to understanding them as social conditions that require collective behavior changes. Successful media advocacy uses the…

  11. Promoting Health Through Policy and Systems Change: Public Health Students and Mentors on the Value of Policy Advocacy Experience in Academic Internships. (United States)

    Marquez, Daniela; Pell, Dylan; Forster-Cox, Sue; Garcia, Evelyn; Ornelas, Sophia; Bandstra, Brenna; Mata, Holly


    Emerging professionals and new Certified Health Education Specialists often lack academic training in and actual experience in National Commission for Health Education Credentialing Area of Responsibility VII: Communicate, Promote, and Advocate for Health, Health Education/Promotion, and the Profession. For undergraduate and graduate students who have an opportunity to complete an internship or practicum experience, gaining experience in Competencies 7.2: Engage in advocacy for health and health education/promotion and 7.3: Influence policy and/or systems change to promote health and health education can have a profound impact on their career development and their ability to advocate for policies that promote health and health equity. Compelling evidence suggests that interventions that address social determinants of health such as poverty and education and those that change the context through improved policy or healthier environments have the greatest impact on public health, making it vital for emerging public health professionals to gain experience in policy advocacy and systems change. In this commentary, students and faculty from two large universities in the U.S.-Mexico border region reflect on the value of policy advocacy in academic internship/fieldwork experiences. Based on their experiences, they highly recommend that students seek out internship opportunities where they can participate in policy advocacy, and they encourage university faculty and practicum preceptors to provide more opportunities for policy advocacy in both classroom and fieldwork settings.

  12. Historical note: How bringing women's health advocacy groups to WHO helped change the research agenda. (United States)

    Cottingham, Jane


    The politics of population control and its sometimes coercive methods in developing countries documented during the 1960s, 70s and 80s, gave rise to strong opposition by women's groups, and put into question the safety of contraceptive methods that were being developed and introduced into countries. In 1991, the Special Programme on Human Reproduction at the World Health Organization, a research programme focused on development of new methods and safety assessments of existing fertility regulation methods, started a process of "dialogue" meetings between scientists and women's health advocacy groups which lasted for nearly a decade. This paper describes the process of these meetings and what they achieved in terms of bringing new or different research topics into the agenda, and some of the actions taken as a result. Copyright © 2015. Published by Elsevier Ltd.

  13. Scaling up cervical cancer screening in the midst of human papillomavirus vaccination advocacy in Thailand

    Directory of Open Access Journals (Sweden)

    Teerawattananon Yot


    Full Text Available Abstract Background Screening tests for cervical cancer are effective in reducing the disease burden. In Thailand, a Pap smear program has been implemented throughout the country for 40 years. In 2008 the Ministry of Public Health (MoPH unexpectedly decided to scale up the coverage of free cervical cancer screening services, to meet an ambitious target. This study analyzes the processes and factors that drove this policy innovation in the area of cervical cancer control in Thailand. Methods In-depth interviews with key policy actors and review of relevant documents were conducted in 2009. Data analysis was guided by a framework, developed on public policy models and existing literature on scaling-up health care interventions. Results Between 2006 and 2008 international organizations and the vaccine industry advocated the introduction of Human Papillomavirus (HPV vaccine for the primary prevention of cervical cancer. Meanwhile, a local study suggested that the vaccine was considerably less cost-effective than cervical cancer screening in the Thai context. Then, from August to December 2008, the MoPH carried out a campaign to expand the coverage of its cervical cancer screening program, targeting one million women. The study reveals that several factors were influential in focusing the attention of policymakers on strengthening the screening services. These included the high burden of cervical cancer in Thailand, the launch of the HPV vaccine onto the global and domestic markets, the country’s political instability, and the dissemination of scientific evidence regarding the appropriateness of different options for cervical cancer prevention. Influenced by the country’s political crisis, the MoPH’s campaign was devised in a very short time. In the view of the responsible health officials, the campaign was not successful and indeed, did not achieve its ambitious target. Conclusion The Thai case study suggests that the political crisis was a

  14. Chemoprevention of Breast Cancer: The Paradox of Evidence versus Advocacy Inaction

    Directory of Open Access Journals (Sweden)

    Rakhshanda Layeequr Rahman


    Full Text Available Women who are at high risk of breast cancer can be offered chemoprevention. Chemoprevention strategies have expanded over the past decade and include selective receptor modulator inhibitors and aromatase inhibitors. Physicians are expected to provide individualized risk assessments to identify high risk women who may be eligible for chemoprevention. It is prudent that physicians utilize a shared decision approach when counseling high risk women about their preventive options. Barriers and misperceptions however exist with patient and physician acceptance of chemoprevention and continue to impede uptake of chemoprevention as a strategy to reduce breast cancer risk. Programs to increase awareness and elucidate the barriers are critical for women to engage in cancer prevention and promote chemoprevention adherence.

  15. Empowering Women through Education and Advocacy in Breast and Cervical Cancer Prevention and Control (United States)

    Through partnerships with the Peruvian Ministry of Health and the Pan American Health Organization regional office, CGH co-supported the first Women’s Cancer Summit was held in Lima, Peru. This unique training workshop brought primary-level health care providers from 26 districts together with patient advocates and survivors from Peru, Bolivia, Colombia, and Ecuador.

  16. Advocacy coalitions, REDD+, and forest governance in Papua New Guinea: how likely is transformational change?

    National Research Council Canada - National Science Library

    Babon, Andrea; McIntyre, Daniel; Gowae, Gae Y; Gallemore, Caleb; Carmenta, Rachel; Di Gregorio, Monica; Brockhaus, Maria


    ...+ requires addressing both tropical forests as complex social-ecological systems and the multiple sectors involved in tropical forest resources, which may necessitate transformational change away...

  17. More than a message: framing public health advocacy to change corporate practices. (United States)

    Dorfman, Lori; Wallack, Lawrence; Woodruff, Katie


    Framing battles in public health illustrate the tension in our society between individual freedom and collective responsibility. This article describes how two frames, market justice and social justice, first articulated in a public health context by Dan Beauchamp, influence public dialogue on the health consequences of corporate practices. The authors argue that public health advocates must articulate the social justice values motivating the changes they seek in specific policy battles that will be debated in the context of news coverage. The authors conclude with lessons for health education practitioners who need to frame public health issues in contentious and controversial policy contexts. Specific lessons include the importance of understanding the existing values and beliefs motivating the public health change being sought, the benefits of articulating core messages that correspond to shared values, and the necessity of developing media skills to compete effectively with adversaries in public debate.

  18. Advocacy coalitions, REDD+, and forest governance in Papua New Guinea: how likely is transformational change?


    Andrea Babon; Daniel McIntyre; Gae Y. Gowae; Caleb Gallemore; Rachel Carmenta; Monica Di Gregorio; Maria Brockhaus


    Tropical forests in developing countries are increasingly being valued for their role in carbon sequestration. Such interest is reflected in the emergence of international initiatives for Reducing Emissions from Deforestation and Forest Degradation (REDD+). REDD+ requires addressing both tropical forests as complex social-ecological systems and the multiple sectors involved in tropical forest resources, which may necessitate transformational change away from business-as-usual approaches to fo...

  19. A pilot study evaluating the effects of a youth advocacy program on youth readiness to advocate for environment and policy changes for obesity prevention. (United States)

    Millstein, Rachel A; Woodruff, Susan I; Linton, Leslie S; Edwards, Christine C; Sallis, James F


    Youth advocacy for obesity prevention is a promising but under-evaluated intervention. The aims of this study are to evaluate a youth advocacy program's outcomes related to youth perceptions and behaviors, develop an index of youth advocacy readiness, and assess potential predictors of advocacy readiness. Youth ages 9-22 in an advocacy training program (n = 92 matched pairs) completed surveys before and after training. Youth outcomes and potential predictors of advocacy readiness were assessed with evaluated scales. All 20 groups who completed the evaluation study presented their advocacy projects to a decision maker. Two of six perception subscales increased following participation in the advocacy program: self-efficacy for advocacy behaviors (p sports and physical activity enjoyment (B = .55, 95 % CI = .05-1.05), roles and participation (B = 1.81, 95 % CI = .60-3.02), and advocacy activities (B = 1.49, 95 % CI = .64-2.32). The youth advocacy readiness index is a novel way to determine the effects of multiple correlates of advocacy readiness. Childhood obesity-related advocacy training appeared to improve youths' readiness for advocacy and physical activity.

  20. Cancer-associated lysosomal changes

    DEFF Research Database (Denmark)

    Kallunki, T; Olsen, O D; Jaattela, Marja


    -targeting anti-cancer drugs. In this review we compile our current knowledge on cancer-associated changes in lysosomal composition and discuss the consequences of these alterations to cancer progression and the possibilities they can bring to cancer therapy.Oncogene advance online publication, 9 July 2012; doi...

  1. Banning shisha smoking in public places in Iran: an advocacy coalition framework perspective on policy process and change. (United States)

    Khayatzadeh-Mahani, Akram; Breton, Eric; Ruckert, Arne; Labonté, Ronald


    Shisha smoking is a widespread custom in Iran with a rapidly growing prevalence especially among the youth. In this article, we analyze the policy process of enforcing a federal/state ban on shisha smoking in all public places in Kerman Province, Iran. Guided by the Advocacy Coalition Framework (ACF), we investigate how a shisha smoking ban reached the political agenda in 2011, how it was framed by different policy actors, and why no significant breakthrough took place despite its inclusion on the agenda. We conducted a qualitative study using a case study approach. Two main sources of data were employed: face-to-face in-depth interviews and document analysis of key policy texts. We interviewed 24 policy actors from diverse sectors. A qualitative thematic framework, incorporating both inductive and deductive analyses, was employed to analyze our data. We found that the health sector was the main actor pushing the issue of shisha smoking onto the political agenda by framing it as a public health risk. The health sector and its allies advocated enforcement of a federal law to ban shisha smoking in all public places including teahouses and traditional restaurants whereas another group of actors opposed the ban. The pro-ban group was unable to neutralize the strategies of the anti-ban group and to steer the debate towards the health harms of shisha smoking. Our analysis uncovers three main reasons behind the policy stasis: lack of policy learning due to lack of agreement over evidence and related analytical conflicts between the two groups linked to differences in core and policy beliefs; the inability of the pro-ban group to exploit opportunities in the external policy subsystem through generating stronger public support for enforcement of the shisha smoking ban; and the nature of the institutional setting, in particular the autocratic governance of CHFS which contributed to a lack of policy learning within the policy subsystem. Our research demonstrated the utility


    African Journals Online (AJOL)


    Sep 11, 2017 ... increased the tax on these items from 0 to 16%. This had a direct result in increasing the cost of healthcare by almost a third (5). On the other hand, South East. Asia countries especially India ... changed to reflect this new reality. The role of advocacy is huge here. NHIF reimburses between KShs. 40,000.

  3. Advocacy in neurology

    National Research Council Canada - National Science Library

    Pauranik, Apoorva


    ...), launched the Neurological Alliance of Ireland, a nationwide coalition of patient advocacy groups and physicians and authored Standards of Care, the "blueprint" for the development of neurological...

  4. Philosophy + Advocacy = Success (United States)

    Tutt, Kevin; Townley, Marc


    Knowledge about music advocacy strategies has long been promoted as important for music educators, not only for the benefit of their individual programs but also for the specific benefit of music students and the general public. This article suggests an approach to advocacy grounded in the teacher's professional beliefs, phrased in terms…

  5. The Surgeon and Advocacy

    African Journals Online (AJOL)

    There has been debate whether advocacy for the healthcare provider ... regulatory bodies have placed patient advocacy as an expectation .... emergency and surgical care in sub-saharan. Africa: the infrastructure gap. Health policy plan. 2011 doi: 10.1093/heapol/czr023. 7. Hutter MM, Kellogg KC, Ferguson CM et al. The.

  6. A History of Music Education Advocacy. (United States)

    Mark, Michael L.


    Provides a history of advocacy in music education discussing when formal advocacy started as well as advocacy with government agencies, the state level, and other types of advocacy. Includes a bibliography of resources related to music advocacy. (CMK)

  7. The Importance of Quality Patient Advocacy to Biobanks: A Lay Perspective from Independent Cancer Patients Voice (ICPV), Based in the United Kingdom. (United States)

    Wilcox, Maggie; Grayson, Margaret; MacKenzie, Mairead; Stobart, Hilary; Bulbeck, Helen; Flavel, Robert


    Biobanking in the twentieth century will become of increasing importance in health research. Regulation and governance of biobanks must be open and transparent to ensure public trust and confidence and increase donation. Effective Lay Involvement all levels in biobank organisations should be standard practice helping ensure patient benefit remains the central aim and assisting the Promotion of Biobanks and Recruitment of Donors. Properly selected, educated and supported, they become valued members of the Biobank Team. This chapter is based on the work of Independent Cancer Patients' Voice (ICPV) in the UK and recognises that the National Health Service provides a framework which is not universal and neither is the model of patient advocacy which has been developed particularly in cancer research. However, although it has not been easy to find potential members for ICPV, nor to attract funding, we have earned the respect of our professional colleagues by our commitment in giving time and developing the skills necessary to provide effective involvement. These colleagues have enthusiastically mentored and supported us and have provided venues and tutoring for Educational Events. We are sure that patient advocates in other countries would welcome the opportunity for similar involvement and hope our experiences will be of interest.

  8. Advocacy for eye care

    Directory of Open Access Journals (Sweden)

    Thulasiraj D Ravilla


    Full Text Available The effectiveness of eye care service delivery is often dependant on how the different stakeholders are aligned. These stakeholders range from the ministries of health who have the capacity to grant government subsidies for eye care, down to the primary healthcare workers who can be enrolled to screen for basic eye diseases. Advocacy is a tool that can help service providers draw the attention of key stakeholders to a particular area of concern. By enlisting the support, endorsement and participation of a wider circle of players, advocacy can help to improve the penetration and effectiveness of the services provided. There are several factors in the external environmental that influence the eye care services - such as the availability of trained manpower, supply of eye care consumables, government rules and regulations. There are several instances where successful advocacy has helped to create an enabling environment for eye care service delivery. Providing eye care services in developing countries requires the support - either for direct patient care or for support services such as producing trained manpower or for research and dissemination. Such support, in the form of financial or other resources, can be garnered through advocacy.

  9. Public health and media advocacy. (United States)

    Dorfman, Lori; Krasnow, Ingrid Daffner


    Media advocacy blends communications, science, politics, and advocacy to advance public health goals. In this article, we explain how media advocacy supports the social justice grounding of public health while addressing public health's "wicked problems" in the context of American politics. We outline media advocacy's theoretical foundations in agenda setting and framing and describe its practical application, from the layers of strategy to storytelling, which can illuminate public health solutions for journalists, policy makers, and the general public. Finally, we describe the challenges in evaluating media advocacy campaigns.

  10. Linking Exposure Assessment Science With Policy Objectives for Environmental Justice and Breast Cancer Advocacy: The Northern California Household Exposure Study (United States)

    Morello-Frosch, Rachel; Zota, Ami; Brown, Phil; Pérez, Carla; Rudel, Ruthann A.


    Objectives. We compared an urban fence-line community (neighboring an oil refinery) and a nonindustrial community in an exposure study focusing on pollutants of interest with respect to breast cancer and environmental justice. Methods. We analyzed indoor and outdoor air from 40 homes in industrial Richmond, California, and 10 in rural Bolinas, California, for 153 compounds, including particulates and endocrine disruptors. Results. Eighty compounds were detected outdoors in Richmond and 60 in Bolinas; Richmond concentrations were generally higher. Richmond's vanadium and nickel levels indicated effects of heavy oil combustion from oil refining and shipping; these levels were among the state's highest. In nearly half of Richmond homes, PM2.5 exceeded California's annual ambient air quality standard. Paired outdoor–indoor measurements were significantly correlated for industry- and traffic-related PM2.5, polycyclic aromatic hydrocarbons, elemental carbon, metals, and sulfates (r = 0.54–0.92, P environmental injustice concerns in communities that host polluters. Community-based participatory exposure research can contribute to science and stimulate and inform action on the part of community residents and policymakers. PMID:19890164

  11. Perspectives on Self-Advocacy: Comparing Perceived Uses, Benefits, and Drawbacks Among Survivors and Providers (United States)

    Hagan, Teresa; Rosenzweig, Margaret; Zorn, Kristin; van Londen, Josie; Donovan, Heidi


    To describe and compare survivors' and providers' views of the uses of and perceived benefits and drawbacks of survivor self-advocacy. A cross-sectional, two-group, mixed-methods survey. Survivors were recruited from local and national registries and advocacy organizations. Providers were recruited from the University of Pittsburgh Medical Center Cancer Center and a regional Oncology Nursing Society chapter. 122 female cancer survivors and 39 providers involved in their direct care. Quantitative survey data were summarized using descriptive statistics, including means and frequencies. Qualitative survey data were collected and analyzed using content analysis techniques, and main themes were counted and summarized. Perceptions of the uses, benefits, and drawbacks of female cancer survivor self-advocacy. Survivors and providers perceived similar but distinct uses of self-advocacy. Survivors and providers generally agreed on the potential benefits of self-advocacy but had different views of the potential drawbacks. Survivors were most concerned with finding and making sense of information, that their questions would not be answered, and having a worse relationship with their provider; providers were concerned with increases in clinic time and difficulties developing treatment plans. Although survivors and providers recognized similar benefits to survivor self-advocacy, they had different views of the uses and drawbacks of female cancer survivor self-advocacy. Attempts to increase self-advocacy among female cancer survivors must address survivors’ and providers’ views and apprehensions about self-advocacy.

  12. Recovering and Framing the George I. Sanchez Legacy of Chicana/o Student and Policy Advocacy: Utilizing Data for Social Change (United States)

    Rodríguez, Cristóbal


    Recovering and critically examining the pioneering scholarship and history of George I. Sanchez provides an interpretation toward a legacy of a Chicana/o student and policy advocacy framework for Chicana/o scholars to consider. The author of this work applies a critical policy theoretical analysis by Frank Fischer to develop a Chicana/o student…

  13. IPPF focuses on advocacy. Advocacy for reproductive health: worldwide. (United States)

    Puri, S; Ketting, E


    The International Planned Parenthood Federation has been advocating human rights since its establishment in 1952. Since the adoption of its global strategic plan, Vision 2000, it has dealt with advocacy in a more systematic manner. Advocacy aims to gain broader support for a cause. In family planning and reproductive health, advocacy is important in counteracting conservative opposition movements. Its most effective tool is high-quality information and services for meeting people's needs. Its target groups are women's groups, youth organizations, parliamentarians, media representatives, and religious leaders. Information, education, and communication (IEC) campaigns differ from advocacy, because the latter is deliberately persuasive and campaign-oriented. An Advocacy Working Group was convened by IPPF and an Advocacy Guide was produced in 1995. Advocacy is needed for the promotion of sexual and reproductive health in the face of opposition from traditional and cultural forces represented by small, vocal, well-financed and organized groups. In 1984 they succeeded in halting funding for IPPF by the United States. This made IPPF resolute in strategic planning and setting goals as contained in Vision 2000. The goals include advocacy for family planning, the prevention of unsafe abortion, women's empowerment, the involvement of youth, the responsibility of men for family life, and the improvement of the status of the female child. The IPPF's 1985 Central Council discussed new initiatives and an Issues Manual was published. The 1989 Members' Assembly held a seminar on critical issues in advocating family planning. A further 1993 resolution urged support for advocacy initiatives. A Public Response Guide was published in 1991 and Language Guidelines were also produced for correct family planning terminology. In addition, an Interregional Training Workshop was held in London in 1995 on the use of the Advocacy Guide. Recommendations were also submitted by participants for

  14. The art and science of political advocacy. (United States)

    Kosiorowski, Donna


    School nurses throughout the nation, individually and collectively, work to bring about change for the school nursing profession and to safeguard the health of children and the public. School nurses practice amidst education reform, health care reform, changes in society, and medical and technological advancements. School nurses must be active in decisions that affect their daily practice by involvement in the local, state, and federal political process. School nurses must craft the art and develop the science of political advocacy.

  15. Advocacy and IPR, tutorial 4

    CERN Multimedia

    CERN. Geneva


    With open access and repositories assuming a high profile some may question whether advocacy is still necessary. Those involved in the business of setting up and populating repositories are aware that in the majority of institutions there is still a great need for advocacy. This tutorial will give participants an opportunity to discuss different advocacy methods and approaches, including the 'top down' and 'bottom up' approach, publicity methods and the opportunities offered by funding body positions on open access. Participants will have the opportunity to share experiences of what works and what doesn't. The advocacy role often encompasses responsibility for advising academics on IPR issues. This is a particularly critical area where repository staff are engaged in depositing content on behalf of academics. The tutorial will offer an opportunity to discuss the IPR issues encountered by those managing repositories. The tutorial will draw on the experience of participants who have been engaged in advocacy act...

  16. Glycan changes: cancer metastasis and anti-cancer vaccines

    Indian Academy of Sciences (India)

    Glycosylation changes are universal hallmarks of malignant transformation and tumour progression in human cancer, which take place on the whole cells or some specific molecules. Accordingly, those changes make them prominent candidates for cancer biomarkers in the meantime. This review mainly focuses on the ...

  17. Building a Latin American cancer patient advocacy movement: Latin American cancer NGO regional overview Desarrollando un movimiento de apoyo para pacientes de cáncer en America Latina: resumen regional - ONGs de cáncer

    Directory of Open Access Journals (Sweden)

    Alessandra Durstine


    Full Text Available The objective of the this paper is to assess and identify the key strengths and weaknesses for cancer control NGOs in Latin America, with the goal to make recommendations about how to improve thev impact of the patient advocacy movement as it pertains to cancer. The methods included literature review, expert interviews and site visits to Latin American cancer hospitals and NGOs. The overall findings conclude that NGOs currently do not take a leadership role in cancer control in Latin America. The lack of a survivorship movement, faulty patient information services and failure of the governments to include NGOs in policy creation are identified as areas for further project work and collaboration. The stigma of cancer still remains and a burgeoning patient movement can be created to help destigmatize and debunk the myths that surround cancer.El objetivo de este artículo es el de identificar y evaluar las fortalezas y debilidades clave de las ONG dedicadas al control del cáncer en Latinoamérica, con el fin de generar recomendaciones sobre el modo de mejorar el impacto del movimiento de apoyo para pacientes de cáncer. Los métodos incluyeron una revisión de la literatura, entrevistas a expertos y visitas a hospiptales y ONG dedicados al cáncer en Latinoamérica. Los hallazgos principales permiten concluir que en este momento las ONG no tienen un rol de liderazgo para el control del cáncer en Latinoamérica. La ausencia de un movimiento de sobrevivientes, servicios de información deficientes a los pacientes y el fracaso del gobierno para incluir a las ONG en la creación de políticas se identifican como áreas de trabajo y colaboración en proyectos a futuro. El estigma del cáncer aún subsiste y es factible crear un movimiento que florezca y ayude a desvanecerlo al exponer los mitos que rodean este padecimiento.

  18. Taste and smell changes in cancer patients

    NARCIS (Netherlands)

    IJpma, Irene


    Patients with cancer often experience changes in taste and smell perception during chemotherapy. The aim of this dissertation was to investigate taste and smell changes and short- and long-term effects of chemotherapy in a homogeneous population of testicular cancer patients treated with

  19. Advocacy Science: Explaining the Term with Case Studies from Biotechnology. (United States)

    Gerasimova, Ksenia


    The paper discusses the use of term 'advocacy science' which is communication of science which goes beyond simple reporting of scientific findings, using the case study of biotechnology. It argues that advocacy science should be used to distinguish the engagement of modern civil society organizations to interpret scientific knowledge for their lobbying. It illustrates how this new communicative process has changed political discourse in science and general perception of the role of science in contemporary society.

  20. Patient advocacy: barriers and facilitators

    Directory of Open Access Journals (Sweden)

    Nikravesh Mansoure


    Full Text Available Abstract Background During the two recent decades, advocacy has been a topic of much debate in the nursing profession. Although advocacy has embraced a crucial role for nurses, its extent is often limited in practice. While a variety of studies have been generated all over the world, barriers and facilitators in the patient advocacy have not been completely identified. This article presents the findings of a study exploring the barriers and facilitators influencing the role of advocacy among Iranian nurses. Method This study was conducted by grounded theory method. Participants were 24 Iranian registered nurses working in a large university hospital in Tehran, Iran. Semi-structured interviews were used for data collection. All interviews were transcribed verbatim and simultaneously Constant comparative analysis was used according to the Strauss and Corbin method. Results Through data analysis, several main themes emerged to describe the factors that hindered or facilitated patient advocacy. Nurses in this study identified powerlessness, lack of support, law, code of ethics and motivation, limited communication, physicians leading, risk of advocacy, royalty to peers, and insufficient time to interact with patients and families as barriers to advocacy. As for factors that facilitated nurses to act as a patient advocate, it was found that the nature of nurse-patient relationship, recognizing patients' needs, nurses' responsibility, physician as a colleague, and nurses' knowledge and skills could be influential in adopting the advocacy role. Conclusion Participants believed that in this context taking an advocacy role is difficult for nurses due to the barriers mentioned. Therefore, they make decisions and act as a patient's advocate in any situation concerning patient needs and status of barriers and facilitators. In most cases, they can not act at an optimal level; instead they accept only what they can do, which we called 'limited advocacy' in

  1. Colorectal Cancer: Genetics is Changing Everything. (United States)

    Obuch, Joshua C; Ahnen, Dennis J


    Cancer is fundamentally a genetic disease caused by mutational or epigenetic alterations in DNA. There has been a remarkable expansion of the molecular understanding of colonic carcinogenesis in the last 30 years and that understanding is changing many aspects of colorectal cancer care. It is becoming increasingly clear that there are genetic subsets of colorectal cancer that have different risk factors, prognosis, and response to treatment. This article provides a general update on colorectal cancer and highlights the ways that genetics is changing clinical care. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Customer advocacy and brand development


    Lawer, Christopher; Knox, Simon


    Purpose – The purpose of this article is to define and explore the strategic value of customer advocacy through the lens of the brand management literature.  Design/methodology/approach – The paper reviews recent analysis of the value and vulnerabilities of brands and branding in order to understand why customer advocacy is becoming an attractive strategic option for many firms. A model of empowered consumer value drivers is constructed to demonstrate how they are becoming an important source...

  3. Competition Advocacy: Time for Rethink?


    Evenett, Simon J.


    This paper examines the conventional wisdom concerning competition advocacy, paying particular attention to the applicability of such wisdom to developing countries. The definition of competition advocacy, its evaluation, and the likelihood of its successful implementation are discussed in some detail. The paper concludes with a call for considerably more thought about what, hitherto, has been one of the relatively uncontroversial aspects of many competition authorities' activities.

  4. New Zealand's National Health and Disability Advocacy Service: A successful model of advocacy

    National Research Council Canada - National Science Library

    Drage, Jean


    .... This paper, in exploring both the debate and practice of advocacy, uses the National Health and Disability Advocacy Service in New Zealand to describe a successful model of advocacy that is based...

  5. Perspective: Medical professionalism and medical education should not involve commitments to political advocacy. (United States)

    Huddle, Thomas S


    It is increasingly suggested that political advocacy is a core professional responsibility for physicians. The author argues that this is an error. Advocacy on behalf of societal goals, even those goals as unexceptionable as the betterment of human health, is inevitably political. Claims that political advocacy are a professional responsibility are mistaken, the author argues, because (1) civic virtues are outside the professional realm, (2) even if civic virtues were professionally obligatory, it is unclear that civic participation is necessary for such virtue, and (3) the profession of medicine ought not to require any particular political stance of its members. Claims that academic health centers should systematically foster advocacy are also deeply problematic. Although advocacy may coexist alongside the core university activities of research and education, insofar as it infects those activities, advocacy is likely to subvert them, as advocacy seeks change rather than knowledge. And official efforts on behalf of advocacy will undermine university aspirations to objectivity and neutrality.American society has conferred remarkable success and prosperity on its medical profession. Physicians are deserving of such success only insofar as they succeed in offering society excellence and dedication in professional work. Mandatory professional advocacy must displace such work but cannot substitute for it. The medical profession should steadfastly resist attempts to add advocacy to its essential professional commitments.

  6. Assessing the Efficacy of a School Health Education Advocacy Lesson with College Students (United States)

    Wallen, Michele; Chaney, Beth H.; Birch, David A.


    Purpose: The researchers evaluated the efficacy of an advocacy lesson to assess change in intentions to advocate for school health education. This study also measured changes in participants' understanding the importance of school health education and perceived effectiveness in applying advocacy skills. Methods: A convenience sample of college…

  7. Essentials of Advocacy in Case Management: Part 2: Client Advocacy Model and Case Manager's Advocacy Strategies and Competencies. (United States)

    Tahan, Hussein M


    This article describes a client advocacy model for use by case managers. It delineates necessary competencies for the case manager and shares important strategies for effective client advocacy. All practice settings across the continuum of health and human services and case managers of diverse professional backgrounds. Advocacy is a primary role and necessary competency of professional case managers functioning in various care settings. It is rooted in ethical theory and principles. Successful case managers apply ethical principles of advocacy at every step of the case management process and in the decisions they make. Part II of this two-part article presents a client advocacy model for case managers to apply in their practice, describes the role of advocacy in client engagement, and identifies important strategies and a set of essential competencies for effective case management advocacy. Part I already explored the ethical theories and principles of advocacy, the perception of case management-related professional organizations of advocacy, and the common types of advocacy based on scope, complexity, impact, and reach. Acquiring foundational knowledge, skills, and competencies in what advocacy is and how to effectively enact its related behaviors is essential for success of case managers and for achieving desired outcomes for both the clients and health care agencies/providers alike. Case management leaders are urged to use the knowledge shared in this article to develop advocacy training and competency management programs for their case managers.

  8. Competition Advocacy: the Italian Experience

    Directory of Open Access Journals (Sweden)

    Salvatore Rebecchini


    Full Text Available Competition advocacy is considered, together with enforcement, the core business of an antitrust authority. Broadly speaking there are at least three main tasks regularly performed by most, if not all, antitrust agencies that are amenable to the advocacy function: addressing laws and regulations in order to remove unnecessary impediments to competition; engaging in sector enquiries to understand markets behavior and identify critical issues; explaining the benefits of open competitive markets to the public opinion. This article examines these three main tasks and outlines the challenges for competition agencies, with references to the experience of the Italian Competition Authority (ICA and the initiatives undertaken at international level.

  9. The Changing World of Breast Cancer (United States)

    Kuhl, Christiane K.


    Abstract Compared with other fields of medicine, there is hardly an area that has seen such fast development as the world of breast cancer. Indeed, the way we treat breast cancer has changed fundamentally over the past decades. Breast imaging has always been an integral part of this change, and it undergoes constant adjustment to new ways of thinking. This relates not only to the technical tools we use for diagnosing breast cancer but also to the way diagnostic information is used to guide treatment. There is a constant change of concepts for and attitudes toward breast cancer, and a constant flux of new ideas, new treatment approaches, and new insights into the molecular and biological behavior of this disease. Clinical breast radiologists and even more so, clinician scientists, interested in breast imaging need to keep abreast with this rapidly changing world. Diagnostic or treatment approaches that are considered useful today may be abandoned tomorrow. Approaches that seem irrelevant or far too extravagant today may prove clinically useful and adequate next year. Radiologists must constantly question what they do, and align their clinical aims and research objectives with the changing needs of contemporary breast oncology. Moreover, knowledge about the past helps better understand present debates and controversies. Accordingly, in this article, we provide an overview on the evolution of breast imaging and breast cancer treatment, describe current areas of research, and offer an outlook regarding the years to come. PMID:26083829

  10. Negotiating effectiveness in transnational advocacy evaluation

    NARCIS (Netherlands)

    Arensman, Bodille; Wessel, Margit Van


    International development organizations increasingly use advocacy as a strategy to pursue effectiveness. However, establishing the effectiveness of advocacy is problematic and dependent on the interpretations of the stakeholders involved, as well as the interactions between them. This article

  11. Applying Buddhist Practices to Advocacy: The Advocacy-Serving Model (United States)

    Warren, Jane; Klepper, Konja K.; Lambert, Serena; Nunez, Johnna; Williams, Susan


    Creating and retaining empathic connections with the most disenfranchised among us can take a toll on the wellness of counselor advocates. The Advocacy-Serving Model is introduced as a creative approach to strengthening the ability of advocates to serve through enhancing awareness, focusing actions, and connecting to community. The model…

  12. Ovarian Cancer FAQ (United States)

    ... vein thrombosis (DVT) , heart attack, and stroke. Current theories suggest that some types of ovarian cancer may ... Annual Meeting CME Overview CREOG Meetings Calendar Congressional Leadership Conference Advocacy Legislative Priorities GR & Outreach State Advocacy ...

  13. The changing incidence of thyroid cancer. (United States)

    Kitahara, Cari M; Sosa, Julie A


    During the past few decades, the incidence of thyroid cancer has increased substantially in many countries, including the USA. The rise in incidence seems to be attributable both to the growing use of diagnostic imaging and fine-needle aspiration biopsy, which has led to enhanced detection and diagnosis of subclinical thyroid cancers, and environmental factors. The latest American Thyroid Association (ATA) practice guidelines for the management of adult patients with thyroid nodules and differentiated thyroid cancer differ substantially from the previous ATA guidelines published in 2009. Specifically, the problems of overdiagnosis and overtreatment of a disease that is typically indolent, where treatment-related morbidity might not be justified by a survival benefit, now seem to be acknowledged. As few modifiable risk factors for thyroid cancer have been established, the specific environmental factors that have contributed to the rising incidence of thyroid cancer remain speculative. However, the findings of several large, well-designed epidemiological studies have provided new information about exposures (such as obesity) that might influence the development of thyroid cancer. In this Review, we describe the changing incidence of thyroid cancer, suggest potential explanations for these trends, emphasize the implications for patients and highlight ongoing and potential strategies to combat this growing clinical and public health issue.

  14. Weight changes during chemotherapy for breast cancer

    Directory of Open Access Journals (Sweden)

    Luciano José Megale Costa

    Full Text Available CONTEXT: Patients receiving adjuvant chemotherapy for breast cancer have a tendency to gain weight. This tendency has determining factors not completely defined and an unknown prognostic impact. OBJECTIVE: To evaluate weight change during chemotherapy for breast cancer in a defined population and to identify its predisposing factors and possible prognostic significance. DESIGN: Observational, retrospective cohort study. SETTING: Private clinical oncology service. PARTICIPANTS: 106 consecutive patients with breast cancer treated between June 1994 and April 2000, who received neoadjuvant (n = 8, adjuvant (n = 74 or palliative (n = 24 chemotherapy. INTERVETION: Review of medical records and gathering of clinical information, including patients’ body weights before treatment and at follow-up reviews. MAIN MEASUREMENTS: Body weight change, expressed as percentage of body weight per month in treatment; role of clinical data in weight change; and influence of weight change in overall survival and disease-free survival. RESULTS: There was a mean increase of 0.50 ± 1.42% (p = 0.21 of body weight per month of treatment. We noted a negative correlation between metastatic disease and weight gain (r = -0.447, p < 0.0001. In the adjuvant and neoadjuvant therapy groups there was a mean weight gain of 0.91 ± 1.19 % (p < 0.00001 per month, whereas in the metastatic (palliative group, we observed a mean loss of 0.52 ± 1.21% (p = 0.11 of body weight per month during the treatment. We did not observe any statistically significant correlation between weight changes and disease-free survival or overall survival. CONCLUSIONS: Women with breast cancer undergoing adjuvant or neoadjuvant chemotherapy gain weight, whereas metastatic cancer patients will probably lose weight during palliative chemotherapy. Further studies are needed in order to evaluate the prognostic significance of weight changes during chemotherapy.

  15. Advocacy Update: Autism Speaks (United States)

    Ursitti, Judith


    Autism Speaks, the world's largest autism non-profit organization, is addressing a struggle to obtain evidence-based treatment on autism. The mission of Autism Speaks is to change the future for all who struggle with autism spectrum disorders (ASD). Part of their focus is to change state insurance laws to require private health insurance policies…

  16. The Importance of Physician Climate Advocacy in the Face of Political Denial. (United States)

    Jameton, Andrew


    Most physicians accept the general scientific discoveries about anthropogenic global warming and its dangers. Occasional denial by individual physicians of climate change can be readily answered by reference to the scientific consensus. But widespread, organized, political denial of climate change is hazardous to physicians' advocacy for an effective public health and health care response to climate change. This article assumes that physician climate advocacy is ethical and celebrates the many forms of health climate advocacy already under way. It concludes by drawing attention to measures that can scale up and strengthen the health care system's organized response to growing climate health hazards. © 2017 American Medical Association. All Rights Reserved.

  17. 76 FR 51044 - National Cancer Institute; Notice of Meeting (United States)


    ... HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to.... Agenda: 09/21 Welcome and review of how science is changing; 09/ 22 The role of regulatory science; 09/23.... Contact Person: Shannon K. Bell, MSW, Director, Office of Advocacy Relations, National Cancer Institute...

  18. General changes in hemostasis in gastric cancer. (United States)

    Kovacova, E; Kinova, S; Duris, I; Remkova, A


    Disorders of haemostasis and haemocoagulation are often seen in patients with cancer as a part of paraneoplastic syndrome. Thrombotic and/or haemorrhagic complications are the second most common cause of mortality in patients with cancer. The evaluation of the haemostatic parameters of 67 patients with gastric cancer have indicated tendency to thrombophilia and activation of intravascular coagulation, of which 31.3% showed tendency to hypercoagulation and 47.8% disseminated intravascular coagulation (DIC). Only 7.5% of subjects have yielded normal laboratory findings while 5.9% of patients had DIC with remarkable hypocoagulation. Thrombocytosis, platelet hyperaggregability and elevation of beta-thromboglobulin are the indicators of changes in primary haemostasis and elevation of thrombomodulin indicates vascular wall damage. Lower antithrombin III levels, C-protein and S-protein in plasma have indicated lower antithrombotic potential in patients with gastric cancer. It can be concluded that patients suffering from gastric cancer are at higher risk of thromboembolism as for haemorrhagic diathesis (20.1% thromboembolism, 11.94% fatal thromboembolic events vs 5.9 % haemorrhagic diathesis) (Tab. 5, Ref. 22). Full Text (Free, PDF)

  19. The principles and practices of nutrition advocacy: evidence, experience and the way forward for stunting reduction. (United States)

    Pelletier, David; Haider, Rukhsana; Hajeebhoy, Nemat; Mangasaryan, Nune; Mwadime, Robert; Sarkar, Satyajit


    Advocacy represents an intervention into complex, dynamic and highly contextual socio-political systems, in which strategies and tactics must be adjusted on a continual basis in light of rapidly changing conditions, reactions from actors and feedback. For this reason, the practice of advocacy is often considered more art than science. However, capacities and practices for advocacy can be strengthened by sharing and analysing experiences in varying contexts, deriving general principles and learning to adapt these principles to new contexts. Nutrition is a particular context for advocacy, but to date, there has been little systematic analysis of experiences. The purpose of this paper is to illustrate and draw lessons from the practice of nutrition advocacy, especially in relation to stunting and complementary feeding, and suggest ways to strengthen capacities and practices in the future. The strategies and tactics, achievements and lessons learnt are described for three case studies: Uganda, Vietnam and Bangladesh. These cases, and experience from elsewhere, demonstrate that concerted, well-planned and well-implemented advocacy can bring significant achievements, even in short period of time. In light of the global and national attention being given to stunting reduction through the SUN (Scaling Up Nutrition) movement and other initiatives, there is now a need for much stronger investments in strategic and operational capacities for advocacy, including the human, organisational and financial resources for the advocacy and strategic communication themselves, as well as for monitoring and evaluation, supportive research and institutional capacity-building. © 2013 John Wiley & Sons Ltd.

  20. Advocacy 201: Incorporating Advocacy Training in Health Education Professional Preparation Programs (United States)

    Thompson, Amy; Kerr, Dianne; Dowling, Jamie; Wagner, Laurie


    Involvement in advocacy is a responsibility of health educators, as identified by the National Commission on Health Education Credentialing. Of all the professional responsibilities, participation in advocacy-related activity is often neglected. This lack of participation may be due to the absence of advocacy and policy skills training in health…

  1. New Zealand's National Health and Disability Advocacy Service: a successful model of advocacy. (United States)

    Drage, Jean


    This paper, in exploring both the debate and practice of advocacy, uses the National Health and Disability Advocacy Service in New Zealand to describe a successful model of advocacy that is based on the concept of empowerment practiced in an independent environment and strengthened by an enforceable framework of consumer rights. Copyright © 2012 Drage.

  2. Dams and transnational advocacy: Political opportunities in transnational collective action (United States)

    Fu, Teng

    Possible arguments to explain the gradual decline in big dam development and its site transferring from developed to developing countries include technical, economic, and political factors. This study focuses on the political argument---the rise of transnational anti-dam advocacy and its impact on state policy-making. Under what conditions does transnational anti-dam advocacy matter? Under what conditions does transnational advocacy change state dam policies (delay, scale down, or cancel)? It examines the role of transnational anti-dam actors in big dam building in a comparative context in Asia. Applying the social movement theory of political opportunity structure (POS) and using the qualitative case-study method, the study provides both within-case and cross-case analyses. Within-case analysis is utilized to explain the changing dynamics of big dam building in China (Three Gorges Dam and proposed Nu/Salween River dam projects), and to a lesser extent, Sardar Sarovar Project in India and Nam Theun 2 Dam in Laos. Different domestic and international POS (DPOS and IPOS) impact the strategies and outcomes of anti-dam advocacies in these countries. The degree of openness of the POS directly affects the capacity of transnational efforts in influencing state dam policies. The degree of openness or closure is measured by specific laws, institutions, discourse, or elite allies (or the absence of these) for the participation of non-state actors on big dam issues at a particular moment. This degree of openness is relative, varying over time, across countries and regions. This study finds that the impact of transnational anti-dam activism is most effective when both DPOS and IPOS are relatively open. Transnational anti-dam advocacy is least effective in influencing state dam policies when both DPOS and IPOS are relatively closed. Under a relatively open DPOS and closed IPOS, transnational anti-dam advocacy is more likely to successfully change state dam policies and even

  3. Basic Cancer Terms (United States)

    ... Considerations How Cancer is Treated Side Effects Dating, Sex, and Reproduction Advanced Cancer For Children For Teens For Young Adults For Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog ...

  4. School Board Advocacy: Ready, Aim, Inspire! (United States)

    Dowd, Karen


    It is said that "all politics are local," and the same can be said about advocacy and school boards. Advocacy is essential for retaining the progress that's been made in the past, and for building a foundation and network for the future. Advocating for preferred programs, curricula and initiatives has always been important. As a starting point,…

  5. Building Evidence for Music Education Advocacy (United States)

    Shorner-Johnson, Kevin


    The economic challenges facing public schools and music education are immense. In this context, music teachers and supporters will need to engage in persuasive advocacy to protect resource allocations to music programs. It is worthwhile to consider the model of music education advocacy that allowed music to be adopted into the Boston Public…

  6. Advocacy in School Psychology: Problems and Procedures. (United States)

    Mcloughlin, Caven S.

    Inherent in the many roles of a school psychologist is a primary responsibility to act as a child advocate. Child advocacy carries with it a variety of definitions, all of which are concerned with aligning oneself with the cause of either an individual child or a group. Child advocacy involves asserting and defending those rights of an individual…

  7. Professor Brand Advocacy: Do Brand Relationships Matter? (United States)

    Jillapalli, Ravi K.; Wilcox, James B.


    The trend among students to advocate their professors online continues to generate interest within marketing academia. Brand advocacy in products and services has played a vital role in marketing. However, no known research to date has embraced the idea of brand advocacy in marketing education. This research builds on the recent human brand…

  8. Changing policy framing as a deliberate strategy for public health advocacy: a qualitative policy case study of minimum unit pricing of alcohol. (United States)

    Katikireddi, Srinivasa Vittal; Bond, Lyndal; Hilton, Shona


    Scotland is the first country in the world to pass legislation introducing a minimum unit price (MUP) for alcohol in an attempt to reduce consumption and associated harms by increasing the price of the cheapest alcohol. We investigated the competing ways in which policy stakeholders presented the debate. We then established whether a change in framing helped explain the policy's emergence. We conducted a detailed policy case study through analysis of evidence submitted to the Scottish parliament, and in-depth, one-to-one interviews (n = 36) with politicians, civil servants, advocates, researchers, and industry representatives. Public- and voluntary-sector stakeholders tended to support MUP, while industry representatives were more divided. Two markedly different ways of presenting alcohol as a policy problem were evident. Critics of MUP (all of whom were related to industry) emphasized social disorder issues, particularly among young people, and hence argued for targeted approaches. In contrast, advocates for MUP (with the exception of those in industry) focused on alcohol as a health issue arising from overconsumption at a population level, thus suggesting that population-based interventions were necessary. Industry stakeholders favoring MUP adopted a hybrid framing, maintaining several aspects of the critical framing. Our interview data showed that public health advocates worked hard to redefine the policy issue by deliberately presenting a consistent alternative framing. Framing alcohol policy as a broad, multisectoral, public health issue that requires a whole-population approach has been crucial to enabling policymakers to seriously consider MUP, and public health advocates intentionally presented alcohol policy in this way. This reframing helped prioritize public health considerations in the policy debate and represents a deliberate strategy for consideration by those advocating for policy change around the world and in other public health areas. © 2014

  9. National Comprehensive Cancer Network (United States)

    ... Washington, DC Policy Summit: Redefining Quality Measurement in Oncology - Article Coming Soon! Policy Summit: Ensuring Patient Access and Safety in Cancer Care - Article Coming Soon! Patient Advocacy ...

  10. Particulate matter-induced epigenetic changes and lung cancer. (United States)

    Li, Jinghong; Li, Willis X; Bai, Chunxue; Song, Yuanlin


    Lung cancer is the leading cause of cancer death worldwide. Cigarette smoking is the well-known risk factor for lung cancer. Epidemiological studies suggest that air pollution, especially particulate matter (PM) exposure, is associated with increased lung cancer risk and mortality independent of cigarette smoking. English-language publications focusing on PM, epigenetic changes, and lung cancer were reviewed. The epigenome serves as an interface between the environment and the genome. PM is one of the environmental factors that can cause epigenetic changes. The epigenome serves as an interface between the environment and the genome. Some of the epigenetic changes lead to increased disease susceptibility and progression. In cardiovascular disease and asthma, the association between PM exposure and the disease specific epigenetic changes has been identified. In lung cancer, the epigenetic changes in DNA methylation, histone modification and microRNA expression are commonly found, but the specific link between PM exposure and lung cancer remains incompletely understood. The results of epidemiological studies indicate the important effects of PM exposure on lung cancer. PM2.5 is consistently associated with the increased lung cancer risk and mortality. Based on the epidemiological associations between PM exposure and lung cancer, PM-induced epigenetic changes may play important roles in the pathogenesis of lung cancer. In this review, we focus on the current knowledge of epigenetic changes associated with PM exposure and lung cancer. Better understanding of the link between PM exposure and lung cancer at the epigenomic level by comprehensive comparison approach may identify lung cancer early detection biomarkers and novel therapeutic targets. © 2015 John Wiley & Sons Ltd.

  11. Taking a community-based participatory research approach in the development of methods to measure a community health worker community advocacy intervention. (United States)

    Ingram, Maia; Sabo, Samantha J; Gomez, Sofia; Piper, Rosalinda; de Zapien, Jill Guernsey; Reinschmidt, Kerstin M; Schachter, Ken A; Carvajal, Scott C


    Public health advocacy is by necessity responsive to shifting sociopolitical climates, and thus a challenge of advocacy research is that the intervention must by definition be adaptive. Moving beyond the classification of advocacy efforts to measurable indicators and outcomes of policy, therefore, requires a dynamic research approach. The purposes of this article are to (1) describe use of the CBPR approach in the development and measurement of a community health worker (CHW) intervention designed to engage community members in public health advocacy and (2) provide a model for application of this approach in advocacy interventions addressing community-level systems and environmental change. The Kingdon three streams model of policy change provided a theoretical framework for the intervention. Research and community partners collaboratively identified and documented intervention data. We describe five research methods used to monitor and measure CHW advocacy activities that both emerged from and influenced intervention activities. Encounter forms provided a longitudinal perspective of how CHWs engaged in advocacy activities in the three streams. Strategy maps defined desired advocacy outcomes and health benefits. Technical assistance notes identified and documented intermediate outcomes. Focus group and interview data reflected CHW efforts to engage community members in advocacy and the development of community leaders. APPLICATION OF LESSONS LEARNED: We provide a model for application of key principles of CPBR that are vital to effectively capturing the overarching and nuanced aspects of public health advocacy work in dynamic political and organizational environments.

  12. Factors for success in mental health advocacy (United States)

    Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian


    Background Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition – Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. Design The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Results Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. Conclusions The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings. PMID:26689456

  13. Dietary changes among breast cancer patients in Malaysia. (United States)

    Shaharudin, Soraya Hanie; Sulaiman, Suhaina; Shahril, Mohd Razif; Emran, Nor Aina; Akmal, Sharifah Noor


    Breast cancer patients often show an interest in making dietary changes after diagnosis of breast cancer to improve their health condition and prevent cancer recurrence. The objective of the study was to determine changes in dietary intake 2 years after diagnosis among breast cancer patients. One hundred sixteen subjects were asked to complete a semiquantitative food frequency questionnaire, diet recalls, and dietary changes questionnaire to assess dietary intake before and after diagnosis. The information on sociodemographic background, cancer treatment history, and anthropometric indices was also collected. Seventy-two subjects considered diet as a contributing factor to breast cancer, and 67 subjects changed their dietary habits after breast cancer diagnosis. The reasons for changes in diet were physician and dietitian advice and desire to cure cancer. The sources of information were derived from their physician, mass media, and family members. Total energy, protein, total fat, fatty acids, and vitamin E intake were significantly decreased after diagnosis. Meanwhile, the intake of β-carotene and vitamin C increased significantly after diagnosis. The changes included reduction in red meat, seafood, noodles, and poultry intake. An increased consumption of fruits, vegetables, fish, low-fat milk, and soy products was observed. The subjects tended to lower high-fat foods intake and started to eat more fruits and vegetables. Breast cancer patients had changed to a healthier diet after breast cancer diagnosis, although the changes made were small. This will be helpful to dietitians in providing a better understanding of good eating habits that will maintain patients' health after breast cancer diagnosis.

  14. Health Policy and Advocacy for New Mexico Medical Students in the Family Medicine Clerkship. (United States)

    Cole McGrew, Martha; Wayne, Sharon; Solan, Brian; Snyder, Tiffany; Ferguson, Cheryl; Kalishman, Summers


    Learners in medical education are often inadequately prepared to address the underlying social determinants of health and disease. The objective of this article is to describe the development, implementation, and evaluation of a Health Policy and Advocacy curriculum incorporated into our family medicine clerkship. We developed a Health Policy and Advocacy course for medical students within our family medicine clerkship. We evaluated the curriculum using a survey of our own design administered to students before and after their clerkship year. We created a mean score for each subscale that measured (1) physician's role, (2) knowledge, and (3) confidence in ability and calculated differences between the pre-survey and the post-survey scores for four medical school classes. We also conducted a focus group to get student input on the new curriculum. Mean scores on the pre- and post-surveys were highest for the subscale regarding attitudes about a physician's role in health policy and advocacy and did not change over time. Scores for self-reported knowledge and confidence in abilities increased significantly from the beginning to the end of the clerkship year. Students were generally positive about the curriculum but had some concerns about finding time for advocacy in their future practices. Training in health care policy and advocacy can be successfully implemented into a medical school curriculum with positive outcomes in students' self-reported knowledge and confidence in their abilities. Work remains on providing advocacy role models for students.

  15. Evaluating Human Rights Advocacy on Criminal Justice and Sex Work. (United States)

    Amon, Joseph; Wurth, Margaret; McLemore, Megan


    Between October 2011 and September 2013, we conducted research on the use, by police and/or prosecutors, of condom possession as evidence of intent to engage in prostitution-related offenses. We studied the practice in five large, geographically diverse cities in the U.S. To facilitate our advocacy on this issue, conducted concurrent to and following our research, we developed an advocacy framework consisting of six dimensions: (1) raising awareness, (2) building and engaging coalitions, (3) framing debate, (4) securing rhetorical commitments, (5) reforming law and policy, and (6) changing practice. Using a case study approach, we describe how this framework also provided a basis for the evaluation of our work, and discuss additional considerations and values related to the measurement and evaluation of human rights advocacy. Copyright 2015 Amon, Wurth, and McLemore. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  16. Haemorheological Changes in African Breast Cancer Patients

    African Journals Online (AJOL)


    ABSTRACT. Several Studies have indicated the existence of thrombo-embolic complications in cancer patients and that this ... There were significant differences between the controls and breast cancer patients in all the parameters measured. (p<0.05). .... the previous work of Trosseau2 which suggested an evidence of ...

  17. Changes in Abundance of Oral Microbiota Associated with Oral Cancer (United States)

    Schmidt, Brian L.; Kuczynski, Justin; Bhattacharya, Aditi; Huey, Bing; Corby, Patricia M.; Queiroz, Erica L. S.; Nightingale, Kira; Kerr, A. Ross; DeLacure, Mark D.; Veeramachaneni, Ratna; Olshen, Adam B.; Albertson, Donna G.


    Individual bacteria and shifts in the composition of the microbiome have been associated with human diseases including cancer. To investigate changes in the microbiome associated with oral cancers, we profiled cancers and anatomically matched contralateral normal tissue from the same patient by sequencing 16S rDNA hypervariable region amplicons. In cancer samples from both a discovery and a subsequent confirmation cohort, abundance of Firmicutes (especially Streptococcus) and Actinobacteria (especially Rothia) was significantly decreased relative to contralateral normal samples from the same patient. Significant decreases in abundance of these phyla were observed for pre-cancers, but not when comparing samples from contralateral sites (tongue and floor of mouth) from healthy individuals. Weighted UniFrac principal coordinates analysis based on 12 taxa separated most cancers from other samples with greatest separation of node positive cases. These studies begin to develop a framework for exploiting the oral microbiome for monitoring oral cancer development, progression and recurrence. PMID:24887397

  18. The Changing Landscape of Lung Cancer Research and Treatment (United States)

    Along with the Lung Cancer Social Media (#LCSM) community, the National Cancer Institute will be co-hosting a lively and interactive Google Hangout on Air about the changing landscape of lung cancer research and treatment. During the chat, viewers will have the opportunity to pose questions to a panel of lung cancer experts including NCI's Dr. Shakun Malik, the head of thoracic oncology therapeutics, Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven and David Tom Cooke MD FACS, Head, Section of General Thoracic Surgery University of California, Davis. You can also learn more and follow along on the #LCSM Chat page. The chat will be moderated by lung cancer advocate and #LCSM co-founder, Janet Freeman-Daily. To ask questions of our experts, simply use the #LCSM hashtag during the chat.

  19. State gun control advocacy tactics and resources. (United States)

    Zakocs, R C; Earp, J A; Runyan, C W


    Enacting state laws to regulate firearm use, availability, or manufacture is one plausible strategy for preventing firearm-related injuries. Organizations that use a wide range of advocacy tactics may be successful in promoting gun control policies. To describe tactics commonly used by groups that advocate for state gun control laws and to assess whether financial resources were associated with groups' use of these advocacy tactics. We identified 679 local and state organizations potentially active on state-level gun control issues in 1998 and mailed a 153-item questionnaire to the groups' leaders. Organizations' use of 35 gun control advocacy tactics. Seventy-nine percent (n=538) of groups responded to our survey, and, of those eligible, eighty-one percent (n=207) completed questionnaires. Organizations commonly used public education, media, and legislative lobbying tactics, and fewer engaged in electioneering and litigation. Except for lobbying, no associations were found between groups' use of advocacy tactics and their level of financial resources. Organizations advocating for state gun control laws have a varied tactical repertoire, with fewer using electioneering and litigation than other approaches. Financial resources do not appear to be the determining factor in the advocacy methods employed.

  20. [Infections and epigenetic changes in cancer]. (United States)

    Corvalán, Alejandro H; Maturana, María José


    The role of epigenetics and infectious diseases at early stages of life influence pre-malignant lesions of cancer, in particular, gastric cancer, one of the most frequent tumours in Chile, Latin America, and worldwide. This article examines the role of H.pylori and epigenetic alterations (i.e. DNA methylation) at early stages of gastric cancer and proposes, from the paediatric point of view, strategies for prevention and early detection. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  1. Change in knowledge, attitude and practice regarding oral cancer ...

    African Journals Online (AJOL)

    Introduction: Oral cancer is a global health problem with increasing incidence and mortality rates. Screening is useful because of the easily detectable precancerous lesions. Aim: To assess change in knowledge, attitude and practice (KAP) regarding oral cancer and screening practices through visual oral examination ...

  2. BMI and Lifetime Changes in BMI and Cancer Mortality Risk

    NARCIS (Netherlands)

    Taghizadeh, Niloofar; Boezen, H Marike; Schouten, Jan P; Schröder, Carolien P; de Vries, Elisabeth G. E.; Vonk, Judith M


    Body Mass Index (BMI) is known to be associated with cancer mortality, but little is known about the link between lifetime changes in BMI and cancer mortality in both males and females. We studied the association of BMI measurements (at baseline, highest and lowest BMI during the study-period) and

  3. Community stakeholder responses to advocacy advertising

    Energy Technology Data Exchange (ETDEWEB)

    Miller, B.; Sinclair, J. [Elon University, Elon, NC (United States). School Community


    Focus group research was used to examine how community stakeholders, a group with local industry experience, responded to coal industry advocacy messages. The stakeholders expressed beliefs about both the advertiser and the coal industry, and while their knowledge led to critical consideration of the industry campaign, they also expressed a desire to identify with positive messages about their community. Applying a postpositivist research perspective, a new model is introduced to integrate these beliefs in terms of advertiser trust and industry accountability under the existing theoretical framework of persuasion knowledge. Agent and topic knowledge are combined in this model based on responses to the industry advocacy campaign. In doing so, this study integrates a priori theory within a new context, extending the current theoretical framework to include an understanding of how community stakeholders - a common target for marketplace advocacy - interpret industry messages.

  4. Legislating for advocacy: The case of whistleblowing. (United States)

    Watson, Chanel L; O'Connor, Tom


    The role of nurses as patient advocates is one which is well recognised, supported and the subject of a broad body of literature. One of the key impediments to the role of the nurse as patient advocate is the lack of support and legislative frameworks. Within a broad range of activities constituting advocacy, whistleblowing is currently the subject of much discussion in the light of the Mid Staffordshire inquiry in the United Kingdom (UK) and other instances of patient mistreatment. As a result steps to amend existing whistleblowing legislation where it exists or introduce it where it does not are underway. This paper traces the development of legislation for advocacy. The authors argue that while any legislation supporting advocacy is welcome, legislation on its own will not encourage or enable nurses to whistleblow.

  5. Advocacy in the Western Hemisphere Region: some FPA success stories. (United States)

    Andrews, D J


    The International Planned Parenthood Federation's Vision 2000 Strategic Plan has emphasized advocacy and the training of family planning associations (FPAs) in the Western Hemisphere region. During the summer of 1995 training programs in advocacy leadership management were sponsored for six FPAs in the Bahamas, Suriname, Belize, Colombia, Honduras, and Brazil. At the Western Hemisphere Regional Council Meeting in September 1995 awards were presented to FPAs for media outstanding projects. These FPAs used outreach to the community to promote the goals of Vision 2000. The Bahamas FPA won the Rosa Cisneros Award for articles published in a magazine that is distributed in primary and secondary schools and deals with the activities, achievements, and opinions of students. Issues include: love, relationships, responsibility, and teen pregnancy. A weekly television talk show also addresses the issues facing youth including education, music, community work, sexuality, pregnancy, and the relationship between teenagers and adults. The Family Planning Association of Honduras was also nominated for the award for a radio show on the health of mothers and children, the problems of adolescents, and FP. The newspaper Tiempo received the award for feature articles on social issues and FP. In 1994 the Association distributed thousands of booklets on contraceptives as well as fliers on vasectomy, female sterilization, oral contraceptives, IUDs, condoms, responsible parenthood, high-risk pregnancy, vaginal cytology, and cervical cancer. Similar posters were placed in hospitals and health centers, in 1997 FP posts, and 400 commercial outlets. The Family Planning Association of Suriname also carried out an impressive advocacy program during the period of 1968-93 with the goals of establishing a balance between population growth and the available resources to achieve well-being with regard to education, health care, nutrition, and housing.

  6. Cancer Care Gets Personal: How Tumor Treatments Are Changing (United States)

    ... January 2018 Print this issue Cancer Care Gets Personal How Tumor Treatments Are Changing En español Send ... also be passed down from your parents. These insights have led scientists to look for the unique ...

  7. Essentials of Advocacy in Case Management: Part 1: Ethical Underpinnings of Advocacy-Theories, Principles, and Concepts. (United States)

    Tahan, Hussein M


    This article describes the meaning and underpinnings of advocacy in the field of case management and shares essential principles and concepts for effective client advocacy. All practice settings across the continuum of health and human services and case managers of diverse professional backgrounds. Advocacy is vital to case management practice and a primary role of the professional case manager. It is rooted in ethical theory and principles. Successful case managers apply advocacy at every step of the case management process and in every action they take. Part I of this 2-part article explores the ethical theories and principles of advocacy, the perception of case management-related professional organizations of advocacy, and types of advocacy. Part II then presents a client advocacy model for case managers to apply in their practice, describes the role of advocacy in client engagement, and identifies important strategies and a set of essential competencies for effective case management advocacy. Acquiring foundational knowledge, skills, and competencies in what advocacy is equips case managers with the ability and confidence to enact advocacy-related behaviors in the provision of care to achieve desired outcomes for both the clients and health care agencies/providers alike. Case management leaders may use the knowledge shared in this article to develop advocacy training and competency programs for their case managers.

  8. Nausea and Vomiting Caused by Cancer Treatment (United States)

    ... Considerations How Cancer is Treated Side Effects Dating, Sex, and Reproduction Advanced Cancer For Children For Teens For Young Adults For Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog ...

  9. Changing Trends in oral cancer - a global scenario. (United States)

    Gupta, Neha; Gupta, Ritu; Acharya, Arun Kumar; Patthi, Basavaraj; Goud, Venkatesh; Reddy, Somanath; Garg, Anshul; Singla, Ashish


    Oral cancer is one of the highly prevalent cancers worldwide and a leading cause of mortality in certain regions like South-Central Asia. It is a major public health problem. Late diagnosis, high mortality rates and morbidity are characteristics of the disease worldwide. For control of oral cancer an idea of the coverage of the same in the various regions is necessary. The estimated incidence, mortality and 5-year survival due to lip, oral cavity cancer in world is 3, 00, 373(2.1%), 1, 45, 328(1.8%) and 7, 02, 149(2.2%) respectively according to data of GLOBOCAN 2012. A changing trend in incidence and prevalence of oral cancer has been observed with more women and youngsters being affected by oral cancer.

  10. Thirty years of advocacy in San Francisco: lessons learned and the next generation of leadership. (United States)

    Lee, Ntanya


    Professional advocacy organizations are often challenged by the question of their authentic community representation and their ability to balance short-term pragmatism with strategic plans for long-term, systemic change. Coleman Advocates, one of the nation's most effective child advocacy organizations, has taken up this challenge under the leadership of a next-generation leader of color who followed a dynamic director of the baby boom generation. In this piece, Coleman's thirty years of social change strategies are analyzed from the perspective of this new executive director, who has facilitated the latest organizational shift that deepens its commitment to building bottom-up grassroots leadership and community power while keeping the best of the professional, staff-led advocacy model. Issues of race, accountability, power, and movement building are addressed through the lens of one organization's evolution, with the goal of building a long-term movement that will achieve racial and economic equity for all children and families.

  11. Has the character of gastric cancer changed?

    African Journals Online (AJOL)


    Apr 6, 1991 ... The maJonty of patients with cancer of the stomach have widespread disease at the time of diagnosis. This well-known bleak outlook may easily lead to a fatalistic approach to the disease, as was expressed by MacDonald and Kotin1 in 1954. In their pessimistic hypothesis they stated that the outcome of.

  12. Celebrities as Health Educators: Media Advocacy Guidelines. (United States)

    Baker, Judith A.; And Others


    Commentary is provided on the role of celebrities as media advocates for health education, particularly in light of the acquired immunodeficiency syndrome (AIDS) epidemic. It is suggested that the media advocacy approach offers greater effectiveness to celebrity messages in stimulating health policy improvements. (GLR)

  13. Taking Our Seat at the Advocacy Table (United States)

    Laverdure, Patricia


    The Policy-Advocacy-Leadership (PAL) column is developed to initiate and facilitate important dialogue about health care and educational policy, and develop and share the knowledge, tools, and resources that enable all of us to be effective advocates for our clients and our practice and leaders in our practice settings and profession. In this…

  14. Educational Expertise, Advocacy, and Media Influence (United States)

    Malin, Joel R.; Lubienski, Christopher


    The efforts of many advocacy organizations to advance their preferred policies despite conflicting evidence of the effectiveness of these policies raise questions about factors that shape successful policy promotion. While many may like to think that expertise on an issue in question is an essential prerequisite for influence in public policy…

  15. Advocacy and political convergence under preference uncertainty

    NARCIS (Netherlands)

    Reuben, E.; Traxler, C.; van Winden, F.


    We study the formation of advocacy groups and how they can impact policy outcomes by revealing information about voters׳ preferences to uninformed political candidates. We conduct a laboratory experiment based on a two-candidate spatial electoral competition setting where the policy preferences of

  16. Evidence, Analysis and Advocacy for Equity- The

    African Journals Online (AJOL)

    Evidence, Analysis and Advocacy for Equity- The. Perspective of the Malawi Health Equity Network. John Njunga', Alinafe Kasiya2. ' Malawi Health Equity Network. 2 Care International Malawi, Board Member Malawi Health Equity Network. Introduction. This paper presents a synopsis of experiences of Malawi Health.

  17. Advocacy for biofortification: building stakeholder support ...

    African Journals Online (AJOL)

    Africa as a continent faces high prevalence of micronutrient deficiencies such as vitamin A, iron, and zinc. Biofortification offers a dietary agriculture-based strategy that has shown potential to address selected micronutrient deficiencies. This chapter describes how advocacy for biofortification by HarvestPlus and its partners ...

  18. Higher Education Alumni Associations and Political Advocacy (United States)

    Buchli, Richard N.


    Political advocacy is comprised of speaking on the behalf of a cause or participating as part of a political action group (Weerts, Cabrera, & Sanford, 2010). Because state financial support for public higher education has not been maintained at previous levels, higher education (HE) institutions have been recruiting alumni in an attempt to win…

  19. Cancer Terms: After Treatment (United States)

    ... Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog About ... means different things to different people. Two common definitions include having no disease after the completion of ...

  20. BMI and Lifetime Changes in BMI and Cancer Mortality Risk (United States)

    Taghizadeh, Niloofar; Boezen, H. Marike; Schouten, Jan P.; Schröder, Carolien P.; de Vries, E. G. Elisabeth; Vonk, Judith M.


    Body Mass Index (BMI) is known to be associated with cancer mortality, but little is known about the link between lifetime changes in BMI and cancer mortality in both males and females. We studied the association of BMI measurements (at baseline, highest and lowest BMI during the study-period) and lifetime changes in BMI (calculated over different time periods (i.e. short time period: annual change in BMI between successive surveys, long time period: annual change in BMI over the entire study period) with mortality from any cancer, and lung, colorectal, prostate and breast cancer in a large cohort study (n=8,645. Vlagtwedde-Vlaardingen, 1965-1990) with a follow-up on mortality status on December 31st 2008. We used multivariate Cox regression models with adjustments for age, smoking, sex, and place of residence. Being overweight at baseline was associated with a higher risk of prostate cancer mortality (hazard ratio (HR) =2.22; 95% CI 1.19-4.17). Obesity at baseline was associated with a higher risk of any cancer mortality [all subjects (1.23 (1.01-1.50)), and females (1.40 (1.07-1.84))]. Chronically obese females (females who were obese during the entire study-period) had a higher risk of mortality from any cancer (2.16 (1.47-3.18), lung (3.22 (1.06-9.76)), colorectal (4.32 (1.53-12.20)), and breast cancer (2.52 (1.15-5.54)). We found no significant association between long-term annual change in BMI and cancer mortality risk. Both short-term annual increase and decrease in BMI were associated with a lower mortality risk from any cancer [all subjects: (0.67 (0.47-0.94)) and (0.73 (0.55-0.97)), respectively]. In conclusion, a higher BMI is associated with a higher cancer mortality risk. This study is the first to show that short-term annual changes in BMI were associated with lower mortality from any type of cancer. PMID:25881129

  1. Towards a global framework for capacity building for non-communicable disease advocacy in low- and middle-income countries. (United States)

    Shilton, Trevor; Champagne, Beatriz; Blanchard, Claire; Ibarra, Lorena; Kasesmup, Vijj


    Non-communicable diseases (NCDs) represent an increasing proportion of morbidity and mortality throughout the world. Sustained advocacy, carried out by a skilled workforce, is an important strategy to realize the political will and implement the policy changes necessary to reduce the global burden of NCDs. Competencies for effective advocacy include a combination of scientific and technical as well as communication-based skills. Recognizing the need to build local capacity for NCD advocacy in low- and middle-income countries (LMIC), the International Union for Health Promotion and Education (IUHPE), the US Centers for Disease Control and Prevention (CDC), the National Heart Foundation of Australia and the InterAmerican Heart Foundation joined efforts to conduct two pilot advocacy courses, one in Thailand and one in Colombia. A Global Advisory Group engaged a Local Organizing Committee in each country to ensure the courses would meet the needs of the local stakeholders. While both courses contained a set of key competencies and helped participants develop joint strategies for moving forward with consensus advocacy targets, the courses differed in content and participant background depending on the local context. A key goal of the courses was to determine and describe the lessons learned and make recommendations for a framework to be used for future advocacy capacity-building activities in LMIC. The planning and execution of each course generated lessons in the following five areas that informed the development of a global framework for capacity building for NCD advocacy: 1) using a comprehensive theoretical framework to teach advocacy competencies, 2) engaging key stakeholders, 3) meeting local needs and priorities, 4) planning local logistics, and 5) ensuring the skills obtained through training are applied to sustained advocacy for NCDs.

  2. Weight change, obesity and risk of prostate cancer progression among men with clinically localized prostate cancer. (United States)

    Dickerman, Barbra A; Ahearn, Thomas U; Giovannucci, Edward; Stampfer, Meir J; Nguyen, Paul L; Mucci, Lorelei A; Wilson, Kathryn M


    Obesity is associated with an increased risk of fatal prostate cancer. We aimed to elucidate the importance and relevant timing of obesity and weight change for prostate cancer progression. We identified 5,158 men diagnosed with localized prostate cancer (clinical stage T1/T2) from 1986 to 2012 in the Health Professionals Follow-up Study. Men were followed for biochemical recurrence and lethal prostate cancer (development of distant metastasis or prostate cancer-specific mortality) until 2012. Cox regression estimated hazard ratios (HRs) for body mass index (BMI) at age 21, BMI at diagnosis, "long-term" weight change from age 21 to diagnosis and "short-term" weight change over spans of 4 and 8 years preceding diagnosis. Because weight, weight change and mortality are strongly associated with smoking, we repeated analyses among never smokers only (N = 2,559). Among all patients, neither weight change nor BMI (at age 21 or at diagnosis) was associated with lethal prostate cancer. Among never smokers, long-term weight gain was associated with an increased risk of lethal disease (HR for gaining >30 pounds vs. stable weight [±10 pounds] 1.59, 95% CI, 1.01-2.50, p-trend = 0.06). Associations between weight change, BMI and lethal prostate cancer were stronger for men with BMI ≥ 25 at age 21 compared to those with BMI obesity were not associated with an increased risk of biochemical recurrence. Our findings among never smoker men diagnosed with localized prostate cancer suggest a positive association between long-term weight gain and risk of lethal prostate cancer. Metabolic changes associated with weight gain may promote prostate cancer progression. © 2017 UICC.

  3. Media advocacy and underage drinking policies: a study of Louisiana news media from 1994 through 2003. (United States)

    Harwood, Eileen M; Witson, Jean C; Fan, David P; Wagenaar, Alexander C


    The communications literature firmly establishes the significant role of media advocacy in setting public agenda and influencing the direction of public opinion on social issues. Recent public health campaigns embrace media advocacy as an integral part of efforts to change public health policies, yet further studies are needed on the best strategies to promote legislative action. This article examines press coverage in the Baton Rouge Advocate and the New Orleans Times-Picayune newspapers and Louisiana State legislation pertaining to underage drinking from January 1994 to June 2003 and focuses on evidence of media priming and framing of underage drinking and four related legislative policies. High press coverage of alcohol bills during the legislative process was associated with defeated legislation, whereas little or no press coverage was associated with bills successfully passed into law. The authors conclude that more work is needed to understand how media advocacy strategies may hinder enactment of bills.

  4. Breast cancer screening and the changing population pyramid of Japan. (United States)

    Uchida, Ken; Ohashi, Hitoshi; Kinoshita, Satoki; Nogi, Hiroko; Kato, Kumiko; Toriumi, Yasuo; Yamashita, Akinori; Kamio, Makiko; Mimoto, Rei; Takeyama, Hiroshi


    Breast cancer has been the most prevalent cancer in Japan since the 1990s. The mortality from breast cancer is increasing in Japan, whereas in other industrialized countries it has been decreasing since 1990. On the other hand, Japan faces unparalleled growth in its aging population. The aim of this study was to report the mammography screening among Japanese women and the related upcoming changes in the population pyramid of Japan. The reference data for our study were obtained from the Center for Cancer Control and Information Services, Japan Ministry of Internal Affairs and Communications, Ministry of Health, Labour and Welfare, the Japanese Cancer Society, and the National Institute of Population and Social Security. The survey data were obtained from breast cancer and mammography screenings in the Tokyo Prefecture in 2008. The following parameters were analyzed: annual breast cancer incidence, current screening rates, average life-span, and predicted demographic statistics. Our results showed that breast cancer incidence and mortality have been increasing annually in Japan. The average age of breast cancer patients increased to 58.40 years in 2010. The incidence of breast cancer in women aged 65 years and older increased from 25.3 to 32.9 % in the last 10 years and is expected to continue to increase in the future. The check-up rate was 16.0-20.0 % for women aged 65-74 years and 43.0-46.0 % for women aged 40-54 years. According to our questionnaire survey, concerns about breast cancer and mammography screening were high in the young and low in the elderly women. The Japanese population aged 65 years and older was 30,740 (24.1 %) in 2012 and is estimated to increase by 40 % over the next 20 years despite Japan's declining population size. Breast cancer incidence has increased in Japan, even among patients aged 65 years and older. Breast cancer has become increasingly prevalent in older Japanese women. As the population pyramid of Japan changes, women aged 65

  5. Local changes in hemostasis in patients with gastric cancer. (United States)

    Kovacova, E; Kinova, S; Duris, I; Remkova, A


    Disorders of haemostasis and haemocoagulation are often seen in cancer patients as a part of the paraneoplastic syndrome. This study describes a novel compound that activates coagulation and also inhibits fibrinolytic system and fibrin degradation products in the gastric juice of 33 patients with gastric cancer. Similar, but less pronounced changes have been found in gastric juice of patients with gastric precancerosis. Procoagulant activity, induced by pathologically changed cells or monocytes, macrophages from tumor stroma, indicates the activation of local coagulation with the production of fibrin. It can be concluded that the local changes of coagulation and fibrinolysis may precede coagulopathies in cancer patients (Tab. 2, Ref. 15). Full Text (Free, PDF)

  6. The Changing Face of Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Rachel E. Melhado


    Full Text Available The two main histological esophageal cancer types, adenocarcinoma and squamous cell carcinoma, differ in incidence, geographic distribution, ethnic pattern and etiology. This article focuses on epidemiology with particular reference to geographic and temporal variations in incidence, along with a review of the evidence supporting environmental and genetic factors involved in esophageal carcinogenesis. Squamous cell carcinoma of the esophagus remains predominantly a disease of the developing world. In contrast, esophageal adenocarcinoma is mainly a disease of western developed societies, associated with obesity and gastro-esophageal reflux disease. There has been a dramatic increase in the incidence of adenocarcinoma in developed countries in parallel with migration of both esophageal and gastric adenocarcinomas towards the gastro-esophageal junction.

  7. The Changing Face of Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Melhado, Rachel E., E-mail:; Alderson, Derek; Tucker, Olga [Academic Department of Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham (United Kingdom)


    The two main histological esophageal cancer types, adenocarcinoma and squamous cell carcinoma, differ in incidence, geographic distribution, ethnic pattern and etiology. This article focuses on epidemiology with particular reference to geographic and temporal variations in incidence, along with a review of the evidence supporting environmental and genetic factors involved in esophageal carcinogenesis. Squamous cell carcinoma of the esophagus remains predominantly a disease of the developing world. In contrast, esophageal adenocarcinoma is mainly a disease of western developed societies, associated with obesity and gastro-esophageal reflux disease. There has been a dramatic increase in the incidence of adenocarcinoma in developed countries in parallel with migration of both esophageal and gastric adenocarcinomas towards the gastro-esophageal junction.

  8. Addressing overdiagnosis and overtreatment in cancer: a prescription for change (United States)

    Esserman, Laura J.; Thompson, Ian M.; Reid, Brian; Nelson, Peter; Ransohoff, David F.; Welch, H. Gilbert; Hwang, Shelley; Berry, Donald A.; Kinzler, Kenneth W.; Black, William C.; Bissell, Mina; Parnes, Howard; Srivastava, Sudhir


    A vast range of disorders—from indolent to fast-growing lesions—are labelled as cancer. Therefore, we believe that several changes should be made to the approach to cancer screening and care, such as use of new terminology for indolent and precancerous disorders. We propose the term indolent lesion of epithelial origin, or IDLE, for those lesions (currently labelled as cancers) and their precursors that are unlikely to cause harm if they are left untreated. Furthermore, precursors of cancer or high-risk disorders should not have the term cancer in them. The rationale for this change in approach is that indolent lesions with low malignant potential are common, and screening brings indolent lesions and their precursors to clinical attention, which leads to overdiagnosis and, if unrecognised, possible overtreatment. To minimise that potential, new strategies should be adopted to better define and manage IDLEs. Screening guidelines should be revised to lower the chance of detection of minimal-risk IDLEs and inconsequential cancers with the same energy traditionally used to increase the sensitivity of screening tests. Changing the terminology for some of the lesions currently referred to as cancer will allow physicians to shift medicolegal notions and perceived risk to reflect the evolving understanding of biology, be more judicious about when a biopsy should be done, and organise studies and registries that offer observation or less invasive approaches for indolent disease. Emphasis on avoidance of harm while assuring benefit will improve screening and treatment of patients and will be equally effective in the prevention of death from cancer. PMID:24807866

  9. Perioperative Nutritional Status Changes in Gastrointestinal Cancer Patients (United States)

    Shim, Hongjin; Cheong, Jae Ho; Lee, Kang Young; Lee, Hosun; Noh, Sung Hoon


    Purpose The presence of gastrointestinal (GI) cancer and its treatment might aggravate patient nutritional status. Malnutrition is one of the major factors affecting the postoperative course. We evaluated changes in perioperative nutritional status and risk factors of postoperative severe malnutrition in the GI cancer patients. Materials and Methods Nutritional status was prospectively evaluated using patient-generated subjective global assessment (PG-SGA) perioperatively between May and September 2011. Results A total of 435 patients were enrolled. Among them, 279 patients had been diagnosed with gastric cancer and 156 with colorectal cancer. Minimal invasive surgery was performed in 225 patients. PG-SGA score increased from 4.5 preoperatively to 10.6 postoperatively (p60, pnutritional support should be considered. PMID:24142640

  10. Perioperative nutritional status changes in gastrointestinal cancer patients. (United States)

    Shim, Hongjin; Cheong, Jae Ho; Lee, Kang Young; Lee, Hosun; Lee, Jae Gil; Noh, Sung Hoon


    The presence of gastrointestinal (GI) cancer and its treatment might aggravate patient nutritional status. Malnutrition is one of the major factors affecting the postoperative course. We evaluated changes in perioperative nutritional status and risk factors of postoperative severe malnutrition in the GI cancer patients. Nutritional status was prospectively evaluated using patient-generated subjective global assessment (PG-SGA) perioperatively between May and September 2011. A total of 435 patients were enrolled. Among them, 279 patients had been diagnosed with gastric cancer and 156 with colorectal cancer. Minimal invasive surgery was performed in 225 patients. PG-SGA score increased from 4.5 preoperatively to 10.6 postoperatively (pcancer patients, postoperative severe malnourishment increased significantly (p60, pcancer (pcancer, and open surgery remained significant as risk factors of severe malnutrition. The prevalence of severe malnutrition among GI cancer patients in this study increased from 2.3% preoperatively to 26.3% after an operation. Old age, preoperative weight loss, gastric cancer, and open surgery were shown to be risk factors of postoperative severe malnutrition. In patients at high risk of postoperative severe malnutrition, adequate nutritional support should be considered.

  11. Identification of DNA methylation changes associated with human gastric cancer

    Directory of Open Access Journals (Sweden)

    Park Jung-Hoon


    Full Text Available Abstract Background Epigenetic alteration of gene expression is a common event in human cancer. DNA methylation is a well-known epigenetic process, but verifying the exact nature of epigenetic changes associated with cancer remains difficult. Methods We profiled the methylome of human gastric cancer tissue at 50-bp resolution using a methylated DNA enrichment technique (methylated CpG island recovery assay in combination with a genome analyzer and a new normalization algorithm. Results We were able to gain a comprehensive view of promoters with various CpG densities, including CpG Islands (CGIs, transcript bodies, and various repeat classes. We found that gastric cancer was associated with hypermethylation of 5' CGIs and the 5'-end of coding exons as well as hypomethylation of repeat elements, such as short interspersed nuclear elements and the composite element SVA. Hypermethylation of 5' CGIs was significantly correlated with downregulation of associated genes, such as those in the HOX and histone gene families. We also discovered long-range epigenetic silencing (LRES regions in gastric cancer tissue and identified several hypermethylated genes (MDM2, DYRK2, and LYZ within these regions. The methylation status of CGIs and gene annotation elements in metastatic lymph nodes was intermediate between normal and cancerous tissue, indicating that methylation of specific genes is gradually increased in cancerous tissue. Conclusions Our findings will provide valuable data for future analysis of CpG methylation patterns, useful markers for the diagnosis of stomach cancer, as well as a new analysis method for clinical epigenomics investigations.

  12. Advocacy training in US advanced pediatric dentistry training programs. (United States)

    Amini, Homa; Casamassimo, Paul S; Lin, Hsuan L; Hayes, John R


    This study: (1) assessed pediatric dentistry residency program directors' attitudes toward and involvement in advocacy training; and (2) identified types and extent of advocacy training in U.S. pediatric dentistry programs. Between October 2005 and February 2006, all 66 pediatric dentistry residency program directors were invited to complete a 62-item online questionnaire. The survey investigated: (1) directors' attitudes toward advocacy training; (2) nature of advocacy training offered during residency; (3) extent of resident involvement in different settings; and (4) directors' involvement in advocacy. Forty-two program directors responded (64%). Overall, respondents agreed that advocacy by pediatric dentists for children beyond the dental office was important and that residency programs should provide advocacy training. Most programs did not routinely offer advocacy opportunities in nonclinical settings. Over half of programs required community outreach clinic rotations for all residents. One third offered didactic curriculum in the legislative process. Over 50% of program directors reported personal involvement in legislative oral health lobbying within 3 years, but fewer than a third were involved with professional political action committees (PACs). Advocacy is seen as on important in pediatric dentistry but variation in attitudes of program directors and program offerings exists in US training programs.

  13. Collagen mRNA levels changes during colorectal cancer carcinogenesis

    DEFF Research Database (Denmark)

    Skovbjerg, Hanne; Anthonsen, Dorit; Lothe, Inger M B


    . In addition, corresponding tissue was examined from healthy volunteers (n = 20). mRNA levels were normalized to beta-actin. Immunohistochemical analysis of the distributions of type IV and type VII collagens were performed on normal and affected tissues from colorectal cancer patients. RESULTS: The alpha1(IV......). The level of alpha 6(IV) was 5-fold lower in colorectal cancer tissue as compared to healthy individuals (p alpha 6(IV) mRNA coincides...... zone of stratified epithelia. Immunohistochemical studies have previously reported changes in steady-state levels of different alpha(IV) chains in several epithelial cancer types. In the present study we aimed to quantitatively determine the mRNA levels of type IV collagen (alpha1/alpha 4/alpha 6...

  14. Labor unions in medicine: the intersection of patient advocacy and self-advocacy. (United States)

    Manthous, Constantine A


    Labor unions have been a weak force in the medical marketplace. To briefly review the history of physicians' and nurses' labor unions, explore the ethics of unions in medicine, and offer a solution that simultaneously serves patients and professionals. A selective review of the literature. Labor unions of medical professionals pose an ethical quandary, that is a tension between selfless patient advocacy versus self-advocacy. The primary role of labor unions has been to extract from management benefits for employees. The threat of work actions is the primary tool that labor unions can apply to encourage management to negotiate mutually acceptable conditions of employment. Work actions-namely slow-downs and strikes-may harm patients and may therefore run afoul of professionals' primary duty to the primacy of patients' welfare. An alternative model is offered wherein medical unions align self-centered and patient-centered interests and leverage the Public Good, in the form of public opinion, to encourage good-faith bargaining with management. As medicine becomes increasingly corporatized, physicians will join nurses in "at-will employment" arrangements whereby self-advocacy and patient advocacy may be impacted. Although labor unions have been a means of counterbalancing unchecked discretion of corporate management, conventional labor unions may run afoul of medical ethical principles. Reconsideration and innovation, to address this ethical dilemma, could provide a solution that aligns both clinicians' and patients' welfare.

  15. Disease Advocacy Organizations Catalyze Translational Research

    Directory of Open Access Journals (Sweden)

    Sharon Fontaine Terry


    Full Text Available Disease advocacy organizations have long played an important role in the continuum from basic science to therapy development in rare disease research. PXE International has sometimes led the field in innovative ways, venturing into specific activities that have traditionally been conducted by scientists. As lay founders, we have engaged in gene discovery, gene patenting, diagnostic development, epidemiological studies, clinical trials and therapy research and development. This article will describe the steps that we took, and the ways in which we have scaled these efforts for the larger community.

  16. Advocacy, recovery, and the challenges of consumerism for schizophrenia. (United States)

    Frese, F J


    Advocacy organizations such as the National Alliance for the Mentally Ill (NAMI) and patient consumer groups are playing an ever-increasing role in public health policy and patient care in schizophrenia. The recovery philosophy which recognizes the unique contributions of those who have experienced mental illness is now a part of treatment approaches in many states. Several states have extended these consumer initiatives to incorporate advance directives, an approach that has generated much debate. The NAMI destigmatization campaign, grounded in the neurobiology of major mental illness, is an unprecedented, concerted effort to change public opinion and to achieve parity at all levels for persons with severe and persistent mental illness. This article describes and chronicles these initiatives and explores their implications for the management of schizophrenia into the next millenium.

  17. Effectiveness of narrative pedagogy in developing student nurses' advocacy role. (United States)

    Gazarian, Priscilla K; Fernberg, Lauren M; Sheehan, Kelly D


    The literature and research on nursing ethics and advocacy has shown that generally very few nurses and other clinicians will speak up about an issue they have witnessed regarding a patient advocacy concern and that often advocacy in nursing is not learned until after students have graduated and begun working. To evaluate the effectiveness of narrative pedagogy on the development of advocacy in student nurses, as measured by the Protective Nursing Advocacy Scale. We tested the hypothesis that use of a narrative pedagogy assignment related to ethics would improve student nurse's perception of their advocacy role as measured by the Protective Nursing Advocacy Scale using a quasi-experimental nonrandomized study using a pre-test, intervention, post-test design. Data collection occurred during class time from October 2012 to December 2012. The Protective Nursing Advocacy Scale tool was administered to students in class to assess their baseline and was administered again at the completion of the educational intervention to assess whether narrative pedagogy was effective in developing the nursing student's perception of their role as a patient advocate. Students were informed that their participation was voluntary and that the data collected would be anonymous and confidential. The survey was not a graded assignment, and students did not receive any incentive to participate. The institutional review board of the college determined the study to be exempt from review. School of Nursing at a small liberal arts college in the Northeastern United States. A consecutive, nonprobability sample of 44 senior-level nursing students enrolled in their final nursing semester was utilized. Results indicated significant differences in student nurse's perception of their advocacy role related to environment and educational influences following an education intervention using an ethics digital story. Using the Protective Nursing Advocacy Scale, we were able to measure the effectiveness of

  18. Distinct genetic and epigenetic changes in medullary breast cancer. (United States)

    Osin, P; Lu, Y-J; Stone, J; Crook, T; Houlston, R S; Gasco, M; Gusterson, B A; Shipley, J


    Genetic instability resulting in chromosome aneuploidy or mismatch repair deficiency characterizes cancer. Medullary carcinoma (MC) of the breast is a specific form of breast cancer with unique clinical, epidemiologic, and prognostic features, suggesting distinctive tumorigenic pathways. To investigate the nature of the genetic changes associated with MC we analyzed a series of 22 tumors. Chromosomal imbalances were assessed by comparative genomic hybridization (CGH) and mismatch repair (MMR) deficiency tested for through assessment of microsatellite instability (MSI) and expression of MLH1 and MSH2 genes. MMR deficiency was detected in only a small proportion of cases. The chromosomal copy number changes showed some similarities to BRCA1-associated tumors. A high level of BRCA1 promoter hypermethylation was detected, suggesting a possible role of this gene in MC development.

  19. Credibility and advocacy in conservation science. (United States)

    Horton, Cristi C; Peterson, Tarla Rai; Banerjee, Paulami; Peterson, Markus J


    Conservation policy sits at the nexus of natural science and politics. On the one hand, conservation scientists strive to maintain scientific credibility by emphasizing that their research findings are the result of disinterested observations of reality. On the other hand, conservation scientists are committed to conservation even if they do not advocate a particular policy. The professional conservation literature offers guidance on negotiating the relationship between scientific objectivity and political advocacy without damaging conservation science's credibility. The value of this guidance, however, may be restricted by limited recognition of credibility's multidimensionality and emergent nature: it emerges through perceptions of expertise, goodwill, and trustworthiness. We used content analysis of the literature to determine how credibility is framed in conservation science as it relates to apparent contradictions between science and advocacy. Credibility typically was framed as a static entity lacking dimensionality. Authors identified expertise or trustworthiness as important, but rarely mentioned goodwill. They usually did not identify expertise, goodwill, or trustworthiness as dimensions of credibility or recognize interactions among these 3 dimensions of credibility. This oversimplification may limit the ability of conservation scientists to contribute to biodiversity conservation. Accounting for the emergent quality and multidimensionality of credibility should enable conservation scientists to advance biodiversity conservation more effectively. © 2015 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

  20. Medical advocacy on behalf of detained immigrants. (United States)

    Venters, Homer D; Foote, Mary; Keller, Allen S


    Detention of immigrants by Immigration and Customs Enforcement (ICE) is a rapidly growing form of incarceration in the U.S. with almost 400,000 people detained in 2008 (Schriro in Immigration and Customs Enforcement, 2009, ). ICE detainees are predominantly from Mexico and Latin America and only a small minority of detainees are asylum seekers. Immigrant detainees lack a legal guarantee of medical care (unlike criminal arrestees and prisoners) and face challenges in receiving medical care, particularly those with chronic medical conditions (Venters and Keller in J Health Care Poor Underserved 20:951-957, 2009). Although we and others have long been involved in advocating for detained asylum seekers, few resources are dedicated to medical advocacy for the broader population of ICE detainees. At the NYU Center for Health and Human Rights (CHHR), a program of medical advocacy was initiated in 2007 on behalf of ICE detainees focused on improvement of care in detention and medical parole. Our preliminary efforts reveal a pressing need for more involvement by physicians and other health advocates in this area.

  1. Disability Identity of Leaders in the Self-Advocacy Movement (United States)

    Caldwell, Joe


    Life stories and perspectives of leaders in the self-advocacy movement were explored to enhance knowledge about disability identity formation. In-depth qualitative interviews were conducted with 13 leaders in the self-advocacy movement. Five major themes emerged: (a) resistance-claiming personhood and voice; (b) connection with disability…

  2. Having a Voice: An Exploration of Children's Rights and Advocacy. (United States)

    Dalrymple, Jane, Ed.; Hough, Jan, Ed.

    This book explores the concept of advocacy in British society with regard to children and young people, examining advocacy from a number of different perspectives, and taking into account the UN Convention on the Rights of the Child and legislation that affects children and young people. The three parts of the book examine why young people need an…

  3. Speaking Up. Some Guidelines for Improving Advocacy Skills. (United States)

    Caldwell, Bettye M.

    Advocacy for child development programs is discussed in this document. Advocacy for child development programs is described as having two main components: (1) convincing the general public of the importance of early childhood development; and (2) persuading lawmakers to allocate funds needed to do the job well. Ten guidelines for effective…

  4. Arts Up Front: Approaches to Advocacy in the Secondary School. (United States)

    Saunders, Karen


    This article presents positive approaches to advocacy of art programs in the Tempe Union High School District (Arizona) during its development and expansion. Stated is the belief that teachers must take a leadership role in advocacy if students are to benefit from the unique opportunities available only through the arts. (Author/KC)

  5. Parent Advocacy: The Good, the Bad, and the Ugly (United States)

    Kidder, Annie


    Parent advocacy is a complicated beast. Parent advocates for the most part, are born from three distinct impetuses: a desire to fix something for their own child or children; anger about a new policy being imposed; or a collective drive to create a new service or program. Just as it is impossible to relegate all parent advocacy into one category,…

  6. The Tradition of Advocacy in the Yoruba Courts. (United States)

    Asante, Molefi Kete


    Examines the extensive system of advocacy (based on the idea of group consensus) among the Yoruba in Nigeria. Gives a detailed account of communicative forms and functions of advocacy in legal proceedings and their relationship to Yoruba culture. Explores how Yoruba people argue their cases and find harmony out of a context of disputations. (SR)

  7. A Media Advocacy Intervention Linking Health Disparities and Food Insecurity (United States)

    Rock, Melanie J.; McIntyre, Lynn; Persaud, Steven A.; Thomas, Karen L.


    Media advocacy is a well-established strategy for transmitting health messages to the public. This paper discusses a media advocacy intervention that raised issues about how the public interprets messages about the negative effects of poverty on population health. In conjunction with the publication of a manuscript illustrating how income-related…

  8. Advocacy for Child Wellness in High-Poverty Environments (United States)

    Mullen, Carol A.


    Child wellness needs to be understood holistically so that children and youth from high-poverty environments can succeed in schooling and life. Teachers who foster advocacy in themselves are well equipped to teach students to take ownership of their own well-being. Such advocacy can enrich the classroom curriculum and mitigate the negative effects…

  9. Social Justice Advocacy among Graduate Students: An Empirical Investigation (United States)

    Linnemeyer, Rachel McQuown


    Although social justice advocacy has increasingly been acknowledged as important in the field of psychology (e.g., Goodman et al., 2004; Toporek et al., 2006a, Vera & Speight, 2003), there is a dearth of empirical research examining social justice advocacy across graduate psychology students. This mixed-methods study examined demographic and…

  10. The prostate cancer conundrum revisited: treatment changes and prostate cancer mortality declines. (United States)

    Etzioni, Ruth; Gulati, Roman; Tsodikov, Alex; Wever, Elisabeth M; Penson, David F; Heijnsdijk, Eveline A M; Katcher, Jeffrey; Draisma, Gerrit; Feuer, Eric J; de Koning, Harry J; Mariotto, Angela B


    Prostate cancer mortality rates in the United States declined by >40% between 1991 and 2005. The impact of changes in primary treatment and adjuvant and neoadjuvant hormone therapy on this decline is unknown. The authors applied 3 independently developed models of prostate cancer natural history and disease detection under common assumptions about treatment patterns, treatment efficacy, and survival in the population. Primary treatment patterns were derived from the Surveillance, Epidemiology, and End Results registry; data on the frequency of hormone therapy were obtained from the CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) database; and treatment efficacy was based on estimates from randomized trials and comparative effectiveness studies of treatment alternatives. The models projected prostate cancer mortality without prostate-specific antigen screening and in the presence and absence of treatment benefit. The impact of primary treatment was expressed as a fraction of the difference between observed mortality and projected mortality in the absence of treatment benefit. The 3 models projected that changes in treatment explained 22% to 33% of the mortality decline by 2005. These contributions were accounted for mostly by surgery and radiation therapy, which increased in frequency until the 1990s, whereas hormone therapies contributed little to the mortality decline by 2005. Assuming that treatment benefit was less for older men, changes in treatment explained only 16% to 23% of the mortality decline by 2005. Changes in primary treatment explained a minority of the observed decline in prostate cancer mortality. The remainder of the decline probably was because of other interventions, such as prostate-specific antigen screening and advances in the treatment of recurrent and progressive disease. Copyright © 2012 American Cancer Society.

  11. Gay-Straight Alliances vary on dimensions of youth socializing and advocacy: factors accounting for individual and setting-level differences. (United States)

    Poteat, V Paul; Scheer, Jillian R; Marx, Robert A; Calzo, Jerel P; Yoshikawa, Hirokazu


    Gay-Straight Alliances (GSAs) are school-based youth settings that could promote health. Yet, GSAs have been treated as homogenous without attention to variability in how they operate or to how youth are involved in different capacities. Using a systems perspective, we considered two primary dimensions along which GSAs function to promote health: providing socializing and advocacy opportunities. Among 448 students in 48 GSAs who attended six regional conferences in Massachusetts (59.8 % LGBQ; 69.9 % White; 70.1 % cisgender female), we found substantial variation among GSAs and youth in levels of socializing and advocacy. GSAs were more distinct from one another on advocacy than socializing. Using multilevel modeling, we identified group and individual factors accounting for this variability. In the socializing model, youth and GSAs that did more socializing activities did more advocacy. In the advocacy model, youth who were more actively engaged in the GSA as well as GSAs whose youth collectively perceived greater school hostility and reported greater social justice efficacy did more advocacy. Findings suggest potential reasons why GSAs vary in how they function in ways ranging from internal provisions of support, to visibility raising, to collective social change. The findings are further relevant for settings supporting youth from other marginalized backgrounds and that include advocacy in their mission.

  12. A Queer Theorist's Critique of Online Domestic Violence Advocacy: Critically Responding to the National Coalition Against Domestic Violence Web Site. (United States)

    Shelton, Samuel Z


    Since the foundations of the contemporary anti-violence movement in the 1960s and 1970s, advocates have sought to establish a critical understanding of domestic violence that we can use to direct our efforts for social change. Yet many advocates and advocacy organizations continue to rely on a problematic narrative of sameness that marginalizes and erases diverse victims' experiences and needs. In this article, I conduct a critical discourse analysis of the National Coalition Against Domestic Violence Web site to identify outcomes of this narrative for the inclusivity of advocacy efforts. I argue that despite the organization's numerous claims to represent diverse victims' experiences, Web site content reveals that its purportedly general account of domestic violence normalizes the experiences of a small group of victims-namely, heterosexual, cisgender women. Further, the Web site's content greatly limits the potential for thinking about and discussing violence across difference. I conclude with recommendations for changes in advocacy practices.

  13. Myc mediates cancer stem-like cells and EMT changes in triple negative breast cancers cells.

    Directory of Open Access Journals (Sweden)

    Shuping Yin

    Full Text Available Women with triple negative breast cancer (TNBC have poor prognosis compared to other breast cancer subtypes. There were several reports indicating racial disparity in breast cancer outcomes between African American (AA and European American (EA women. For example, the mortality rates of AA breast cancer patients were three times higher than of EA patients, even though, the incidence is lower in AA women. Our in vitro studies indicate that cancer stem-like cells (CSCs derived from AA TNBC cell lines have significantly higher self-renewal potential (mammosphere formation than CSCs derived from EA cell lines. TNBC tumors express high levels of Myc compared to luminal A or HER2 expressing breast cancers. We studied the effects of c-Myc overexpression on CSCs and chemotherapy in AA, and EA derived TNBC cell line(s. Overexpression of c-Myc in AA derived MDA-MB-468 (Myc/MDA-468 cells resulted in a significant increase in CSCs and with minimal changes in epithelial-to-mesenchymal transition (EMT compared to the control group. In contrast, overexpression of c-Myc in EA derived MDA-MB-231(Myc/MDA-231 cells led to increased epithelial-to-mesenchymal transition (EMT, with a minimal increase in CSCs compared to the control group. Myc/MDA-468 cells were resistant to standard chemotherapeutic treatments such as iniparib (PARP inhibitor plus cisplatin, / iniparib, cisplatin, paclitaxel and docetaxel. However, Myc/MDA-231 cells, which showed EMT changes responded to iniparib with cisplatin, but were resistant to other drugs, such as iniparib, cisplatin, paclitaxel and docetaxel. Collectively, our results indicate that intrinsic differences in the tumor biology may contribute to the breast cancer disparities.

  14. Effects of obesity on transcriptomic changes and cancer hallmarks in estrogen receptor-positive breast cancer. (United States)

    Fuentes-Mattei, Enrique; Velazquez-Torres, Guermarie; Phan, Liem; Zhang, Fanmao; Chou, Ping-Chieh; Shin, Ji-Hyun; Choi, Hyun Ho; Chen, Jiun-Sheng; Zhao, Ruiying; Chen, Jian; Gully, Chris; Carlock, Colin; Qi, Yuan; Zhang, Ya; Wu, Yun; Esteva, Francisco J; Luo, Yongde; McKeehan, Wallace L; Ensor, Joe; Hortobagyi, Gabriel N; Pusztai, Lajos; Fraser Symmans, W; Lee, Mong-Hong; Yeung, Sai-Ching Jim


    Obesity increases the risk of cancer death among postmenopausal women with estrogen receptor-positive (ER+) breast cancer, but the direct evidence for the mechanisms is lacking. The purpose of this study is to demonstrate direct evidence for the mechanisms mediating this epidemiologic phenomenon. We analyzed transcriptomic profiles of pretreatment biopsies from a prospective cohort of 137 ER+ breast cancer patients. We generated transgenic (MMTV-TGFα;A (y) /a) and orthotopic/syngeneic (A (y) /a) obese mouse models to investigate the effect of obesity on tumorigenesis and tumor progression and to determine biological mechanisms using whole-genome transcriptome microarrays and protein analyses. We used a coculture system to examine the impact of adipocytes/adipokines on breast cancer cell proliferation. All statistical tests were two-sided. Functional transcriptomic analysis of patients revealed the association of obesity with 59 biological functional changes (P cancer hallmarks. Gene enrichment analysis revealed enrichment of AKT-target genes (P = .04) and epithelial-mesenchymal transition genes (P = .03) in patients. Our obese mouse models demonstrated activation of the AKT/mTOR pathway in obesity-accelerated mammary tumor growth (3.7- to 7.0-fold; P obesity-induced secretion of adipokines and breast tumor formation and growth (0.5-fold, P = .04; 0.3-fold, P cancer cell proliferation and invasion. Metformin suppress adipocyte-induced cell proliferation and adipocyte-secreted adipokines in vitro. Adipokine secretion and AKT/mTOR activation play important roles in obesity-accelerated breast cancer aggressiveness in addition to hyperinsulinemia, estrogen signaling, and inflammation. Metformin and everolimus have potential for therapeutic interventions of ER+ breast cancer patients with obesity. © The Author 2014. Published by Oxford University Press.

  15. 'Cancer changes everything!' Exploring the lived experiences of women with metastatic breast cancer. (United States)

    Krigel, Susan; Myers, Jamie; Befort, Christie; Krebill, Hope; Klemp, Jennifer


    The aim of this study was to further explore the lived experiences of women with metastatic breast cancer (MBC), to inform the development of interventions to enhance survivorship care for women with advanced disease. Four semi-structured focus groups were conducted with women with MBC. The data was analysed using qualitative content analysis. Participants described the challenges of living with uncertainty, as a result of a lack of information regarding treatment options and symptom management, and a sense of the unknown related to prognosis and survival. Of major concern were changes in role functioning, altered relationships, and self-image. Women with metastatic breast cancer must cope with dramatic changes in all aspects of their lives. Clinicians should tailor survivorship care and evidence-based interventions to individuals' concerns with changes in role functioning, fatigue, relationships, and self-image. A multidisciplinary approach should be used to address practical and existential concerns focused on improving quality of life.

  16. Metastatic castration-resistant prostate cancer: changing landscape with cabazitaxel. (United States)

    Fernández, Ovidio; Afonso, Javier; Vázquez, Sergio; Campos, Begoña; Lázaro, Matín; León, Luis; Antón Aparicio, Luis M


    Docetaxel is the standard first-line chemotherapy for men with metastatic castration-resistant prostate cancer. Until recently, there was no standard therapy after failure of docetaxel treatment. Cabazitaxel has been shown to improve overall survival in this setting. As a result, the treatment paradigm for mCRPC is changing rapidly. The improved survival shown with cabazitaxel provides an important new opportunity to treat men with mCRPC after docetaxel treatment. Despite the toxicity recorded in the pivotal study, subsequent trials have shown that cabazitaxel is a safe drug. Patient selection and the optimal interval between prior docetaxel treatment and cabazitaxel remain the critical issues. According to a subanalysis of the various studies discussed in this review, there is a patient profile that will probably benefit from use of cabazitaxel after docetaxel failure. Cabazitaxel represents a new treatment option for patients with prostate cancer.

  17. Pregnancy-induced changes in breast cancer risk. (United States)

    Russo, Irma H; Russo, Jose


    Breast cancer is the malignant disease most frequently diagnosed in women of all races and nationalities. Since the 1970s the worldwide incidence of this disease has increased 30-40% in postmenopausal women, in whom, paradoxically, the risk of developing breast cancer is significantly reduced by an early first full term pregnancy (FTP) as compared to nulliparous and late parous women. Although the cause of breast cancer is not known, the mechanisms mediating the protection conferred by an early FTP have been identified to reside in the breast itself, and to be modulated by endogenous and environmental exposures that might negatively affect this organ during specific windows in its development that extend from prenatal life until the first pregnancy. Soon after conception the embryo initiates the production of human chorionic gonadotropin (hCG), the glycoprotein hormone that is diagnostic of pregnancy. HCG in conjunction with ovarian steroid hormones primes the hypothalamic neuroendocrine system for maintaining the pregnancy. Higher levels of hCG during the first trimester of pregnancy have been associated with a reduction in maternal breast cancer incidence after age 50. In preclinical studies it has been demonstrated that both FTP and hCG treatment of virgin rats prevent the development of chemically-induced mammary tumors, a phenomenon mediated by the differentiation of the mammary gland epithelial cells prior to carcinogen exposure. Complete differentiation proceeds through complex morphological, physiological and molecular changes that occur during pregnancy and lactation, that ultimately result in increased DNA repair capabilities of the mammary epithelium, activation of genes controlling differentiation and programmed cell death and imprinting in the breast epithelium a specific and permanent genomic signature of pregnancy. This signature is indicative of a reduced breast cancer risk and serves as a molecular biomarker of differentiation for evaluating the

  18. Buddhism and the Perils of Advocacy

    Directory of Open Access Journals (Sweden)

    Ian Reader


    Full Text Available This article raises problems with the use of advocacy in Buddhist Studies, and critiques those who bring their Buddhist beliefs into the classroom and into their research. It argues that the foundations of the academic discipline (Religious Studies within which Buddhist Studies is located are grounded in the search for an objective, non-confessional approach to the study of religion, one that distinguishes Religious Studies from Theology, and that this perspective is what gives the field its integrity. It cites examples of the problems that occur in teaching and research when such objectivity is replaced by confessional approaches, and provides an example from another field (the study of new religious movements in which immense problems have occurred because some scholars have become advocates rather than analysts, to warn of the problems that can arise when confessional approaches become a dominant field paradigm.

  19. Cognitive changes associated with cancer and cancer treatment: state of the science. (United States)

    Von Ah, Diane


    Cognitive impairment is a distressing, disruptive, and potentially debilitating symptom that can occur as a direct result of cancer or its treatment. National organizations have identified cognitive impairment as a challenge many survivors face and call for research to address this problem. Despite the priority, research is still relatively limited and questions remain unanswered about prevalence and impact on survivors, as well as coping strategies and effective treatment options available to address this potentially debilitating problem. The purpose of this article is to (a) analyze the prevalence and types of cognitive impairment that commonly affect survivors; (b) delineate the impact that cognitive impairment after cancer and cancer treatment has on self-esteem, social relationships, work ability, and overall quality of life among survivors; and (c) synthesize and appraise commonly used coping strategies used by survivors to address cognitive impairment and evidence-based interventions that may be incorporated into clinical practice. A comprehensive review and synthesis of the literature was conducted. Evidence-based interventions to address cognitive changes after cancer and cancer treatment are limited. However, emerging research has demonstrated that nonpharmacologic treatments, such as cognitive training, are likely to be effective.

  20. Changes in Awareness of Cancer Risk Factors among Adult New Zealanders (CAANZ): 2001 to 2015 (United States)

    Richards, R.; McNoe, B.; Iosua, E.; Reeder, A. I.; Egan, R.; Marsh, L.; Robertson, L.; Maclennan, B.; Dawson, A.; Quigg, R.; Petersen, A.-C.


    Behaviour change, specifically that which decreases cancer risk, is an essential element of cancer control. Little information is available about how awareness of risk factors may be changing over time. This study describes the awareness of cancer risk behaviours among adult New Zealanders in two cross-sectional studies conducted in 2001 and…

  1. Child and adolescent advocacy through research: introduction to special section. (United States)

    Budd, Karen S; Eyberg, Sheila M


    In this special section, Clinical Child and Adolescent Advocacy Through Research, luminaries in advocacy for children tell important, personal stories of how research and values intertwine to influence the policies that affect children and families. In this introduction, we provide a brief historical overview of child advocacy in the United States, its link to American child psychology, and the roles of the Society of Clinical Child and Adolescent Psychology and the Division of Child, Youth, and Family Services of the American Psychological Association in educating and showing us how to use our science wisely in the service of children. We then preview the individual themes of the articles of this special section.

  2. Advocacy for Art Education: Beyond Tee-Shirts and Bumper Stickers (United States)

    Bobick, Bryna; DiCindio, Carissa


    Advocacy is not new to art education. Over the years, Goldfarb (1979), Hodsoll (1985), and Erickson and Young (1996) have written about the importance of arts advocacy, but the concept of advocacy has evolved with the times. For example, in the 1970s, arts advocacy was described as a "movement" and brought together art educators,…

  3. [Will the climate change affect the mortality from prostate cancer?]. (United States)

    Santos Arrontes, Daniel; García González, Jesús Isidro; Martín Muñoz, Manuel Pablo; Castro Pita, Miguel; Mañas Pelillo, Antonio; Paniagua Andrés, Pedro


    (p = 0.041). The adjusted mortality rate associated with extreme aridity regions and was 21.51 cases/100,000 males year, whereas in humid zones it was 35.87 cases/100,000 males years. Mortality associated with prostate cancer is significantly superior in regions with less exposition to the sunlight. The climate change may lead to a modification of the main epidemiologic patterns, and it may be associated with a modification of cancer mortality rates. Nevertheless, these results should be taken with caution and should be confirmed by prospective studies.

  4. Changes in apoptosis during the development of colorectal cancer : a systematic review of the literature

    NARCIS (Netherlands)

    Koornstra, JJ; de Jong, S; Hollema, H; de Vries, EGE; Kleibeuker, JH

    The development of colorectal cancer is characterised by an accumulation of molecular genetic alterations causing disorders in cell growth, differentiation and apoptosis. Although changes in apoptosis with colorectal cancer development have been studied extensively, a clear consensus of opinion has

  5. Living in a changed female body after gynecological cancer. (United States)

    Sekse, Ragnhild J Tveit; Gjengedal, Eva; Råheim, Målfrid


    In this article we elaborate on how living in a changed female body after gynecological cancer is experienced 5 to 6 years after treatment. Based on a phenomenological life-world perspective, 32 interviews with 16 women showed that changes involved dealing with unfamiliarity related to experiences of bodily emptiness, temperature fluctuations, sex-life consequences, vulnerability, and uncertainty. Findings are discussed in relation to Svenaeus's perspective on illness as an unhomelike being-in-the-body and being-in-the-world. This perspective could spur health personnel to improve patient information and dialogue and thus facilitate a process leading to more familiarity and homelikeness for patients during treatment and follow-up.

  6. [Early detection of cervical cancer in Chile: time for change]. (United States)

    Léniz Martelli, Javiera; Van De Wyngard, Vanessa; Lagos, Marcela; Barriga, María Isabel; Puschel Illanes, Klaus; Ferreccio Readi, Catterina


    Mortality rates for cervical cancer (CC) in Chile are higher than those of developed countries and it has an unequal socioeconomic distribution. The recognition of human papilloma virus (HPV) as the causal agent of cervical cancer in the early 80's changed the prevention paradigms. Current goals are to prevent HPV infection by vaccination before the onset of sexual activity and to detect HPV infection in women older than 30 years. This article reviews CC prevention and early detection methods, discusses relevant evidence to support a change in Chile and presents an innovation proposal. A strategy of primary screening based on HPV detection followed by triage of HPV-positive women by colposcopy in primary care or by cytological or molecular reflex testing is proposed. Due to the existence in Chile of a well-organized nationwide CC prevention program, the replacement of a low-sensitivity screening test such as the Papanicolau test with a highly sensitive one such as HPV detection, could quickly improve the effectiveness of the program. The program also has a network of personnel qualified to conduct naked-eye inspections of the cervix, who could easily be trained to perform triage colposcopy. The incorporation of new prevention strategies could reduce the deaths of Chilean women and correct inequities.


    Directory of Open Access Journals (Sweden)

    Corina Anamaria IOAN


    Full Text Available The advocacy activity is of significant importance for the business community, the perception of its need to influence the legislative process in order to have a transparent legislative procedure, the necessity of understanding the way in which the decisions are taken and the desire of the business community to assist the changing of laws and norms being linking elements of the advocacy activity to the business environment. The branding impact is practically immeasurable in social and cultural terms as it over exceeded the commercial origins. It has spread in education, sports, fashion, tourism, arts, theater, literature, regional and national politics and in almost all other fields that we could think of. The non-profit and charitable organizations that compete with the commercial brands in the emotional territory of the minds and hearts of people, for the money in their pockets, use branding more and more.


    Directory of Open Access Journals (Sweden)



    Full Text Available Advocacy media campaigns, staged by Romanian television channels and focused on changing social policies, have gained increasing visibility in the Romanian public sphere. The article examines models of journalism and normative theories about the role of the press in a democracy in order to carve out a normative position from which this emerging media format can be analysed. It situates media advocacy within the frame of interpretive journalism, aimed both at facilitating democratic debate and citizen participation (civic journalism, and at social reform (radical journalism. The reassessment of media strategies based on emotions and interpretation as mediators of social reality may lead to a positive, ‘optimistic’ view of campaign journalism. However, the advanced commercialisation of the media and the struggles for political representation interfere with and make the task of socially responsible journalism an incredibly challenging one

  9. Using a digital storytelling assignment to teach public health advocacy. (United States)

    de Castro, A B; Levesque, Salem


    The need and expectation for advocacy is central to public health nursing practice. Advocacy efforts that effectively call attention to population health threats and promote the well-being of communities rely on strategies that deliver influential messaging. The digital story is a lay method to capture meaningful, impactful stories that can be used to advocate for public health concerns. Readily available, user-friendly digital technologies allow engagement in digital media production to create digital stories. This paper describes how digital story making can be utilized as an academic assignment to teach public health advocacy within an undergraduate nursing curriculum. Providing nursing students this artistic outlet can facilitate meeting academic learning goals, while also equipping them with creative skills that can be applied in future professional practice. Nursing educators can take advantage of institutional resources and campus culture to support the use of novel digital media assignments that facilitate application of advocacy concepts. © 2017 Wiley Periodicals, Inc.

  10. Foundation's consumer advocacy health reform initiative strengthened groups' effectiveness

    National Research Council Canada - National Science Library

    Strong, Debra; Lipson, Debra; Honeycutt, Todd; Kim, Jung


    Private foundations may hesitate to fund consumer advocacy for enacting and implementing health reform because the effects are hard to measure, and because they are concerned that funds will be used...

  11. LYNX community advocacy & service engagement (CASE) project final report. (United States)


    This report is a final assessment of the Community Advocacy & Service Engagement (CASE) project, a LYNX-FTA research project designed : to study transit education and public engagement methods in Central Florida. In the Orlando area, as in other part...

  12. Handicapped Infants and Euthanasia: A Challenge to Our Advocacy. (United States)

    Smith, J. David


    The issue of pediatric euthanasia for handicapped newborns is examined and contrasting viewpoints emphasizing the quality and the sanctity of life are considered. The author asserts that advocacy for handicapped children involves decisions regarding the euthanasia question. (CL)

  13. Transforming values into action: Advocacy as a professional imperative. (United States)

    Kirsh, Bonnie H


    The goal of enabling meaningful occupation for all requires occupational therapy to become a more socially and politically responsible discipline. This paper argues that occupational therapy's dominant individualist perspective is too narrow to meet this goal. It presents an argument for integrating advocacy into occupational therapy identity and discusses why we should advocate at political and public levels. Although the dominant paradigm and political climate pose challenges, there must be a realignment of the balance between helping individuals who are facing disruptions in their occupational lives and addressing systems and structures that prevent them from moving forward. Adopting a broader sociopolitical approach involves engaging in advocacy as a key strategy. Indeed, advocacy is a professional imperative for occupational therapy. Advocacy must become part of the process of professional socialization. A new set of competencies is needed in our educational programs and in our professional development, accompanied by a sense of self-confident idealism.

  14. On the Record: Savera Kalideen, senior Advocacy Manager for Soul ...

    African Journals Online (AJOL)

    Abstract. Chandré Gould speaks to Savera Kalideen, senior Advocacy Manager for Soul City, about the Phuza Wize campaign and the challenges of developing and implementing holistic violence prevention campaigns.

  15. Attitudes towards organ donor advocacy among Swedish intensive care nurses. (United States)

    Forsberg, Anna; Lennerling, Annette; Fridh, Isabell; Rizell, Magnus; Lovén, Charlotte; Flodén, Anne


    To explore the attitudes of Swedish intensive care nurses towards organ donor advocacy. The concept of organ donor advocacy is critical to nurses who care for potential donors in order to facilitate organ donation (OD). A retrospective cross-sectional study was employed. Inclusion criteria in this survey were to be a registered nurse and to work in a Swedish intensive care unit (ICU). Participants were identified by the Swedish association of health professionals. A number of 502 Swedish ICU nurses answered the 32-item questionnaire Attitudes Towards Organ Donor Advocacy Scale (ATODAS), covering the five dimensions of organ donor advocacy: attitudes towards championing organ donation at a structural hospital level, or at a political and research level, attitudes towards actively and personally safeguarding the will and wishes of the potential organ donor, or by using a more professional approach and finally to safeguard the will and wishes of the relatives. Data were analysed with the SPSS version 18·0 and the results were assessed by using Student's t-test and post hoc test, analysis of variance (ANOVA), χ(2) , Pearson's correlation and regression analysis. The most favoured advocacy action was safeguarding the POD's will and wishes by a professional approach, closely followed by actively and personally safeguarding the POD's will and wishes. Nurses at local hospitals reported a more positive attitude towards organ donor advocacy overall compared with nurses at larger regional or university hospitals. Important factors leading to positive attitudes were seniority, working experience, participating in conversations with relatives, caring for brain-dead persons and private experiences from OD or organ transplantation. Intensive and critical care nurses with short working experience in university hospitals showed the least positive attitude towards organ donor advocacy. This is problematic because many ODs and all transplantations are performed in university

  16. Science, advocacy, human and environmental health. (United States)

    Rolston, H


    Medicine and public health sciences are applied sciences. The research upon which these are based is mission-oriented and as such they are underlain by advocacy. Ecological sciences, by way of parallel, involve managing ecological systems so they can remain healthy to support productive natural processes and the human population. In any eco-system, however, renewal has associated with it naturally occurring background levels of diseases and death. These are normal in all biological systems. 'Sustainable development' has been focused on commodity-based, managed systems where the goal is to ensure that the needs of growing human populations are met, producing healthy people. This objective is deemed by the Ecological Society of America to be too narrow. Priority should rather be given to the sustainability of natural ecosystems, otherwise the biosphere that sustains all life forms is neglected. Epidemiologists concerned with the health of populations need to recognize that human health and the health of natural systems have entwined destinies. Some convictions about limits, about the role of disease, degeneration, and death in healthy, that is, stable and sustainable human ecologies, ought to be embedded into any ethics for epidemiologists.

  17. Advocacy of women family caregivers: response to nonsupportive interactions with professionals. (United States)

    Neufeld, Anne; Harrison, Margaret J; Stewart, Miriam; Hughes, Karen


    Support from health and social service professionals assists women in caring for a relative with a chronic condition. However, nonsupportive interactions coexist with supportive interactions and might have unanticipated consequences. The purpose of this ethnographic study was to examine advocacy as a proactive response to nonsupportive interactions with professionals among women family caregivers in four caregiving situations. Data generation included in-depth interviews with 34 women. Interviews were tape-recorded, transcribed verbatim, and analyzed using thematic and constant comparative analysis techniques. As a consequence of nonsupportive interactions women experienced negative feelings, a lack of trust, powerlessness, and challenges in their caregiving situations that were catalysts for advocacy involving assertively taking charge in a relationship with a health professional. As advocates women employed strategies of monitoring their relative's condition, educating themselves or others, negotiating or fighting for resources, or campaigning for change. There were stress and fatigue involved in becoming an advocate, but the women also described the experience as one of personal growth. This research provided insight into the role of nonsupportive interactions with professionals as a catalyst for the development of individual-level advocacy initiatives.

  18. Civil society advocacy in Nigeria: promoting democratic norms or donor demands? (United States)

    Williamson, R Taylor; Rodd, Joshua


    Civil society organizations (CSOs) are often assumed to be institutions that facilitate communication between citizens and policymakers. However, CSO advocacy is only as effective as the space allowed by government, the resources available from funders, and their own internal capacity. This article presents findings from a study in Nigeria that explores the advocacy and service delivery roles of CSOs working in Human Immunodeficiency Virus (HIV) prevention and mitigation. We will argue that donor and government treatment of civil society as service delivery organizations, rather than as organizations that participate in democratic norms, have shaped how civil society organizations work to mitigate and prevent HIV. From February to April 2012, a team of Health Systems 20/20 staff and one consultant conducted 48 in-depth interviews with civil society organizations, State AIDS Control Agencies (SACAs), donors, international organizations, and networks of people living with HIV to examine a wide range of advocacy efforts by CSOs. For quantitative data collection, sampling frames were assembled from lists of HIV-oriented or involved CSOs. This sampling frame consisted of 2548 CSOs from all 36 states and the Federal Capital Territory. A random sample was then taken from the sampling frame, and we contacted 665 CSOs to arrange interviews. With a response rate of 80.2 %, the project conducted 533 surveys in February 2012. These surveys showed that CSOs advocacy efforts focused on community mobilization related to behavior change, such as peer education (54.9 % of CSOs) and rallies (58.2 % of CSOs), and not on changing government policies. In-depth interviews highlighted the role of donors and government in shaping a purely apolitical role for most CSOs through funding constraints, regulations, and capacity development choices. In light of these findings, we present key points for considering the influence of donors and government on civil society advocacy for HIV services

  19. Computer-Aided Interval Change Analysis of Microcalifications on Management for Breast Cancer Detection (United States)


    of Microcalcifications on Mammograms for Breast Cancer Detection PRINCIPAL INVESTIGATOR: Lubomir Hadjiiski, Ph.D...Computer-Aided Interval Change Analysis of Microcalcifications on Mammograms for 5a. CONTRACT NUMBER Breast Cancer Detection 5b. GRANT NUMBER DAMD17...CAD(p=0.04). 15. SUBJECT TERMS Breast Cancer , Computer-aided diagnosis, Screening, Classification, Image Analysis 16. SECURITY CLASSIFICATION OF

  20. Movement Advocacy, Personal Relationships, and Ending Health Care Disparities. (United States)

    Chin, Marshall H


    Deep-rooted structural problems drive health care disparities. Compounding the difficulty of attaining health equity, solutions in clinics and hospitals require the cooperation of clinicians, administrators, patients, and the community. Recent protests over police brutality and racism on campuses across America have opened fresh wounds over how best to end racism, with lessons for achieving health equity. Movement advocacy, the mobilizing of the people to raise awareness of an injustice and to advocate for reform, can break down ingrained structural barriers and policies that impede health equity. However, simultaneously advocates, clinicians, and health care organizations must build trusting relationships and resolve conflict with mutual respect and honesty. Tension is inherent in discussions about racial and ethnic disparities. Yet, tension can be constructive if it forces self-examination and spurs systems change and personal growth. We must simultaneously advocate for policy reform, build personal relationships across diverse groups, and honestly examine our biases. Copyright © 2016 National Medical Association. Published by Elsevier Inc. All rights reserved.

  1. Pan-cancer analysis of frequent DNA co-methylation patterns reveals consistent epigenetic landscape changes in multiple cancers. (United States)

    Zhang, Jie; Huang, Kun


    DNA methylation is the major form of epigenetic modifications through which the cell regulates the gene expression and silencing. There have been extensive studies on the roles of DNA methylation in cancers, and several cancer drugs were developed targeting this process. However, DNA co-methylation cluster has not been examined in depth, and co-methylation in multiple cancer types has never been studied previously. In this study, we applied newly developed lmQCM algorithm to mine co-methylation clusters using methylome data from 11 cancer types in TCGA database, and found frequent co-methylated gene clusters exist in these cancer types. Among the four identified frequent clusters, two of them separate the tumor sample from normal sample in 10 out of 11 cancer types, which indicates that consistent epigenetic landscape changes exist in multiple cancer types. This discovery provides new insight on the epigenetic regulation in cancers and leads to potential new direction for epigenetic biomarker and cancer drug discovery. We also found that genes commonly believed to be silenced via hypermethylation in cancers may still display highly variable methylation levels among cancer cells, and should be considered while using them as epigenetic biomarkers.

  2. Changes in mammographic density and breast cancer risk

    NARCIS (Netherlands)

    Lokate, A.J.M.


    Breast cancer is the most frequently occurring cancer among women worldwide. One of the most important risk factors for breast cancer is high mammographic density. Mammographic density represents the amount of fibroglandular tissue relative to the fat tissue in the breast. Women with >75% of their

  3. Medicaid Consent to Sterilization forms: historical, practical, ethical, and advocacy considerations. (United States)

    Block-Abraham, Dana; Arora, Kavita S; Tate, Danielle; Gee, Rebekah E


    The US government developed a Medicaid Consent to Sterilization form in the mid-1970s to protect vulnerable populations from coerced sterilization. US health care practices have evolved significantly since that time. The form, however, has not changed, and may be preventing access to desired services for the same vulnerable populations it was originally created to protect. This paper discusses the relevant historical, practical use, ethical, and advocacy considerations of the Medicaid sterilization consent form and proposes changes to make the form more pertinent to today's medical environment.

  4. Social justice advocacy in nursing: what is it? How do we get there? (United States)

    Paquin, Siobhan O'Mahony


    Social justice advocacy is an expectation of all nurses as expressed in the professional codes that guide nursing practice. Nursing literature reflects this shift in the focus of nursing advocacy, providing insight into the potentials and challenges associated with nursing's evolution toward a broader social justice advocacy model. This article describes the concept of social justice advocacy as currently reflected in professional codes and nursing literature and contrasts this with the individual patient-nurse advocacy model, which continues to dominate in nursing practice today. Challenges associated with movement toward a social justice advocacy model and options for addressing these hurdles are also discussed.

  5. Advocacy groups and their role in rare diseases research. (United States)

    Dunkle, Mary; Pines, Wayne; Saltonstall, Peter L


    One of the remarkable and unique aspects of the recent history of rare disease research has been the evolving role of patient advocacy groups and the collaborative partnership that exists among such groups and the scientists who study rare diseases, as well as the government officials charged with overseeing medical research and regulatory processes. This collaboration, which in many respects developed out of necessity on all sides, is unparalleled in other areas of medical research and product development. It has played a significant role over the past 30 years in the adoption of public policies, available research funding and other factors affecting the general climate for research on rare diseases. Specific areas of interest include the adoption of the Orphan Drug Act in the U.S. in 1983 and subsequent similar legislation elsewhere in the world; the relationship of patient advocacy groups with government research funding and regulatory entities; the role of patient advocacy groups in seeking to "de-risk" orphan product development through initiatives such as facilitating patient registries and disease natural histories; the role of advocacy groups in ensuring that patients have access to treatments; and the increasing globalization of patient advocacy initiatives.

  6. Patient advocacy from the clinical nurses' viewpoint: a qualitative study. (United States)

    Davoodvand, Shirmohammad; Abbaszadeh, Abbas; Ahmadi, Fazlollah


    One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients' health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy.

  7. Exploring Lobbying Practices in Israel’s Nonprofit Advocacy Organizations: An Application of the Libby Lobbying Model

    Directory of Open Access Journals (Sweden)

    Patricia Libby


    Full Text Available Nonprofit and voluntary associations around the world are the primary vehicle for representing the voices of citizens in the policy-making process. As scholars who are committed to advancing the role of civil society and the citizen, it is incumbent upon us to provide theoretical and practical frameworks that can assist nonprofits with this important work. In developed nations, the similarity between societal values and structures in democratic countries makes it possible to assess and advance best practices for policy advocacy regardless of the origin of those advocacy models. This research introduces a recently developed conceptual framework originally deployed to diagnose nonprofit organizations in the U.S. engaged in legislative advocacy. Applied to 12 Israeli nonprofit organizations involved in legislative advocacy and seeking to advance change through the legislative process, this paper assesses and expands the proposed model confirming that most facets of the U.S. framework were commonly used by Israeli nonprofits. There is also evidence that culturally embedded norms are the main source for deviations from the model applied in the U.S.

  8. International Dengue Vaccine Communication and Advocacy: Challenges and Way Forward. (United States)

    Carvalho, Ana; Van Roy, Rebecca; Andrus, Jon


    Dengue vaccine introduction will likely occur soon. However, little has been published on international dengue vaccine communication and advocacy. More effort at the international level is required to review, unify and strategically disseminate dengue vaccine knowledge to endemic countries' decision makers and potential donors. Waiting to plan for the introduction of new vaccines until licensure may delay access in developing countries. Concerted efforts to communicate and advocate for vaccines prior to licensure are likely challenged by unknowns of the use of dengue vaccines and the disease, including uncertainties of vaccine impact, vaccine access and dengue's complex pathogenesis and epidemiology. Nevertheless, the international community has the opportunity to apply previous best practices for vaccine communication and advocacy. The following key strategies will strengthen international dengue vaccine communication and advocacy: consolidating existing coalitions under one strategic umbrella, urgently convening stakeholders to formulate the roadmap for integrated dengue prevention and control, and improving the dissemination of dengue scientific knowledge.

  9. PET/CT may change diagnosis and treatment in cancer patients

    DEFF Research Database (Denmark)

    Petersen, Henrik; Nielsen, Mie Jung; Høilund-Carlsen, Mette


    diagnosis in 16% and induced a change in staging and treatment plan in 28% to 32% of cases, respectively. CONCLUSION: FDG PET/CT was mainly used for diagnosis in lung cancer and in cases with an unknown primary tumour, and for response evaluation in lymphomas and colorectal cancer. PET/CT caused a change...... diagnosis was mainly used in lung cancer and in cases with unknown primary tumour. In malignant lymphomas and colorectal cancer, the technique was mainly employed for response evaluation. Use of PET/CT for staging and recurrence was more evenly distributed across specialities. PET/CT changed the primary......INTRODUCTION: The national focus on cancer has propelled the use of PET/CT for cancer imaging in Denmark. We believe that first-year experiences from a large PET centre may be of interest to new users. MATERIAL AND METHODS: Data from all scans made in the period from February 28 2006 to March 1...

  10. Where Have We Been and Where Are We Going? A Conceptual Framework for Child Advocacy

    National Research Council Canada - National Science Library

    Cascardi, Michele; Brown, Cathy; Shpiegel, Svetlana; Alvarez, Ariel


    The primary goal of this article is to chart the development of child advocacy as an interdisciplinary field of study and conclude with a conceptual framework for research and higher education in child advocacy...

  11. Shaping corporate social responsibility management and reporting through engagement : The role of advocacy organisations

    NARCIS (Netherlands)

    Clune, C.


    Advocacy organisations have traditionally played a prominent role in shaping corporate social responsibility (CSR) management and reporting practices through organisational-level and institutional-level engagement. Recent years have seen advocacy organisations expand the nature and content of their

  12. Psychometric Properties of the Patient Self-Advocacy Scale: The Persian Version

    Directory of Open Access Journals (Sweden)

    Shaghayegh Vahdat


    Full Text Available Background: Advances in science and technology and the changes in lifestyle have changed the concept of health in terms of etiology and mortality. The aim of this study was to test the psychometric properties of the original Patient Self-Advocacy Scale for use with an Iranian population. Methods: In the current study, 50 chronic patients between the ages of 25 and 75 were selected as samples. This study was conducted in May 2013 at Bou Ali Sina Hospital in Sari. The translation process and cultural adaptation of the Patient Self-Advocacy Scale were conducted. The face validity and content validity of the instrument were formally verified by analyzing the feedback of patients and health professionals. In order to evaluate questionnaire’s reliability, the intraclass correlation coefficient (ICC was calculated for each item and each domain; and the Cronbach’s alpha was calculated for the entire instruments and each domain. Results: Of the 50 patients participating in the study, 36% were male and 64% were female. The mean age of the patients was 42.5. To comply with the Iranian culture and the study target population, slight changes were applied to the process of translation and validation. In the present study, intraclass correlation coefficient for each item was 0.8-1, which demonstrates excellent reliability of the questionnaire. The Cronbach’s alpha value was 0.75 for overall scale. Conclusion: The Persian version of Patient Self-Advocacy Scale was valid and reliable. Hence, it can be used by public health researchers and health system policy makers for programming and offering patient-oriented health services based on patients’ comments, needs, and preferences.

  13. Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

    DEFF Research Database (Denmark)

    Emaus, Marleen J; van Gils, Carla H; Bakker, Marije F


    Long-term weight gain (i.e., weight gain since age 20) has been related to higher risk of postmenopausal breast cancer, but a lower risk of premenopausal breast cancer. The effect of weight change in middle adulthood is unclear. We investigated the association between weight change in middle...... adulthood (i.e., women aged 40-50 years) and the risk of breast cancer before and after the age of 50. We included female participants of the European Prospective Investigation into Cancer and Nutrition cohort, with information on anthropometric measures at recruitment and after a median follow-up of 4...

  14. Building Knowledge and Advocacy Agendas for Change in the Arab ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... to help formulate social and economic public policy proposals -Contribute to creating an inclusive, democratic culture in Syria and help with conflict resolution efforts through support, research, and dialogue -Measure public opinion through survey instruments (Arab Democracy Index and the Arab Barometer) and enhance ...

  15. The changing epidemiology of esophageal cancer in sub-Saharan ...

    African Journals Online (AJOL)

    Introduction: Esophageal cancer portends a grim prognosis. Most patients present with incurable disease. Scanty epidemiologic data on the disease has contributed to its low priority on the national. We sought to evaluate the current national trend in the presentation and outcome of esophageal cancer using our institutional ...

  16. Lifestyle Changes and the Risk of Colorectal Cancer among ...

    African Journals Online (AJOL)

    Scientific observations have shown low prevalence of this cancer in sub-Saharan Africa, Middle East, South Asia and the Caribbean. This is not so for Australasia, North America and Western Europe where the prevalence of colorectal cancer is high. Evidence have shown that migrant populations from low risk regions to ...

  17. Anatomy of Advocacy: A Case Study of the White House Petition (United States)

    Burns, Elizabeth; Kimmel, Sue; Dickinson, Gail


    Little research has been conducted examining advocacy efforts in the school library field despite the fact that program advocate is a prominent role for school librarians. One element of advocacy is the engagement in political initiatives that may affect school library programs. This case study investigates the effectiveness of one advocacy effort…

  18. What's news: perspectives on HIV/AIDS advocacy in the South ...

    African Journals Online (AJOL)

    These were, firstly, the need to balance the journalistic objectives of (a) advocacy and (b) neutrality and, secondly, the need to balance the objectives of (a) advocacy and (b) news value and profitability. Findings suggest that reticence regarding the adoption of an explicit advocacy role regarding HIV/AIDS has much to do ...

  19. Expert and Advocacy Group Consensus Findings on the Horizon of Public Health Genetic Testing

    Directory of Open Access Journals (Sweden)

    Stephen M. Modell


    Full Text Available Description: Among the two leading causes of death in the United States, each responsible for one in every four deaths, heart disease costs Americans $300 billion, while cancer costs Americans $216 billion per year. They also rank among the top three causes of death in Europe and Asia. In 2012 the University of Michigan Center for Public Health and Community Genomics and Genetic Alliance, with the support of the Centers for Disease Control and Prevention Office of Public Health Genomics, hosted a conference in Atlanta, Georgia to consider related action strategies based on public health genomics. The aim of the conference was consensus building on recommendations to implement genetic screening for three major heritable contributors to these mortality and cost figures: hereditary breast and ovarian cancer (HBOC, familial hypercholesterolemia (FH, and Lynch syndrome (LS. Genetic applications for these three conditions are labeled with a “Tier 1” designation by the U.S. Centers for Disease Control and Prevention because they have been fully validated and clinical practice guidelines based on systematic review support them. Methodology: The conference followed a deliberative sequence starting with nationally recognized clinical and public health presenters for each condition, followed by a Patient and Community Perspectives Panel, working group sessions for each of the conditions, and a final plenary session. The 74 conference participants represented disease research and advocacy, public health, medicine and nursing, genetics, governmental health agencies, and industry. Participants drew on a public health framework interconnecting policy, clinical intervention, surveillance, and educational functions for their deliberations. Results: Participants emphasized the importance of collaboration between clinical, public health, and advocacy groups in implementing Tier 1 genetic screening. Advocacy groups could help with individual and institutional

  20. Can exercise change the stereotypes associated with individuals with cancer? (United States)

    Clément-Guillotin, C; Falzon, C; d'Arripe-Longueville, F


    The purpose of this study was to examine whether exercising can positively influence the stereotypes associated with individuals with cancer and, more specifically, have an effect on the impression formation related to warmth and competence. A total of 193 French college students (Mage  = 21.08, SD = 1.44 years; 88 females and 105 males) were randomly assigned to one of the conditions of a 2 (participant sex) × 2 (target health status: cancer vs no information) × 3 (target exercise status: exerciser vs non-exerciser vs no information) experimental design. Results indicated that exercising target with cancer was perceived as the most competent compared with targets with cancer and those without information about cancer. These results suggest that exercising could be an effective way to undermine cancer stereotypes and reduce discrimination against people with cancer. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Breast cancer cells induce stromal fibroblasts to secrete ADAMTS1 for cancer invasion through an epigenetic change.

    Directory of Open Access Journals (Sweden)

    Shiaw-Wei Tyan

    Full Text Available Microenvironment plays an important role in cancer development. We have reported that the cancer-associated stromal cells exhibit phenotypic and functional changes compared to stromal cells neighboring to normal tissues. However, the molecular mechanisms as well as the maintenance of these changes remain elusive. Here we showed that through co-culture with breast cancer cells for at least three to four passages, breast normal tissue-associated fibroblasts (NAFs gained persistent activity for promoting cancer cell invasion, partly via up-regulating ADAM metallopeptidase with thrombospondin type 1 motif, 1 (ADAMTS1. Furthermore, we demonstrated that the DNA methylation pattern in the ADAMTS1 promoter has no alteration. Instead, the loss of EZH2 binding to the ADAMTS1 promoter and the resulting decrease of promoter-associated histone H3K27 methylation may account for the up-regulation of ADAMTS1. Importantly, the lack of EZH2 binding and the H3K27 methylation on the ADAMTS1 promoter were sustained in cancer cell-precocultured NAFs after removal of cancer cells. These results suggest that cancer cells are capable of inducing stromal fibroblasts to secrete ADAMTS1 persistently for their invasion and the effect is epigenetically inheritable.

  2. Research methods to change clinical practice for patients with rare cancers. (United States)

    Billingham, Lucinda; Malottki, Kinga; Steven, Neil


    Rare cancers are a growing group as a result of reclassification of common cancers by molecular markers. There is therefore an increasing need to identify methods to assess interventions that are sufficiently robust to potentially affect clinical practice in this setting. Methods advocated for clinical trials in rare diseases are not necessarily applicable in rare cancers. This Series paper describes research methods that are relevant for rare cancers in relation to the range of incidence levels. Strategies that maximise recruitment, minimise sample size, or maximise the usefulness of the evidence could enable the application of conventional clinical trial design to rare cancer populations. Alternative designs that address specific challenges for rare cancers with the aim of potentially changing clinical practice include Bayesian designs, uncontrolled n-of-1 trials, and umbrella and basket trials. Pragmatic solutions must be sought to enable some level of evidence-based health care for patients with rare cancers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Information Politics, Transnational Advocacy, and Education for All (United States)

    Magrath, Bronwen


    This article explores transnational activism within Education for All (EFA), looking specifically at the strategic use of information and research by transnational advocacy organizations. Through a comparative case-study examination of two prominent civil society organizations within the EFA movement--the Asia South Pacific Association for Basic…

  4. Domestic Violence Assessments in the Child Advocacy Center (United States)

    Thackeray, Jonathan D.; Scribano, Philip V.; Rhoda, Dale


    Objective: This study was designed to identify the frequency, methods, and practices of universal assessments for domestic violence (DV) within child advocacy centers (CACs) and determine which factors are associated with CACs that conduct universal DV assessments. Methods: The study design was a cross-sectional, web-based survey distributed to…

  5. Critical Literacy as Policy and Advocacy: Lessons from Colombia (United States)

    Mora, Raúl Alberto


    This article, the first column for this issue's Policy and Advocacy department, features a discussion about a recent experience in a graduate program in Medellín, Colombia introducing students to critical literacy. Graduate students used ideas from critical literacy to engage in an in-depth analysis of textbooks they had used in their practice.…

  6. Diabetes Advocacy and Care in Nigeria: A Review

    African Journals Online (AJOL)


    care into the primary healthcare system in Nigeria. METHODOLOGY. This is a review paper and sources of ... Diabetes Mellitus is the commonest endocrine- metabolic disorder in Nigeria comparable to the experience in ... healthcare system in Nigeria, will evaluate each of the above advocacy issues for DM in. Nigeria.

  7. Human Rights Advocacy and National Integration in Niyi Osundare's ...

    African Journals Online (AJOL)

    The paper adopts an interdisciplinary approach to the study of Niyi Osundare's poetry, focusing on human rights advocacy and national integration. It explores and illuminates the concepts of human rights and national integration within the framework of law, isolating the striking features of the concepts replete in Osundare's ...

  8. Psychology, public policy, and advocacy: Past, present, and future. (United States)

    Garrison, Ellen Greenberg; DeLeon, Patrick H; Smedley, Brian D


    This article offers a historical perspective on the contributions of the field of psychology and the American Psychological Association (APA) to the public policy arena. It traces APA's involvement from a 1956 Council of Representatives resolution on the application of psychology to inform public policy to current advocacy initiatives related to psychological science, practice, and education in the public interest. Attention is directed to APA's early policy structures together with the development of affiliated state, provincial, and territorial psychological associations and the first political action committee for psychology. The criteria for engagement in advocacy and the goals and functions of APA's policy and advocacy initiatives, including the APA Congressional and Executive Branch Science Fellowship Program, are also discussed. The evolution of psychology's public policy role is illustrated by an increasing level of federal advocacy engagement and effectiveness over time, as well as by the emergence of psychology leaders in Congress and the Executive Branch. The authors' concluding reflections on the future of psychology in the public policy arena derive from their many years of experience working on or with Capitol Hill, at APA as elected officials or senior staff, and in various roles in academia, think tanks, service delivery, and the private sector. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Assessment of Newspaper Advocacy for Rural Development and ...

    African Journals Online (AJOL)


    Key words: Print media, Content analysis, Advocacy journalism, Rural development, Environmental management. 1.0 INTRODUCTION. Adoption of .... 4.0 RESULTS AND DISCUSSION. Quarterly Trends in Newspaper Coverage. Data in Table 1 show that the newspapers showed some concern and addressed rural.

  10. an equity advocacy opportunity for access to antiretroviral therapy in

    African Journals Online (AJOL)


    Mar 7, 2006 ... From 3 by 5 to universal access: an equity advocacy opportunity for access to antiretroviral therapy in. Malawi? Sally Theobald'f, lreen Makwiza', ... posal writing for 5 year programmes and resubmitting after 2 years is problematic as it can result in decision making delays and risks of interrupted supplies of ...

  11. Advocacy Journey Promoting Child Sexual Abuse Prevention in Hong Kong. (United States)

    Cheung, Monit; Leung, Carol A; Liu, Elaine Suk-Ching


    In a country without a mandatory child abuse reporting system, advocacy for child welfare law can be a tedious and difficult process. This article documents a 10-year advocacy journey based on the capacity-building concept in social sustainability theory which aims to: raise public awareness of child sexual abuse, provide an idea for branding an inquiry column, and connect advocacy efforts to law reforms. Over the past decade in Hong Kong, a total of 336 public inquiries were anonymously sent to Wu Miu Column and published in three local major newspapers. Among these inquiries, 131 inquiries involved child sexual abuse that the "affected individuals" were molested in school or at home and knew the abusers but did not report their cases to child protection services. Inquirers reported more male than female abusers. Proportionally and significantly, female abusers tended to abuse younger children, compared to male abusers who tended to abuse older children. Many abusers were minors who abused younger children, which explains people's reluctance to report the abuse to child protection services. The discovery of this underage phenomenon motivated child advocates to challenge the common law presumption that a boy under the age of 14 is incapable of sexual intercourse. Social workers in this advocacy journey must sustain continuous efforts to prevent youth from becoming future perpetrators.

  12. Reading Advocacy: What Matters in Students', Parents', and Teachers' Lives (United States)

    Thomas, Karen F.


    In December of 2006 and again in February of 2007, fifty Literacy Professors representing almost every college and university in Michigan met in a collegial forum to discuss and advocate for all students involved in reading instruction/education. This advocacy spans students from prekindergarten through college undergraduates and graduates. The…

  13. Corruption of Client Advocacy in a Community Mental Health System. (United States)

    Denner, Bruce

    This speech discusses client advocacy, a paraprofessional service offered in many community mental health centers to help bridge the gap between therapist and client. While having an advocate on the mental health team is an attractive idea, these client advocates are quite susceptible to "corruption." The author discusses two major causes of this…

  14. 109 Strategizing Drama as Tool for Advocacy and Rural Development

    African Journals Online (AJOL)

    Nekky Umera

    people to embrace and accept new innovations and ideas that affect their lives. This is where drama comes in as an agency for advocacy, mobilization, and conscientization through the efforts of non-governmental organizations which must seek to work in tandem with the rural communities. African Research Review Vol.

  15. Inclusive Education National Research Advocacy Agenda: A Call to Action (United States)

    Morningstar, Mary E.; Allcock, Heather C.; White, Julia M.; Taub, Deborah; Kurth, Jennifer A.; Gonsier-Gerdin, Jean; Ryndak, Diane L.; Sauer, Janet; Jorgensen, Cheryl M.


    The TASH Inclusive Education National Committee responded to Horner and Dunlap's call to ensure that future research integrates inclusive values with strong science by developing an inclusive education national research advocacy agenda. Qualitative methods were implemented to answer three questions: (a) "What is the state of inclusive…

  16. Participatory Video: Toward a Method, Advocacy and Voice (MAV) Framework (United States)

    Sitter, Kathleen C.


    Using the new conceptual framework of participatory visual media as method, advocacy and voice (MAV), the author explores an action research study using an exemplar in which advocates from the disability community created and distributed a series of videos about love and sexuality as a critical human rights issue in the disability community. The…

  17. The Surgeon and Advocacy | Mwenda | Annals of African Surgery

    African Journals Online (AJOL)

    Annals of African Surgery. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 12, No 1 (2015) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. The Surgeon and Advocacy. AS Mwenda, MD Mwachiro. Abstract. No Abstract.

  18. Know Violence in Childhood – India: Advocacy, communication and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Know Violence in Childhood (KVIC) is a global learning and advocacy initiative to stimulate coordinated action to end violence in childhood. It leverages available information about the prevalence of violence during childhood and develops strategies that help prevent such violence. As part of this global initiative, ...

  19. Blue fingerprint in spectrum of cancer change of biotissues (United States)

    Yermolenko, Sergey B.


    This paper follows to combine optical and biochemical techniques for identification the cell membrane transformation in the dynamic of growth and development of experimental solid tumour. It is researched that in all the cases the linear dichroism appears in biotissues (the human esophagus, the muscle tissue of rats, prostate tissue) with the cancer disease the magnitude of which depends on the type of the tissue and on the time of the cancer process development. As the linear dichroism is lacking for healthy tissues, then the obtained results can have diagnostic values with the purpose of detection and estimation of the stage of the cancer disease development.

  20. Calcium channels and pumps in cancer: changes and consequences. (United States)

    Monteith, Gregory R; Davis, Felicity M; Roberts-Thomson, Sarah J


    Increases in intracellular free Ca(2+) play a major role in many cellular processes. The deregulation of Ca(2+) signaling is a feature of a variety of diseases, and modulators of Ca(2+) signaling are used to treat conditions as diverse as hypertension to pain. The Ca(2+) signal also plays a role in processes important in cancer, such as proliferation and migration. Many studies in cancer have identified alterations in the expression of proteins involved in the movement of Ca(2+) across the plasma membrane and subcellular organelles. In some cases, these Ca(2+) channels or pumps are potential therapeutic targets for specific cancer subtypes or correlate with prognosis.

  1. Calcium Channels and Pumps in Cancer: Changes and Consequences* (United States)

    Monteith, Gregory R.; Davis, Felicity M.; Roberts-Thomson, Sarah J.


    Increases in intracellular free Ca2+ play a major role in many cellular processes. The deregulation of Ca2+ signaling is a feature of a variety of diseases, and modulators of Ca2+ signaling are used to treat conditions as diverse as hypertension to pain. The Ca2+ signal also plays a role in processes important in cancer, such as proliferation and migration. Many studies in cancer have identified alterations in the expression of proteins involved in the movement of Ca2+ across the plasma membrane and subcellular organelles. In some cases, these Ca2+ channels or pumps are potential therapeutic targets for specific cancer subtypes or correlate with prognosis. PMID:22822055

  2. Impact of cancer on employment: A qualitative study exploring employment changes and financial coping strategies following breast cancer

    Directory of Open Access Journals (Sweden)

    Yek-Ching Kong


    Full Text Available Background: Few studies have examined the impact of cancer diagnosis on employment among breast cancer patients. We aim to gain an in-depth understanding on the employment issues faced by breast cancer patients as well as their financial coping strategies in a multi-ethnic Asian setting. Methods: Six focus group discussions (FGDs were carried out with breast cancer patients, representing various ethnicities and socioeconomic backgrounds, who were recruited from Hospital Kuala Lumpur, a public hospital, and University Malaya Medical Centre, a public academic hospital. All FGDs were audio recorded and transcribed verbatim. Thematic content analysis was carried out using the NVivo software. Results: Majority of breast cancer patients quitted their jobs upon diagnosis of breast cancer, with many describing that their bosses were not understanding in terms of their cancer diagnosis. Those who were self-employed meanwhile reported less productivity. Patterns of financial coping strategies due to employment changes were diverse. Some patients chose to do light weight part time jobs, while others described the important role of husbands and relatives in coping with income loss. There were mixed responses regarding return to work, in which money was the major reason to return to work, while stress was cited as a barrier to not return to work. However, many reported barriers in finding a job after cancer due to discrimination against their cancer and their age. Conclusion: It is evident that a breast cancer diagnosis brings about adverse impact on employment. Multidisciplinary interventions are urgently required in Malaysia to improve the employment status of our cancer survivors including legislative reforms to prevent discrimination. This study was funded by AIA Bhd. NMRR ID: NMRR-16-2054-32802 

  3. Prospective weight change and colon cancer risk in male US health professionals

    DEFF Research Database (Denmark)

    Thygesen, Lau Caspar; Grønbaek, Morten; Johansen, Christoffer


    Epidemiological studies are remarkably consistent, especially among men, in showing that overweight and obesity [body mass index (BMI) >25] are associated with increased risk of colon cancer. However, no prospective studies address the influence of weight change in adulthood on subsequent colon c.......5. Our results add support that overweight and obesity are modifiable risk factors for colon cancer among men and suggest that weight has an important influence on colon cancer risk even in later life....

  4. Base changes in tumour DNA have the power to reveal the causes and evolution of cancer


    Hollstein, M; Alexandrov, L.B.; Wild, C. P.; Ardin, M; J. Zavadil


    Next-generation sequencing (NGS) technology has demonstrated that the cancer genomes are peppered with mutations. Although most somatic tumour mutations are unlikely to have any role in the cancer process per se, the spectra of DNA sequence changes in tumour mutation catalogues have the potential to identify the mutagens, and to reveal the mutagenic processes responsible for human cancer. Very recently, a novel approach for data mining of the vast compilations of tumour NGS data succeeded in ...

  5. Advocacy for active transport: advocate and city council perspectives

    Directory of Open Access Journals (Sweden)

    Rosenby Marieah


    Full Text Available Abstract Background Effective advocacy is an important part of efforts to increase population participation in physical activity. Research about effective health advocacy is scarce, however, the health sector can learn from the experiences and knowledge of community advocates and those who are on the receiving end of this advocacy. The aim of this study is to explore advocacy for active transport from the perspectives of community advocates and representatives from City councils. Methods Cycling and walking advocates were identified from the local contact list of Cycling Advocates Network and Living Streets Aotearoa. Semi-structured telephone interviews were conducted with cycle and walking advocates from throughout New Zealand. Advocates also nominated a suitable council officer at their local City council to be interviewed. Interviews were recorded and transcribed and categories of responses for each of the questions created. Results Several processes were used by advocates to engage with council staff, including formal council submissions, meetings, stakeholder forums and partnership in running community events promoting active transport. Several other agencies were identified as being influential for active transport, some as potential coalition partners and others as potential adversaries. Barriers to improving conditions for active transport included a lack of funding, a lack of will-power among either council staff or councillors, limited council staff capacity (time or training and a culture of providing infrastructure for motor vehicles instead of people. Several suggestions were made about how the health sector could contribute to advocacy efforts, including encouraging political commitment, engaging the media, communicating the potential health benefits of active transport to the general public and being role models in terms of personal travel mode choice and having workplaces that support participation in active transport

  6. Nonmuscle-invasive bladder cancer: what's changing and what has changed. (United States)

    Manikandan, Ramanitharan; Rodriguez, Oscar; Parada, Rubén; Palou Redorta, Joan


    Nonmuscle-invasive bladder cancer (NMIBC) is a challenging disease to manage primarily due to its varied clinical course. The management of NMIBC has witnessed a widespread change with respect to its diagnosis and treatment. Although transurethral resection (TUR) and adjuvant bacillus Calmette-Guerin (BCG) stills remain the cornerstone, newer protocols has come into vogue to achieve optimal care. On the basis of a literature review, we aimed to establish 'what changes has already occurred and what is expected in the future' in NMIBC. A Medline search was performed to identify the published literature with respect to diagnosis, treatment and future perspectives on NMIBC. Particular emphasis was directed to determinants such as the quality of TUR and the newer modifications, Re-TUR, current status of newer macroscopic and microscopic imaging, role of urinary biomarkers, clinical, histologic and molecular predictors of high-risk disease, administration of intravesical agents, salvage therapy in BCG recurrence and the current best practice guidelines were analyzed. Optimal TUR, restaging in select group, incorporation of newer endoscopic imaging and judicious administration of intravesical chemo-immunotherapeutic agents can contribute to better patient care. Although there is a plethora of urinary markers, there is insufficient evidence for their use in isolation. The future probably lies in identification of genetic markers to determine disease recurrence, nonresponders to standard treatment and early institution of alternative/targeted therapy.

  7. Voices from the Margins: Policy Advocacy and Marginalized Communities

    Directory of Open Access Journals (Sweden)

    Gloria DeSantis


    Full Text Available This article aims to explore policy advocacy processes facilitated by social service nonprofit organizations (NPOs using a social justice lens. Qualitative interview results from 39 NPOs from 18 communities provide a deeper understanding of advocacy, revealing that NPOs perceive that policy advocacy is not a discrete phenomenon, that advocacy activity differs in visibility and scale, and that advocacy strategies are clearly informed by NPOs' front-line service delivery work. A typology of policy advocacy showing different advocacy types and their fluid nature is presented. The results also show that marginalized people's involvement varies depending on a diversity of influential conditions. Conclusions and implications focus on social inclusion/exclusion, the varied and fluid nature of policy advocacy, challenges for practitioners, and the complex nature of "advocacy chill. / "Les organismes sans but lucratif (OSBL de services sociaux ont pour mission de préserver la santé des communautés au moyen de défense de politiques sociales. Toutefois, peu d'études concrètes au Canada portent sur la nature des processus en cause, en particulier lorsqu'il s'agit de politiques mises en œuvre au sein de collectivités marginalisées. Cet article a pour but d'explorer sous l'angle de la justice sociale la nature des processus défense des politiques tels qu'ils sont pratiqués par les OSBL de services sociaux. Un entretien qualitatif avec 39 OSBL issues de 18 collectivités permet une meilleure compréhension des processus. Les OSBL ne conçoivent pas défense des politiques comme un phénomène discret; les activités qui y sont reliées varient en visibilité et en étendue, et les stratégies employées sont clairement influencées par les services de première ligne qu'offrent les OSBL. Nous proposons une typologie des processus défense des politiques exposant les différents types d'approches et leur nature changeante. Les résultats indiquent

  8. Clinical profile and post-operative lifestyle changes in cancer and non-cancer patients with ostomy (United States)

    Anaraki, Fakhryalsadat; Vafaie, Mohamad; Behboo, Roobic; Maghsoodi, Nakisa; Esmaeilpour, Sahar


    Aim The aim of this was to investigate some clinical profiles and lifestyle changes in stoma patients. Background Stoma patients experienced multiple complications due to their ostomy formation. Patients and methods A cross-sectional study performed on 102 random samples of stoma patients. Any patient with adequate physical and mental capability to participate and having had an ostomy in place for at least 3 months was eligible to enter the study. Participants asked to answer study questions concerning age, sex, type of stoma, having permanent or temporary ostomy, underlying cause of stoma formation, type of cancers cause of stoma. Patient also questioned about some lifestyle changes because of stoma including: changing diet, sexual satisfaction (if sexually active after stoma formation), sense of depression, changing job, change clothing style. Results Colostomy was the most common type of stoma followed by ileostomy and urostomy. In 80.4% of patients under study the stoma was permanent. Most patients had a stoma because of cancer (77.5%), with colon cancer (41.2%) being the most common malignant diagnosis. The mean age of cancer patients (56.1±10.9) with stoma was significantly higher than non-cancer patients (44.7±12.9) (p sexual satisfaction after stoma formation between the two groups (p sexually satisfied post-ostomy. Conclusion In conclusion, stoma formation can caused multiple problems for both cancer and non-cancer patients. Counseling of patient is an important component of care that could help stoma patients to adjust with new situations. PMID:24834234

  9. Management of rectal cancer: Times they are changing

    Directory of Open Access Journals (Sweden)

    Marilia Cravo


    In this review, we critically examine recent advances in staging, surgery, and chemoradiation in the management of patients with rectal cancer which have not typically been incorporated in published treatment guidelines.

  10. Function of oncogenes in cancer development: a changing paradigm. (United States)

    Vicente-Dueñas, Carolina; Romero-Camarero, Isabel; Cobaleda, Cesar; Sánchez-García, Isidro


    Tumour-associated oncogenes induce unscheduled proliferation as well as genomic and chromosomal instability. According to current models, therapeutic strategies that block oncogene activity are likely to selectively target tumour cells. However, recent evidences have revealed that oncogenes are only essential for the proliferation of some specific tumour cell types, but not all. Indeed, the latest studies of the interactions between the oncogene and its target cell have shown that oncogenes contribute to cancer development not only by inducing proliferation but also by developmental reprogramming of the epigenome. This provides the first evidence that tumorigenesis can be initiated by stem cell reprogramming, and uncovers a new role for oncogenes in the origin of cancer. Here we analyse these evidences and propose an updated model of oncogene function that can explain the full range of genotype-phenotype associations found in human cancer. Finally, we discuss how this vision opens new avenues for developing novel anti-cancer interventions.

  11. Physician advocacy in Western medicine: a 21st century challenge. (United States)

    Bagshaw, Philip; Barnett, Pauline


    Physician advocacy occurs when doctors speak up for the health and healthcare of patients and communities. Historically, this was strong in some Western countries with doctors finding that it enhanced their authority, prestige and power. But it weakened in the 20th century when the biomedical model of heath triumphed and medicine became a dominant profession. In the second part of the 20th century, this dominance was threatened by political, technological and socioeconomic forces. These weakened medicine's state support, brought it under managerial control and undermined the social contract on which trust between doctors and the community was based. Defence of the profession was assumed by medical colleges, societies and associations. They had some success in retaining professional autonomy but did not undertake open advocacy, particularly on social justice issues, and did not therefore enhance their standing in the community. Opinion is divided on the level of advocacy that it is ethically proper for the medical profession to employ. Some contend doctors should only advise authorities when expert opinion is requested. Others contend doctors should speak out proactively on all health issues, and that collective action of this type is a hallmark of professionalism. This lack of consensus needs to be debated. Recent developments such as clinical leadership have not revitalised physician advocacy. However, continued deterioration of the UK National Health Service has led some English medical colleges to take up open advocacy in its defence. It is to be seen whether medical colleges elsewhere follow suit, as and when their healthcare systems are similarly threatened.

  12. The Mental Health Leadership and Advocacy Program (mhLAP): a pioneering response to the neglect of mental health in Anglophone West Africa (United States)


    Developing countries in Africa and other regions share a similar profile of insufficient human resources for mental health, poor funding, a high unmet need for services and a low official prioritisation of mental health. This situation is worsened by misconceptions about the causes of mental disorders, stigma and discrimination that frequently result in harmful practices against persons with mental illness. Previous explorations of the required response to these challenges have identified the need for strong leadership and consistent advocacy as potential drivers of the desired change. The Mental Health Leadership and Advocacy Program (mhLAP) is a project that aims to provide and enhance the acquisition of skills in mental health leadership, service development, advocacy and policy planning and to build partnerships for action. Launched in 2010 to serve the Anglophone countries of The Gambia, Ghana, Liberia, Nigeria, Sierra Leone, this paper describes the components of the program, the experience gained since its initiation, and the achievements made during the three years of its implementation. These achievements include: 1) the annual training in mental health leadership and advocacy which has graduated 96 participants from 9 different African countries and 2) the establishment of a broad coalition of service user groups, non-governmental organizations, media practitioners and mental health professionals in each participating country to implement concerted mental health advocacy efforts that are focused on country-specific priorities PMID:24467884

  13. The Changing Landscape of Breast Cancer: How Biology Drives Therapy

    Directory of Open Access Journals (Sweden)

    Sarah Friend


    Full Text Available Breast cancer is the most prevalent life-threatening cancer in women. Optimizing therapy to increase cure rates in early stage disease, and improving life expectancy and palliation for advanced stages, are goals driving major areas of research. The armamentarium of targeted treatments for breast cancer is ever expanding as understanding of breast cancer biology deepens. A revolution in our treatment was heralded a decade ago by the introduction of trastuzumab for human epidermal receptor-2 positive (HER2+ disease resulting in remarkable reductions in recurrence and improvements in overall survival (OS. Advances continue to be made in other breast cancer subtypes targeting key activating pathways for therapeutic development. However, for these other targeted agents, improvement in OS has been elusive. This article focuses on the development of targeted therapy in breast cancer focusing primarily on the last 5 years, to illustrate that as we understand the complex pathways allowing the dysregulated cell to become malignant, it also propels us closer towards the promise of precision and personalized medicine.

  14. Insights from Breast Cancer Survivors: The Interplay between Context, Epistemology, and Change (United States)

    Hoggan, Chad


    This study explored the processes by which a group of breast cancer survivors experienced positive learning and growth from their cancer experiences. The author argues that such learning and growth can be considered transformative learning, especially from ontological perspectives of the theory. The participants' change process consisted of…

  15. DNA copy number changes in young gastric cancer patients with special reference to chromosome 19

    NARCIS (Netherlands)

    Varis, A.; van Rees, B.; Weterman, M.; Ristimäki, A.; Offerhaus, J.; Knuutila, S.


    Only a few cytogenetic and genetic studies have been performed in gastric cancer patients in young age groups. In the present study we used the comparative genomic hybridisation (CGH) method to characterise frequent DNA copy number changes in 22 gastric cancer patients of 45 years or younger and

  16. Tools Beyond Control: Social Media and the Work of Advocacy Organizations

    Directory of Open Access Journals (Sweden)

    Luis E. Hestres


    Full Text Available Advocacy organizations rely on social media services, such as Facebook and Twitter, to engage their supporters. These services increasingly influence how citizens and advocacy organizations engage politically online through the technical features and policies they choose to implement—a phenomenon that can sometimes disrupt the work of advocates. Interviews with digital strategists at several US advocacy organizations revealed low levels of awareness of this phenomenon, despite its potential impact on their work; substantial dependence on these services for advocacy work; and a shared sense of necessity to embrace these tools, despite their potential downsides. Implications for the scholarship and practice of Internet governance and digitally mediated advocacy are discussed.

  17. Adult weight change and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition. (United States)

    Aleksandrova, Krasimira; Pischon, Tobias; Buijsse, Brian; May, Anne M; Peeters, Petra H; Bueno-de-Mesquita, H Bas; Jenab, Mazda; Fedirko, Veronika; Dahm, Christina C; Siersema, Peter D; Freisling, Heinz; Ferrari, Pietro; Overvad, Kim; Tjønneland, Anne; Trichopoulou, Antonia; Lagiou, Pagona; Naska, Androniki; Pala, Valeria; Mattiello, Amalia; Ohlsson, Bodil; Jirström, Karin; Key, Timothy J; Khaw, Kay-Tee; Riboli, Elio; Boeing, Heiner


    Weight change during adult life may reflect metabolic changes and influence colorectal cancer (CRC) development, but such role is not well established. We aimed to explore the association between adult weight change (from age 20 to 50) and CRC risk. In particular, we investigated differences according to colon and rectal cancer, sex and measures of attained adiposity. We included 201,696 participants from six participating countries in the European Prospective Investigation into Cancer and Nutrition (1992-2010). During a mean follow-up of 11.2 years 2384 (1194 in men and 1190 in women) incident CRC cases occurred. Cox proportional hazard models adjusted for body mass index at age 20 and lifestyle factors at study recruitment were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After multivariable adjustment, each kg of weight gained annually from age 20 to 50 was associated with a 60% higher risk of colon cancer (95% CI 1.20-2.09), but not rectal cancer (HR 1.13, 95% CI 0.79-1.62, P(interaction)=0.04). The higher risk of colon cancer was restricted to people with high attained waist circumference at age 50 (HR 1.82, 95%CI 1.14-2.91, P(interaction)=0.02). Results were not different in men and women (P(interaction)=0.81). Adult weight gain, as reflected by attained abdominal obesity at age 50, increases colon cancer risk in both men and women. These data underline the importance of weight management and metabolic health maintenance in early adult life years for colon cancer prevention. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Why Music? Essays on the Importance of Music Education and Advocacy: Why Does Our Profession Need Advocacy? (United States)

    Mark, Michael L.


    Advocacy for music education has become a major professional activity that is not always understood by music educators. Education decision makers--boards of education, legislators, government policy makers--must appreciate why music education is important to society so they can make informed decisions about any number of issues that affect music…

  19. Thinking/Learning/Doing Advocacy: A Report on the National Advocacy Project of United Cerebral Palsy Associations, Inc. (United States)

    Dickman, Irving R., Comp.

    Described is the National Advocacy Project of the United Cerebral Palsy Association involving demonstration projects and model programs advocating the legal and human rights of the person with a developmental disability and his family. Goals and objectives of the project are listed as follows: improving the effectiveness of agencies and services…

  20. Age- and treatment-related associations with health behavior change among breast cancer survivors. (United States)

    Anderson, Chelsea; Sandler, Dale P; Weinberg, Clarice R; Houck, Kevin; Chunduri, Minal; Hodgson, M Elizabeth; Sabatino, Susan A; White, Mary C; Rodriguez, Juan L; Nichols, Hazel B


    The aim of this study was to identify demographic and treatment-related factors associated with health-promoting behavior changes after a breast cancer diagnosis. Changes in health behaviors were also evaluated according to weight, exercise, diet and alcohol consumption patterns before breast cancer diagnosis. We examined self-reported behavior changes among 1415 women diagnosed with breast cancer in the NIEHS Sister Study cohort. Women reported changes in exercising, eating healthy foods, maintaining a healthy body weight, drinking alcohol, smoking, getting enough sleep, spending time with family and friends, and participating in breast cancer awareness events. On average, women were 3.7 years from their breast cancer diagnosis. Overall, 20-36% reported positive changes in exercise, eating healthy foods, maintaining a healthy weight, or alcohol consumption. However, 17% exercised less. With each 5-year increase in diagnosis age, women were 11-16% less likely to report positive change in each of these behaviors (OR = 0.84-0.89; p cancer survivorship guideline-supported behaviors after diagnosis. Positive changes were more common among younger women or those who underwent chemotherapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. How changes in extracellular matrix mechanics and gene expression variability might combine to drive cancer progression.

    Directory of Open Access Journals (Sweden)

    Justin Werfel

    Full Text Available Changes in extracellular matrix (ECM structure or mechanics can actively drive cancer progression; however, the underlying mechanism remains unknown. Here we explore whether this process could be mediated by changes in cell shape that lead to increases in genetic noise, given that both factors have been independently shown to alter gene expression and induce cell fate switching. We do this using a computer simulation model that explores the impact of physical changes in the tissue microenvironment under conditions in which physical deformation of cells increases gene expression variability among genetically identical cells. The model reveals that cancerous tissue growth can be driven by physical changes in the microenvironment: when increases in cell shape variability due to growth-dependent increases in cell packing density enhance gene expression variation, heterogeneous autonomous growth and further structural disorganization can result, thereby driving cancer progression via positive feedback. The model parameters that led to this prediction are consistent with experimental measurements of mammary tissues that spontaneously undergo cancer progression in transgenic C3(1-SV40Tag female mice, which exhibit enhanced stiffness of mammary ducts, as well as progressive increases in variability of cell-cell relations and associated cell shape changes. These results demonstrate the potential for physical changes in the tissue microenvironment (e.g., altered ECM mechanics to induce a cancerous phenotype or accelerate cancer progression in a clonal population through local changes in cell geometry and increased phenotypic variability, even in the absence of gene mutation.

  2. The views and experiences of learning disability nurses concerning their advocacy education. (United States)

    Llewellyn, Penny; Northway, Ruth


    A mixed methods project [Llewellyn, P., 2005. An investigation into the advocacy role of the learning disability nurse. University of Glamorgan, unpublished PhD Thesis] investigated the advocacy role of learning disability nurses. This paper discusses the section concerned with nurses' advocacy education. Focus groups, interviews and a questionnaire survey enabled nurses from a wide range of grades, seniority and experience to explore their received education in advocacy and their educational requirements concerning their advocacy role. Findings revealed that nurses' received education in advocacy varied according to the syllabus under which they qualified, with those whose education was influenced by the 1979 Jay Report having the highest incidence of advocacy training. Many learning disability nurses who had received theoretical education did not feel confident to advocate for their clients. Many were also unsure of their ability to access independent advocacy services and when it was permissible to do this. Nurse informants expressed a need for ongoing support and training in advocacy relating to The Human Rights Act (1998) and The Disability Discrimination Act (1995); and also specifically in relation to advocacy for clients within their own work area. Most nurses had definite ideas regarding how and by whom their advocacy education and training should be provided.

  3. MicroRNAs Change the Landscape of Cancer Resistance. (United States)

    Zhu, Jun; Zhu, Wei; Wu, Wei


    One of the major challenges in the cancer treatment is the development of drug resistance. It represents a major obstacle to curing cancer with constrained efficacy of both conventional chemotherapy and targeted therapies, even recent immune checkpoint blockade therapy. Deciphering the mechanisms of resistance is critical to further understanding the multifactorial pathways involved, and developing more specific targeted treatments. To date, numerous studies have reported the potential role of microRNAs (miRNAs) in the resistance to various cancer treatments. MicroRNAs are a family of small noncoding RNAs that regulate gene expression by sequence-specific targeting of mRNAs causing translational repression or mRNA degradation. More than 1200 validated human miRNAs have been identified in human genome. While one miRNA can regulate hundreds of targets, a single target can also be affected by multiple miRNAs. Evidence suggests that dysregulation of specific miRNAs may be involved in the acquisition of resistance, thereby modulating the sensitivity of cancer cells to treatment. Therefore, manipulation of miRNAs may be an attractive strategy for more effective individualized therapies through reprograming resistant network in cancer cells.

  4. Procaine Induces Epigenetic Changes in HCT116 Colon Cancer Cells

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    Hussein Sabit


    Full Text Available Colon cancer is the third most commonly diagnosed cancer in the world, and it is the major cause of morbidity and mortality throughout the world. The present study aimed at treating colon cancer cell line (HCT116 with different chemotherapeutic drug/drug combinations (procaine, vorinostat “SAHA,” sodium phenylbutyrate, erlotinib, and carboplatin. Two different final concentrations were applied: 3 μM and 5 μM. Trypan blue test was performed to assess the viability of the cell before and after being treated with the drugs. The data obtained showed that there was a significant decrease in the viability of cells after applying the chemotherapeutic drugs/drug combinations. Also, DNA fragmentation assay was carried out to study the effect of these drugs on the activation of apoptosis-mediated DNA degradation process. The results indicated that all the drugs/drug combinations had a severe effect on inducing DNA fragmentation. Global DNA methylation quantification was performed to identify the role of these drugs individually or in combination in hypo- or hypermethylating the CpG dinucleotide all over the genome of the HCT116 colon cancer cell line. Data obtained indicated that different combinations had different effects in reducing or increasing the level of methylation, which might indicate the effectiveness of combining drugs in treating colon cancer cells.

  5. Body mass index at early adulthood, subsequent weight change and cancer incidence and mortality. (United States)

    Han, Xuesong; Stevens, June; Truesdale, Kimberly P; Bradshaw, Patrick T; Kucharska-Newton, Anna; Prizment, Anna E; Platz, Elizabeth A; Joshu, Corinne E


    Obesity later in adulthood is associated with increased risks of many cancers. However, the effect of body fatness in early adulthood, and change in weight from early to later adulthood on cancer risk later in life is less clear. We used data from 13,901 people aged 45-64 in the Atherosclerosis Risk in Communities cohort who at baseline (1987-1989) self-reported their weight at the age of 25 and had weight and height measured. Incident cancers were identified through 2006 and cancer deaths were ascertained through 2009. Multivariable Cox proportional hazard models were used to relate body mass index (BMI) at age 25 and percent weight change from age 25 to baseline to cancer incidence and mortality. After adjusting for weight change from age 25 until baseline, a 5 kg/m(2) increment in BMI at age 25 was associated with a greater risk of incidence of all cancers in women [hazard ratio (95% confidence interval): 1.10 (1.02-1.20)], but not in men. Associations with incident endometrial cancer were strong [1.83 (1.47-2.26)]. After adjusting for BMI at age 25, a 5% increment in weight from age 25 to baseline was associated with a greater risk of incident postmenopausal breast cancer [1.05 (1.02-1.07)] and endometrial cancer [1.09 (1.04-1.14)] in women and incident colorectal cancer [1.05 (1.00-1.10)] in men. Excess weight during young adulthood and weight gain from young to older adulthood may be independently associated with subsequent cancer risk. Excess weight and weight gain in early adulthood should be avoided. © 2014 UICC.

  6. Mammographic Density Change With Estrogen and Progestin Therapy and Breast Cancer Risk. (United States)

    Byrne, Celia; Ursin, Giske; Martin, Christopher F; Peck, Jennifer D; Cole, Elodia B; Zeng, Donglin; Kim, Eunhee; Yaffe, Martin D; Boyd, Norman F; Heiss, Gerardo; McTiernan, Anne; Chlebowski, Rowan T; Lane, Dorothy S; Manson, JoAnn E; Wactawski-Wende, Jean; Pisano, Etta D


    Estrogen plus progestin therapy increases both mammographic density and breast cancer incidence. Whether mammographic density change associated with estrogen plus progestin initiation predicts breast cancer risk is unknown. We conducted an ancillary nested case-control study within the Women's Health Initiative trial that randomly assigned postmenopausal women to daily conjugated equine estrogen 0.625 mg plus medroxyprogesterone acetate 2.5 mg or placebo. Mammographic density was assessed from mammograms taken prior to and one year after random assignment for 174 women who later developed breast cancer (cases) and 733 healthy women (controls). Logistic regression analyses included adjustment for confounders and baseline mammographic density when appropriate. Among women in the estrogen plus progestin arm (97 cases/378 controls), each 1% positive change in percent mammographic density increased breast cancer risk 3% (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01 to 1.06). For women in the highest quintile of mammographic density change (>19.3% increase), breast cancer risk increased 3.6-fold (95% CI = 1.52 to 8.56). The effect of estrogen plus progestin use on breast cancer risk (OR = 1.28, 95% CI = 0.90 to 1.82) was eliminated in this study, after adjusting for change in mammographic density (OR = 1.00, 95% CI = 0.66 to 1.51). We found the one-year change in mammographic density after estrogen plus progestin initiation predicted subsequent increase in breast cancer risk. All of the increased risk from estrogen plus progestin use was mediated through mammographic density change. Doctors should evaluate changes in mammographic density with women who initiate estrogen plus progestin therapy and discuss the breast cancer risk implications.

  7. Shared Risk Factors for Cardiovascular Disease and Cancer: Implications for Preventive Health and Clinical Care in Oncology Patients. (United States)

    Johnson, Christopher B; Davis, Margot K; Law, Angeline; Sulpher, Jeffrey


    The cardiovascular toxicity of cancer therapy has raised awareness of the importance of heart disease in cancer care among oncologists and cardiologists, leading to the new interdisciplinary field of cardio-oncology. Evidence is accumulating to suggest that risk factors associated with cardiovascular disease are also related to an increased incidence of cancer and excess cancer mortality. We review the epidemiologic evidence that smoking, obesity, poor diet, and inactivity can cause both heart disease and cancer. The importance of cardiovascular disease and cardiovascular risk factors in adversely affecting oncological outcomes and leading to increased cancer mortality is discussed. Cardiotoxicity prediction tools that incorporate cardiac disease and risk factors are described. Raising awareness about shared risk factors for cancer and heart disease may result in more effective advocacy to promote healthy lifestyle changes through the combined efforts of the historically separate specialties of cardiology and oncology. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  8. Dynamic changes of driver genes' mutations across clinical stages in nine cancer types. (United States)

    Li, Xia


    The driver genes play critical roles for tumorigenesis, and the number of identified driver genes reached plateau. But how they act during different cancer development stages is lack of knowledge. We investigated 138 driver genes' mutation changes across clinical stages using 3,477 cases in nine cancer types from the Cancer Genome Atlas (TCGA) and constructed their temporal order relationships. We also examined the codon changes for the widely mutated TP53 and PIK3CA in tumor stages. Combinations of one to three driver genes specifically dominated in each cancer. Across the clinical stages, we categorized three patterns for the behaviors of driver genes' mutation changes in the nine cancer types: recurrently mutated in all the stages and triggering other mutations; certain mutations lost meanwhile other mutations emerged; mutations dominated across entire stages, while other mutations gradually appeared or disappeared. We observed different codon changes dominated in different stages and revealed mutations recurrently occurring on the hotspot regions of the coding sequence may be the core factor for driver genes' tumorigenesis. Our results highlighted the dynamic changes of oncogenesis roles in different clinical stages and suggested different diagnostic decision making according to the clinical stages of patients. © 2016 The Author. Cancer Medicine published by John Wiley & Sons Ltd.

  9. Recent trends in population-based cancer registries in Japan: the Act on Promotion of Cancer Registries and drastic changes in the historical registry. (United States)

    Matsuda, Tomohiro; Sobue, Tomotaka


    Cancer registration in Japan has a long history spanning over 60 years; the first population-based cancer registry was established in Miyagi prefecture in 1951. The progress made in the regional population-based cancer registries in terms of standardization and quality improvement during the 10 years of the third comprehensive strategy for cancer control was highlighted in the history of cancer registration in Japan. However, there were still weak points regarding local government-oriented cancer registries that remained, e.g., the reporting of cancer cases to the population-based cancer registries was not a mandatory task for medical institutions. After the Cancer Control Act in 2006, the Act on Promotion of Cancer Registries was finally enacted in Japan on December 6, 2013. According to that Act, hospital managers must report information on any primary cancer that was first diagnosed in their institutions from January 1, 2016 to the prefectural governors. Given the increasing number of cases and amount of information recorded, it would have been almost impossible to maintain our cancer registries using the same system, and changes were required to obtain reliable cancer statistics. This was particularly important in Japan, because the country is facing a hyper-aging society, with two to three million cancer patients requiring entry of detailed information. We appreciate the long history of the Japanese cancer registry, but it is necessary to make dramatic changes to bring the registry up to date and to be able to track the increasing amount of information.

  10. Diet and physical activity in relation to weight change among breast cancer patients. (United States)

    Yaw, Yong Heng; Shariff, Zalilah Mohd; Kandiah, Mirnalini; Weay, Yong Heng; Saibul, Nurfaizah; Sariman, Sarina; Hashim, Zailina


    This study aimed to provide an overview of lifestyle changes after breast cancer diagnosis and to examine the relationship between dietary and physical activity changes with weight changes in breast cancer patients. Women with breast carcinomas (n=368) were recruited from eight hospitals and four breast cancer support groups in peninsular Malaysia. Dietary and physical activity changes were measured from a year preceding breast cancer diagnosis to study entry. Mean duration since diagnosis was 4.86±3.46 years. Dietary changes showed that majority of the respondents had decreased their intake of high fat foods (18.8-65.5%), added fat foods (28.3-48.9%), low fat foods (46.8-80.7%), red meat (39.7%), pork and poultry (20.1-39.7%) and high sugar foods (42.1-60.9%) but increased their intake of fish (42.7%), fruits and vegetables (62.8%) and whole grains (28.5%). Intake of other food groups remained unchanged. Only a small percentage of the women (22.6%) had increased their physical activity since diagnosis where most of them (16.0%) had increased recreational activities. Age at diagnosis (β= -0.20, p= 0.001), and change in whole grain (β= -0.15, p= 0.003) and fish intakes (β= 0.13, p= 0.013) were associated with weight changes after breast cancer diagnosis. In summary, the majority of the women with breast cancer had changed their diets to a healthier one. However, many did not increase their physical activity levels which could improve their health and lower risk of breast cancer recurrence.

  11. Patient advocacy groups: Need and opportunity in India

    Directory of Open Access Journals (Sweden)

    Kunal Shah


    Full Text Available With an increasing number of corporate hospitals, healthcare related issues, research trials and undue attention by media in India, there is a need to focus more on patient′s rights and protection. In India, multiple agencies like regulatory bodies, scientific review committees, ethics committees, NGOs, etc. work toward patient rights and protection. However, these agencies are inadequate to cater to the general issues related to patient′s rights. There′s a need to have a separate group of people who provide advocacy to the patient, or simply, a patient advocacy group which will work explicitly in these areas to increase transparency and credibility of healthcare system in India. This group will provide special attention to patient care and protection of rights from the planning stage rather than at the troubleshooting stage.

  12. The pediatrician's role in community advocacy for childhood obesity prevention. (United States)

    Wacker, Julia; Bosley, Eric; Bolling, Christopher


    As childhood obesity rates continue to rise, increasing numbers of pediatric providers are advocating for healthier environments outside clinic walls. Understanding the role of the pediatrician in childhood obesity advocacy within the context of the socioecological model helps ground engagement efforts. Once a project is underway, applying evidence-based obesity clinical care principles to community-focused work creates a template for engaging with partners and developing an intervention. In addition to content expertise, providers can guide community partners through the project development process, particularly in setting realistic goals and determining relevant, attainable health outcomes. Capitalizing on existing advocacy resources designed for busy pediatricians, specifically those available through national and state chapters of the American Academy of Pediatrics, aids in initiating or continuing any community-engaged effort. Copyright 2014, SLACK Incorporated.

  13. Antiscience and ethical concerns associated with advocacy of Lyme disease (United States)

    Auwaerter, Paul G; Bakken, Johan S; Dattwyler, Raymond J; Dumler, J Stephen; Halperin, John J; McSweegan, Edward; Nadelman, Robert B; O’Connell, Susan; Shapiro, Eugene D; Sood, Sunil K; Steere, Allen C; Weinstein, Arthur; Wormser, Gary P


    Advocacy for Lyme disease has become an increasingly important part of an antiscience movement that denies both the viral cause of AIDS and the benefits of vaccines and that supports unproven (sometimes dangerous) alternative medical treatments. Some activists portray Lyme disease, a geographically limited tick-borne infection, as a disease that is insidious, ubiquitous, difficult to diagnose, and almost incurable; they also propose that the disease causes mainly non-specific symptoms that can be treated only with long-term antibiotics and other unorthodox and unvalidated treatments. Similar to other antiscience groups, these advocates have created a pseudoscientific and alternative selection of practitioners, research, and publications and have coordinated public protests, accused opponents of both corruption and conspiracy, and spurred legislative efforts to subvert evidence-based medicine and peer-reviewed science. The relations and actions of some activists, medical practitioners, and commercial bodies involved in Lyme disease advocacy pose a threat to public health. PMID:21867956

  14. Nursing Actions in practicing inpatient advocacy in a Burn Unit

    Directory of Open Access Journals (Sweden)

    Aline Carniato Dalle Nogario


    Full Text Available OBJECTIVEUnderstanding nursing actions in the practice of inpatient advocacy in a burn unit.METHODA single and descriptive case study, carried out with nurses working in a referral burn center in southern Brazil. Data were collected through focus group technique, between February and March 2014, in three meetings. Data was analysed through discursive textual analysis.RESULTSThree emerging categories were identified, namely: (1 instructing the patient; (2 protecting the patient; and (3 ensuring the quality of care.CONCLUSIONSThis study identified that the nurses investigated exercised patient advocacy and that the recognition of their actions is an advance for the profession, contributing to the autonomy of nurses and the effectiveness of patients' rights and social justice.

  15. SaludableOmaha: Development of a Youth Advocacy Initiative to Increase Community Readiness for Obesity Prevention, 2011–2012 (United States)

    Frerichs, Leah; Brittin, Jeri; Stewart, Catherine; Robbins, Regina; Riggs, Cara; Mayberger, Susan; Cervantes, Alberto


    Background Childhood obesity rates in minority populations continue to rise despite leveling national trends. Although interventions that address social and environmental factors exist, processes that create demand for policy and environmental change within communities have not been identified. Community Context We developed a pilot program in South Omaha, a Nebraska Latino community, based on the community readiness model (CRM), called SaludableOmaha. We used CRM to explore the potential of youth advocacy to shift individual and community norms regarding obesity prevention in South Omaha and to advocate for health-promoting community environments. Methods We used CRM to assess supply and demand for health programs, engage the community, determine the community’s baseline readiness to address childhood obesity, and guide youth advocacy program development. We conducted our project in 2 phases. In the first, we trained a cohort of youth. In the second, the youth cohort created and launched a Latino health movement, branded as SaludableOmaha. A third phase, which is currently under way, is directed at institutionalizing youth advocacy in communities. Outcome At baseline, the community studied was at a low stage of readiness for change. Our program generated infrastructure and materials to support the growth and institutionalization of youth advocacy as a means of increasing community readiness for addressing obesity prevention. Interpretation CRM is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community. Community partnerships such as SaludableOmaha can aid the adoption of obesity prevention programs. PMID:23217590

  16. The Advocacy for Pedestrian Safety Study: Cluster Randomised Trial Evaluating a Political Advocacy Approach to Reduce Pedestrian Injuries in Deprived Communities (United States)

    Lyons, Ronan A.; Kendrick, Denise; Towner, Elizabeth M. L.; Coupland, Carol; Hayes, Mike; Christie, Nicola; Sleney, Judith; Jones, Sarah; Kimberlee, Richard; Rodgers, Sarah E.; Turner, Samantha; Brussoni, Mariana; Vinogradova, Yana; Sarvotham, Tinnu; Macey, Steven


    package was positively viewed and raised interest but changes in interventions were not statistically significance. Longer term supported advocacy may be needed. Trial Registration Current Controlled Trials ISRCTN91381117 PMID:23577088

  17. The advocacy for pedestrian safety study: cluster randomised trial evaluating a political advocacy approach to reduce pedestrian injuries in deprived communities.

    Directory of Open Access Journals (Sweden)

    Ronan A Lyons

    Full Text Available To determine whether advocacy targeted at local politicians leads to action to reduce the risk of pedestrian injury in deprived areas.Cluster randomised controlled trial.239 electoral wards in 57 local authorities in England and Wales.617 elected local politicians.Intervention group politicians were provided with tailored information packs, including maps of casualty sites, numbers injured and a synopsis of effective interventions.25-30 months post intervention, primary outcomes included: electoral ward level: percentage of road traffic calmed; proportion with new interventions; school level: percentage with 20 mph zones, Safe Routes to School, pedestrian training or road safety education; politician level: percentage lobbying for safety measures. Secondary outcomes included politicians' interest and involvement in injury prevention, and facilitators and barriers to implementation.PRIMARY OUTCOMES DID NOT SIGNIFICANTLY DIFFER: % difference in traffic calming (0.07, 95%CI: -0.07 to 0.20; proportion of schools with 20 mph zones (RR 1.47, 95%CI: 0.93 to 2.32, Safe Routes to School (RR 1.34, 95%CI: 0.83 to 2.17, pedestrian training (RR 1.23, 95%CI: 0.95 to 1.61 or other safety education (RR 1.16, 95%CI: 0.97 to 1.39. Intervention group politicians reported greater interest in child injury prevention (RR 1.09, 95%CI 1.03 to 1.16, belief in potential to help prevent injuries (RR 1.36, 95%CI 1.16 to 1.61, particularly pedestrian safety (RR 1.55, 95%CI 1.19 to 2.03. 63% of intervention politicians reported supporting new pedestrian safety schemes. The majority found the advocacy information surprising, interesting, effectively presented, and could identify suitable local interventions.This study demonstrates the feasibility of an innovative approach to translational public health by targeting local politicians in a randomised controlled trial. The intervention package was positively viewed and raised interest but changes in interventions were not

  18. Evolution of breast cancer management in Ireland: a decade of change.

    LENUS (Irish Health Repository)

    Heneghan, Helen M


    BACKGROUND: Over the last decade there has been a paradigm shift in the management of breast cancer, subsequent to revised surgical oncology guidelines and consensus statements which were derived in light of landmark breast cancer clinical trials conducted throughout the latter part of the 20th century. However the sheer impact of this paradigm shift upon all modalities of treatment, and the current trends in management of the disease, are largely unknown. We aimed to assess the changing practices of breast cancer management over the last decade within a specialist tertiary referral Breast Cancer Centre. METHODS: Comparative analysis of all aspects of the management of breast cancer patients, who presented to a tertiary referral Breast Cancer Centre in 1995\\/1996 and 2005\\/2006, was undertaken and measured against The European Society for Surgical Oncology guidelines for the surgical management of mammographically detected lesions [1998]. RESULTS: 613 patients\\' case profiles were analysed. Over the last decade we observed a dramatic increase in incidence of breast cancer [>100%], a move to less invasive diagnostic and surgical therapeutic techniques, as well as increased use of adjuvant therapies. We also witnessed the introduction of immediate breast reconstruction as part of routine practice CONCLUSION: We demonstrate that radical changes have occurred in the management of breast cancer in the last decade, in keeping with international guidelines. It remains incumbent upon us to continue to adapt our practice patterns in light of emerging knowledge and best evidence.

  19. Regulatory advocacy hit in NARUC probe of EEI funds

    Energy Technology Data Exchange (ETDEWEB)

    Utroska, D.


    The Edison Electric Institute (EEI) now estimates that it spends 20% of its expenses on legislative and 15% on regulatory lobbying. The National Association of Regulatory Utility Commissioners had challenged EEI's earlier estimate of 14% spent on lobbying. This means that 35% of EEI expenses must be borne by shareholders, and cannot be charged to Ratepayers. EEI argues that regulatory advocacy should not be disallowed because these activities differ from lobbying, but NARUC officials disagree.

  20. Celebrity advocacy and public engagement: the divergent uses of celebrity


    Markham, Tim


    This article sounds a cautionary note about the instrumental use of celebrity advocacy to (re)engage audiences in public life. It begins by setting out the steps necessary to achieve public recognition of a social problem requiring a response. It then presents empirical evidence which suggests that those most interested in celebrity, while also paying attention to the main stories of the day, are also least likely to participate in any form of politics. However, this does not rule out the pos...

  1. Navy Family Advocacy Program. Appendix. Analysis of Central Registry Reports. (United States)


    2/76) 2 Suspected Abuzso/Malect/Sexua1 Assault an ae2404 65.) "Suspected Abuso /Neglect/ Sexual Assault and Rape Report" 2226 60.5 NAVMED 6320/15A...ANALYSIS OF SEXUAL ASSAULT REPORTS ........... 50 HAPTER V: SUMAY ANALYSIS Or rAMILY ADVOCACY PROGRAM REPORTS . 56 APPENDIX...cont’d)I PAGE CHAPTER IV: SEXUAL ASSAULT TV-1 Fore . . . . . . . . . . . . . . . . . . . . . 51 IV-2 Type of Maltreatment ............... 53 IV-3

  2. Gene expression, molecular class changes and pathway analysis after neoadjuvant systemic therapy for breast cancer (United States)

    Gonzalez-Angulo, Ana M.; Iwamoto, Takayuki; Liu, Shuying; Chen, Huiqin; Do, Kim-Anh; Hortobagyi, Gabriel N.; Mills, Gordon B.; Meric-Bernstam, Funda; Symmans, W. Fraser; Pusztai, Lajos


    Purpose To examine gene expression differences between pre- and post-NST specimens of breast cancers and identify biological changers that may lead to new therapeutic insights. Methods Gene expression data from pre-chemotherapy fine needle aspiration specimens were compared to resected residual cancers in 21 patients after 4-6 months of NST. We removed stroma-associated genes to minimize confounding effects. PAM50 was used to assign molecular class. Paired t-test and gene set analysis were used to identify differentially expressed genes and pathways. Results The ER and HER2 status based on mRNA expression remained stable in all but two cases and there were no changes in proliferation metrics (Ki67 and PCNA expression). Molecular class changed in 8 cases (33.3%) usually to normal-like class and which was associated with low residual cancer cell cellularity. The expression of 200-600 probe sets changed between baseline and post-NST samples. In basal-like cancers, pathways driven by increased expression of PI3K, small G proteins and CAMK2 and energy metabolism were enriched while immune cell-derived and the sonic hedgehog pathways were depleted in residual cancer. In non-basal-like breast cancers, notch signaling and energy metabolism (e.g. fatty acid synthesis) were enriched and sonic hedgehog signaling and immune-related pathways were depleted in residual cancer. There was no increase in epithelial mesenchymal transition or cancer stem cell signatures. Conclusions Our data indicates that energy metabolism related processes are up-regulated and immune related signals are depleted in residual cancers. Targeting these biological processes may represent promising adjuvant treatment strategies for patients with residual cancer. PMID:22235097

  3. Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study. (United States)

    Emaus, Marleen J; van Gils, Carla H; Bakker, Marije F; Bisschop, Charlotte N Steins; Monninkhof, Evelyn M; Bueno-de-Mesquita, H B; Travier, Noémie; Berentzen, Tina Landsvig; Overvad, Kim; Tjønneland, Anne; Romieu, Isabelle; Rinaldi, Sabina; Chajes, Veronique; Gunter, Marc J; Clavel-Chapelon, Françoise; Fagherazzi, Guy; Mesrine, Sylvie; Chang-Claude, Jenny; Kaaks, Rudolf; Boeing, Heiner; Aleksandrova, Krasimira; Trichopoulou, Antonia; Naska, Androniki; Orfanos, Philippos; Palli, Domenico; Agnoli, Claudia; Tumino, Rosario; Vineis, Paolo; Mattiello, Amalia; Braaten, Tonje; Borch, Kristin Benjaminsen; Lund, Eiliv; Menéndez, Virginia; Sánchez, María-José; Navarro, Carmen; Barricarte, Aurelio; Amiano, Pilar; Sund, Malin; Andersson, Anne; Borgquist, Signe; Olsson, Asa; Khaw, Kay-Tee; Wareham, Nick; Travis, Ruth C; Riboli, Elio; Peeters, Petra H M; May, Anne M


    Long-term weight gain (i.e., weight gain since age 20) has been related to higher risk of postmenopausal breast cancer, but a lower risk of premenopausal breast cancer. The effect of weight change in middle adulthood is unclear. We investigated the association between weight change in middle adulthood (i.e., women aged 40-50 years) and the risk of breast cancer before and after the age of 50. We included female participants of the European Prospective Investigation into Cancer and Nutrition cohort, with information on anthropometric measures at recruitment and after a median follow-up of 4.3 years. Annual weight change was categorized using quintiles taking quintile 2 and 3 as the reference category (-0.44 to 0.36 kg/year). Multivariable Cox proportional hazards regression analysis was used to examine the association. 205,723 women were included and 4,663 incident breast cancer cases were diagnosed during a median follow-up of 7.5 years (from second weight assessment onward). High weight gain (Q5: 0.83-4.98 kg/year) was related to a slightly, but significantly higher breast cancer risk (HRQ5_versus_Q2/3 : 1.09, 95% CI: 1.01-1.18). The association was more pronounced for breast cancer diagnosed before or at age 50 (HRQ5_versus_Q2/3 : 1.37, 95% CI: 1.02-1.85). Weight loss was not associated with breast cancer risk. There was no evidence for heterogeneity by hormone receptor status. In conclusion, high weight gain in middle adulthood increases the risk of breast cancer. The association seems to be more pronounced for breast cancer diagnosed before or at age 50. Our results illustrate the importance of avoiding weight gain in middle adulthood. © 2014 UICC.

  4. Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. (United States)

    Gershenwald, Jeffrey E; Scolyer, Richard A; Hess, Kenneth R; Sondak, Vernon K; Long, Georgina V; Ross, Merrick I; Lazar, Alexander J; Faries, Mark B; Kirkwood, John M; McArthur, Grant A; Haydu, Lauren E; Eggermont, Alexander M M; Flaherty, Keith T; Balch, Charles M; Thompson, John F


    Answer questions and earn CME/CNE To update the melanoma staging system of the American Joint Committee on Cancer (AJCC) a large database was assembled comprising >46,000 patients from 10 centers worldwide with stages I, II, and III melanoma diagnosed since 1998. Based on analyses of this new database, the existing seventh edition AJCC stage IV database, and contemporary clinical trial data, the AJCC Melanoma Expert Panel introduced several important changes to the Tumor, Nodes, Metastasis (TNM) classification and stage grouping criteria. Key changes in the eighth edition AJCC Cancer Staging Manual include: 1) tumor thickness measurements to be recorded to the nearest 0.1 mm, not 0.01 mm; 2) definitions of T1a and T1b are revised (T1a, melanoma staging system will guide patient treatment, provide better prognostic estimates, and refine stratification of patients entering clinical trials. CA Cancer J Clin 2017;67:472-492. © 2017 American Cancer Society. © 2017 American Cancer Society.

  5. Salt reduction in Australia: from advocacy to action. (United States)

    Webster, Jacqui; Trieu, Kathy; Dunford, Elizabeth; Nowson, Caryl; Jolly, Kellie-Ann; Greenland, Rohan; Reimers, Jenny; Bolam, Bruce


    As part of its endorsement of the World Health Organization's Global Action Plan to prevent non-communicable diseases, the Federal Government of Australia has committed to a 30% reduction in average population salt intake by 2025. Currently, mean daily salt intake levels are 8-9 g, varying by sex, region and population group. A number of salt reduction initiatives have been established over the last decade, but key elements for a co-ordinated population-level strategy are still missing. The objective of this review is to provide a comprehensive overview of existing population-level salt reduction activities in Australia and identify opportunities for further action. A review of the published literature and stakeholder activities was undertaken to identify and document current activities. The activities were then assessed against a pre-defined framework for salt reduction strategies. A range of initiatives were identified from the review. The Australian Division of World Action on Salt and Health (AWASH) was established in 2005 and in 2007 launched its Drop the Salt! Campaign. This united non-governmental organisations (NGOs), health and medical and food industry organisations in a co-ordinated advocacy effort to encourage government to develop a national strategy to reduce salt. Subsequently, in 2010 the Federal Government launched its Food and Health Dialogue (FHD) with a remit to improve the health of the food supply in Australia through voluntary partnerships with food industry, government and non-government public health organisations. The focus of the FHD to date has been on voluntary reformulation of foods, primarily through salt reduction targets. More recently, in December 2014, the government's Health Star Rating system was launched. This front of pack labelling scheme uses stars to highlight the nutritional profile of packaged foods. Both government initiatives have clear targets or criteria for industry to meet, however, both are voluntary and the extent

  6. Gambling advocacy: lessons from tobacco, alcohol and junk food. (United States)

    Thomas, Samantha L; David, Jennifer; Randle, Melanie; Daube, Mike; Senior, Kate


    To explore the attitudes and opinions of public health experts in gambling and related unhealthy commodity industries towards the tactics used by the gambling industry to prevent reform and the advocacy responses to these tactics. In-depth interviews (30-60 minutes) with a convenience sample of 15 public health experts and stakeholders with a public health approach to gambling (n=10), or other unhealthy commodity industries (food, alcohol, tobacco, n=5). Participants described the influences of political lobbying and donations on public policy, and industry framing of problem gambling as an issue of personal responsibility. Industry funding of, and influence over, academic research was considered to be one of the most effective industry tactics to resist reform. Participants felt there was a need to build stronger coalitions and collaborations between independent academics, and to improve the utilisation of media to more effectively shift perceptions of gambling harm away from the individual and towards the product. Gambling industry tactics are similar to the tactics of other unhealthy commodity industries. However, advocacy initiatives to counter these tactics in gambling are less developed than in other areas. The formation of national public health coalitions, as well as a strong evidence base regarding industry tactics, will help to strengthen advocacy initiatives. © 2015 Public Health Association of Australia.

  7. Advocacy coalitions and wind power development: Insights from Quebec

    Energy Technology Data Exchange (ETDEWEB)

    Jegen, Maya, E-mail: [Departement de science politique, Universite du Quebec a Montreal, Case postale 8888, Montreal, QC, H3C 3P8 (Canada); Audet, Gabriel [Departement de science politique, Universite du Quebec a Montreal, Case postale 8888, Montreal, QC, H3C 3P8 (Canada)


    This article addresses the issue of wind energy acceptance in the Canadian province of Quebec and, in particular, the impact of different models of wind power development on the degree of social acceptance. We show that the dominant advocacy coalition, which favors a hard path energy development in general, enforces a large-scale development of wind energy. Two other coalitions - a soft path coalition and a nationalist coalition - oppose this development, but not wind energy per se. We argue that difference in belief systems explains their opposition rather than planning issues or NIMBY concerns. We also contend that, despite its predominance over (wind) energy policy, the hard path coalition is willing to learn and make concessions towards the soft path coalition, but not towards the nationalist coalition. - Highlights: > We address social acceptance of wind energy. > We illustrate the interaction of advocacy coalitions. > Different advocacy coalitions support different models of wind energy development. > Models of wind energy development influence the degree of social acceptance. > Opposition is not aimed at wind energy per se, but at the hard path model.

  8. Height, weight, weight change and risk of breast cancer in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Anelise Bezerra de Vasconcelos

    Full Text Available CONTEXT: The relationship between body size and breast cancer still remains controversial in considering menopausal status. OBJECTIVE: To evaluate the association of height, weight and weight changes with breast cancer in the city of Rio de Janeiro, Brazil. DESIGN: Case-control study. SETTING: National Cancer Institute (INCA, Rio de Janeiro, Brazil, and State University of Rio de Janeiro (UERJ. SAMPLE: 177 incident cases of invasive breast cancer admitted to the main hospital of INCA between May 1995 and February 1996, and 377 controls recruited from among female visitors to the same hospital. MAIN MEASUREMENTS: Height and weight were measured and information on maximum weight, weight at ages 18 and 30 years, and potential risk factors were ascertained by interview at the hospital. RESULTS: Height was not related to risk of breast cancer among both pre and postmenopausal women. Nevertheless, women in this study were shorter than in studies that have found a positive association. Premenopausal women in the upper quartile of recent body mass index (BMI and maximum BMI showed a reduced risk of breast cancer (P for trend <= 0.03. Weight loss between ages 18 and 30 years and from 18 years to present was also associated with breast cancer among premenopausal women. CONCLUSIONS: These findings may merely indicate the known association between leanness and breast cancer. Further studies should explore the role of weight loss on breast cancer risk.

  9. A medical student leadership course led to teamwork, advocacy, and mindfulness. (United States)

    Warde, Carole M; Vermillion, Michelle; Uijtdehaage, Sebastian


    Many medical trainees seek work among underserved communities but may be unprepared to cope with the challenges. Relationship-centered qualities have been shown to promote physician resilience and prevent burnout. The UCLA-PRIME program aims to prepare medical students to work among vulnerable groups and begins with a 3-week leadership course. We describe this course and share lessons with those seeking to foster leadership, advocacy, and resiliency in our future physician workforce. Twenty students participated in our curriculum that emphasized five competencies: leadership, advocacy, teamwork, mindfulness, and self-care. Course activities complemented the students' work as they developed a community outreach project. They assessed and reflected on their leadership, relationship, and team behaviors, were coached to improve these, learned mindfulness meditation, and participated in community forums. Our evaluation assessed course quality, project completion, leadership, mindfulness, and team relational coordination. Students were very satisfied with all aspects of the course. They designed a medical student elective addressing the health challenges of an incarcerated and formerly incarcerated population. While we found no change in leadership practices scores, students had high team relational coordination scores and improved mindfulness scores upon course completion. Our course to develop medical students as resilient leaders, team members, and advocates for medically underserved groups consisted of a community-based service project, coupled with a facilitated relationship-centered curriculum. It promoted qualities in students that characterize effective and resilient physician leaders; they were more mindful, related to each other effectively, and coordinated their activities well with one another.

  10. Can Diabetes Change the Intrinsic Subtype Specificity of Breast Cancer? (United States)


    whether Luminal type A breast cancer cell line MCF-7 implanted into nude mice with experimentally induced type I diabetes (no Insulin but hyperglycemia ...or type II diabetes (elevated serum Insulin and hyperglycemia ) progress to become Luminal type B or any other intrinsic subtype. Progress on in...GATA-3. As the expression of some of the above factors are controlled by insulin , the objective of this study was to investigate the ability of insulin

  11. The changing natural history of metastatic prostate cancer. (United States)

    Alva, Ajjai; Hussain, Maha


    Since 1941, the understanding of prostate cancer pathogenesis and therapy has undergone a significant transformation. Rigorous translational research has identified multiple mechanisms underlying castration resistance, the fatal clinical state of the disease. Therapeutic approaches targeting these mechanisms in metastatic castration-resistant prostate cancer have now been clinically validated in the clinic including high-potency androgen signaling inhibition, novel cytotoxic chemotherapy, and bone-targeted therapies. Despite these advances, cure remains an elusive goal. The natural history of metastatic prostate cancer has evolved particularly in the last 2 decades in step with improved management of age-associated comorbidities, improved imaging, and the expansion of novel therapies, thus providing new opportunities and challenges. It is also important to note that the advent of prostate-specific antigen testing caused a stage shift in the disease spectrum, thus leading to earlier interventions and potentially positively impacting survival. The optimal sequencing and combinations of available therapies, predictive biomarkers, and better understanding of mechanisms of resistance remain high priority. Further refinement of the clinical niche for novel therapies in hormone-sensitive and castration-resistant disease through rationally designed clinical trials incorporating molecular, clinical, and imaging biomarkers and quality-of-life correlatives is of paramount importance.

  12. A changing landscape in castration resistant prostate cancer treatment

    Directory of Open Access Journals (Sweden)

    Alessandra eFelici


    Full Text Available Prostate cancer (PC is the leading cause of cancer and the second leading cause of cancer-death among men in the Western world. About 10%-20% of men with PC present with metastatic disease at diagnosis, while 20%-30% of patients diagnosed with localized disease will eventually develop metastases. Although most respond to initial androgen deprivation therapy (ADT, progression to castration resistant PC (CRPC is universal. In 2004 the docetaxel/prednisone regimen was approved for the management of patients with metastatic CRPC, becoming the standard first-line therapy. Recent advances have now led to an unprecedented number of new drug approvals within the past years, providing many new treatment options for patients with metastatic CRPC. Four new drugs have received U.S. Food and Drug Administration (FDA-approval in 2010 and 2011: sipuleucel-T, an immunotherapeutic agent; cabazitaxel, a novel microtubule inhibitor; abiraterone acetate, a new androgen biosynthesis inhibitor; and denosumab, a bone-targeting agent. The data supporting the approval of each of these agents are described in this review, as are current approaches in the treatment of metastatic CRPC and ongoing clinical trials of novel treatments and strategies.

  13. Age-related changes in mammographic density and breast cancer risk. (United States)

    Lokate, Mariëtte; Stellato, Rebecca K; Veldhuis, Wouter B; Peeters, Petra H M; van Gils, Carla H


    High mammographic density is a strong breast cancer risk factor. Density normally declines with aging. We investigated whether the level of decline in mammographic density is related to breast cancer risk using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Prospect cohort. This cohort was recruited among participants of a population-based breast cancer screening program in the Netherlands between 1993 and 1997. We examined whether age-related changes in mammographic density were different for 533 cases and 1,367 controls who were 49-69 years of age at the time of recruitment into the cohort. We used mixed models with linear and quadratic terms for age and interaction terms between age terms and case status. The percent mammographic density at the first available mammogram was higher for cases than for controls (25.2% vs. 22.5%) (P = 0.003). The average decline in density over 10 years was 11% in both cases and controls (P = 0.56). When studying changes among 4 categories of density, we saw some indication that large changes may influence breast cancer risk. Although no difference was seen in the average decline, we cannot exclude that large changes may influence breast cancer risk.

  14. Changing patterns of microcalcification on screening mammography for prediction of breast cancer. (United States)

    Kim, Kwan Il; Lee, Kyung Hee; Kim, Tae Ryung; Chun, Yong Soon; Lee, Tae Hoon; Choi, Hye Young; Park, Heung Kyu


    The presence of microcalcification on mammography is one of the earliest signs in breast cancer detection. However, it is difficult to distinguish malignant calcifications from benign calcifications. The aim of this study is to evaluate correlation between changing patterns of microcalcification on screening mammography and malignant breast lesions. Medical records and diagnostic images of 67 women who had previously undergone at least two digital mammograms at least 6 months apart and underwent mammography-guided needle localization and surgical excision between 2011 and 2013 were retrospectively reviewed and analyzed. Breast cancer was detected in the surgical specimens of 20 patients (29.9 %). Annual change of extent of microcalcification on mammography showed statistically significant correlation with pathologic outcome (P = 0.023). The changing pattern of new appearance or increased extent of microcalcification on mammography had positive predictive value of 54.8 % for breast cancer, and it was a statistically significant predictor for breast cancer (P = 0.012). Shape or number change of microcalcification without increased extent had less accurate predictive value for breast cancer, particularly in women younger than 50 years (P microcalcification on screening mammography was a significant predictor for breast cancer. We suggest that mammography-guided needle localization and surgical excision should be considered when increased extent of microcalcification is observed on screening mammography and closed follow-up without pathologic confirmation can be permitted if absence of extension of microcalcification was confirmed in women younger than 50 years.

  15. Inherited cancer predisposition sensitizes colonic mucosa to address Western diet effects and putative cancer-predisposing changes on mouse proteome. (United States)

    Đermadi, Denis; Valo, Satu; Pussila, Marjaana; Reyhani, Nima; Sarantaus, Laura; Lalowski, Maciej; Baumann, Marc; Nyström, Minna


    Human epidemiological evidence and previous studies on mice have shown that Western-style diet (WD) may predispose gut mucosa to colorectal cancer (CRC). The mechanisms that mediate the effects of diet on tumorigenesis are largely unknown. To address putative cancer-predisposing events available for early detection, we quantitatively analyzed the proteome of histologically normal colon of a wild-type (Mlh1(+/+)) and an Mlh1(+/-) mouse after a long-term feeding experiment with WD and AIN-93G control diet. The Mlh1(+/-) mouse carries susceptibility to colon cancer analogous to a human CRC syndrome (Lynch syndrome). Remarkably, WD induced expression changes reflecting metabolic disturbances especially in the cancer-predisposed colon, while similar changes were not significant in the wild-type proteome. Overall, the detected changes constitute a complex interaction network of proteins involved in ATP synthesis coupled proton transport, oxidoreduction coenzyme and nicotinamide nucleotide metabolic processes, important in cell protection against reactive oxygen species toxicity. Of these proteins, selenium binding protein 1 and galectin-4, which directly interact with MutL homolog 1, are underlined in neoplastic processes, suggesting that sensitivity to WD is increased by an Mlh1 mutation. The significance of WD on CRC risk is highlighted by the fact that five out of six mice with neoplasias were fed with WD. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Organizational Change: A Case Study in Implementing a Breast Cancer Screening Clinic (United States)



  17. "What Made Me Unhappy". Experiences of, and Responses to, Lifestyle Changes in Breast Cancer Patients (United States)

    Bitsika, Vicki; Sharpley, Christopher F.; Christie, David R. H.


    Sixteen breast cancer patients were interviewed about any lifestyle changes they had experienced and their reactions to those changes. Data were collected and analysed via content analysis and then summary tabulations of patient responses until replication of responses was verified across patients. Results indicated that most patients suffered a…

  18. Association between changes in fat distribution and biomarkers for breast cancer

    NARCIS (Netherlands)

    van Gemert, Willemijn A.M.; Monninkhof, Evelyn M.; May, Anne M.; Elias, Sjoerd G.; Van Der Palen, Job; Veldhuis, Wouter B.; Stapper, Maaike; Stellato, Rebecca K.; Schuit, Jantine A.; Peeters, Petra H.


    We assessed the associations between changes in total and abdominal fat and changes in biomarkers for breast cancer risk using data of the SHAPE-2 trial. In the SHAPE-2 trial, 243 postmenopausal overweight women were included. The intervention in this trial consisted of 5-6 kg weight loss either by

  19. Association between changes in fat distribution and biomarkers for breast cancer

    NARCIS (Netherlands)

    van Gemert, Willemijn A; Monninkhof, Evelyn M; May, Anne M; Elias, Sjoerd G; van der Palen, Job; Veldhuis, Wouter; Stapper, Maaike; Stellato, Rebecca K; Schuit, A.J.; Peeters, Petra H

    We assessed the associations between changes in total and abdominal fat and changes in biomarkers for breast cancer risk using data of the SHAPE-2 trial. In the SHAPE-2 trial, 243 postmenopausal overweight women were included. The intervention in this trial consisted of 5-6 kg weight loss either by

  20. Dietary changes and food intake in the first year after breast cancer treatment. (United States)

    Vance, Vivienne; Campbell, Sharon; McCargar, Linda; Mourtzakis, Marina; Hanning, Rhona


    Understanding dietary habits of women after breast cancer is a critical first step in developing nutrition guidelines that will support weight management and optimal health in survivorship; however, limited data are available. The objective of this study was to describe changes in diet among breast cancer survivors in the first year after treatment, and to evaluate these changes in the context of current dietary intake. Changes in diet were assessed in 28 early stage breast cancer survivors, using a self-reported survey in which women identified changes in food intake since their diagnosis. Current dietary intake was estimated from 3-day food records and described relative to current recommendations. The majority of women reported changes in diet after diagnosis, most common being an increase in vegetables/fruit and fish, lower intake of red meat, and reduced alcohol. Many women reported that these changes were initiated during active treatment. Dietary changes were largely consistent with current recommendations for cancer prevention; however, some women were still above the guidelines for total and saturated fat, and many were below recommendations for vegetables/fruit, milk/alternatives, calcium, and vitamin D. Evidence that some women are willing and able to initiate positive changes in diet early in the treatment trajectory suggests that early intervention may be effective in promoting dietary habits that will assist with weight management and overall health. Data on current dietary intake highlights several possible targets for dietary intervention in this population.

  1. Changes in the use and costs of diagnostic imaging among Medicare beneficiaries with cancer, 1999-2006. (United States)

    Dinan, Michaela A; Curtis, Lesley H; Hammill, Bradley G; Patz, Edward F; Abernethy, Amy P; Shea, Alisa M; Schulman, Kevin A


    Emerging technologies, changing diagnostic and treatment patterns, and changes in Medicare reimbursement are contributing to increasing use of imaging in cancer. Imaging is the fastest growing expense for Medicare but has not been examined among beneficiaries with cancer. To examine changes in the use of imaging and how those changes contribute to the overall cost of cancer care. Analysis of a nationally representative 5% sample of claims from the US Centers for Medicare & Medicaid Services from 1999 through 2008. Patients were Medicare beneficiaries with incident breast cancer, colorectal cancer, leukemia, lung cancer, non-Hodgkin lymphoma, or prostate cancer. Use and cost of imaging by modality, year, and cancer type. There were 100,954 incident cases of breast cancer, colorectal cancer, leukemia, lung cancer, non-Hodgkin lymphoma, and prostate cancer from 1999 through 2006. Significant mean annual increases in imaging use occurred among all cancer types for positron emission tomography (35.9%-53.6%), bone density studies (6.3%-20.0%), echocardiograms (5.0%-7.8%), magnetic resonance imaging (4.4%-11.5%), and ultrasound (0.7%-7.4%). Conventional radiograph rates decreased or stayed the same. As of 2006, beneficiaries with lung cancer and beneficiaries with lymphoma incurred the largest overall imaging costs, exceeding a mean of $3000 per beneficiary within 2 years of diagnosis. By 2005, one-third of beneficiaries with breast cancer underwent bone scans and half of beneficiaries with lung cancer or lymphoma underwent positron emission tomography scans. Mean 2-year imaging costs per beneficiary increased at a rate greater than the increase in mean total costs per beneficiary for all cancer types. Imaging costs among Medicare beneficiaries with cancer increased from 1999 through 2006, outpacing the rate of increase in total costs among Medicare beneficiaries with cancer.

  2. Combining polarimetry and spectropolarimetry techniques in diagnostics of cancer changes in biological tissues (United States)

    Yermolenko, Sergey; Ivashko, Pavlo; Gruia, Ion; Gruia, Maria; Peresunko, Olexander; Zelinska, Natalia; Voloshynskyi, Dmytro; Fedoruk, Olexander; Zimnyakov, Dmitry; Alonova, Marina


    The aim of the study is combining polarimetry and spectropolarimetry techniques for identifying the changes of opticalgeometrical structure in different kinds of biotissues with solid tumours. It is researched that a linear dichroism appears in biotissues (human esophagus, muscle tissue of rats, human prostate tissue, cervical smear) with cancer diseases, magnitude of which depends on the type of the tissue and on the time of cancer process development.

  3. [Changes in serum protease and cytokine in patients with silicosis, tuberculosis, and lung cancer]. (United States)

    Miao, Rongming; Ding, Bangmei; You, Dehong; You, Qingjun; Zhang, Yingyi; Fang, Zhonghua; Gao, Feng; Qian, Guiliang; Cao, Rong; Xia, Qian; Li, Yong


    To investigate the changes in serum protease and cytokine in patients with silicosis, tuberculosis, and lung cancer. Serum samples of patients with silicosis, tuberculosis, and lung cancer were collected. The variation trends of the expression of granzyme A, cathepsin G, apolipoprotein A, and interferon-β (IFN-β) were analyzed using enzyme-linked immunosorbent assay. The concentration of apolipoprotein A of the silicosis group was 200 µg/ml, significantly higher than those of the tuberculosis and lung cancer groups (P silicosis group had significantly higher expression of cathepsin G compared with the tuberculosis and lung cancer groups (P 0.05). The tuberculosis group had a significantly higher concentration of granzyme A than the silicosis and lung cancer groups (P silicosis group and lung cancer group had similar protein concentration trends (P > 0.05). The tuberculosis group and lung cancer group had significantly higher concentration of IFN-β compared with the silicosis group (P 0.05). This study may offer diagnostic markers for the clinical diagnosis of silicosis, tuberculosis, and lung cancer, and could provide a basis for the research, as well as potential molecular targets for the diagnosis and treatment of these diseases.

  4. Loss, uncertainty, or acceptance: subjective experience of changes to fertility after breast cancer. (United States)

    Perz, J; Ussher, J; Gilbert, E


    This qualitative study examines the subjective experience of infertility in a large sample of Australian women with breast cancer. Participants were 1830 women, average age 54, who responded to an email invitation to complete an online survey on sexual well-being and fertility concerns after breast cancer. 24.6% (n = 452) reported that cancer had affected their fertility; 21.3% (n = 391) did not know their fertility status. In thematic analysis of open-ended responses provided by 381 women about changes to fertility status, reactions to infertility, and experiences of information and interventions to assist fertility, five themes were identified: 'Negative responses to infertility and early menopause'; 'Sexual changes associated with menopause and infertility'; 'Uncertainty and anxiety about fertility status'; 'Information and fertility preservation'; 'Acceptance of the end of fertility'. These findings confirm previous reports that infertility and premature menopause are a significant cause of anxiety for many women with breast cancer. However, some women closer to natural menopause, or who had completed their families, reported acceptance of changed fertility status. Accounts of deficits in information provision and fertility counselling suggest an urgent need for accessible and comprehensive information about fertility and cancer to be developed and evaluated, as well as education and training of health professionals in addressing fertility concerns following cancer. © 2013 John Wiley & Sons Ltd.

  5. Social Justice and Advocacy for Transgender and Gender-Diverse Clients. (United States)

    Dickey, Lore M; Singh, Anneliese A


    This article explores the role of mental health providers and advocacy for transgender people. It begins with a history of the mental health provider's relationship with transgender and gender-diverse people. The article explores the ways that major mental health professional organizations have called for providers to serve in advocacy roles. The article ends with recommendations about how to serve in an advocacy role. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Changes in Susceptibility to Oncolytic Vesicular Stomatitis Virus during Progression of Prostate Cancer. (United States)

    Yu, Nanmeng; Puckett, Shelby; Antinozzi, Peter A; Cramer, Scott D; Lyles, Douglas S


    A major challenge to oncolytic virus therapy is that individual cancers vary in their sensitivity to oncolytic viruses, even when these cancers arise from the same tissue type. Variability in response may arise due to differences in the initial genetic lesions leading to cancer development. Alternatively, susceptibility to viral oncolysis may change during cancer progression. These hypotheses were tested using cells from a transgenic mouse model of prostate cancer infected with vesicular stomatitis virus (VSV). Primary cultures from murine cancers derived from prostate-specific Pten deletion contained a mixture of cells that were susceptible and resistant to VSV. Castration-resistant cancers contained a higher percentage of susceptible cells than cancers from noncastrated mice. These results indicate both susceptible and resistant cells can evolve within the same tumor. The role of Pten deletion was further investigated using clonal populations of murine prostate epithelial (MPE) progenitor cells and tumor-derived Pten(-/-) cells. Deletion of Pten in MPE progenitor cells using a lentivirus vector resulted in cells that responded poorly to interferon and were susceptible to VSV infection. In contrast, tumor-derived Pten(-/-) cells expressed higher levels of the antiviral transcription factor STAT1, activated STAT1 in response to VSV, and were resistant to VSV infection. These results suggest that early in tumor development following Pten deletion, cells are primarily sensitive to VSV, but subsequent evolution in tumors leads to development of cells that are resistant to VSV infection. Further evolution in castration-resistant tumors leads to tumors in which cells are primarily sensitive to VSV. There has been a great deal of progress in the development of replication-competent viruses that kill cancer cells (oncolytic viruses). However, a major problem is that individual cancers vary in their sensitivity to oncolytic viruses, even when these cancers arise from the

  7. Electronic game: A key effective technology to promote behavioral change in cancer patients

    Directory of Open Access Journals (Sweden)

    Reza Safdari


    Full Text Available Cancer diagnosis is a very unpleasant and unbelievable experience. Appropriate management and treatment of these diseases require a high degree of patient engagement. Interactive health electronic games are engaging, fun, challenging, and experiential and have the potential to change the attitude and behavior, which can improve the player's health. The use of these digital tools, as one of the most attractive and entertaining modern technologies, canem power patients, provide suitable palliative care, promote health behavior change strategies, increase patient engagement, enhance healthy lifestyle habits, improve, and finally improve the quality of life of the patients. Finally, the aim of this article was to describe electronic games and their effects on the promotion of behavior change in cancer patients. In addition, this article describes categories, characteristic features, and benefits of this digital media in the lifestyle modification of cancer patients.

  8. Advocacy Priorities and Strategies for ASAHP: A Survey of the ASAHP Membership. (United States)

    Fry, Donna; Demo, David H; Devine, Nancy; Butler, Andrew; Saladin, Lisa


    The Association of Schools of Allied Health Professions (ASAHP) recently established a strategic goal to increase advocacy efforts. The purpose of this study was to identify advocacy priorities and preferred advocacy strategies among the ASAHP membership. A brief Advocacy Priorities and Strategies Survey was sent to 234 ASAHP members included in the ASAHP email list using an online survey software. Forty-eight members (20%) completed the survey. Data were analyzed using the online survey software and response frequency counts. ASAHP members identified the following federal advocacy priorities: 1) support for students entering allied health professions, 2) support for faculty seeking higher degrees to enhance quality of education in allied health programs, 3) support for higher education institutions to increase capacity of professional programs to address projected allied health workforce needs identified by the Bureau of Labor Statistics, and 4) support for research funding from federal agencies for allied health. The need for education regarding allied health professions to enhance advocacy efforts was also reported. Preferred advocacy strategies included scheduling ASAHP conferences in Washington, DC, to facilitate trips to Capitol Hill and visiting legislators in home states. Members also indicated a need to participate in advocacy training to enhance their advocacy skills.

  9. A qualitative analysis of faculty advocacy on LGBT issues on campus. (United States)

    Messinger, Lori


    Faculty activism is an integral part of shared governance in higher education institutions, yet little is known about the dynamics that underlie this activism. Using oral history interviews with 30 faculty members working to secure lesbian, gay, bisexual, and transgender (LGBT)-supportive policies on their respective campuses, this article identifies reasons the faculty members became involved in this advocacy, types of advocacy in which they engaged, factors associated with engaging in advocacy, and challenges facing these faculty advocates. Specific dynamics facing LGBT faculty are discussed, and predictions are made for the future of faculty advocacy on LGBT campus policy issues.

  10. Advocacy and Public Policy Perceptions and Involvement of Master Certified Health Education Specialists. (United States)

    Kerr, Dianne L; Van Wasshenova, Emily; Mahas, Rachel; Everhart, F Jeannine; Thompson, Amy; Boardley, Debra


    Master Certified Health Education Specialists (MCHES; n = 186) participated in a mail survey on advocacy and public policy. Over half of participants reported that they had contacted a public official or provided policy-related information to consumers or other professionals. Participants identified barriers and benefits to influencing public policy. The greatest benefit was identified as improving the health or welfare of the public while the greatest barrier was that they were busy with other priorities. Participants also described their level of involvement, knowledge, training in advocacy, and their self-efficacy in performing various advocacy activities. Most MCHES reported voting and other basic advocacy functions while far fewer had participated in more advanced advocacy activities. Although nearly 73% had formal training on advocacy and policy, only 26% received it through college coursework. Factors predictive of advocacy and policy involvement were determined through a stepwise regression analysis. Five independent variables predicted the total number of advocacy activities and when combined accounted for nearly 61% of the variance. Government-level health educators' misconception that they cannot participate in advocacy and public policy issues should be dispelled. Health education specialists with the MCHES credential need coursework and additional training on how to effectively influence public health policy.

  11. Changes in siblings after the death of a child from cancer. (United States)

    Foster, Terrah L; Gilmer, Mary Jo; Vannatta, Kathryn; Barrera, Maru; Davies, Betty; Dietrich, Mary S; Fairclough, Diane L; Gerhardt, Cynthia A


    Few studies have examined changes in siblings after the death of a brother or sister, particularly from mother, father, and sibling perspectives within the first year after death. This descriptive study identified and assessed the frequency of changes in siblings after a child's death from cancer. Participants were recruited from cancer registries at 3 hospitals in the United States and Canada 3 to 12 months after the child's death. Thirty-six mothers, 24 fathers, and 39 siblings from 40 families were included. Semistructured interviews using open-ended questions were conducted with each parent and sibling separately in the home. Content analysis identified emerging themes, and the McNemar tests compared frequencies between each paired set of reports (sibling vs mother, sibling vs father, mother vs father). Sixty-nine percent of participants reported personal changes in siblings (eg, changes in personality, school work, goals/life perspective, activities/interests). Forty-seven percent noted changes in siblings' relationships with family members and peers. Only 21% of participants reported no changes attributed to the death. Comparisons of frequencies across informants were not significant. Most siblings experienced changes in multiple areas of their lives after the death of a brother or sister to cancer. Some changes reflected siblings that were positively adapting to the death, whereas other changes reflected difficulties. Our findings offer guidance to improve aftercare for bereaved siblings and their families. Additional research is needed to further delineate the needs of bereaved siblings and to develop strategies to promote adaptation to loss.

  12. Breast cancer in the Arctic - changes over the past decades

    DEFF Research Database (Denmark)

    Fredslund, Stine Overvad; Bonefeld-Jørgensen, Eva Cecilie


    reviewed, especially focusing on the Arctic and the special conditions that exist in this region. Breast cancer incidence is increasing all over the world, including in the Arctic. The enormous transition in health conditions and lifestyle in the Arctic might be contributing to the known risk factors....... In Greenland, the age at menarche has diminished by 3 years during the course of 100 years, and the number of children per women as well as the duration of breastfeeding is decreasing. Obesity and intake of saturated fat is increasing and the intake of traditional food rich in unsaturated fat and vitamin D...... decreasing. Smoking and alcohol consumption in the Arctic has been relatively high but is now decreasing. More focus on genetic susceptibility in relation to BC has identified the specific BRCA1 founder mutation in the Greenlandic population, which might appear to be an important risk factor. However...

  13. Image and pathological changes after microwave ablation of breast cancer: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Wenbin [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Jiang, Yanni [Department of Radiology, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Chen, Lin; Ling, Lijun; Liang, Mengdi; Pan, Hong [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Wang, Siqi [Department of Radiology, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Ding, Qiang [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Liu, Xiaoan, E-mail: [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Wang, Shui, E-mail: [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China)


    Highlights: • We report successful experience of MWA in breast cancer under local anesthesia. • We report MR imaging evaluation of microwave ablation zone in breast cancer. • Pathological changes after microwave ablation in breast cancer was reported. • 2 min MWA caused an ablation zone with three diameters > 2 cm in breast cancer. - Abstract: Purpose: To prospectively assess MR imaging evaluation of the ablation zone and pathological changes after microwave ablation (MWA) in breast cancer. Materials and methods: Twelve enrolled patients, diagnosed with non-operable locally advanced breast cancer (LABC), were treated by MWA and then neoadjuvant chemotherapy, followed by surgery. MR imaging was applied to evaluate the effect of MWA. Hematoxylin-eosin (HE) staining and transmission electron microscopy (TEM) were applied to analyze the ablated area. Results: All MWA procedures were performed successfully under local anesthesia. For a mean duration of 2.15 min, the mean largest, middle and smallest diameters in the ablated zone 24-h post-ablation in MR imaging were 2.98 cm ± 0.53, 2.51 cm ± 0.41 and 2.23 cm ± 0.41, respectively. The general shape of the ablation zone was close to a sphere. The ablated area became gradually smaller in MR imaging. No adverse effects related to MWA were noted in all 12 patients during and after MWA. HE staining could confirm the effect about 3 months after MWA, which was confirmed by TEM. Conclusions: 2 min MWA can cause an ablation zone with three diameters larger than 2 cm in breast cancer, which may be suitable for the local treatment of breast cancer up to 2 cm in largest diameter. However, the long-term effect of MWA in the treatment of small breast cancer should be determined in the future.

  14. Base changes in tumour DNA have the power to reveal the causes and evolution of cancer. (United States)

    Hollstein, M; Alexandrov, L B; Wild, C P; Ardin, M; Zavadil, J


    Next-generation sequencing (NGS) technology has demonstrated that the cancer genomes are peppered with mutations. Although most somatic tumour mutations are unlikely to have any role in the cancer process per se, the spectra of DNA sequence changes in tumour mutation catalogues have the potential to identify the mutagens, and to reveal the mutagenic processes responsible for human cancer. Very recently, a novel approach for data mining of the vast compilations of tumour NGS data succeeded in separating and precisely defining at least 30 distinct patterns of sequence change hidden in mutation databases. At least half of these mutational signatures can be readily assigned to known human carcinogenic exposures or endogenous mechanisms of mutagenesis. A quantum leap in our knowledge of mutagenesis in human cancers has resulted, stimulating a flurry of research activity. We trace here the major findings leading first to the hypothesis that carcinogenic insults leave characteristic imprints on the DNA sequence of tumours, and culminating in empirical evidence from NGS data that well-defined carcinogen mutational signatures are indeed present in tumour genomic DNA from a variety of cancer types. The notion that tumour DNAs can divulge environmental sources of mutation is now a well-accepted fact. This approach to cancer aetiology has also incriminated various endogenous, enzyme-driven processes that increase the somatic mutation load in sporadic cancers. The tasks now confronting the field of molecular epidemiology are to assign mutagenic processes to orphan and newly discovered tumour mutation patterns, and to determine whether avoidable cancer risk factors influence signatures produced by endogenous enzymatic mechanisms. Innovative research with experimental models and exploitation of the geographical heterogeneity in cancer incidence can address these challenges.

  15. Correlation of Smoking-Associated DNA Methylation Changes in Buccal Cells With DNA Methylation Changes in Epithelial Cancer. (United States)

    Teschendorff, Andrew E; Yang, Zhen; Wong, Andrew; Pipinikas, Christodoulos P; Jiao, Yinming; Jones, Allison; Anjum, Shahzia; Hardy, Rebecca; Salvesen, Helga B; Thirlwell, Christina; Janes, Samuel M; Kuh, Diana; Widschwendter, Martin


    The utility of buccal cells as an epithelial source tissue for epigenome-wide association studies (EWASs) remains to be demonstrated. Given the direct exposure of buccal cells to potent carcinogens such as smoke, epigenetic changes in these cells may provide insights into the development of smoke-related cancers. To perform an EWAS in buccal and blood cells to assess the relative effect of smoking on the DNA methylation (DNAme) patterns in these cell types and to test whether these DNAme changes are also seen in epithelial cancer. In 2013, we measured DNAme at more than 480,000 CpG sites in buccal samples provided in 1999 by 790 women (all aged 53 years in 1999) from the United Kingdom Medical Research Council National Survey of Health and Development. This included matched blood samples from 152 women. We constructed a DNAme-based smoking index and tested its sensitivity and specificity to discriminate normal from cancer tissue in more than 5000 samples. CpG sites whose DNAme level correlates with smoking pack-years, and construction of an associated sample-specific smoking index, which measures the mean deviation of DNAme at smoking-associated CpG sites from a normal reference. In a discovery set of 400 women, we identified 1501 smoking-associated CpG sites at a genome-wide significance level of P smoking index constructed from the DNAme changes in buccal cells was able to discriminate normal tissue from cancer tissue with a mean receiver operating characteristic area under the curve of 0.99 (range, 0.99-1.00) for lung cancers and of 0.91 (range, 0.71-1.00) for 13 other organs. The corresponding area under the curve of a smoking signature derived from blood cells was lower than that derived from buccal cells in 14 of 15 cancer types (Wilcoxon signed rank test, P = .001). These data point toward buccal cells as being a more appropriate source of tissue than blood to conduct EWASs for smoking-related epithelial cancers.

  16. Self-advocacy among people with disabilities in the transition from good will to civil rights: Is it sufficient? (United States)

    Palmer, Charles D.


    The burdens associated with eliminating discrimination on the basis of disability have been bestowed upon those individuals in our society with the least experience in defending themselves from social and interpersonal bias. Offering people with disabilities training in civil rights, barrier identification, interpersonal communication, and problem solving skills to enhance and empower self-advocacy have been the primary means of government sponsored human service institutions to generate the desired social change. There is evidence that these actions are less than effective. Overt public commitment and outreach efforts are needed to effectively elicit change from those individuals who are directly responsible for discriminatory actions.

  17. Changes in cancer mortality among HIV-infected patients: the Mortalité 2005 Survey. (United States)

    Bonnet, Fabrice; Burty, Christine; Lewden, Charlotte; Costagliola, Dominique; May, Thierry; Bouteloup, Vincent; Rosenthal, Eric; Jougla, Eric; Cacoub, Patrice; Salmon, Dominique; Chêne, Geneviève; Morlat, Philippe


    The goal of the current study was to describe the distribution and characteristics of malignancy related deaths among human immunodeficiency virus (HIV)-infected patients with use of data obtained from a national survey conducted in France in 2005 and to compare with results obtained from a similar survey conducted in 2000. The underlying cause of death was documented using a standardized questionnaire fulfilled in French hospital wards and networks that were involved in the treatment of HIV-infected patients. Among the 1042 deaths reported in 2005 (964 were reported in 2000), 344 were cancer related (34%), which represented a significant increase from 2000 (29% of deaths were cancer related) (P=.02); 134 of the cancer-related deaths were AIDS related and 210 were not AIDS related. Among the cancer-related causes of death, the proportion of hepatitis-related cancers (6% in 2000 vs. 11% in 2005) and non-AIDS/hepatitis-related cancers (38% in 2000 vs 50% in 2005) significantly increased from 2000 to 2005 (P=.03 and P=.01, respectively), compared with the proportion of cancer that was AIDS related and adjusting for age and sex. Among cases involving AIDS, the proportion of non-Hodgkin lymphoma-associated deaths did not change statistically significantly between 2000 and 2005 (11% and 10% of deaths, respectively). In this study, an increasing proportion of lethal non-AIDS-related cancers was demonstrated from 2000 to 2005; meanwhile, the proportion of lethal AIDS-related cancers remained stable among HIV-infected patients. Thus, cancer prophylaxis, early diagnosis, and improved management should be included in the routine long-term follow-up of HIV-infected patients.

  18. Immuno-oncology: A changing paradigm in cancer therapy

    Directory of Open Access Journals (Sweden)

    Omar Abdel-Rahman


    Full Text Available Immune checkpoint inhibitors are undeniably among the most important advances made in the field of cancer therapy in the past decade[1]. By releasing the immune system brakes that limit the activation of T-cells, they boost self-response against foreign antigens including cancer cells[2]. In the past three years, a number of checkpoint inhibitors have been approved for use in routine clinical settings. Ipilimumab was among the first to be approved for the management of melanoma in both adjuvant and metastatic settings[3-5].Meanwhile, nivolumab and pembrolizumab are two programmed cell death protein 1 (PD-1-targeted monoclonal antibodies that have been approved for the treatment of advanced melanoma and advanced non-small cell lung cancer (NSCLC[6-11]. Moreover, nivolumab has also been approved for previously treated metastatic renal cell carcinoma and previously treated head and neck squamous cell carcinoma[9,12]. In addition to the aforementioned compounds, atezolizumab is a novel anti programmed death-ligand 1 (PD-L1 monoclonal antibody that has shown impressive activity for advanced urothelial carcinoma and previously treated NSCLC[13,14]. A number of other checkpoint inhibitors including avelumab, durvalumab, and tremelimumab are currently undergoing evaluation at different preclinical and clinical phases[15].However, the use of these agents presents a number of challenges to the treating physicians, most notably being the response evaluation criteria, the role of biomarkers, and the detection and management of peculiar toxicities associated with these agents. Given the peculiar response patterns observed with these agents, specific immune-related response evaluation criteria have been suggested and they are now widely used in different clinical settings[16]. Moreover, a number of biomarkers have been proposed as response predictors of these agents, particularly the PD-L1 status in association with anti-PD-L1 treatment[17,18]. Nonetheless

  19. Breast Cancer Treatment: Experiences of Changes and Social Stigma Among Thai Women in Southern Thailand. (United States)

    Suwankhong, Dusanee; Liamputtong, Pranee


    Women with breast cancer receive different forms of treatment. Although treatment can save the lives of women, they can result in adverse physical, psychological, and social effects that can impact the women's quality of life. The objective of this study was to describe the experiences of breast cancer treatment among Thai women in southern Thailand. This study used qualitative methods (in-depth interviewing and drawings) with 20 Thai women who had been diagnosed with breast cancer. Data were analyzed using thematic analysis methods. Three themes emerged: (a) being a breast cancer patient: visible signs and adverse effects of therapy, (b) experiencing emotional chaos, and (c) experiencing social dysfunction. The women had to deal with physical body changes, emotional burden, treatment-related social stigma, and being marginalized within their own social context. Women experienced changes including social stigma after receiving breast cancer treatments. They had to manage stigma and difficulties themselves without sufficient professional support. It is important for nurses to understand such experiences so that they may support appropriate coping strategies suited to each woman. Community health nurses need to view each woman with breast cancer as a unique person and appreciate how to provide appropriate care and support based on each woman's experience with her illness and treatment.

  20. A Research Agenda for Appearance Changes Due to Breast Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Mia K. Markey


    Full Text Available Breast cancer is one of the most prevalent forms of cancer in the US. It is estimated that more than 180,000 American women will be diagnosed with invasive breast cancer in 2008. Fortunately, the survival rate is relatively high and continually increasing due to improved detection techniques and treatment methods. However, maintaining quality of life is a factor often under emphasized for breast cancer survivors. Breast cancer treatments are invasive and can lead to deformation of the breast. Breast reconstruction is important for restoring the survivor’s appearance. However, more work is needed to develop technologies for quantifying surgical outcomes and understanding women’s perceptions of changes in their appearance. A method for objectively measuring breast anatomy is needed in order to help both the breast cancer survivors and their surgeons take expected changes to the survivor’s appearance into account when considering various treatment options. In the future, augmented reality tools could help surgeons reconstruct a survivor’s breasts to match her preferences as much as possible.

  1. Capturing Changes in the Brain Microenvironment during Initial Steps of Breast Cancer Brain Metastasis (United States)

    Lorger, Mihaela; Felding-Habermann, Brunhilde


    Brain metastases are difficult to treat and mostly develop late during progressive metastatic disease. Patients at risk would benefit from the development of prevention and improved treatments. This requires knowledge of the initial events that lead to brain metastasis. The present study reveals cellular events during the initiation of brain metastasis by breast cancer cells and documents the earliest host responses to incoming cancer cells after carotid artery injection in immunodeficient and immunocompetent mouse models. Our findings capture and characterize heterogeneous astrocytic and microglial reactions to the arrest and extravasation of cancer cells in the brain, showing immediate and drastic changes in the brain microenvironment on arrival of individual cancer cells. We identified reactive astrocytes as the most active host cell population that immediately localizes to individual invading tumor cells and continuously associates with growing metastatic lesions. Up-regulation of matrix metalloproteinase-9 associated with astrocyte activation in the immediate vicinity of extravasating cancer cells might support their progression. Early involvement of different host cell types indicates environmental clues that might codetermine whether a single cancer cell progresses to macrometastasis or remains dormant. Thus, information on the initial interplay between brain homing tumor cells and reactive host cells may help develop strategies for prevention and treatment of symptomatic breast cancer brain metastases. PMID:20382702

  2. Advocacy Interventions to Reduce or Eliminate Violence and Promote the Physical and Psychosocial Wellbeing of Women Who Experience Intimate Partner Abuse: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rivas, C


    had considerable clinical heterogeneity in relation to staff delivering advocacy; setting (community, shelter, antenatal, healthcare; advocacy intensity (from 30 minutes to 80 hours; and abuse severity. Three trials evaluated advocacy within multi-component interventions. Eleven measured some form of abuse (eight scales, six assessed quality of life (three scales, and six measured depression (three scales. Countries and ethnic groups varied (one or more minority ethnic groups in the USA or UK, and local populations in Hong Kong and Peru. Setting was associated with intensity and duration of advocacy. Risk of bias was high in five studies, moderate in five, and low in three. The quality of evidence (considering multiple factors such as risk of bias, study size, missing data was moderate to low for brief advocacy and very low for intensive advocacy. Incidence of abuse Physical abuse Moderate quality pooled data from two healthcare studies (moderate risk of bias and one community study (low risk of bias, all with 12-month follow-up data, showed no effect on physical abuse for brief (< 12 hours advocacy interventions (standardised mean difference (SMD 0.00, 95% confidence interval (CI - 0.17 to 0.16; n = 558. One antenatal study (low risk of bias showed an association between brief advocacy and reduced minor physical abuse at one year (mean difference (MD change - 1.00, 95% CI - 1.82 to - 0.18; n = 110. An antenatal, multi-component study showed a greater likelihood of physical abuse ending (odds ratio (OR 0.42, 95% CI 0.23 to 0.75 immediately after advocacy (number needed to treat (NNT = 8; we cannot exclude impact from other components. Low to very low quality evidence from two intensive advocacy trials (12 hours plus duration showed reduced severe physical abuse in women leaving a shelter at 24 months (OR 0.39, 95% CI 0.20 to 0.77; NNT = 8, but not at 12 or 36 months. Sexual abuse Meta-analysis of two studies (n = 239 showed no effect of advocacy on sexual abuse (SMD

  3. Body weight and composition changes in ovarian cancer patients during adjuvant chemotherapy. (United States)

    Gil, Karen M; Frasure, Heidi E; Hopkins, Michael P; Jenison, Eric L; von Gruenigen, Vivian E


    To prospectively examine body weight changes in women with newly diagnosed ovarian cancer receiving surgery and adjuvant chemotherapy. Body composition was examined in a subset of these women. Body weight (BW) and body composition, using bioelectrical impedance (RJL Systems Inc.), were prospectively measured pre- and post-operatively, and at 3, 6, and 12 months. Mean age of 42 women was 59 years and did not differ by stage of disease. Nine women with early stage disease did not receive adjuvant chemotherapy. Mean BW of 33 patients receiving chemotherapy decreased from the pre- to post-operative visit and then returned to baseline levels by 12 months (F = 8.70, P = 0.003). Nine patients who did not receive chemotherapy demonstrated a similar pattern (F = 7.0, P = 0.002). Women receiving chemotherapy with stage I/II cancer had a 2.8 +/- 2.0 kg weight gain over the year, and women with stage III/IV cancer had a 1.5 +/- 1.5 kg weight loss (t = 1.72, P = 0.096). A subset of women with stage I/II (n = 6) and stage III/IV (n = 6) ovarian cancer receiving chemotherapy had body composition measured at three time points. Absolute body fat changes paralleled changes in BW (F = 9.95, P = 0.002). Our study is the first prospective evaluation of body weight and composition in women undergoing surgery and chemotherapy for ovarian cancer. These results demonstrate that women undergoing surgery for ovarian cancer lost weight following surgery and regained it slowly over the following year. Further investigations of weight changes during adjuvant chemotherapy are indicated to assess potential changes in different stages of disease.

  4. Asbestos-associated genome-wide DNA methylation changes in lung cancer. (United States)

    Kettunen, Eeva; Hernandez-Vargas, Hector; Cros, Marie-Pierre; Durand, Geoffroy; Le Calvez-Kelm, Florence; Stuopelyte, Kristina; Jarmalaite, Sonata; Salmenkivi, Kaisa; Anttila, Sisko; Wolff, Henrik; Herceg, Zdenko; Husgafvel-Pursiainen, Kirsti


    Previous studies have revealed a robust association between exposure to asbestos and human lung cancer. Accumulating evidence has highlighted the role of epigenome deregulation in the mechanism of carcinogen-induced malignancies. We examined the impact of asbestos on DNA methylation. Our genome-wide studies (using Illumina HumanMethylation450K BeadChip) of lung cancer tissue and paired normal lung from 28 asbestos-exposed or non-exposed patients, mostly smokers, revealed distinctive DNA methylation changes. We identified a number of differentially methylated regions (DMR) and differentially variable, differentially methylated CpGs (DVMC), with individual CpGs further validated by pyrosequencing in an independent series of 91 non-small cell lung cancer and paired normal lung. We discovered and validated BEND4, ZSCAN31 and GPR135 as significantly hypermethylated in lung cancer. DMRs in genes such as RARB (FDR 1.1 × 10 -19 , mean change in beta [Δ] -0.09), GPR135 (FDR 1.87 × 10 -8 , mean Δ -0.09) and TPO (FDR 8.58 × 10 -5 , mean Δ -0.11), and DVMCs in NPTN, NRG2, GLT25D2 and TRPC3 (all with p asbestos exposure status in exposed versus non-exposed lung tumors. Hypomethylation was characteristic to DVMCs in lung cancer tissue from asbestos-exposed subjects. When DVMCs related to asbestos or smoking were analyzed, 96% of the elements were unique to either of the exposures, consistent with the concept that the methylation changes in tumors may be specific for risk factors. In conclusion, we identified novel DNA methylation changes associated with lung tumors and asbestos exposure, suggesting that changes may be present in causal pathway from asbestos exposure to lung cancer. © 2017 UICC.

  5. Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients

    DEFF Research Database (Denmark)

    Jensen, Siri Beier; Mouridsen, Henning T.; Bergmann, Olav Jonas


    OBJECTIVE: The aim of the study was to examine oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy (CT) in breast cancer patients during and 1 year after treatment. STUDY DESIGN: Forty-five consecutive breast cancer patients, eligible for adjuvant CT...... with cyclophosphamide, epirubicin or methotrexate, and 5-fluorouracil were followed before, during, 6 months and 1 year after CT and were compared to a control group of 31 breast cancer patients not receiving adjuvant CT. RESULTS: During CT, oral mucosal lesions developed including erythema (n = 10, 22%) and ulceration...... in the CT group. CONCLUSION: In breast cancer patients, moderate-intensive adjuvant CT caused oral mucosal lesions, oral candidosis, taste disturbances and a more acidophilic oral microflora. These adverse effects were temporary and the majority of the patients were mildly affected....


    Directory of Open Access Journals (Sweden)

    Laurence Thieux


    Full Text Available This article analyses the role of civil society in the process of political transformation in several countries in North Africa. Through different case studies, concrete experiences of advocacy strategy and the role of CSO in the mobilization of collective actions that have driven reform processes or political transformation in these countries are highlighted. Far from presenting a homogeneous scenario, "Arab Springs" have accentuated disparities and divergences in the political evolution of the North African societies. While some countries have maintained their authoritarian political systems (Algeria, others have managed to maintain the structures and balances of powers and they have tried to adopt reforms without changing the nature of the system (Morocco. Others (Tunisia and Egypt are involved in complex processes of transition in which civil society organizations have had varying influence accordingly.

  7. Mental health advocacy and African and Caribbean men: good practice principles and organizational models for delivery. (United States)

    Newbigging, Karen; McKeown, Mick; French, Beverley


    Advocacy has a critical role to play in addressing concerns about access to appropriate mental health care and treatment for African and Caribbean men. To investigate good practice principles and organizational models for mental health advocacy provision for African and Caribbean men. The study consisted of: (i) A systematic literature review. Bibliographic and internet searching was undertaken from 1994 to 2006. The inclusion criteria related to mental health, advocacy provision for African and Caribbean men. (ii) Four focus groups with African and Caribbean men to explore needs for and experiences of mental health advocacy. (iii) An investigation into current advocacy provision through a survey of advocacy provision in England, Wales and Northern Ireland. (iv) Twenty-two qualitative stakeholder interviews to investigate the operation of mental health advocacy for this client group. The study was undertaken in partnership with two service user-led organizations and an African Caribbean mental health service. Primary research in this area is scant. Mainstream mental health advocacy services are often poor at providing appropriate services. Services developed by the Black Community and voluntary sector are grounded in different conceptualizations of advocacy and sharper understanding of the needs of African and Caribbean men. The lack of sustainable funding for these organizations is a major barrier to the development of high-quality advocacy for this group, reflecting a lack of understanding about their distinctive role. The commissioning and provision of mental health advocacy needs to recognize the distinct experiences of African and Caribbean men and develop capacity in the range of organizations to ensure equitable access. © 2011 Blackwell Publishing Ltd.

  8. Changes in brain activation in breast cancer patients depend on cognitive domain and treatment type. (United States)

    Menning, Sanne; de Ruiter, Michiel B; Veltman, Dick J; Boogerd, Willem; Oldenburg, Hester S A; Reneman, Liesbeth; Schagen, Sanne B


    Cognitive problems in breast cancer patients are common after systemic treatment, particularly chemotherapy. An increasing number of fMRI studies show altered brain activation in breast cancer patients after treatment, suggestive of neurotoxicity. Previous prospective fMRI studies administered a single cognitive task. The current study employed two task paradigms to evaluate whether treatment-induced changes depend on the probed cognitive domain. Participants were breast cancer patients scheduled to receive systemic treatment (anthracycline-based chemotherapy +/- endocrine treatment, n = 28), or no systemic treatment (n = 24) and no-cancer controls (n = 31). Assessment took place before adjuvant treatment and six months after chemotherapy, or at similar intervals. Blood oxygen level dependent (BOLD) activation and performance were measured during an executive functioning task and an episodic memory task. Group-by-time interactions were analyzed using a flexible factorial design. Task performance did not differ between patient groups and did not change over time. Breast cancer patients who received systemic treatment, however, showed increased parietal activation compared to baseline with increasing executive functioning task load compared to breast cancer patients who did not receive systemic treatment. This hyperactivation was accompanied by worse physical functioning, higher levels of fatigue and more cognitive complaints. In contrast, in breast cancer patients who did not receive systemic treatment, parietal activation normalized over time compared to the other two groups. Parietal hyperactivation after systemic treatment in the context of stable levels of executive task performance is compatible with a compensatory processing account of hyperactivation or maintain adequate performance levels. This over-recruitment of brain regions depends on the probed cognitive domain and may represent a response to decreased neural integrity after systemic treatment. Overall

  9. Cancer (United States)

    ... Prostate cancer Lung cancer Colorectal cancer In US women, other than skin cancer the three most common cancers are: Breast cancer Lung cancer Colorectal cancer Some cancers are more common in certain parts of the world. For example, in Japan, there are many cases of stomach cancer . But ...

  10. Parotid cancer: Impact of changes from the 1997 to the 2002 American Joint Committee on Cancer classification on outcome prediction. (United States)

    Schroeder, Ursula; Groppe, Daniela; Mueller, Rolf-Peter; Guntinas-Lichius, Orlando


    The TNM classification [American Joint Committee on Cancer (AJCC)] of salivary gland cancer was revised again in 2002. In the present study, the outcome prediction of the new TNM system was compared with the old 1997 TNM system in 202 patients with primary parotid cancer. All patients treated from 1986 to 2006 were reclassified in both TNM systems. Disease-free survival (DFS) rates were calculated. The prognostic validity of both the TNM system and other factors were analyzed univariately (log-rank test) and multivariately (Cox regression). AJCC TNM stage changes from 1997 to 2002 altered the disease staging in 35% of the patients. Concerning DFS, the new TNM 2002 staging allowed significantly better separation of stage III, but not of stage I versus stage II. The TNM 2002 staging was the most powerful predictor for DFS according to multivariate analysis. The 1997 system showed no independent significance. The subclassification of the new stage IV was not satisfactory; no clear distinction of IVA versus III, and IVA versus IVB was possible. The TNM 2002 staging is more valid than the 1997 system, but a significant problem was observed in separating stage I from stage II, and within the stage IV subgroups. 2008 American Cancer Society

  11. A novel measure of dietary change in a prostate cancer dietary program incorporating mindfulness training. (United States)

    Carmody, James F; Olendzki, Barbara C; Merriam, Philip A; Liu, Qin; Qiao, Yongxia; Ma, Yunsheng


    Diet may represent a modifiable prostate cancer risk factor, but a vegetable-based prostate-healthy diet is a major change for most men. We used a ratio of animal to vegetable proteins (A:V) to evaluate whether a comprehensive dietary change was self-sustaining following completion of 11 weekly dietary and cooking classes that integrated mindfulness training. Thirty-six men with recurring prostate cancer were randomized to the intervention or wait-list control. Assessments were at baseline, 3 months, and 6 months. Of 17 men randomized to the intervention, 14 completed the requirements. Nineteen were randomized to control and 17 completed requirements. Compared with controls, a significant postintervention (3 months) decrease in A:V in the intervention group (P=0.01) was self-maintained 3 months postintervention (P=0.049). At each assessment, A:V was correlated with lycopene, fiber, saturated fat, and dietary cholesterol, four dietary components linked to clinically relevant outcomes in prostate cancer. Change in A:V was also significantly correlated with changes in fiber, saturated fat, and dietary cholesterol intake. Participants reported regular mindfulness training practice, and there was a significant correlation between mindfulness training practice and changes in both initiation and maintenance of the change in A:V. These pilot results provide encouraging evidence for the feasibility of a dietary program that includes mindfulness training in supporting dietary change for men with recurrent prostate cancer and invite further study to explore the possible role of mindfulness training as a means of supporting both initiation of dietary changes and maintenance of those changes over time. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  12. Organizational change: a way to increase colon, breast and cervical cancer screening in primary care practices. (United States)

    Arroyave, Ana Maria; Penaranda, Eribeth K; Lewis, Carmen L


    Screening tests for colon, cervical and breast cancer remain underutilized despite their proven effectiveness in reducing morbidity and mortality. Stone et al. concluded that cancer screening is most likely to improve when a health organization supports performance through organizational changes (OC) in staffing and clinical procedures. OC interventions include the use of separate clinics devoted to prevention, use of a planned care visit, designation of non-physician staff for specific prevention activities and continuous quality improvement interventions. To identify specific elements of OC interventions that increases the selected cancer screening rates. To determine to which extent practices bought into the interventions. Eleven randomized controlled trials from January 1990 to June 2010 that instituted OC to increase cancer screening completion were included. Qualitative data was analyzed by using a framework to facilitate abstraction of information. For quantitative data, an outcome of measure was determined by the change in the proportion of eligible individuals receiving cancer screening services between intervention and control practices. The health prevention clinic intervention demonstrated a large increase (47%) in the proportion of completed fecal occult blood test; having a non-physician staff demonstrated an increase in mammography (18.4%); and clinical breast examination (13.7%); the planned care visit for prevention intervention increased mammography (8.8%); continuous quality improvement interventions showed mixed results, from an increase in performance of mammography 19%, clinical breast examination (13%); Pap smear (15%) and fecal occult blood test (13%), to none or negative change in the proportion of cancer screening rates. To increase cancer screening completion goals, OC interventions should be implemented tailored to the primary care practice style. Interventions that circumvent the physicians were more effective. We could not conclude

  13. The Trend in Histological Changes and the Incidence of Esophagus Cancer in Iran (2003-2008). (United States)

    Rafiemanesh, Hosein; Maleki, Farzad; Mohammadian-Hafshejani, Abdollah; Salemi, Morteza; Salehiniya, Hamid


    Esophageal cancer is the sixth cause of death in the world, there was a lack of population-based information on the trend and incidence rate of esophagus cancer, so this study aimed to determine the incidence and pathological changes of esophagus cancer in Iran. In this study, data were extracted from annual cancer registry reports of Iranian ministry of health between 2003 and 2008. Standardized incidence rates were calculated using the world standard population, and incidence rate was calculated by age groups, sex, and histological type. Data on epidemiologic trend and histology were analyzed using Joinpoint software package. In this study, there were 18,177 recorded cases of esophagus cancer. Of all cases, 45.72% were females and 54.28% were males. Sex ratio was 1.19. The most common histological types related to squamous cell carcinoma NOS and adenocarcinoma NOS were 64.53% and 10.37%, respectively. The trend of annual changes of incidence rate significantly increased in both sexes. The annual percentage changes, the incidence rate was 7.9 (95% confidence interval [CI]: 3.3-12.6) for women and 9.6 (95% CI: 6.0-13.2) for men. The histology type of SCC, large cell, nonkeratinizing and SCC, keratinizing and SCC, NOS had a significant decreasing trend in total population (P trend of age-standardized incidence rate of esophagus cancer in Iran is rising. Hence, to prevent and control this cancer, it is necessary to investigate related risk factors and implement prevention programs in Iran.

  14. Accessing evidence to inform public health policy: a study to enhance advocacy. (United States)

    Tabak, R G; Eyler, A A; Dodson, E A; Brownson, R C


    Improving population health often involves policy changes that are the result of complex advocacy efforts. Information exchanges among researchers, advocates, and policymakers is paramount to policy interventions to improve health outcomes. This information may include evidence on what works well for whom and cost-effective strategies to improve outcomes of interest. However, this information is not always readily available or easily communicated. The purposes of this paper are to describe ways advocates seek information for health policy advocacy and to compare advocate demographics. Cross-sectional telephone survey. Seventy-seven state-level advocates were asked about the desirable characteristics of policy-relevant information including methods of obtaining information, what makes it useful, and what sources make evidence most reliable/trustworthy. Responses were explored for the full sample and variety of subsamples (i.e. gender, age, and position on social and fiscal issues). Differences between groups were tested using t-tests and one-way analysis of variance. On average, advocates rated frequency of seeking research information as 4.3 out of five. Overall, advocates rated the Internet as the top source, rated unbiased research and research with relevancy to their organization as the most important characteristics, and considered information from their organization as most reliable/believable. When ratings were examined by subgroup, the two characteristics most important for each question in the total sample (listed above) emerged as most important for nearly all subgroups. Advocates are a resource to policymakers on health topics in the policy process. This study, among the first of its kind, found that advocates seek research information, but have a need for evidence that is unbiased and relevant to their organizations and report that university-based information is reliable. Researchers and advocates should partner so research is useful in advocating for

  15. Changes in alcohol intake and risk of upper digestive tract cancer

    DEFF Research Database (Denmark)

    Thygesen, Lau C; Keiding, Niels; Johansen, Christoffer


    of these cancers. MATERIAL AND METHODS: In the Copenhagen City Heart Study we assessed alcohol intake among 4 896 men and 6 239 women who participated at both the first (1976-1978) and second (1981-1983) examination of the study. Alcohol intake changes on risk of upper digestive tract cancer 1981-2002 were......INTRODUCTION: Alcohol intake measured at one point in time is a strong predictor for later development of cancer of the oral cavity, pharynx, larynx and esophagus. In this prospective cohort study, we examined whether changes in individual alcohol intake resulted in subsequent altered risk...... examined by a Cox model adjusted for potential confounders. RESULTS: Despite a small number of cases (n = 105), alcohol intake increase > 14 drinks/week was associated with significantly elevated risk (hazard ratio = 2.5; 95% confidence interval, 1.1-5.3), while suggestively decreased risk was observed...

  16. The perioperative changes in physical function and physique of patients with gastrointestinal cancer. (United States)

    Hara, Tsuyoshi; Kubo, Akira


    [Purpose] The purpose of this study was to observe the long-term change in physical function and physique from perioperative to discharge of patients with gastrointestinal cancer. [Subjects and Methods] Subjects were 47 perioperative patients with gastrointestinal cancer [25 men and 22 women aged 61.3 ± 11.0 years (mean ± SD)]. Six-minute walk distance was measured for physical function and body mass index and calf circumference were measured for physique. These items were evaluated at three time points: before surgery, after surgery, and after discharge. [Results] Significant declines in physical function and physique were observed temporarily after surgery. Physical function improved equally before surgery in after discharge. On the other hand, postoperative physique was significantly lower than that observed pre-operatively. [Conclusion] These results suggest that the perioperative changes in physical function and physique follow different courses in patients with gastrointestinal cancer.

  17. Importance of sexuality in colorectal cancer: predictors, changes, and response to an intimacy enhancement intervention. (United States)

    Reese, Jennifer Barsky; Haythornthwaite, Jennifer A


    The primary objectives were (1) to examine the importance of sexuality within the self-view and cross-sectional correlates for 120 colorectal cancer patients and (2) to determine whether the importance of sexuality changed for 46 colorectal cancer patients and partners participating in an intimacy enhancement intervention. Two newly developed items assessed importance of sexuality within the self-view (1) currently and (2) before cancer; a calculated change score assessed perceived change. In the cross-sectional sample, associations between importance of sexuality and demographic and medical factors and sexual function status were examined. Intervention participants' importance ratings before and after participation were used to calculate effect sizes. For patients, importance of sexuality before cancer was greater (M = 65.7) than current importance (M = 56.8, p = .001). Greater current importance of sexuality was associated with partnered status, non-metastatic disease, and not being in treatment. Scoring in the sexually functional range was associated with greater current importance of sexuality for men and a smaller perceived change in importance for both men and women (p values Sexual function status also significantly predicted current importance independent of covariates. Small to medium effect sizes for intervention patients (.37) and partners (.60) were found for increases in importance of sexuality. Items showed evidence of test-retest reliability and construct validity. Coping with sexual concerns is important to those affected by colorectal cancer. Findings suggest that the importance of sexuality can decrease through colorectal cancer and associated sexual problems and can increase through participating in an intimacy-focused intervention.

  18. Exploring communication during the journey from noticing bodily changes to a diagnosis of endometrial cancer. (United States)

    Cook, Catherine; Brunton, Margaret; Pukepuke, Tepora; Tan, Ai Ling


    To understand women's perspectives about the trajectory from first bodily changes to diagnosis. With endometrial cancer, as with all gynaecological cancers, early diagnosis is key to successful outcomes. However, women do not always seek clinical advice early. Previously, this gap has been referred to as a "delay," blamed on fear or refusal to acknowledge symptoms. A qualitative research project which involved face-to-face interviews with 16 women who had presented with symptoms of endometrial cancer. The paucity of research in the trajectory of women who experience a diagnosis of endometrial cancer required an exploratory overview of the data. Accordingly, an inductive thematic analysis was conducted using the framework of Braun and Clarke (Qualitative Research in Psychology, 3, 2006, 77). Women and health professionals both resorted to satisficing, using heuristics to make decisions about the importance of symptoms depending on their severity and duration. Most women initially determined that the bodily changes were within the realms of normal. Time to diagnosis was also affected by the following: women's long-standing assumptions; communication with health professionals; liminality-women oscillating between their self-assessment that these changes were something significant or nothing important; and gaps in health literacy. The journey from noticing bodily changes to diagnosis was a nonlinear trajectory. Women worked to make sense of what was happening to them, informed by their sociocultural environment. In particular, confusion about the purpose of cervical screening led a number of participants who had regular smears to assume they were "safe" from cancer worries. Women and some health professionals may be unfamiliar with symptoms potentially indicative of endometrial cancer. There may be structural and communication barriers for women navigating healthcare systems. It is vital that nurses take time both to listen to women and to provide them with resources

  19. Changes in symptoms and pain intensity of cancer patients after enrollment in palliative care at home

    NARCIS (Netherlands)

    Dumitrescu, Luminita; van den Heuvel-Olaroiu, Marinela; van den Heuvel, Wim J. A.


    This study describes the activities and interventions carried out by an at-home palliative care team treating cancer patients who died within two years of being enrolled in a palliative care program. It analyzes which changes in symptoms and pain occurred and which sociodemographic and medical

  20. Lower cognitive performance and white matter changes in testicular cancer survivors 10 years after chemotherapy

    NARCIS (Netherlands)

    Stouten-Kemperman, Myrle M.; de Ruiter, Michiel B.; Caan, Matthan W. A.; Boogerd, Willem; Kerst, Martijn J.; Reneman, Liesbeth; Schagen, Sanne B.


    Chemotherapy (CT) is associated with adverse effects on cognition. Only few studies have investigated cognition in testicular cancer (TC) patients and studies on very late effects of CT on cognition are absent. Further, brain changes in relation to treatment have not been investigated in TC. The

  1. Validation of a Milk Consumption Stage of Change Algorithm among Adolescent Survivors of Childhood Cancer (United States)

    Mays, Darren; Gerfen, Elissa; Mosher, Revonda B.; Shad, Aziza T.; Tercyak, Kenneth P.


    Objective: To assess the construct validity of a milk consumption Stages of Change (SOC) algorithm among adolescent survivors of childhood cancer ages 11 to 21 years (n = 75). Methods: Baseline data from a randomized controlled trial designed to evaluate a health behavior intervention were analyzed. Assessments included a milk consumption SOC…

  2. Adult BMI Change and Risk of Colon Cancer in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Lyla Blake-Gumbs


    Full Text Available Purpose. We recently reported an association of adult BMI change with colon cancer risk. Here, we sought to further explore this association with respect to postmenopausal HRT use in a larger study population. Methods. We included 1,457 postmenopausal women participating in an ongoing population-based case-control study of colon cancer. Results. We confirmed a previously reported association of adulthood weight gain and increased risk of colon cancer: compared to those with 10 kg/m2 BMI changes since their 20s had OR estimates of 1.54 (95% CI = 1.09–2.19 and 1.45 (95% CI = 0.90–2.33, respectively (P for trend = 0.05. Stratified analyses showed that this association was limited to HRT nonusers: ORs were 1.77 (95% CI = 1.02–3.05 and 2.21 (95% CI = 1.09–4.45, respectively (P for trend = 0.03, for BMI changes occurring between the 20s decade and time of recruitment among non-users. Similar associations were observed for BMI changes since the 30s decade. There was no association among HRT users. Conclusion. Our results suggest early adulthood weight gain increases colon cancer risk in postmenopausal women who do not use HRT.

  3. Changes in body composition after childhood cancer treatment : Impact on future health status - A review

    NARCIS (Netherlands)

    Brouwer, C. A. J.; Gietema, J. A.; Kamps, W. A.; de Vries, E. G. E.; Postma, A.

    Purpose: To describe data on changes in body composition in childhood cancer survivors. Underlying mechanisms in development of obesity are addressed, in order to discuss intervention strategies. Methods: A systematic literature search was undertaken with a number of search terms. Results: Female

  4. Quantitative Changes In Human Epithelial Cancers And Osteogenesis Imperfecta Disease Detected Using Nonlinear Multicontrast Microscopy.


    Adur, Javier; Vitor B Pelegati; de Thomaz, Andre A.; D'Souza-Li, Lilia; Assunção, Maria do Carmo; Bottcher-Luiz, Fátima; Andrade, Liliana A L A; CESAR, CARLOS L.


    We show that combined multimodal nonlinear optical (NLO) microscopies, including two-photon excitation fluorescence, second-harmonic generation (SHG), third harmonic generation, and fluorescence lifetime imaging microscopy (FLIM) can be used to detect morphological and metabolic changes associated with stroma and epithelial transformation during the progression of cancer and osteogenesis imperfecta (OI) disease. NLO microscopes provide complementary information about tissue microstructure, sh...

  5. Changes in body mass index in long-term childhood cancer survivors

    NARCIS (Netherlands)

    van Santen, HM; Geskus, Ronald B; Raemaekers, Steven; van Trotsenburg, A S Paul; Vulsma, Thomas; van der Pal, Helena J H; Caron, Hubert N; Kremer, Leontien C M


    BACKGROUND: Previous studies have reported changes in the body mass index (BMI) with time in childhood cancer survivors (CCSs) during follow-up. The limitations of these studies include that they described only a subgroup of survivors or used questionnaires with self-reported heights and weights.

  6. Changes in plasma TIMP-1 levels after resection for primary colorectal cancer

    DEFF Research Database (Denmark)

    Frederiksen, C.; Lomholt, A.F.; Davis, G.J.


    BACKGROUND: Increased plasma levels of tissue inhibitor of metalloproteinases (TIMP-1) are associated with poor outcome in colorectal cancer (CRC), however postoperative changes in plasma TIMP-1 levels after resections for CRC have not been thoroughly evaluated. MATERIALS AND METHODS: Plasma samp...

  7. Weight change trajectory in women with breast cancer receiving chemotherapy and the effect of different regimens. (United States)

    Liu, Li-Ni; Wen, Fur-Hsing; Miaskowski, Christine; Lin, Yung-Chang; Wang, Jong-Shyan; Jeng, Chii; Chen, Mei-Ling


    To investigate the trajectory of weight change in Taiwanese women with breast cancer after starting chemotherapy and the impact of chemotherapy regimens on weight change while controlling for age, menopausal status, body mass index, lymph node involvement and changes in habits of dietary fat intake and exercise. Weight gain after adjuvant chemotherapy in women with breast cancer has negative impact on health outcomes. Longitudinal, clinical observational study. Weights were repeatedly measured in 147 women with breast cancer stages I-III. Hierarchical linear modelling was used to analyse these longitudinal data. The overall pattern of weight change was a cubic form beginning with a mean of 56·9 kg before chemotherapy. It gradually increased to 59·4 kg at 8·5 months after the first chemotherapy followed by a decrease to 58·5 kg at 21·5 months. During the last 2·5 months, weight increased slightly and never returned to the initial level. After controlling for confounders, steeper weight change was observed among women receiving cyclophosphamide, methotrexate and fluorouracil. The highest weight gain in the cyclophosphamide, methotrexate and fluorouracil group was 2·9 kg (5%) vs. 0·9 kg (1%) in the anthracycline-based group. The trajectory of body weight change within two years after chemotherapy shows a trend of gradual ascent, followed by a small decline and a slight increase in the last 2·5 months. The chemotherapy regimen can predict the trend after controlling for other confounders; women on cyclophosphamide, methotrexate and fluorouracil have a steeper weight change. Nurses can inform women with breast cancer about the expected changes in body weight after chemotherapy to reduce their uncertainty. Future studies on effective interventions to minimise chemotherapy-induced weight gain are needed. © 2014 John Wiley & Sons Ltd.

  8. Strong advocacy led to successful implementation of smokefree Mexico City (United States)

    Crosbie, Eric; Sebrié, Ernesto M; Glantz, Stanton A


    Objective To describe the approval process and implementation of the 100% smokefree law in Mexico City and a competing federal law between 2007 and 2010. Methods Reviewed smokefree legislation, published newspaper articles and interviewed key informants. Results Strong efforts by tobacco control advocacy groups and key policymakers in Mexico City in 2008 prompted the approval of a 100% smokefree law following the WHO FCTC. As elsewhere, the tobacco industry utilised the hospitality sector to block smokefree legislation, challenged the City law before the Supreme Court and promoted the passage of a federal law that required designated smoking areas. These tactics disrupted implementation of the City law by causing confusion over which law applied in Mexico City. Despite interference, the City law increased public support for 100% smokefree policies and decreased the social acceptability of smoking. In September 2009, the Supreme Court ruled in favour of the City law, giving it the authority to go beyond the federal law to protect the fundamental right of health for all citizens. Conclusions Early education and enforcement efforts by tobacco control advocates promoted the City law in 2008 but advocates should still anticipate continuing opposition from the tobacco industry, which will require continued pressure on the government. Advocates should utilise the Supreme Court’s ruling to promote 100% smokefree policies outside Mexico City. Strong advocacy for the City law could be used as a model of success throughout Mexico and other Latin American countries. PMID:21059606

  9. Antiscience and ethical concerns associated with advocacy of Lyme disease. (United States)

    Auwaerter, Paul G; Bakken, Johan S; Dattwyler, Raymond J; Dumler, J Stephen; Halperin, John J; McSweegan, Edward; Nadelman, Robert B; O'Connell, Susan; Shapiro, Eugene D; Sood, Sunil K; Steere, Allen C; Weinstein, Arthur; Wormser, Gary P


    Advocacy for Lyme disease has become an increasingly important part of an antiscience movement that denies both the viral cause of AIDS and the benefits of vaccines and that supports unproven (sometimes dangerous) alternative medical treatments. Some activists portray Lyme disease, a geographically limited tick-borne infection, as a disease that is insidious, ubiquitous, difficult to diagnose, and almost incurable; they also propose that the disease causes mainly non-specific symptoms that can be treated only with long-term antibiotics and other unorthodox and unvalidated treatments. Similar to other antiscience groups, these advocates have created a pseudoscientific and alternative selection of practitioners, research, and publications and have coordinated public protests, accused opponents of both corruption and conspiracy, and spurred legislative efforts to subvert evidence-based medicine and peer-reviewed science. The relations and actions of some activists, medical practitioners, and commercial bodies involved in Lyme disease advocacy pose a threat to public health. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Advocacy for reform of the abortion law in Nigeria. (United States)

    Oye-Adeniran, Boniface A; Long, Carolyn M; Adewole, Isaac F


    Safe abortion services are only legal in Nigeria to save the life of the woman. Widespread incidence of unsafe induced abortions often results in death or irreparable harm to women. The Campaign Against Unwanted Pregnancy (CAUP) was launched on 17 August 1991 to address this public health crisis through advocacy for reform of the abortion law, research, education and preparation of service providers, and development of a constituency to support provision of safe abortion to the full extent of the law. CAUP commissioned an evaluation in 2004 to examine and analyse the work of the campaign during its 14 years of existence, which included a review of documents, a participatory learning workshop with CAUP, and almost 50 interviews with different stakeholders. This article, adapted from the evaluation report, tells how CAUP took a taboo topic and, in the midst of an extremely complex political and cultural environment, made it a legitimate subject for public discussion and debate. The Campaign undertook groundbreaking research on abortion in Nigeria. Service providers are being trained to provide, to the full extent of the law, safe abortions and post-abortion care, and advocacy efforts are continuing to lay the groundwork for improving the abortion law.

  11. The Texas Dental Association and advocacy: a TDA president's perspective. (United States)

    Eggleston, Frank K; Jeske, Arthur H


    The TDA can take pride in the joint efforts of its leadership, its grassroots members, and its elected representatives in the middle of the decade of the 1990's. When asked about his legacy for the leadership of our organization, Dr. Eggleston emphatically states, "You have to act. You have to do the right thing even when you have critics and detractors." More recently, during his campaign for ADA President-elect, he constantly stressed the importance of our relationship with each other. Our relationship, in Dr. Eggleston's words now and during his TDA presidency, "is more important than all issues put together". As this brief retrospective illustrates, the issues faced by dentists and the TDA are never trivial and are always tied to the legislative process. Political advocacy by our association is, therefore, our first priority now, no less so than it was in the mid-1990's. As described in the recent "TDA Report Card" on our legislative agenda for the 80th Texas Legislature, our challenges continue unabated, but these challenges are answered, and in many cases, successfully overcome as a result of our advocacy efforts. Our need for constant involvement in the legislative process is perhaps best summarized by advice given to Dr. Eggleston by Senator (and oral surgeon) David Sibley at the 1995 TDA Annual Session. Senator Sibley complimented TDA on its achievements during the 1995 Texas legislative session, and added "but you've got to keep your garden weeded."

  12. Whistle-Blowing as a Form of Advocacy: Guidelines for the Practitioner and Organization (United States)

    Greene, Annette D.; Latting, Jean Kantambu


    Advocacy has been an inherent component of social work since the mid-1800s. The NASW Code of Ethics explicitly promotes advocacy as an ethical stance against inhumane conditions. Whistle-blowing, on the other hand, occurs mostly in the business and public administration disciplines and is relatively unknown in the social work profession. Using…

  13. A Demonstration of Three Models of Advocacy Programs for Developmentally Disabled Children. (United States)

    Moore, Marie L.

    Three demonstration models of advocacy programs for developmentally disabled children and their families are reviewed by the United Cerebral Palsy Associations, Inc. In a general summary statement, advocacy is defined as responsibility for seeing that legal and human rights are met; the history, rationale, and future plans for the 5-year Child…

  14. Fostering Skills in Self-Advocacy: A Key to Access in School and Beyond (United States)

    Luckner, John L.; Becker, Sharon J.


    Self-advocacy occurs when deaf or hard of hearing individuals explain to hearing teachers, classmates, bosses, and officemates the nature of their hearing loss, their language skills, and the accommodations they require in order to effectively do their work, participate in conversations, and get involved in other activities. Self-advocacy may be…

  15. Advocacy planning in resettlement schemes: A study of old and new ...

    African Journals Online (AJOL)

    The paper also contended that resettlement schemes without sound economic base and public participation is a mere human environmental distortion. And that advocacy planning is not anti-public planning but a complementary effort toward the attainment of rational comprehensive planning paradigm. Keywords: Advocacy ...

  16. What History Is Teaching Us: 100 Years of Advocacy in "Music Educators Journal" (United States)

    Hedgecoth, David M.; Fischer, Sarah H.


    As "Music Educators Journal" celebrates its centennial, it is appropriate to look back over the past century to see how advocacy in music education has evolved. Of the more than 200 submitted articles on advocacy, four main themes emerged: music education in community, the relevancy of music education, the value of music education, and…

  17. Management, Leadership, and User Control in Self-Advocacy: An English Case Study (United States)

    Tilley, Elizabeth


    This paper presents findings from a qualitative research project on an English self-advocacy organization. In light of recent political and economic developments that have threatened the sustainability of a number of self-advocacy groups for people with intellectual disability, I seek to explore how one particular organization managed to survive…

  18. Policy and Advocacy Concepts and Processes: Innovative Content in Early Childhood Teacher Education (United States)

    Hollingsworth, Heidi L.; Knight-McKenna, Mary; Bryan, Ren


    Knowledge and skills regarding policy and advocacy are important expectations for today's early childhood workforce, yet policy and advocacy content and processes have not traditionally been emphasized in teacher preparation programmes. This article describes an innovative undergraduate course that goes beyond traditional foci on developmental…

  19. Weber's Critique of Advocacy in the Classroom: Critical Thinking and Civic Education. (United States)

    Weaver, Mark


    Discusses the four aspects of Max Weber's argument against including advocacy in the political science classroom. Believes that Weber's critique is a useful starting point for considering the issue in relation to contemporary education. Describes two models, critical thinking and civic education, that present advocacy in the political science…

  20. Japanese Culture and the Philosophy of Self-Advocacy: The Importance of Interdependence in Community Living (United States)

    Tsuda, Eiji


    In Japan, there is a growing network of self-advocacy groups. Some groups are involved in campaigning. Other groups are involved in social events and education. The age of de-institutionalization is gradually arriving and community living for people with learning difficulties is becoming an urgent political issue. Self-advocacy groups can help…

  1. Where Have We Been and Where Are We Going? A Conceptual Framework for Child Advocacy

    Directory of Open Access Journals (Sweden)

    Michele Cascardi


    Full Text Available The primary goal of this article is to chart the development of child advocacy as an interdisciplinary field of study and conclude with a conceptual framework for research and higher education in child advocacy. Historically, child advocacy has justifiably focused on protection needs. Values and assumptions about children’s best interest have also governed child advocacy, in part because evidence to inform decisions was lacking and in part because of its history as an activist movement. Against this historical backdrop, we describe contemporary trends in child advocacy that reconcile children’s protection with their inherent rights to personhood. We rely on the principles and articles of the United Nations Convention on the Rights of the Child, most notably children’s rights to participation and self-expression. At the same time, we demonstrate how values and ideology are being integrated with empiricism and objective analysis to inform policy and practice in child advocacy. The future of child advocacy depends on continued synthesis of rights and protection as well as values and rigorous analysis. From this perspective, we offer a conceptual framework for research and education in child advocacy.

  2. Learning about Advocacy, A Case-Study of Challenges, Everyday Practices

    NARCIS (Netherlands)

    Ringsing, B.; Leeuwis, C.


    Advocacy has become an important area of development support. Simultaneously, the interest in learning-oriented monitoring of advocacy programmes has increased. Starting from the premise that learning has sociopolitical dimensions, this article explores how the challenges and contradictions of such

  3. My changed body: breast cancer, body image, distress and self-compassion. (United States)

    Przezdziecki, Astrid; Sherman, Kerry A; Baillie, Andrew; Taylor, Alan; Foley, Elizabeth; Stalgis-Bilinski, Kellie


    Bodily changes after breast cancer treatment can lead to long-term distress. Self-compassion, the ability to be kind to oneself, is an internal resource that may enhance a woman's ability to adjust to cancer-related bodily changes. The aim of the present study was to test the hypothesis that self-compassion mediates the relationship between body image and distress, controlling for alternate plausible mediators. Members of a nationwide breast cancer consumer network were invited to participate. A total of 279 women who had finished active cancer treatment completed the online survey. Assessments included the Body Image Scale; Self-compassion Scale; Depression, Anxiety and Stress Scale and items measuring perceived normative pressure and comfort with one's weight. Possible mediating effects of proposed variables on the body image-distress relationship were assessed. Tests using a bootstrapping approach with multiple mediators were significant for self-compassion on distress. Body image disturbance was indirectly associated with distress through low self-compassion. Body image disturbance and lower self-compassion were associated with increased psychological distress among these breast cancer survivors. This study provides preliminary evidence for a mediating role of self-compassion between body image disturbance and psychological distress, suggesting a potentially protective effect of higher levels of self-compassion for women at risk of experiencing body image disturbance. Copyright © 2012 John Wiley & Sons, Ltd.

  4. Ultrasensitive fluorescent ratio imaging probe for the detection of glutathione ultratrace change in mitochondria of cancer cells. (United States)

    Zhang, Hua; Wang, Caixia; Wang, Kui; Xuan, Xiaopeng; Lv, Qingzhang; Jiang, Kai


    Glutathione (GSH) ultratrace change in mitochondria of cancer cells can mildly and effectively induce cancer cells apoptosis in early stage. Thus, if GSH ultratrace change in mitochondria of cancer cells could be recognized and imaged, it will be beneficial for fundamental research of cancer therapy. There have reported a lot of fluorescent probes for GSH, but the fluorescent probe with ultrasensitivity and high selectivity for the ratio imaging of GSH ultratrace changes in mitochondria of cancer cells is scarce. Herein, based on different reaction mechanism of sulfonamide under different pH, a sulfonamide-based reactive ratiometric fluorescent probe (IQDC-M) was reported for the recognizing and imaging of GSH ultratrace change in mitochondria of cancer cells. The detection limit of IQDC-M for GSH ultratrace change is low to 2.02nM, which is far less than 1.0‰ of endogenic GSH in living cells. And during the recognition process, IQDC-M can emit different fluorescent signals at 520nm and 592nm, which results in it recognizing GSH ultratrace change on ratio mode. More importantly, IQDC-M recognizing GSH ultratrace change specifically occurs in mitochondria of cancer cells because of appropriate water/oil amphipathy (log P) of IQDC-M. So, these make IQDC-M possible to image and monitor GSH ultratrace change in mitochondria during cancer cells apoptosis for the first time. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Changes in Female Support Network Systems and Adaptation after Breast Cancer Diagnosis: Differences between Older and Younger Patients (United States)

    Ashida, Sato; Palmquist, Aunchalee E. L.; Basen-Engquist, Karen; Singletary, S. Eva; Koehly, Laura M.


    Purpose: This study evaluates the changes in social networks of older and younger breast cancer patients over a 6-month period following their first diagnosis and how such modifications are associated with changes in the patients' mood state. Design and Methods: Newly diagnosed breast cancer patients were interviewed shortly after their diagnosis…

  6. Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study

    DEFF Research Database (Denmark)

    Steins Bisschop, Charlotte N; van Gils, Carla H; Emaus, Marleen J


    BACKGROUND: A moderate association exists between body mass index (BMI) and colorectal cancer. Less is known about the effect of weight change. OBJECTIVE: We investigated the relation between BMI and weight change and subsequent colon and rectal cancer risk. DESIGN: This was studied among 328,781...

  7. Marked improvements in survival of patients with rectal cancer in the Netherlands following changes in therapy, 1989-2006.

    NARCIS (Netherlands)

    Elferink, M.A.; Steenbergen, L.N. van; Krijnen, P.; Lemmens, V.E.; Rutten, H.J.; Marijnen, C.A.; Nagtegaal, I.D.; Karim-Kos, H.E.; Vries, E. de; Siesling, S.


    BACKGROUND: Since the 1990s, treatment of patients with rectal cancer has changed in the Netherlands. Aim of this study was to describe these changes in treatment over time and to evaluate their effects on survival. METHODS: All patients in the Netherlands Cancer Registry with invasive primary

  8. Determination of a Change Point in the Age at Diagnosis of Breast Cancer Using a Survival Model. (United States)

    Abdollahi, Mahbubeh; Hajizadeh, Ebrahim; Baghestani, Ahmad Reza; Haghighat, Shahpar


    Breast cancer, the second cause of cancer-related death after lung cancer and the most common cancer in women after skin cancer, is curable if detected in early stages of clinical presentation. Knowledge as to any age cut-off points which might have significance for prognostic groups is important in screening and treatment planning. Therefore, determining a change-point could improve resource allocation. This study aimed to determine if a change point for survival might exist in the age of breast cancer diagnosis. This study included 568 cases of breast cancer that were registered in Breast Cancer Research Center, Tehran, Iran, during the period 1986-2006 and were followed up to 2012. In the presence of curable cases of breast cancer, a change point in the age of breast cancer diagnosis was estimated using a mixture survival cure model. The data were analyzed using SPSS (versions 20) and R (version 2.15.0) software. The results revealed that a change point in the age of breast cancer diagnosis was at 50 years age. Based on our estimation, 35% of the patients diagnosed with breast cancer at age less than or equal to 50 years of age were cured while the figure was 57% for those diagnosed after 50 years of age. Those in the older age group had better survival compared to their younger counterparts during 12 years of follow up. Our results suggest that it is better to estimate change points in age for cancers which are curable in early stages using survival cure models, and that the cure rate would increase with timely screening for breast cancer.

  9. Change in Breast Cancer Screening Intervals Since the 2009 USPSTF Guideline. (United States)

    Wernli, Karen J; Arao, Robert F; Hubbard, Rebecca A; Sprague, Brian L; Alford-Teaster, Jennifer; Haas, Jennifer S; Henderson, Louise; Hill, Deidre; Lee, Christoph I; Tosteson, Anna N A; Onega, Tracy


    In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended biennial mammography for women aged 50-74 years and shared decision-making for women aged 40-49 years for breast cancer screening. We evaluated changes in mammography screening interval after the 2009 recommendations. We conducted a prospective cohort study of women aged 40-74 years who received 821,052 screening mammograms between 2006 and 2012 using data from the Breast Cancer Surveillance Consortium. We compared changes in screening intervals and stratified intervals based on whether the mammogram at the end of the interval occurred before or after the 2009 recommendation. Differences in mean interval length by woman-level characteristics were compared using linear regression. The mean interval (in months) minimally decreased after the 2009 USPSTF recommendations. Among women aged 40-49 years, the mean interval decreased from 17.2 months to 17.1 months (difference -0.16%, 95% confidence interval [CI] -0.30 to -0.01). Similar small reductions were seen for most age groups. The largest change in interval length in the post-USPSTF period was declines among women with a first-degree family history of breast cancer (difference -0.68%, 95% CI -0.82 to -0.54) or a 5-year breast cancer risk ≥2.5% (difference -0.58%, 95% CI -0.73 to -0.44). The 2009 USPSTF recommendation did not lengthen the average mammography interval among women routinely participating in mammography screening. Future studies should evaluate whether breast cancer screening intervals lengthen toward biennial intervals following new national 2016 breast cancer screening recommendations, particularly among women less than 50 years of age.

  10. Quantifying the changes in survival inequality for Indigenous people diagnosed with cancer in Queensland, Australia. (United States)

    Baade, Peter D; Dasgupta, Paramita; Dickman, Paul W; Cramb, Susanna; Williamson, John D; Condon, John R; Garvey, Gail


    The survival inequality faced by Indigenous Australians after a cancer diagnosis is well documented; what is less understood is whether this inequality has changed over time and what this means in terms of the impact a cancer diagnosis has on Indigenous people. Survival information for all patients identified as either Indigenous (n=3168) or non-Indigenous (n=211,615) and diagnosed in Queensland between 1997 and 2012 were obtained from the Queensland Cancer Registry, with mortality followed up to 31st December, 2013. Flexible parametric survival models were used to quantify changes in the cause-specific survival inequalities and the number of lives that might be saved if these inequalities were removed. Among Indigenous cancer patients, the 5-year cause-specific survival (adjusted by age, sex and broad cancer type) increased from 52.9% in 1997-2006 to 58.6% in 2007-2012, while it improved from 61.0% to 64.9% among non-Indigenous patients. This meant that the adjusted 5-year comparative survival ratio (Indigenous: non-Indigenous) increased from 0.87 [0.83-0.88] to 0.89 [0.87-0.93], with similar improvements in the 1-year comparative survival. Using a simulated cohort corresponding to the number and age-distribution of Indigenous people diagnosed with cancer in Queensland each year (n=300), based on the 1997-2006 cohort mortality rates, 35 of the 170 deaths due to cancer (21%) expected within five years of diagnosis were due to the Indigenous: non-Indigenous survival inequality. This percentage was similar when applying 2007-2012 cohort mortality rates (19%; 27 out of 140 deaths). Indigenous people diagnosed with cancer still face a poorer survival outlook than their non-Indigenous counterparts, particularly in the first year after diagnosis. The improving survival outcomes among both Indigenous and non-Indigenous cancer patients, and the decreasing absolute impact of the Indigenous survival disadvantage, should provide increased motivation to continue and enhance

  11. Immunohistochemical and quantitative changes in salivary EGF, amylase and haptocorrin following radiotherapy for oral cancer

    DEFF Research Database (Denmark)

    Christensen, M E; Hansen, H S; Poulsen, Steen Seier


    Epidermal growth factor (EGF), amylase and haptocorrin are molecules produced in the salivary glands. The aim of the present study was to determine immunohistochemical and quantitative alterations in EGF as compared with haptocorrin and amylase following radiotherapy for oral cancer. Changes...... a reduction in the mitogenic peptide EGF both immunohistochemically and quantitatively following irradiation for oral cancer, results which may contribute to the understanding of the clinical signs of mucositis........ The concentration of EGF in saliva before treatment was significantly higher in patients than in the control group (p oral tumors contribute with EGF to the saliva. In conclusion we have demonstrated...

  12. Optical imaging of radiation-induced metabolic changes in radiation-sensitive and resistant cancer cells (United States)

    Alhallak, Kinan; Jenkins, Samir V.; Lee, David E.; Greene, Nicholas P.; Quinn, Kyle P.; Griffin, Robert J.; Dings, Ruud P. M.; Rajaram, Narasimhan


    Radiation resistance remains a significant problem for cancer patients, especially due to the time required to definitively determine treatment outcome. For fractionated radiation therapy, nearly 7 to 8 weeks can elapse before a tumor is deemed to be radiation-resistant. We used the optical redox ratio of FAD/(FAD+NADH) to identify early metabolic changes in radiation-resistant lung cancer cells. These radiation-resistant human A549 lung cancer cells were developed by exposing the parental A549 cells to repeated doses of radiation (2 Gy). Although there were no significant differences in the optical redox ratio between the parental and resistant cell lines prior to radiation, there was a significant decrease in the optical redox ratio of the radiation-resistant cells 24 h after a single radiation exposure (p=0.01). This change in the redox ratio was indicative of increased catabolism of glucose in the resistant cells after radiation and was associated with significantly greater protein content of hypoxia-inducible factor 1 (HIF-1α), a key promoter of glycolytic metabolism. Our results demonstrate that the optical redox ratio could provide a rapid method of determining radiation resistance status based on early metabolic changes in cancer cells.

  13. Changes of 2015 WHO Histological Classification of Lung Cancer 
and the Clinical Significance

    Directory of Open Access Journals (Sweden)

    Xin YANG


    Full Text Available Due in part to remarkable advances over the past decade in our understanding of lung cancer, particularly in area of medical oncology, molecular biology, and radiology, there is a pressing need for a revised classification, based not on pathology alone, but rather on an integrated multidisciplinary approach to classification of lung cancer. The 2015 World Health Organization (WHO Classification of Tumors of the Lung, Pleura, Thymus and Heart has just been published with numerous important changes from the 2004 WHO classification. The revised classification has been greatly improved in helping advance the field, increasing the impact of research, improving patient care and assisting in predicting outcome. The most significant changes will be summarized in this paper as follows: (1 main changes of lung adenocarcinoma as proposed by the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS classification, (2 reclassifying squamous cell carcinomas into keratinizing, nonkeratinizing, and basaloid subtypes with the nonkeratinizing tumors requiring immunohistochemistry proof of squamous differentiation, (3 restricting the diagnosis of large cell carcinoma only to resected tumors that lack any clear morphologic or immunohistochemical differentiation with reclassification of the remaining former large cell carcinoma subtypes into different categories, (4 grouping of neuroendocrine tumors together in one category, (5 and the current viewpoint of histologic grading of lung cancer.

  14. Boston Violence Intervention Advocacy Program: a qualitative study of client experiences and perceived effect. (United States)

    James, Thea L; Bibi, Salma; Langlois, Breanne K; Dugan, Elizabeth; Mitchell, Patricia M


    This study intended to explore clients' experiences and provide a contextual basis for understanding their perceptions of the effectiveness of the Boston Medical Center (BMC) Violence Intervention Advocacy Program (VIAP). This was an exploratory, qualitative study conducted in an urban, Level I trauma center from July 1, 2011 to February 24, 2012. Emergency department (ED) patients older than 18 years with penetrating trauma, and who were enrolled in the VIAP, were eligible. Two trained, qualitative interviewers who were not part of the VIAP obtained consent and conducted in-depth, semistructured interviews. Interviews were audiotaped, transcribed, deidentified, coded, and analyzed. Thematic content analysis consistent with grounded theory was used to identify themes related to client experiences with VIAP, life circumstances, challenges to physical and emotional healing postinjury, services provided by VIAP, and perceptions of VIAP's effectiveness. Twenty subjects were interviewed. Most were male, African American, and younger than 30 years of age, reflecting the overall program's clientele. Most subjects perceived their advocates as caring adults in their lives and cited aspects of the peer support model that helped establish trusting relationships. Major challenges to healing were fear and safety, trust, isolation as a coping mechanism, bitterness, and symptoms of posttraumatic stress disorder (PTSD). Every subject noted important services provided by VIAP advocates. Most subjects explicitly stated that they had positive experiences with the VIAP and perceived advocates' roles as a positive influence, providing client-centered advocacy, education, and support. This study provides insight into the lives of 20 BMC VIAP clients and contextualizes their unique challenges. Participants described positive, life-changing behaviors on their journey to healing through connections to caring, supportive adults. Information gained from this study will help the VIAP to

  15. The Commissioning and Provision of Advocacy for Problem Drug Users in English DATS: A Cross-Sectional Survey (United States)

    Cargill, Tamsin; Weaver, Tim D.; Patterson, Sue


    Aims: This study investigated the commissioning and delivery of advocacy for problem drug users. We aimed to quantify provision, describe the commissioning of advocacy services in Drug Action Teams (DATs) and to identify factors influencing advocacy provision. Methods: A cross-sectional survey of a randomly selected sample of 50 English DATs. The…

  16. Brief Report: The Feasibility and Effectiveness of an Advocacy Program for Latino Families of Children with Autism Spectrum Disorder (United States)

    Burke, Meghan M.; Magaña, Sandra; Garcia, Marlene; Mello, Maria P.


    Latino, Spanish-speaking families of children with autism spectrum disorder (ASD) face unique barriers in special education advocacy. Although advocacy programs are becoming more common in the United States, none of these programs target Latino families. This is a pilot study to examine the feasibility and effectiveness of an advocacy program for…

  17. Electrocardiography changes during adjuvant breast cancer therapy: incidence and risk factors. (United States)

    Elme, Anneli; Saarto, Tiina; Tötterman, Karl Johan; Utrianen, Meri; Kautiainen, Hannu; Järvenpää, Salme; Tenhuen, Mikko; Blomqvist, Carl


    Breast cancer survivors have a higher cardiovascular morbidity/mortality rate, when compared with healthy age-matched general population. Electrocardiography (ECG) changes have been found to be associated with chemo- and radiation therapy. In the present study we investigated changes in ECG patterns following modern adjuvant therapy for breast cancer. A standard 12-lead electrocardiogram was recorded at rest three times (prior and after adjuvant therapy) and retrospectively analyzed in 414 breast cancer patients, who participated in the open prospective phase III randomized trial (BREX) of exercise training 2005-2007. New electrocardiographic changes in the T-wave or ST-segment (depression or elevation) after the adjuvant therapy were recorded in 49 patients (13%). In multivariate analyses, hypertension treated with anti-hypertensive medication was the only significant factor associated with irreversible ECG changes (OR=4.71; 95% CI=1.36-16.38; p=0.015). New irreversible pathological electrocardiographic changes, which acquired during the adjuvant therapy, had a clear relationship with hypertension This patients subgroup needs to be studied further.

  18. Changes in Siblings after the Death of a Child from Cancer (United States)

    Foster, Terrah L.; Gilmer, Mary Jo; Vannatta, Kathryn; Barrera, Maru; Davies, Betty; Dietrich, Mary S.; Fairclough, Diane L.; Gerhardt, Cynthia A.


    Background Few studies have examined changes in siblings after the death of a brother or sister, particularly from mother, father, and sibling perspectives within the first year post-death. Objective This descriptive study identified and assessed the frequency of changes in siblings after a child's death from cancer. Methods Participants were recruited from cancer registries at three hospitals in the U.S. and Canada 3–12 months after the child's death. Thirty-six mothers, 24 fathers, and 39 siblings from 40 families were included. Semi-structured interviews using open-ended questions were conducted with each parent and sibling separately in the home. Content analysis identified emerging themes, and McNemar tests compared frequencies between each paired set of reports (sibling vs. mother, sibling vs. father, mother vs. father). Results Sixty-nine percent of participants reported personal changes in siblings (e.g., changes in personality, school work, goals/life perspective, activities/interests). Forty-seven percent noted changes in siblings' relationships with family members and peers. Only 21% of participants reported no changes attributed to the death. Comparisons of frequencies across informants were not significant. Conclusions Most siblings experienced changes in multiple areas of their lives after the death of a brother or sister to cancer. Some changes reflected siblings that were positively adapting to the death, while other changes reflected difficulties. Implications for practice Our findings offer guidance to improve aftercare for bereaved siblings and their families. Additional research is needed to further delineate the needs of bereaved siblings and to develop strategies to promote adaptation to loss. PMID:22067687

  19. Changes in spiritual well-being and psychological outcomes in ovarian cancer survivors. (United States)

    Davis, Lauren Z; Cuneo, Michaela; Thaker, Premal H; Goodheart, Michael J; Bender, David; Lutgendorf, Susan K


    Because of the poor prognosis of ovarian cancer and concomitant distress, understanding contributors to positive well-being is critical. This study examines spiritual growth as a domain of posttraumatic growth and its contribution to longitudinal emotional outcomes in ovarian cancer. Ovarian cancer patients (N = 241) completed measures assessing spirituality (Functional Assessment of Chronic Illness Therapy-Spiritual Well-being-12; subscales: faith, meaning, and peace), depression (Center for Epidemiologic Studies Depression Scale), cancer-specific anxiety (Impact of Event Scale), and total mood disturbance (TMD; Profile of Mood States) prior to surgery and 1-year postsurgery. Stressful life events in the year after diagnosis were measured at 1-year postsurgery. Regressions examined the association between changes in spirituality and depression, anxiety, and TMD at 1-year postsurgery. Additionally, spiritual change was examined as a moderator of the effect of recent life events on mood. Increases in peace were related to lower depression (β = -.40, P meaning and faith were unrelated to all outcomes. Additionally, changes in peace moderated the effect of stressful life events on depression (β = -.14, P = .027), anxiety (β = -.16, P = .05), and TMD (β = -.17, P = .01), such that those with a high number of life events paired with a decrease in peace experienced the worst psychological outcomes at 1 year. These findings suggest that the quality of peace may be the most adaptive facet of spiritual growth in cancer patients. Furthermore, changes in peace appear to moderate the effect of life events on psychological well-being. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse. (United States)

    Rivas, Carol; Ramsay, Jean; Sadowski, Laura; Davidson, Leslie L; Dunne, Danielle; Eldridge, Sandra; Hegarty, Kelsey; Taft, Angela; Feder, Gene


    , antenatal, healthcare); advocacy intensity (from 30 minutes to 80 hours); and abuse severity. Three trials evaluated advocacy within multi-component interventions. Eleven measured some form of abuse (eight scales), six assessed quality of life (three scales), and six measured depression (three scales). Countries and ethnic groups varied (one or more minority ethnic groups in the USA or UK, and local populations in Hong Kong and Peru). Setting was associated with intensity and duration of advocacy.Risk of bias was high in five studies, moderate in five, and low in three. The quality of evidence (considering multiple factors such as risk of bias, study size, missing data) was moderate to low for brief advocacy and very low for intensive advocacy. Incidence of abuse Physical abuseModerate quality pooled data from two healthcare studies (moderate risk of bias) and one community study (low risk of bias), all with 12-month follow-up data, showed no effect on physical abuse for brief (change - 1.00, 95% CI - 1.82 to - 0.18; n = 110). An antenatal, multi-component study showed a greater likelihood of physical abuse ending (odds ratio (OR) 0.42, 95% CI 0.23 to 0.75) immediately after advocacy (number needed to treat (NNT) = 8); we cannot exclude impact from other components.Low to very low quality evidence from two intensive advocacy trials (12 hours plus duration) showed reduced severe physical abuse in women leaving a shelter at 24 months (OR 0.39, 95% CI 0.20 to 0.77; NNT = 8), but not at 12 or 36 months. Sexual abuseMeta-analysis of two studies (n = 239) showed no effect of advocacy on sexual abuse (SMD - 0.12, 95% CI - 0.37 to 0.14), agreeing with the change score (MD - 0.07, 95% CI - 0.30 to 0.16) from a third study and the OR (0.96, 95% CI 0.44 to 2.12) from a fourth antenatal, multi-component study. Emotional abuseOne study in antenatal care, rated at low risk of bias, showed reduced emotional abuse at ≤ 12-month follow-up (MD (change score) - 4.24, 95% CI - 6.42 to - 2

  1. Incidence and mortality of primary liver cancer in England and Wales: changing patterns and ethnic variations. (United States)

    Ladep, Nimzing G; Khan, Shahid A; Crossey, Mary Me; Thillainayagam, Andrew V; Taylor-Robinson, Simon D; Toledano, Mireille B


    To explore recent trends, modes of diagnosis, ethnic distribution and the mortality to incidence ratio of primary liver cancer by subtypes in England and Wales. We obtained incidence (1979-2008) and mortality (1968-2008) data for primary liver cancer for England and Wales and calculated age-standardised incidence and mortality rates. Trends in age-standardised mortality (ASMR) and incidence (ASIR) rates and basis of diagnosis of primary liver cancer and subcategories: hepatocellular carcinoma, intrahepatic bile duct and unspecified liver tumours, were analysed over the study period. Changes in guidelines for the diagnosis of primary liver cancer (PLC) may impact changing trends in the rates that may be obtained. We thus explored changes in the mode of diagnosis as reported to cancer registries. Furthermore, we examined the distribution of these tumours by ethnicity. Most of the statistical manipulations of these data was carried out in Microsoft excel® (Seattle, Washington, United Sttaes). Additional epidemiological statistics were done in Epi Info software (Atlanta, GA, United Sttaes). To define patterns of change over time, we evaluated trends in ASMR and ASIR of PLC and intrahepatic bile duct carcinoma (IHBD) using a least squares regression line fitted to the natural logarithm of the mortality and incidence rates. We estimated the patterns of survival over subsequent 5 and 10 years using complement of mortality to incidence ratio (1-MIR). Age-standardised mortality rate of primary liver cancer increased in both sexes: from 2.56 and 1.29/100000 in 1968 to 5.10 and 2.63/100000 in 2008 for men and women respectively. The use of histology for diagnostic confirmation of primary liver cancer increased from 35.7% of registered cases in 1993 to plateau at about 50% during 2005 to 2008. Reliance on cytology as a basis of diagnosis has maintained a downward trend throughout the study period. Although approximately 30% of the PLC registrations had information on

  2. Patient Advocacy Organizations, Industry Funding, and Conflicts of Interest. (United States)

    Rose, Susannah L; Highland, Janelle; Karafa, Matthew T; Joffe, Steven


    Patient advocacy organizations (PAOs) are influential health care stakeholders that provide direct counseling and education for patients, engage in policy advocacy, and shape research agendas. Many PAOs report having financial relationships with for-profit industry, yet little is known about the nature of these relationships. To describe the nature of industry funding and partnerships between PAOs and for-profit companies in the United States. A survey was conducted from September 1, 2013, to June 30, 2014, of a nationally representative random sample of 439 PAO leaders, representing 5.6% of 7865 PAOs identified in the United States. Survey questions addressed the nature of their activities, their financial relationships with industry, and the perceived effectiveness of their conflict of interest policies. Amount and sources of revenue as well as organizational experiences with and policies regarding financial conflict of interest. Of the 439 surveys mailed to PAO leaders, 289 (65.8%) were returned with at least 80% of the questions answered. The PAOs varied widely in terms of size, funding, activities, and disease focus. The median total revenue among responding organizations was $299 140 (interquartile range, $70 000-$1 200 000). A total of 165 of 245 PAOs (67.3%) reported receiving industry funding, with 19 of 160 PAOs (11.9%) receiving more than half of their funding from industry. Among the subset of PAOs that received industry funding, the median amount was $50 000 (interquartile range, $15 000-$200 000); the median proportion of industry support derived from the pharmaceutical, device, and/or biotechnology sectors was 45% (interquartile range, 0%-100%). A total of 220 of 269 respondents (81.8%) indicated that conflicts of interest are very or moderately relevant to PAOs, and 94 of 171 (55.0%) believed that their organizations' conflict of interest policies were very good. A total of 22 of 285 PAO leaders (7.7%) perceived pressure to conform

  3. [Grape seed extract induces morphological changes of prostate cancer PC-3 cells]. (United States)

    Shang, Xue-Jun; Yin, Hong-Lin; Ge, Jing-Ping; Sun, Yi; Teng, Wen-Hui; Huang, Yu-Feng


    To observe the morphological changes of prostate cancer PC-3 cells induced by grape seed extract (GSE). PC-3 cells were incubated with different concentrations of GSE (100, 200 and 300 microg/ml) for 24, 48 and 72 hours, and then observed for morphological changes by invert microscopy, HE staining and transmission electron microscopy. The incubated PC-3 cells appeared round, small, wrinkled and broken under the invert microscope and exhibited the classical morphological characteristics of cell death under the electron microscope, including cell atrophy, increased vacuoles, crumpled nuclear membrane, and chromosome aggregation. GSE can cause morphological changes and induce necrosis and apoptosis of PC-3 cells.

  4. An evaluation of the behaviour-change techniques used on Canadian cancer centre Web sites to support physical activity behaviour for breast cancer survivors. (United States)

    Sylvester, B D; Zammit, K; Fong, A J; Sabiston, C M


    Cancer centre Web sites can be a useful tool for distributing information about the benefits of physical activity for breast cancer (bca) survivors, and they hold potential for supporting health behaviour change. However, the extent to which cancer centre Web sites use evidence-based behaviour change techniques to foster physical activity behaviour among bca survivors is currently unknown. The aim of our study was to evaluate the presentation of behaviour-change techniques on Canadian cancer centre Web sites to promote physical activity behaviour for bca survivors. All Canadian cancer centre Web sites ( n = 39) were evaluated by two raters using the Coventry, Aberdeen, and London-Refined (calo-re) taxonomy of behaviour change techniques and the eEurope 2002 Quality Criteria for Health Related Websites. Descriptive statistics were calculated. The most common behaviour change techniques used on Web sites were providing information about consequences in general (80%), suggesting goal-setting behaviour (56%), and planning social support or social change (46%). Overall, Canadian cancer centre Web sites presented an average of M = 6.31 behaviour change techniques (of 40 that were coded) to help bca survivors increase their physical activity behaviour. Evidence of quality factors ranged from 90% (sites that provided evidence of readability) to 0% (sites that provided an editorial policy). Our results provide preliminary evidence that, of 40 behaviour-change techniques that were coded, fewer than 20% were used to promote physical activity behaviour to bca survivors on cancer centre Web sites, and that the most effective techniques were inconsistently used. On cancer centre Web sites, health promotion specialists could focus on emphasizing knowledge mobilization efforts using available research into behaviour-change techniques to help bca survivors increase their physical activity.

  5. Meeting the needs of cancer patients: is there a need for an organizational change? (United States)

    Foà, Chiara; Mancini, Tiziana; Prandi, Rossella; Ghirardi, Linda; De Vincenzi, Franca; Cornelli, Maria Cristina; Copelli, Patrizia; Artioli, Giovanna


    As stated in the literature the most important needs of cancer patients are not adequately meet. Improving information, communication and education provided have not led to incisive changes in the organizational model of the oncology departments. The study contributes to this direction, by planning an "Integrated Operating Point" (I.O.P.) dedicated to cancer patients and their relatives in Italy. 42 Some professionals, patients and relatives were involved and 42 of them participated in focus group/or interviews. Results of thematic content analysis allow us to sketch out some key elements that I.O.P. should have in order to support cancer patients and their families. Integration of services, continuity of care, and cooperation between professionals involved are key elements that might qualify such organizational development.

  6. [Changes of mortality rate for cervical cancer during 1970's and 1990's periods in China]. (United States)

    Yang, Ling; Huangpu, Xiao-mei; Zhang, Si-wei; Lu, Feng-zhu; Sun, Xiu-di; Sun, Jie; Mu, Ren; Li, Lian-di; Qiao, You-lin


    To describe the distribution changes of the mortality rate for cervical cancer in China between the 1970's and 1990's and provide the scientific evidence for the prevention and control strategies for cervical cancer campaign in China between next century. Data from two National Surveys for the Causes of Death in 1970's and 1990's in China. The crude and adjusted mortality rates for the cervical cancer and the distributions based on age and area were calculated and described. The comparison of the differences of changes between two mortality rates periods and together with its trends were shown based on the age-standardized. During two decades, the mortality rate for cervical cancer was 10.7 per 100,000 in 1970's which declined to 3.89 per 100,000 in 1990's, and from the 3rd ranking among all female malignant tumors to the 6th in 1990's (decreased about 63.64%). But the declination was not evenly. There have still been some high-risk areas, most located in rural countries in the mid-west of China, with rates remain unchanged and even at the highest level in the world, such as Wudu in Gansu and Yangcheng in Shanxi. A big difference was showed between rural country and city, but in both of them, the mortality rates in 1990's were significantly much lower than in 1970's (P = 0.001) at each five-year age group. And in the city, there was a much sharper increased trend in young women in 1990's. The mortality rate for cervical cancer campaign in China has been substantially declined during past twenty years, but it's still a major health problem for women, especially in rural China. The focus of the prevention and control for the cervical cancer in the next century should put on rural areas, especially in mid-west of China and young women in the city.

  7. Beyond Advocacy: Mapping the Contours of Victim Work. (United States)

    Globokar, Julie L; Erez, Edna; Gregory, Carol R


    In contrast to works on victim advocacy in specific organizational contexts, this article introduces the term "victim work" to capture the vast array of victim-related roles and tasks that have proliferated in recent decades. Data are derived from in-depth interviews with 30 "victim workers" in public and private agencies in two Midwestern states. The interviews revealed diverse work experiences that spanned hotlines, crisis response, legal proceedings, and postconviction support. Three themes emerged that characterize "victim work": flexibility, emotions, and the challenge of "fit"-the multifaceted difficulties of interacting with victims and agents of the justice system. Based on the findings, we offer a revised model of criminal justice vis-à-vis victims and implications for practice and future research. © The Author(s) 2016.

  8. Child advocacy center based group treatment for child sexual abuse. (United States)

    Hubel, Grace S; Campbell, Christopher; West, Tiffany; Friedenberg, Samantha; Schreier, Alayna; Flood, Mary Fran; Hansen, David J


    The present study examines initial symptom presentation among participants, outcomes, and social validity for a group treatment for child sexual abuse delivered at a child advocacy center. Participants were 97 children and their nonoffending caregivers who were referred to Project SAFE (Sexual Abuse Family Education), a standardized, 12-week cognitive-behavioral group treatment for families who have experienced child sexual abuse. Sixty-four percent of children presented with clinically significant symptoms on at least one measure with established clinical cutoffs. Caregivers of children who presented with clinically significant symptoms reported more distress about their competence as caregivers. Children who presented as subclinical were more likely to have experienced intrafamilial sexual abuse. Posttreatment results indicated significant improvements in functioning for all children who participated in treatment, with greater improvements reported for children who initially presented with clinically significant symptoms. Overall, the program was rated favorably on the posttreatment evaluation of social validity.

  9. Restoring rape survivors: justice, advocacy, and a call to action. (United States)

    Koss, Mary P


    Rape results in mental and physical health, social, and legal consequences. For the latter, restorative justice-based programs might augment community response, but they generate controversy among advocates and policy makers. This article identifies survivors' needs and existing community responses to them. Survivors feel their legal needs are most poorly met due to justice system problems that can be summarized as attrition, retraumatization, and disparate treatment across gender, class, and ethnic lines. Empirical data support each problem and the conclusion that present justice options are inadequate. The article concludes by identifying common ground in advocacy and restorative justice goals and calls for a holistic approach to the needs of rape survivors that includes advocating for expanded justice alternatives. A call to action is issued to implement restorative alternatives to expand survivor choice and offender accountability. Conventional and restorative justice are often viewed as mutually exclusive whereas the author argues they are complementary.

  10. Significance of postoperative structural changes in serum N-glycans in pancreatic cancer patients

    Directory of Open Access Journals (Sweden)

    JIN Yu


    Full Text Available ObjectiveTo investigate the structural changes in specific serum N-glycans in pancreatic cancer patients and to identify the specific serum maker of pancreatic cancer. MethodsThe pancreatic cancer patients who visited the Third Affiliated Hospital of Harbin Medical University from June 2011 to December 2013 were assigned to preoperative serum group (123 cases and postoperative serum group (78 cases; healthy controls whose serum samples were collected in the Physical Examination Center were selected as control serum group (271 cases. DNA sequencer-aided fluorophore-assisted carbohydrate electrophoresis (DSA-FACE was used to analyze serum N-glycans and compare them between the three groups. ResultsThe serum N-glycan profiles in pancreatic cancer patients were identified by DSA-FACE. The results indicated that N-glycan peak 8 in preoperative serum group was significantly lower than those in control serum group (t=2.735, P<0.05 and postoperative serum group (P<0.05, but no significant difference was found between the postoperative serum group and control serum group. ConclusionN-glycan peak 8 can be considered as a serum marker of pancreatic cancer.

  11. Sweating the small stuff: microRNAs and genetic changes define pancreatic cancer. (United States)

    Tang, Siuwah; Bonaroti, Jillian; Unlu, Sebnem; Liang, Xiaoyan; Tang, Daolin; Zeh, Herbert J; Lotze, Michael T


    MicroRNAs (miRNAs) are 18- to 22-nucleotide-long, single-stranded, noncoding RNAs that regulate important biological processes including differentiation, proliferation, and response to cellular stressors such as hypoxia, nutrient depletion, and traversion of the cell cycle by controlling protein expression within the cell. Many investigators have profiled cancer tissue and serum miRNAs to identify potential therapeutic targets, understand the pathways involved in tumorigenesis, and identify diagnostic tumor signatures. In the setting of pancreatic cancer, obtaining pancreatic tissue is invasive and impractical for early diagnosis. Several groups have profiled miRNAs that are present in the blood as a means to diagnose tumor progression and predict prognosis/survival or drug resistance. Several miRNA signatures found in pancreatic tissue and the peripheral blood, as well as the pathways that are associated with pancreatic cancer, are reviewed here in detail. Three miRNA biomarkers (miR-21, miR-155, and miR-200) have been repetitively identified in both pancreatic cancer tissue and patients' blood. Those miRNAs regulate and are regulated by the central genetic and epigenetic changes observed in pancreatic cancer including p53, transforming growth factor β, p16(INK4A), BRCA1/2, and Kras. These miRNAs are involved in DNA repair, cell cycle, and cell invasion and also play important roles in promoting metastases.

  12. Changes in Cytokines of the Bone Microenvironment during Breast Cancer Metastasis

    Directory of Open Access Journals (Sweden)

    Donna M. Sosnoski


    Full Text Available It is commonly accepted that cancer cells interact with host cells to create a microenvironment favoring malignant colonization. The complex bone microenvironment produces an ever changing array of cytokines and growth factors. In this study, we examined levels of MCP-1, IL-6, KC, MIP-2, VEGF, MIG, and eotaxin in femurs of athymic nude mice inoculated via intracardiac injection with MDA-MB-231GFP human metastatic breast cancer cells, MDA-MB-231BRMS1GFP, a metastasis suppressed variant, or PBS. Animals were euthanized (day 3, 11, 19, 27 after injection to examine femoral cytokine levels at various stages of cancer cell colonization. The epiphysis contained significantly more cytokines than the diaphysis except for MIG which was similar throughout the bone. Variation among femurs was evident within all groups. By day 27, MCP-1, MIG, VEGF and eotaxin levels were significantly greater in femurs of cancer cell-inoculated mice. These pro-osteoclastic and angiogenic cytokines may manipulate the bone microenvironment to enhance cancer cell colonization.

  13. Swedish registered nurses' and nurse managers' attitudes towards patient advocacy in community care of older patients. (United States)

    Josse-Eklund, Anna; Petzäll, Kerstin; Sandin-Bojö, Ann-Kristin; Wilde-Larsson, Bodil


    To describe and compare registered nurses' (RNs) and nurse managers' (NMs) attitudes towards patient advocacy in the community care of older patients. RNs may act as patients' advocates in the care of older patients. NMs should support patient advocacy in order to make the best care available to patients. A modified Attitudes towards Patient Advocacy Scale was used to collect data from 207 RNs and 23 NMs in the Swedish community care of older patients. The response rate was 52%. Descriptive and inferential statistics were used. Both RNs and NMs showed positive attitudes towards patient advocacy. They were more positive towards patient advocacy for patients unable to help themselves than for competent patients. This study showed that RNs and NMs did not differ in their attitudes towards patient advocacy. This result is consistent with the idea of giving the neediest and vulnerable patients greater care. It is important for NMs to clarify their own and RNs attitudes towards patient advocacy as disparities may affect cooperation between the groups. Any effects on cooperation may, by extension, affect the quality of care. © 2012 John Wiley & Sons Ltd.

  14. Kentucky Teen Institute: Results of a 1-Year, Health Advocacy Training Intervention for Youth. (United States)

    King, Kristi M; Rice, Jason A; Steinbock, Stacie; Reno-Weber, Ben; Okpokho, Ime; Pile, Amanda; Carrico, Kelly


    The Kentucky Teen Institute trains youth throughout the state to advocate for policies that promote health in their communities. By evaluating two program summits held at universities, regularly scheduled community meetings, ongoing technical support, and an advocacy day at the state Capitol, the aims of this study were to assess the impact of the intervention on correlates of youths' advocacy intentions and behaviors and to assess youth participants' and other key stakeholders' perceptions of the intervention. An ecological model approach and the theory of planned behavior served as theoretical frameworks from which pre-post, one-group survey and qualitative data were collected (June 2013-June 2014). An equal number of low-income and non-low-income youth representing five counties participated in the Summer Summit pretest (n = 24) and Children's Advocacy Day at the Capitol posttest (n = 14). Survey data revealed that youths' attitude toward advocacy, intentions to advocate, and advocacy behaviors all improved over the intervention. Observations, interviews, a focus group, and other written evaluations identified that the youths', as well as their mentors' and advocacy coaches', confidence, communities' capacity, and mutually beneficial mentorship strengthened. Stronger public speaking skills, communication among the teams, and other recommendations for future advocacy interventions are described. © 2015 Society for Public Health Education.

  15. A Public Policy Advocacy Project to Promote Food Security: Exploring Stakeholders' Experiences. (United States)

    Atkey, Kayla M; Raine, Kim D; Storey, Kate E; Willows, Noreen D


    To achieve food security in Canada, comprehensive approaches are required, which involve action at the public policy level. This qualitative study explored the experiences of 14 stakeholders engaging in a 9-month participatory public policy advocacy project to promote community food security in the province of Alberta through the initiation of a campaign to develop a Universal School Food Strategy. Through this exploration, four main themes were identified; a positive and open space to contribute ideas, diversity and common ground, confidence and capacity, and uncertainty. Findings from this study suggest that the participatory advocacy project provided a positive and open space for stakeholders to contribute ideas, through which the group was able to narrow its focus and establish a goal for advocacy. The project also seems to have contributed to the group's confidence and capacity to engage in advocacy by creating a space for learning and knowledge sharing, though stakeholders expressed uncertainty regarding some aspects of the project. Findings from this study support the use of participatory approaches as a strategy for facilitating engagement in public policy advocacy and provide insight into one group's advocacy experience, which may help to inform community-based researchers and advocates in the development of advocacy initiatives to promote community food security elsewhere. © 2016 Society for Public Health Education.

  16. Changes in parents after the death of a child from cancer. (United States)

    Gilmer, Mary Jo; Foster, Terrah L; Vannatta, Kathryn; Barrera, Maru; Davies, Betty; Dietrich, Mary S; Fairclough, Diane L; Grollman, Jamie; Gerhardt, Cynthia A


    Few studies have compared multiple perspectives of changes experienced by parents after a child's death. This study used interviews with bereaved parents and siblings to examine changes in parents during the first year after the death of a child from cancer. Mothers (n=36), fathers (n=24), and siblings (n=39) from 40 families were recruited from three hospitals in the U.S. and Canada three to 12 months after the death (M=10.7, SD=3.5). Semistructured interviews with open-ended questions were conducted in the home with each participating parent and sibling separately. Content analysis identified emerging themes, and frequencies were compared between each paired set of reports (mother vs. sibling, father vs. sibling, and mother vs. father). Parents and siblings identified two major categories of change experienced by bereaved parents. These changes occurred in their personal lives (e.g., emotions, perspectives and priorities, physical state, work habits, coping/behaviors, spiritual beliefs, and feeling something is missing) and relationships (e.g., family, others). Ninety-four percent of the mothers, 87% of the fathers, and 69% of the siblings reported parental changes in at least one of these categories. Parents were more likely to report changes in priorities, whereas siblings reported more sadness in parents after the death. Positive and negative changes in parents after the death of a child from cancer occur in both personal and relational domains. Additional research is needed to determine the impact of a child's death on bereaved parents over time and to develop strategies to promote healthy adjustment. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  17. Longitudinal Brain Changes Associated with Prophylactic Cranial Irradiation in Lung Cancer. (United States)

    Simó, Marta; Vaquero, Lucía; Ripollés, Pablo; Gurtubay-Antolin, Ane; Jové, Josep; Navarro, Arturo; Cardenal, Felipe; Bruna, Jordi; Rodríguez-Fornells, Antoni


    The toxic effects of prophylactic cranial irradiation (PCI) and platinum-based chemotherapy on cognition in the lung cancer population have not yet been well established. In the present study we examined the longitudinal neuropsychological and brain structural changes observed in patients with lung cancer who were undergoing these treatments. Twenty-two patients with small cell lung cancer (SCLC) who underwent platinum-based chemotherapy and PCI were compared with two control groups: an age- and education-matched group of healthy controls (n = 21) and a group of patients with non-SCLC (NSCLC, n = 13) who underwent platinum-based chemotherapy. All groups were evaluated using a neuropsychological battery and multimodal structural magnetic resonance imaging: T1-weighted and diffusion tensor imaging at baseline (before PCI for SCLC and chemotherapy for NSCLC) and at 3 months after treatment. T1 voxel-based morphometry and tract-based spatial statistics were used to analyze microstructural changes in gray matter (GM) and white matter (WM). The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Questionnaire was also completed. Patients with SCLC exhibited cognitive deterioration in verbal fluency over time. Structural magnetic resonance imaging showed decreases in GM at 3 months in the right subcortical regions, bilateral insular cortex, and superior temporal gyrus in patients with SCLC compared with both control groups. Additionally, patients with SCLC showed decreases in GM over time in the aforementioned regions plus in the right parahippocampal gyrus and hippocampus, together with changes in the WM microstructure of the entire corpus callosum. These changes had a limited impact on responses to the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Questionnaire, however. Patients with NSCLC showed no cognitive or brain structural differences after chemotherapy. This longitudinal

  18. A comparative content analysis of media reporting of sports betting in Australia: lessons for public health media advocacy approaches. (United States)

    David, Jennifer L; Thomas, Samantha L; Randle, Melanie; Bowe, Steven J; Daube, Mike


    Harmful gambling is a significant public health issue. There has been widespread discussion in the Australian media about the extent and impact of sports betting on the Australian community, particularly relating to young men and children. Given the role that the media plays in influencing policy change and political agendas, and the acknowledgement that media based advocacy is a fundamental component of successful advocacy campaigns, this research aimed to investigate how different stakeholder groups discuss sports betting within the Australian print media. The study uses this information to provide recommendations to guide public health media advocacy approaches. A quantitative content analysis of print media articles was conducted during two significant Parliamentary Inquiries about sports betting - (1) The Joint Select Committee Inquiry into the Advertising and Promotion of Gambling Services in Sport (2012/2013), and (2) 'The Review of Illegal Offshore Wagering (2015/2016). A total of 241 articles from 12 daily Australian newspapers were analysed. Statistical analysis was used to compare frequency of, and changes in, themes, voices and perspectives over time. Discussions about the marketing and communication of sports betting was a main theme in media reporting (n = 165, 68.5%), while discussions about gambling reform decreased significantly across the two time periods (p media reporting of sports betting is important in developing effective public health advocacy approaches. This study indicates that discussions about the marketing strategies utilised by the sports betting industry was still a main theme in media articles. However, discussions relating to sports betting reforms, in particular to protect individuals who may be vulnerable to the harm associated with these products and their promotional strategies (for example children and young men) decreased during the time periods. Public health advocates may seek to address the decrease in media reports

  19. "We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Reuben Hendler

    Full Text Available Few people with mental disorders in low and middle-income countries (LMICs receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs.We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions.Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets", what they advocate for ("asks", how advocates reach their targets ("access", how they make their asks ("arguments", and the results of their advocacy ("outcomes".Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

  20. "We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe. (United States)

    Hendler, Reuben; Kidia, Khameer; Machando, Debra; Crooks, Megan; Mangezi, Walter; Abas, Melanie; Katz, Craig; Thornicroft, Graham; Semrau, Maya; Jack, Helen


    Few people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs. We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions. Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets"), what they advocate for ("asks"), how advocates reach their targets ("access"), how they make their asks ("arguments"), and the results of their advocacy ("outcomes"). Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

  1. Longitudinal study of sexual function and vaginal changes after radiotherapy for cervical cancer

    DEFF Research Database (Denmark)

    Jensen, Pernille T; Groenvold, Mogens; Klee, Marianne C


    PURPOSE: To investigate the longitudinal course of self-reported sexual function and vaginal changes in patients disease free after radiotherapy (RT) for locally advanced, recurrent, or persistent cervical cancer. MATERIALS AND METHODS: A total of 118 patients referred for RT were included......% of the patients, and 45% were never, or only occasionally, able to complete sexual intercourse. Despite sexual dysfunction and vaginal adverse effects, 63% of those sexually active before having cancer remained sexually active after treatment, although with a considerably decreased frequency. CONCLUSIONS....... The patients were assessed, using a validated self-assessment questionnaire, at the termination of RT and 1, 3, 6, 12, 18, and 24 months later. The results were compared with an age-matched control group from the general population. RESULTS: Persistent sexual dysfunction and adverse vaginal changes were...

  2. Changes in nutritional status in childhood cancer patients: a prospective cohort study. (United States)

    Brinksma, Aeltsje; Roodbol, Petrie F; Sulkers, Esther; Kamps, Willem A; de Bont, Eveline S J M; Boot, Annemieke M; Burgerhof, Johannes G M; Tamminga, Rienk Y J; Tissing, Wim J E


    Under- and overnutrition are linked to adverse outcomes during and after childhood cancer treatment. Therefore, understanding the timing of weight loss and weight gain and their contributory factors is essential for improving outcomes. We aimed to determine in which period of treatment changes in nutritional status occurred and which factors contributed to these changes. A prospective cohort study of 133 newly diagnosed cancer patients with hematological, solid, and brain malignancies was performed. Anthropometric data and related factors were assessed at 0, 3, 6 and 12 months after diagnosis. Despite initial weight loss at the beginning of treatment in patients with hematological and solid malignancies, body mass index (BMI) and fat mass (FM) increased within 3 months with 0.13 SDS (P nutritional status might be accomplished by increasing physical activity from the early phase of treatment. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  3. Changing perspective on oncometabolites: from metabolic signature of cancer to tumorigenic and immunosuppressive agents. (United States)

    Corrado, Mauro; Scorrano, Luca; Campello, Silvia


    During tumorigenesis, the shift from oxidative phosphorylation to glycolysis in ATP production accounts for the dramatic change in the cellular metabolism and represents one of the major steps leading to tumour formation. The so-called Warburg effect is currently considered something more than a mere modification in the cellular metabolism. The paradox that during cancer cell proliferation the increase in energy need is supplied by glycolysis can be only explained by taking into account the many roles that intermediates of glycolysis or TCA cycle play in cellular physiology, besides energy production. Recent studies have shown that metabolic intermediates induce changes in chromatin structure or drive neo-angiogenesis. In this review, we present some of the latest findings in the study of cancer metabolism with particular attention to how tumour metabolism and its microenvironment can favour tumour growth and aggressiveness, by hijacking and dampening the anti-tumoral immune response.

  4. Primer on transportation and climate change (United States)


    This primer is an introduction to the issue of climate change and its implications for transportation policy in the United States. Its purpose is to outline the current thinking of governmental agencies, researchers, and advocacy groups on the issue ...

  5. Weight Change and Associated Factors in Long-Term Breast Cancer Survivors.

    Directory of Open Access Journals (Sweden)

    Hye-Yeon Koo

    Full Text Available Weight gain often occurs after breast cancer diagnosis and significantly impacts the general health of cancer survivors. While the number of breast cancer survivors is increasing, few studies have reported data on weight change beyond 5 years post-diagnosis. We investigated weight change and associated factors in long-term survivors of breast cancer.Medical records were reviewed on 1363 breast cancer patients and a total of 822 women who had survived beyond 5 years since diagnosis were included in the final analysis. The association between demographic, anthropometric, lifestyle, cancer related factors (including time since diagnosis, treatment modality, pathologic stage, and hormone receptor status, and weight-change over 5 years were examined.During an average 8.2 years of follow-up time, mean weight gain was 0.32kg (p = 0.017. 175 (21.3% patients had gained more than 5% of their weight at diagnosis and their average gain was 5.55kg. Body mass index (BMI at diagnosis, age at diagnosis, aromatase inhibitor (AI use, heavy drinking, and type of surgery were associated with relative weight gain (≥5% in univariate analysis (all p-values<0.05. Patients who were non-obese at diagnosis showed weight gain, while those who were obese at diagnosis lost weight (0.78kg,-1.11kg, respectively, p<0.001. In multivariate analysis, the non-obese group showed odds ratio of 2.7 (p = 0.001 relative to the obese group. Younger age group (age 18-54 years showed odds ratio of 1.9 (p = 0.021 relative to the older age group (age 55-75 years, and patients who did not use AI showed odds ratio of 2.2 (p = 0.006 relative to women who did.Long-term breast cancer survivors who were non-obese at diagnosis are more likely to gain weight than obese survivors. Younger survivors and survivors who have never used AI are also likely to gain weight.

  6. Regulation of Cancer-Causing Food Additives-Time for a Change? (United States)


    leading causes of death, respectively. Heart disease accounted for 337 deaths per 100,000 population, cancer accounted for 176, and cerebro - vascular...tics of any food. Before a regulation can be established, the additive must be shown to be safe and functional for its intended uses (i.e., it must...essential nature of a disease in animals, especially the struc- tural and functional changes in tissues and organs of a body which cause or are caused by

  7. Changing the way we do business: recommendations to accelerate biomarker development in pancreatic cancer. (United States)

    Tempero, Margaret A; Klimstra, David; Berlin, Jordan; Hollingsworth, Tony; Kim, Paula; Merchant, Nipun; Moore, Malcolm; Pleskow, Doug; Wang-Gillam, Andrea; Lowy, Andrew M


    Pancreatic ductal adenocarcinoma is the most aggressive of all epithelial malignancies. In contrast to the favorable trends seen in most other common malignancies, the five-year survival of patients with this disease remains only 6%, a statistic that has changed minimally for decades. Only two drugs have been approved by the U.S. Food and Drug Administration (FDA) for use in pancreatic cancer in the last 15 years, and there are no established strategies for early detection.

  8. Advocacy Communication and Social Identity: An Exploration of Social Media Outreach. (United States)

    Ciszek, Erica L


    Increasingly, advocacy organizations employ social networking sites as inexpensive and often effective ways to disseminate outreach messages. For groups working to reach lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, social media provide key platforms for connecting with target audiences. Although these young people increasingly utilize social media, little is known about how digital advocacy campaigns influence their sexual identity formation. This article applies concepts of social identity to examine how LGBTQ youth understand advocacy campaigns, how they perceive LGBTQ as a social category presented in campaigns, and what values they assign to LGBTQ group membership.

  9. The legitimate role of advocacy in environmental education: how does it differ from coercion?

    Directory of Open Access Journals (Sweden)

    Karen Cairns


    Full Text Available ABSTRACT: This paper examines the controversy in the field of environmental education over the role of advocacy versus presentation of scientific information. The former involves a view of education as process, while the latter perceives education solely as content. Environmental issues involve ethical concerns and value judgments. Scientific information cannot give us the answers to our environmental questions, as these questions have all the inherent complexity of any social issue. Advocacy differs from coercion, bias, and prejudice. Coercion, bias, and prejudice have no place in environmental education, while advocacy for ecological systems does.

  10. Affordable Care Act Changes To Medicare Led To Increased Diagnoses Of Early-Stage Colorectal Cancer Among Seniors. (United States)

    Lissenden, Brett; Yao, Nengliang Aaron


    The Affordable Care Act (ACA) helped make preventive care, including recommended cancer screening, more affordable and accessible for millions of Americans. Using population-based data from the Surveillance, Epidemiology, and End Results (SEER) Program, we estimated the impact of ACA policy changes to facilitate the diagnosis of cancer at an earlier and more treatable stage. We estimated that the ACA resulted in an increase of 8,400 (8 percent) diagnoses of early-stage colorectal cancer among US seniors in the period 2011-13. However, the ACA had no distinguishable effect on the number of diagnoses of early-stage breast cancer over the same time period. It is likely that the ACA initially affected the diagnosis of colorectal cancer more than that of breast cancer because the decrease in out-of-pocket spending was larger for colorectal than for breast cancer screening. Project HOPE—The People-to-People Health Foundation, Inc.

  11. On physical changes on surface of human cervical epithelial cells during cancer transformations (United States)

    Sokolov, Igor; Dokukin, Maxim; Guz, Nataliia; Woodworth, Craig


    Physical changes of the cell surface of cells during transformation from normal to cancerous state are rather poorly studied. Here we describe our recent studies of such changes done on human cervical epithelial cells during their transformation from normal through infected with human papillomavirus type-16 (HPV-16), immortalized (precancerous), to cancerous cells. The changes were studied with the help of atomic force microscopy (AFM) and through the measurement of physical adhesion of fluorescent silica beads to the cell surface. Based on the adhesion experiments, we clearly see the difference in nonspecific adhesion which occurs at the stage of immortalization of cells, precancerous cells. The analysis done with the help of AFM shows that the difference observed comes presumably from the alteration of the cellular ``brush,'' a layer that surrounds cells and which consists of mostly microvilli, microridges, and glycocalyx. Further AFM analysis reveals the emergence of fractal scaling behavior on the surface of cells when normal cells turn into cancerous. The possible causes and potential significance of these observations will be discussed.

  12. Thermally induced changes of optical and vital parameters in human cancer cells (United States)

    Dressler, C.; Schwandt, D.; Beuthan, J.; Mildaziene, V.; Zabarylo, U.; Minet, O.


    Minimally invasive laser-induced thermotherapy (LITT) presents an alternative method to conventional tumor therapeutically interventions, such as surgery, chemotherapy, radiotherapy or nuclear medicine. Optical tissue characteristics of tumor cells and their heat-induced changes are essential issues for controlling LITT progressions. Therefore, it is indispensable to exactly know the absorption coefficient μa, the scattering coefficient μs and the anisotropy factor g as well as their changes under rising temperatures in order to simulate the treatment parameters successfully. Optical parameters of two different cancer model tissues - breast cancer cells species MX1 and colon cancer cells species CX1 - were measured in the spectral range 400 - 1100 nm as well as in the temperature range 37 - 60°C. The absorption coefficient of both cell species was low throughout the spectral range analyzed, while μs of both species rose with increasing temperatures. The anisotropy factor g however dropped for both tissues with increasing temperatures. Light scatterings inside tissues proceeded continuously forward for all species tested. It was demonstrated that optical tissue properties undergo significant changes along with the vital status of the cells when the temperature increases.

  13. Managing appearance changes resulting from cancer treatment: resilience in adolescent females. (United States)

    Wallace, Melissa L; Harcourt, Diana; Rumsey, Nichola; Foot, Annabel


    Typically, adolescence is marked by cognitive and physical developments impacting on self-esteem, independence and sexual awareness, often resulting in increased appearance awareness and dissatisfaction. Adolescents with cancer have the additional burden of illness, treatments and resultant appearance changes. This study aimed to explore the impact of these changes on adolescents who have had cancer. In depth, semi-structured interviews were conducted with six females between 14 and 19 years who had completed treatment within the previous two years, and analysed using Interpretative Phenomenological Analysis (IPA). Concerns around an altered appearance were significant during treatment, serving as a constant reminder of 'difference' and a marker of illness. However, since treatment, participants expressed an apparent shift in views and expectations of their appearance, as well as the value placed on it -- expressing increased satisfaction with their own appearance and a decrease in its importance. While important to acknowledge the distress and challenges experienced by participants, results highlight the need for research and care to focus on positive experiences of patients, rather than simply maladjustment. Explanations for the findings are explored, including the temporary nature of many appearance changes and the life-threatening nature of cancer.

  14. Distress from changes in physical appearance and support through information provision in male cancer patients. (United States)

    Nozawa, Keiko; Tomita, Makiko; Takahashi, Eriko; Toma, Shoko; Arai, Yasuaki; Takahashi, Miyako


    This study aims to reveal the present situation of changes in physical appearance induced by treatment, the effects of these changes on social activities, and support from medical staff in male cancer patients. A questionnaire survey was administered to 949 male patients (response rate: 90.1%) visiting the National Cancer Center Hospital in Tokyo over 3 days in January 2015. The final respondents were 823 patients (mean age: 65.3, standard deviation (SD) = 12.32). Fifty-two percent of the sample, and 79.4% of patients aged under 65 were employed. A total of 84.9% experienced changes in physical appearance, and the highest mean scores of psychological were observed for stoma (3.1) and skin eczema (2.9). A total of 66.4% reported no difference in daily life even after their physical appearance changed. However, patients younger than 65 years old who were employed experienced high social difficulties (12.5%). Many wanted to stop going to work and experienced severe distress in their social lives; 74.1% reported it is important to have the same physical appearance at work as before treatment. The majority of patients obtained information from doctors (35.2%) and consulted with their wife or partner (66.2%) regarding their appearance changes, and 5.7% did not have anyone to consult with. This study clarified important aspects for supporting male cancer patients: timing, content, target audience and steps of information provision. Appropriate information provision from medical staff prior to treatment can be useful in preparing patients for physical appearance changes and decreasing the severity of symptoms.

  15. Gene Expression Changes in Human Lung Cells Exposed to Arsenic, Chromium, Nickel or Vanadium Indicate the First Steps in Cancer


    Clancy, Hailey A.; Sun, Hong; Passantino, Lisa; Kluz, Thomas; Muñoz, Alexandra; Zavadil, Jiri; Costa, Max


    The complex process of carcinogenesis begins with transformation of a single cell to favor aberrant traits such as loss of contact inhibition and unregulated proliferation – features found in every cancer. Despite cancer’s widespread prevalence, the early events that initiate cancer remain elusive, and without knowledge of these events cancer prevention is difficult. Here we show that exposure to As, Cr, Ni, or Vanadium (V) promotes changes in gene expression that occur in conjunction with ab...

  16. Impact of weight change and weight cycling on risk of different subtypes of endometrial cancer. (United States)

    Nagle, C M; Marquart, L; Bain, C J; O'Brien, S; Lahmann, P H; Quinn, M; Oehler, M K; Obermair, A; Spurdle, A B; Webb, P M


    Obesity is an established risk factor for endometrial cancer. Associations tend to be stronger for the endometrioid subtype. The role of adult weight change and weight cycling is uncertain. Our study aimed to determine whether there is an association between different adult weight trajectories, weight cycling and risk of endometrial cancer overall, and by subtype. We analysed data from the Australian National Endometrial Cancer study, a population-based case-control study that collected self-reported information on height, weight at three time points (age 20, maximum and 1 year prior to diagnosis [recent]), intentional weight loss/regain (weight cycling) from 1398 women with endometrial cancer and 1538 controls. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression analysis. Relative to women who maintained a stable weight during adulthood, greater weight gain after the age of 20 was associated with increased risk of endometrial cancer (OR for gain 40+kg all subtypes 5.3, 95% CI 3.9-7.3; endometrioid 6.5, 95% CI 4.7-9.0). The strongest associations were observed among women who were continually overweight from the age of 20 (all subtypes OR 3.6, 95% CI 2.6-5.0). Weight cycling was associated with increased risk, particularly among women who had ever been obese (OR 2.9 95% CI 1.8-4.7), with ~3-fold risks seen for both endometrioid and non-endometrioid tumour subtypes. Women who had intentionally lost weight and maintained that weight loss were not at increased risk. These results suggest that higher adult weight gain, and perhaps weight cycling, independently increase the risk of endometrial cancer, however women who lost weight and kept that weight off were not at increased risk. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Changes in motivational outcomes after a supervised resistance exercise training intervention in lung cancer survivors. (United States)

    Peddle-McIntyre, Carolyn J; Bell, Gordon; Fenton, David; McCargar, Linda; Courneya, Kerry S


    Short-term supervised exercise interventions improve health-related fitness in lung cancer survivors; however, sustained exercise is required to maintain the health benefits. The impact of exercise interventions on motivational outcomes may be important for long-term exercise adoption. The objective of this study was to examine the effects of a 10-week supervised progressive resistance exercise training program on lung cancer survivors' motivational outcomes based on the Theory of Planned Behavior (TPB). Posttreatment lung cancer survivors were recruited to undergo a 10-week supervised resistance exercise training intervention. The 2-component model of the TPB was measured at baseline and after intervention. Fifteen participants completed assessments of TPB measures. Significant increases in self-efficacy (P = .022) and perceived controllability (P = .032) and a nonsignificant increase in affective attitude (P = .090) were observed after intervention. Intention was significantly lower at postintervention (P = .044). Significant correlates of postintervention intention were instrumental attitude (P = .001), self-efficacy (P = .004), perceived behavioral control (P = .009), and affective attitude (P = .044). At postintervention, self-efficacy was significantly correlated with planning (P resistance exercise training may improve some motivational outcomes for lung cancer survivors. Intentions appeared to be weakened after the intervention, but there are methodological explanations for this finding. Participation in short-term supervised resistance exercise may be an effective method to improve some motivational factors related to exercise in lung cancer survivors. More research is needed to examine the long-term effects of supervised resistance exercise on motivational outcomes in lung cancer survivors. Strategies to maintain motivational changes that occur following a supervised resistance exercise intervention need to be investigated.

  18. A Novel Measure of Dietary Change in a Prostate Cancer Dietary Program Incorporating Mindfulness Training


    Carmody, James F.; Olendzki, Barbara C.; Merriam, Philip A.; Liu, Qin; Qiao, Yongxia; Ma, Yunsheng


    Diet may represent a modifiable prostate cancer (CaP) risk factor, but a vegetable-based prostate-healthy diet is a major change for most men. We used a ratio of animal:vegetable proteins (A:V ratio) to evaluate whether a comprehensive dietary change was self-sustaining following completion of 11 weekly dietary and cooking classes that integrated mindfulness training (MT). Thirty-six men with recurring CaP were randomized to the intervention or wait-list control. Assessments were at baseline,...

  19. Quality of life changes and intensive care preferences in terminal cancer patients. (United States)

    Hwang, In Cheol; Keam, Bhumsuk; Yun, Young Ho; Ahn, Hong Yup; Kim, Young-Ae


    There is scarce research on the short-term fluctuations in end-of-life (EoL) care planning for seriously ill patients. The aim of our study was to investigate the stability of preferences regarding treatment in an intensive care unit (ICU) and identify the factors associated with changes in preferences in terms of quality of life (QoL). A prospective examination on preference changes for ICU care in 141 terminal cancer patients was conducted. Patients were categorized according to their change in preference during the final two months of their lives into four categories: (1) the keep-accept group, (2) the keep-reject group, (3) the change to accept group, and (4) the change to reject group. Using multiple logistic analyses, we explored the association between patient demographics, health-related QoL, and changes in ICU preference. The overall stability of ICU preferences near the end of life was 66.7% (κ = 0.33, p care [adjusted odds ratio (aOR) toward accept 12.35, p = 0.021; aOR toward reject 10.56, p = 0.020] than unmarried patients. Patients with stable physical function tended to accept ICU care (aOR = 5.05, p = 0.023), whereas those with poor performance (aOR = 5.32, p = 0.018), worsened QoL (aOR = 8.34, p = 0.007), or non-aggravated fatigue (aOR = 8.36, p = 0.006) were more likely to not accept ICU care. The attitudes of terminally ill cancer patients regarding ICU care at the end of life were not stable over time, and changes in their QoL were associated with a tendency to change their preferences about ICU care. Attention should thus be paid to patients' QoL changes to improve medical decision making with regard to EoL care.

  20. Demographic changes in breast cancer incidence, stage at diagnosis and age associated with population-based mammographic screening. (United States)

    Verdial, Francys C; Etzioni, Ruth; Duggan, Catherine; Anderson, Benjamin O


    Breast cancer incidence and mortality are influenced by early-detection methods, including mammographic screening. Demographic changes in US statistics serve as a model for changes that can be anticipated in countries where mammographic screening has not been implemented. SEER statistics (1973-2013) for breast cancer mortality, incidence, stage at diagnosis, and age at diagnosis were examined. Temporal associations between screening changes and breast cancer demographics in the US were documented. Before 1982 (pre-screening), breast cancer incidence in the US remained stable, with similar incidence of localized and regional cancers, and with in-situ disease comprising breast cancer incidence increased. In 1991, breast cancer age-adjusted mortality rates began decreasing and have continued to decrease. In the post-screening phase, stage distribution stabilized, but now with localized and in-situ disease representing the majority of diagnosed cases. The median age at diagnosis has increased to 61 years. Mammographic screening increases breast cancer incidence, shifts the stage distribution toward earlier stage disease, and in high-income countries, is associated with improved survival. Whether similar improvement in breast cancer survival can be achieved in the absence of mammographic screening has yet to be conclusively demonstrated. © 2017 Wiley Periodicals, Inc.

  1. Changing trends in symptomatology, diagnostics, stage and survival of prostate cancer in Northern Finland during a period of 20 years. (United States)

    Kavasmaa, Outi T; Tyomkin, Dimitri B; Mehik, Aare; Parpala, Teija M; Tonttila, Panu; Paananen, Ilkka; Kunelius, Pekka; Vaarala, Markku H; Ohtonen, Pasi; Hellström, Pekka A


    Prostate cancer is the most common cancer among men in many countries. The aim of the present study was to find out how the symptoms leading to a diagnosis, diagnostic procedures and stages of the disease among prostate cancer patients have changed over a period of 20 years. This retrospective chart review consisted of 421 prostate cancer patients whose treatment was started in the years 1982, 1987, 1992, 1997 and 2002 at the Oulu University Hospital. Earlier prostatic disorders, specific urological symptoms, diagnostic procedures, the TNM classification and histological grade were recorded. The number of symptom-free prostate cancer patients increased over the 20 years, as did the number of men suffering from chronic prostatitis, although the latter increase was not statistically significant. A drop in the number of clinical T4 cases and increase of clinical T1 and clinical T2 cases was recorded but no clear change in the histological distribution occurred. The 5-year prostate cancer-specific survival improved significantly over the 20 years. The urologist was found to be the person who was contacted first most often. Our data indicate that the number of prostate cancer patients has increased hugely over the period from 1982 to 2002 and although the clinical T stage has moved towards earlier stages, the proportion of well differentiated cancers remains low, so that most patients have clinically significant cancer with the need of some form of therapy. Further, prostate cancer-specific survival improved significantly over the period.

  2. Changing trends in diagnosis, staging, treatment and survival in lung cancer: comparison of three consecutive cohorts in an Australian lung cancer centre. (United States)

    Denton, E J; Hart, D; Wainer, Z; Wright, G; Russell, P A; Conron, M


    Lung cancer accounts for significant morbidity and mortality worldwide. The effect of recent changes in demographics and management on outcomes in Australia has not been clearly defined. To compare three consecutive lung cancer cohorts to evaluate emergent differences in diagnosis, management and mortality. For comparative analysis, 2119 lung cancer patients were divided into three successive cohorts. Current death data were sought from the Victorian Cancer Registry. Age at diagnosis, mode of presentation and pathology did not significantly differ between the groups. Significantly more females were diagnosed with lung cancer in the most recent cohort (P = 0.04). Amongst non-small-cell lung cancer patients, there were more adenocarcinomas and less large cell carcinomas in the latest cohort (P = lung cancer patient cohorts diagnosed between 2001 and 2013 highlights emergent changes in lung cancer demographics, management and outcomes. These include recent increases in proportion of females, pathological and positron emission tomography staging, and Stage IV disease, as well as improved survival despite later stage disease. © 2016 Royal Australasian College of Physicians.

  3. Changes in cancer patients' personal goals in the first 6 months after diagnosis : the role of illness variables

    NARCIS (Netherlands)

    Janse, Moniek; Ranchor, Adelita V.; Smink, Ans; Sprangers, Mirjam A. G.; Fleer, Joke

    Setting and pursuing personal goals is a vital aspect of our identity and purpose in life. Cancer can put pressure on these goals and may be a reason for people to adjust them. Therefore, this paper investigates (1) changes in cancer patients' goals over time and (2) the extent to which illness

  4. Genomic evolution from primary breast carcinoma to distant metastasis: Few copy number changes of breast cancer related genes

    NARCIS (Netherlands)

    Moelans, C.B.; Groep, P. van der; Hoefnagel, L.D.; Vijver, M.J. van de; Wesseling, P.; Wesseling, J.; Wall, E. van der; Diest, P.J. van


    Cancer initiation and progression is characterized by (epi)genetic aberrations. However, little is known about the changes that occur during breast cancer metastasis. In the present study, multiplex ligation-dependent probe amplification was used to compare copy numbers of 21 established oncogenes

  5. Inter-tester reproducibility of tumour change in small cell lung cancer patients undergoing chemoradiotherapy. (United States)

    Ellegaard, Mai-Britt Bjørklund; Knap, Marianne Marquard; Hoffmann, Lone


    Tumour volume change during delivery of chemoradiotherapy is observed in small cell lung cancer (SCLC) patients. In this study, we have compared tumour volume and anatomical changes, e.g. atelectasis or pleural effusions determined by three different methods. A total of 37 SCLC patients undergoing thoracic radiotherapy during 2010-2011 were included. The patients were treated based on a daily three-dimensional (3D) cone beam computed tomography (CBCT) bony anatomy registration. The CBCT scans were retrospectively reviewed visually by a radiation therapist (Visual-RTT) in order to register tumour volume changes. Furthermore, the tumour volume changes were obtained by either deformable image registration (DIR) or delineation by a radiation oncologist (RO). Kappa (κ) statistics and paired t-tests were used for evaluation of the inter-tester agreement. The tumour volume change between the Visual-RTT, the DIR and the RO assessments obtained 84-97% agreement (κ = 0.68-0.95). Furthermore, there was no statistically significant difference between the tumour change assessment of the RO (mean 13.6 ml) and the DIR (mean 14.5 ml), p = 0.59. Tumour shrinkage was observed in 15 (41%) patients and anatomical changes in seven (19%) patients. The inter-tester reproducibility of tumour volume change between the three methods is excellent. Visual-RTT on-line inspection may be used to determine tumour shrinkage and anatomical changes as atelectasis or pleural effusions during the radiotherapy course by use of daily CBCT scans.

  6. Non-small cell lung cancer is characterized by dramatic changes in phospholipid profiles. (United States)

    Marien, Eyra; Meister, Michael; Muley, Thomas; Fieuws, Steffen; Bordel, Sergio; Derua, Rita; Spraggins, Jeffrey; Van de Plas, Raf; Dehairs, Jonas; Wouters, Jens; Bagadi, Muralidhararao; Dienemann, Hendrik; Thomas, Michael; Schnabel, Philipp A; Caprioli, Richard M; Waelkens, Etienne; Swinnen, Johannes V


    Non-small cell lung cancer (NSCLC) is the leading cause of cancer death globally. To develop better diagnostics and more effective treatments, research in the past decades has focused on identification of molecular changes in the genome, transcriptome, proteome, and more recently also the metabolome. Phospholipids, which nevertheless play a central role in cell functioning, remain poorly explored. Here, using a mass spectrometry (MS)-based phospholipidomics approach, we profiled 179 phospholipid species in malignant and matched non-malignant lung tissue of 162 NSCLC patients (73 in a discovery cohort and 89 in a validation cohort). We identified 91 phospholipid species that were differentially expressed in cancer versus non-malignant tissues. Most prominent changes included a decrease in sphingomyelins (SMs) and an increase in specific phosphatidylinositols (PIs). Also a decrease in multiple phosphatidylserines (PSs) was observed, along with an increase in several phosphatidylethanolamine (PE) and phosphatidylcholine (PC) species, particularly those with 40 or 42 carbon atoms in both fatty acyl chains together. 2D-imaging MS of the most differentially expressed phospholipids confirmed their differential abundance in cancer cells. We identified lipid markers that can discriminate tumor versus normal tissue and different NSCLC subtypes with an AUC (area under the ROC curve) of 0.999 and 0.885, respectively. In conclusion, using both shotgun and 2D-imaging lipidomics analysis, we uncovered a hitherto unrecognized alteration in phospholipid profiles in NSCLC. These changes may have important biological implications and may have significant potential for biomarker development. © 2015 The Authors. Published by Wiley Periodicals, Inc. on behalf of UICC.

  7. Mitochondrial DNA polymorphisms, its copy number change and outcome in colorectal cancer. (United States)

    Mohideen, Asan Meera Sahib Haja; Dicks, Elizabeth; Parfrey, Patrick; Green, Roger; Savas, Sevtap


    Mitochondrion is a small organelle inside the eukaryotic cells. It has its own genome (mtDNA) and encodes for proteins that are critical for energy production and cellular metabolism. Mitochondrial dysfunctions have been implicated in cancer progression and may be related to poor prognosis in cancer patients. In this study we hypothesized that genetic variations in mtDNA are associated with clinical outcome in colorectal cancer patients. We tested the associations of six mtDNA polymorphisms [MitoT479C, MitoT491C, MitoT10035C, MitoA13781G, 10398 (A/G), and 16189 (T/C)] and the mtDNA copy number change with overall survival (OS) and disease-free survival (DFS) times. Two mtDNA polymorphisms were genotyped using the TaqMan(®) SNP genotyping technique and the genotypes for the remaining four mtDNA polymorphisms were obtained by the Illumina(®) HumanOmni1-Quad genome wide SNP genotyping platform in 536 patients. The mtDNA copy number change (in tumor tissues with respect to non-tumor tissues) was estimated using the quantitative real time polymerase chain reaction for 274 patients. Associations of these mtDNA variations with OS and DFS were tested using the Cox regression method. In both univariate and multivariable analyses, none of the six mtDNA polymorphisms were associated with OS or DFS. 39.6 and 60.4% of the patients had increased and decreased mtDNA copy number in their tumor tissues when compared to their non-tumor rectum or colon tissues, respectively. However, in contrast to previous findings, the change in the mtDNA copy number was associated with neither OS nor DFS in our patient cohort. Our results suggest that the mitochondrial genetic markers investigated in this study are not associated with outcome in colorectal cancer.

  8. Prospective cohort study of general and central obesity, weight change trajectory and risk of major cancers among Chinese women. (United States)

    Liu, Ying; Warren Andersen, Shaneda; Wen, Wanqing; Gao, Yu-Tang; Lan, Qing; Rothman, Nathaniel; Ji, Bu-Tian; Yang, Gong; Xiang, Yong-Bing; Shu, Xiao-Ou; Zheng, Wei


    General obesity, typically measured using body mass index (BMI), has been associated with an increased risk of several cancers. However, few prospective studies have been conducted in Asian populations. Although central obesity, often measured using waist-hip ratio (WHR), is more predictive for type 2 diabetes and cardiovascular diseases (CVD) risk than BMI, knowledge of its association with cancer incidence is limited. In a cohort of 68,253 eligible Chinese women, we prospectively investigated the association of BMI, WHR and weight change during adulthood with risk of overall cancer and major site-specific cancers using multivariate Cox proportional hazard models. Compared to the BMI group of 18.5-22.9 kg/m(2) , obese (BMI ≥ 30 kg/m(2) ) women were at an increased risk of developing overall cancer (hazard ratio = 1.36, 95% confidence interval = 1.21-1.52), postmenopausal breast cancer (HR: 2.43, 95% CI: 1.73-3.40), endometrial cancer (HR: 5.34, 95% CI: 3.48-8.18), liver cancer (HR: 1.93, 95% CI: 1.14-3.27) and epithelial ovarian cancer (HR: 2.44, 95% CI: 1.37-4.35). Weight gain during adulthood (per 5 kg gain) was associated with increased risk of all cancers combined (HR: 1.05, 95% CI: 1.03-1.08), postmenopausal breast cancer (HR: 1.17, 95% CI: 1.10-1.24) and endometrial cancer (HR: 1.37, 95% CI: 1.27-1.48). On the other hand, WHR was not associated with cancer risk after adjustment for baseline BMI. These findings suggest that obesity may be associated with cancer risk through different mechanisms from those for type 2 diabetes and CVD and support measures of maintaining health body weight to reduce cancer risk in Chinese women. © 2016 UICC.

  9. Changes in weight and body composition in women receiving chemotherapy for breast cancer. (United States)

    Nissen, Mary Jo; Shapiro, Alice; Swenson, Karen K


    This study aimed to identify predictors of changes in weight and body composition among women receiving chemotherapy for breast cancer. Data were from 49 women age 40-54 receiving chemotherapy for breast cancer. Weight, height, and body composition measurements from dual-energy x-ray absorptiometry (DEXA) scanning were completed at baseline (within 1 month of beginning chemotherapy) and 12 months. Caloric intake was assessed from food diaries at baseline, 6 and 12 months, and physical activity was measured by questionnaire at baseline, 3, 6, 9, and 12 months. Baseline body mass index (BMI) was inversely associated with gains in weight (P = .01) and fat mass in torso (P = .006). Women of normal weight gained an average of 4.3 pounds and increased fat mass in torso and arms. Overweight women lost 3.0 pounds, and obese women lost 4.1 pounds, and neither group increased body fat. Decreased physical activity was associated with weight gain (P = .047). Additional predictors of increased fat mass in torso were younger age (P = .023) and treatment with tamoxifen (P = .015). Predictors of loss of bone mineral content included older age (P = .004) and treatment with aromatase inhibitor (P = .024), whereas treatment with bisphosphonate prevented bone loss (P Women receiving chemotherapy for breast cancer who are of normal weight at the time of breast cancer diagnosis are more likely to gain weight and body fat during the following year than overweight or obese women.

  10. Psychosocial problems in head-and-neck cancer patients and their change with time since diagnosis. (United States)

    Rapoport, Y; Kreitler, S; Chaitchik, S; Algor, R; Weissler, K


    Little is known about the psychosocial effects of cancer survivors especially after the first stage of adjustment. The study was designed to provide information about the major psychological problems of head-and-neck cancer patients and their change with time since diagnosis. The subjects were 55 head-and-neck cancer patients, 40 men and 15 women with disease stages I to IV, grade of tumors G1 to G3-4, and disease duration in the range of 3 months to 21 years. A questionnaire with multiple-choice and open-ended questions assessing adjustment in 14 domains (e.g., fears and worries concerning health, functioning in the family) was administered to patients and their partners or closest relatives as well as scales assessing anxiety, anger and depression. The results showed that the domains that were most problem-laden included coping with health problems, fears, communication with the partner and social relations. Comparing the problems of patients in different time periods (0.5-1.5 years after diagnosis, 1.5-5 years, and over 5 years) showed that many medical problems decreased with time but most psychological ones including anxiety and anger deteriorated markedly. Head-and-neck cancer patients suffer from a broad range of psychosocial problems that become exacerbated with time. The deterioration in quality of life may reflect 'patient burnout' which could be decreased by acquiring adequate coping skills.

  11. Fifty years of changes in UV Index and implications for skin cancer in Australia (United States)

    Lemus-Deschamps, Lilia; Makin, Jennifer K.


    Surface ultraviolet (UV) radiation plays an important role in human health. Increased exposure to UV radiation increases the risk of skin cancer. In Australia, public campaigns to prevent skin cancer include the promotion of daily UV forecasts. If all other atmospheric factors are equal, stratospheric ozone decreases result in UV increases. Given that Australia still has the highest skin cancer rates in the world, it is important to monitor Australia's stratospheric ozone and UV radiation levels over time because of the effects cumulative exposure can have on humans. In this paper, two long-term ozone datasets derived from surface and satellite measurements, a radiation code and atmospheric meteorological fields are used to calculate clear-sky UV radiation over a 50-year period (1959-2009) for Australia. The deviations from 1970-1980 levels show that clear-sky UV is on the rise. After the 1990s, an overall annual increase from 2 to 6% above the 1970-1980 levels was observed at all latitudes. Examining the summer and winter deviations from 1970-1980 showed that the winter signal dominated the annual changes, with winter increases almost twice those in summer. With ozone levels not expected to recover to pre-depletion levels until the middle of this century, UV levels are expected to continue to rise. Combined with Australians favoring an outdoor life-style, when temperatures are warmer, under high levels of UV, the associated risk of skin cancer will increase.

  12. Cancer Communication on Social Media: Examining How Cancer Caregivers Use Facebook for Cancer-Related Communication. (United States)

    Gage-Bouchard, Elizabeth A; LaValley, Susan; Mollica, Michelle; Beaupin, Lynda Kwon

    Americans are increasingly using social media (such as Facebook, YouTube, and Twitter) for health-related communication. Much of the previous research on social media and health communication has focused on Facebook groups related to a specific disease or Facebook pages related to an advocacy organization. Less is known about how people communicate about cancer on personal Facebook pages. In this study, we expand upon previous research by examining how cancer caregivers use personal Facebook pages for cancer-related communication. We examined themes in cancer-related exchanges through a content analysis of 12 months of data from 18 publically available Facebook pages hosted by parents of children with acute lymphoblastic leukemia (15 852 total posts). Six themes emerged: (1) documenting the cancer journey, (2) sharing emotional strain associated with caregiving, (3) promoting awareness and advocacy about pediatric cancer, (4) fundraising, (5) mobilizing support, and (6) expressing gratitude for support. Building upon previous research documenting the increasing use of social media for health-related communication and support, our findings show that personal Facebook pages offer a platform for cancer caregivers to share their cancer-related experiences, promote advocacy and awareness, and mobilize social support. Providers must recognize the importance of social media as a vehicle for support and communication for families of children with cancer. Nurses should educate parents on how to appraise information obtained through Facebook using evidence-based guidelines. Providers can encourage caregivers to use Facebook as a tool for communication, information, and support.

  13. Impact of weight change during neoadjuvant chemotherapy on pathologic response in triple-negative breast cancer. (United States)

    Bao, Jean; Borja, Nicholas; Rao, Madhu; Huth, James; Leitch, A Marilyn; Rivers, Aeisha; Wooldridge, Rachel; Rao, Roshni


    Triple-negative breast cancer (TNBC) is an uncommon but aggressive subtype of breast cancer. Obesity has been associated with an increased risk of breast cancer and worse prognosis. Some studies suggest that obese patients are less likely to achieve pathologic complete response (pCR) to neoadjuvant chemotherapy (NCT) and experience worse overall survival. Ki-67 is a proliferation marker that correlates with tumor aggressiveness. The goal of this study was to examine the impact of weight change during NCT for TNBC on pathologic response and Ki-67 reduction. Retrospective review identified 173 TNBC patients treated between 2004 and 2011. Data were collected on patient demographics, pre- and post-NCT body mass index (BMI), Ki-67, and pCR. Data analysis was performed using the two-tailed Student's t-test, analysis of variance (ANOVA), and Fisher's exact test. Sixty-six patients met final study criteria. Forty-three patients lost weight during chemotherapy and 23 gained weight. Patients in the weight gain group were significantly younger (P = 0.0013). There was no significant difference between the two groups in terms of Ki-67 reduction (P = 0.98) or pCR (P = 0.58). When patients were separated into normal weight (BMI<25 kg/m(2) ), overweight (BMI ≥ 25 and <30 kg/m(2) ), and obese (BMI ≥ 30 kg/m(2) ), there was no significant difference in Ki-67 among those groups either before or after NCT. The degree of obesity did not have a significant impact on Ki-67 reduction. Weight change during NCT does not appear to correlate with Ki-67 change or achieving pCR in TNBC. This may reflect the nature of this subtype of breast cancer that is less responsive to the hormonal effects that adipose tissue exerts on cancer cell proliferation. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  14. Coleman Advocates for Children And Youth: a pioneering child advocacy organization (1974-2008). (United States)

    Carnochan, Sarah; Austin, Michael J


    Coleman Advocates for Youth and Children is a pioneering 30-year-old child advocacy organization founded by several affluent community members and children's service professionals to stop housing abused and neglected children in juvenile hall. Today, low-income youth and parents in families of color are now assuming leadership in developing a unique hybrid approach that integrates community organizing with more traditional child advocacy strategies and focuses on increasing affordable housing and improving the city's educational system. The strategies employed by Coleman have also evolved, shifting from insider advocacy with administrative officials to public campaigns targeting the city budget process, to local initiative campaigns, and most recently to electoral politics. This organizational history features the issues mission and structure, leadership, managing issues, advocacy strategies and community relations, and funding.

  15. Developing leadership and advocacy skills in medical students through service learning. (United States)

    Long, Jeremy A; Lee, Rita S; Federico, Steven; Battaglia, Catherine; Wong, Shale; Earnest, Mark


    Traditional medical training focuses on ameliorating disease states but not on the underlying socially determined causes. The LEADS (Leadership Education Advocacy Development Scholarship) program at the University of Colorado Denver School of Medicine was designed to train medical students to become effective advocates and to promote health at the community level. Participants in the LEADS Track complete courses in advocacy skills, perform a summer internship, and complete a mentored scholarly activity addressing population health. Students are paired with a faculty mentor and a community-based organization. Students report empowerment, improved self-efficacy, and increased likelihood of future engagement in leadership and health advocacy. Community sponsors also rate the experience as highly valuable. A curriculum in advocacy and leadership skills that includes an intensive, community-based service learning experience is effective at increasing student empowerment and disposition toward community service.

  16. Management, leadership, and user control in self-advocacy: an english case study. (United States)

    Tilley, Elizabeth


    This paper presents findings from a qualitative research project on an English self-advocacy organization. In light of recent political and economic developments that have threatened the sustainability of a number of self-advocacy groups for people with intellectual disability, I seek to explore how one particular organization managed to survive and grow. In particular, the paper explores themes of management, leadership, and user control, linking these to external perceptions about self-advocacy organizations. The organization in my study developed an "interdependent" governance model based on key organizational roles for nondisabled advisors and self-advocates, which proved popular with external funders. Despite the organization's notable achievements, its success raises questions for the wider self-advocacy movement, notably how leadership capacity can be developed among self-advocates.

  17. Reflections on my journey in biomedical research: the art, science, and politics of advocacy. (United States)

    Slavkin, H C


    Scientific Discovery often reflects the art, science, and advocacy for biomedical research. Here the author reflects on selected highlights of discovery that contributed to several aspects of our understanding of craniofacial biology and craniofacial diseases and disorders.

  18. Adolescents' attitudes and self-perceptions about anti-tobacco advocacy

    National Research Council Canada - National Science Library

    Carver, Vivien; Reinert, Bonita; Range, Lillian M; Campbell, Catherine


    .... Adolescents could make effective and persuasive anti-tobacco advocates in their respective communities, but their attitudes about tobacco advocacy and their perceptions of their own abilities as advocates are unknown...

  19. An exploratory study of HIV-prevention advocacy by persons in HIV ...

    African Journals Online (AJOL)

    An exploratory study of HIV-prevention advocacy by persons in HIV care in Uganda. Christopher Tumwine, Annet Nannungi, Eric Ssegujja, Nicolate Nekesa, Sarah Ssali, Lynn Atuyambe, Gery Ryan, Glenn Wagner ...

  20. Explaining variation in gun control policy advocacy tactics among local organizations. (United States)

    Zakocs, Ronda C; Earp, Jo Anne L


    The goal of this study was to determine how well four organizational characteristics (structure, resources, motivation, or political capacity) explained local organizations' use of a variety of advocacy tactics aimed at promoting state gun control laws. In 1998, 679 local organizations were identified as potentially active on state gun control issues; a questionnaire was mailed to each group's leader. Seventy-nine percent (n = 538) responded to the survey, with 81% (n = 207) of eligible organizations completing questionnaires. The four organizational characteristics explained approximately half the variation in local groups' use of a wide range of advocacy tactics. Organizations with stronger motivation to address the gun control issue and greater political capacity engaged in more diverse gun control advocacy tactics; the authors found organizational structure and resources unlikely to be related. Leaders of advocacy organizations should consider ways to encourage members' motivations on the issue while fostering greater capacity for political action.

  1. Validation of a questionnaire for self-assessment of sexual function and vaginal changes after gynaecological cancer

    DEFF Research Database (Denmark)

    Jensen, Pernille T; Klee, Marianne C; Thranov, Ingrid


    The Sexual function-Vaginal changes Questionnaire (SVQ), was developed to investigate sexual and vaginal problems in gynaecological cancer patients. The instrument consists of 20 core items, measuring sexual interest, lubrication, orgasm, dyspareunia, vaginal dimensions, intimacy, sexual problems...

  2. Chemical Analysis of Morphological Changes in Lysophosphatidic Acid-Treated Ovarian Cancer Cells. (United States)

    Bailey, Karen A; Klymenko, Yuliya; Feist, Peter E; Hummon, Amanda B; Stack, M Sharon; Schultz, Zachary D


    Ovarian cancer (OvCa) cells are reported to undergo biochemical changes at the cell surface in response to treatment with lysophosphatidic acid (LPA). Here we use scanning electron microscopy (SEM) and multiplex coherent anti-Stokes Raman scattering (CARS) imaging via supercontinuum excitation to probe morphological changes that result from LPA treatment. SEM images show distinct shedding of microvilli-like features upon treatment with LPA. Analysis of multiplex CARS images can distinguish between molecular components, such as lipids and proteins. Our results indicate that OvCa429 and SKOV3ip epithelial ovarian cancer cells undergo similar morphological and chemical responses to treatment with LPA. The microvilli-like structures on the surface of multicellular aggregates (MCAs) are removed by treatment with LPA. The CARS analysis shows a distinct decrease in protein and increase in lipid composition on the surface of LPA-treated cells. Importantly, the CARS signals from cellular sheddings from MCAs with LPA treatment are consistent with cleavage of proteins originally present. Mass spectrometry on the cellular sheddings show that a large number of proteins, both membrane and intracellular, are present. An increased number of peptides are detected for the mesenchymal cell line relative to the epithelial cell indicating a differential response to LPA treatment with cancer progression.

  3. Body Mass Index and Weight Change During Adulthood Are Associated With Increased Mortality From Liver Cancer: The JACC Study


    Li, Yuanying; Yatsuya, Hiroshi; Yamagishi, Kazumasa; Wakai, Kenji; Tamakoshi, Akiko; Iso, Hiroyasu


    Background: We investigated the association of baseline body mass index (BMI) and weight change since age 20 years with liver cancer mortality among Japanese.Methods: The data were obtained from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). A total of 31 018 Japanese men and 41 455 Japanese women aged 40 to 79 years who had no history of cancer were followed from 1988 through 2009.Results: During a median 19-year follow-up, 527 deaths from liver cancer (338 ...

  4. Advocacy Disabled in Publishing Newspapers Media in Malaysia

    Directory of Open Access Journals (Sweden)

    Hazzlan Sama


    Full Text Available This article discusses the role of news media in communicating information about Disabled news to the public. The focus of the discussion centered issue and advocacy role of the news media conducted to understand the issues of persons with disabilities. Studies conducted using the method of analysis to systematically review the library of selected journals that conduct media exposure of persons with disabilities at the global level and so focused towards media conference in Malaysia. In this research, the data was obtained through databases ERIC, google scholar, Journal of Education, Journal of Social Sciences and Journal of Communication. A total of 30 articles were based on keywords such as disabled people, newspapers, news exposure to people with disabilities. However, researchers have obtained 13 articles that met after being filtered. The results obtained showed that the press releases are also still not open and not to report the news on disabilities. This is because there is a stigma that prevents acceptance of disabilities such as discrimination and negative attitudes towards them. Outlook negative stereotypes of people with disabilities who are strangers, the great ones, defects often appear in the media. Even now there is increasing advocacy for press media publishing news on this special group but the content or dissemination of information about them is still less show. Artikel ini membincangkan peranan media akhbar dalam menyampaikan maklumat berita tentang Orang Kurang Upaya kepada masyarakat. Fokus perbincangan ditumpukan isu dan peranan advokasi media akhbar dijalankan untuk memahami isu orang kurang upaya. Kajian yang dijalankan menggunakan kaedah analisis perpustakaan secara sistematik review terhadap jurnal-jurnal terpilih yang menjalankan kajian paparan media ke atas orang kurang upaya di peringkat global dan seterusnya difokus ke arah media akhbar di Malaysia. Dalam penyelidikan ini, data-data diperolehi melalui pengkalan

  5. When cancer cannot be cured: A qualitative study on relationship changes in couples facing advanced melanoma. (United States)

    Drabe, Natalie; Jenewein, Josef; Weidt, Steffi; Engeli, Lucia; Meier, Caroline; Büchi, Stefan; Schad, Karin; Schönbucher, Verena; Canella, Claudia; Nuñez, David Garcia


    The aim of this qualitative study was to gain a deeper understanding about couples' relationship changes over time (the first six months) after one partner is diagnosed with an incurable advanced melanoma (stage III or IV). In semistructured interviews, eight patients and their partners were asked separately about potential changes in their relationship since diagnosis. The same questions were asked again six months later, but focusing on relationship changes over the preceding six months. Some 32 audiotaped interviews were analyzed applying qualitative content analysis. At baseline (t1), relationship changes were mostly reported in terms of caring, closeness/distance regulation, and communication patterns. While changes in caregiving and distance/closeness regulation remained main issues at six months follow-up (t2), greater appreciation of the relationship and limitations in terms of planning spare time also emerged as major issues. Unexpectedly, 50% of patients and partners reported actively hiding their negative emotions and sorrows from their counterparts to spare them worry. Furthermore, qualitative content analysis revealed relationship changes even in those patients and partners who primarily reported no changes over the course of the disease. Our findings revealed a differentiated and complex picture about relationship changes over time, which also might aid in the development of support programs for couples dealing with advanced cancer, focusing on the aspects of caring, closeness/distance regulation, and communication patterns.

  6. Temporal Causality Analysis of Sentiment Change in a Cancer Survivor Network. (United States)

    Bui, Ngot; Yen, John; Honavar, Vasant


    Online health communities constitute a useful source of information and social support for patients. American Cancer Society's Cancer Survivor Network (CSN), a 173,000-member community, is the largest online network for cancer patients, survivors, and caregivers. A discussion thread in CSN is often initiated by a cancer survivor seeking support from other members of CSN. Discussion threads are multi-party conversations that often provide a source of social support e.g., by bringing about a change of sentiment from negative to positive on the part of the thread originator. While previous studies regarding cancer survivors have shown that members of an online health community derive benefits from their participation in such communities, causal accounts of the factors that contribute to the observed benefits have been lacking. We introduce a novel framework to examine the temporal causality of sentiment dynamics in the CSN. We construct a Probabilistic Computation Tree Logic representation and a corresponding probabilistic Kripke structure to represent and reason about the changes in sentiments of posts in a thread over time. We use a sentiment classifier trained using machine learning on a set of posts manually tagged with sentiment labels to classify posts as expressing either positive or negative sentiment. We analyze the probabilistic Kripke structure to identify the prima facie causes of sentiment change on the part of the thread originators in the CSN forum and their significance. We find that the sentiment of replies appears to causally influence the sentiment of the thread originator. Our experiments also show that the conclusions are robust with respect to the choice of the (i) classification threshold of the sentiment classifier; (ii) and the choice of the specific sentiment classifier used. We also extend the basic framework for temporal causality analysis to incorporate the uncertainty in the states of the probabilistic Kripke structure resulting from the

  7. Radiation-Induced Changes in Serum Lipidome of Head and Neck Cancer Patients

    Directory of Open Access Journals (Sweden)

    Karol Jelonek


    Full Text Available Cancer radiotherapy (RT induces response of the whole patient’s body that could be detected at the blood level. We aimed to identify changes induced in serum lipidome during RT and characterize their association with doses and volumes of irradiated tissue. Sixty-six patients treated with conformal RT because of head and neck cancer were enrolled in the study. Blood samples were collected before, during and about one month after the end of RT. Lipid extracts were analyzed using MALDI-oa-ToF mass spectrometry in positive ionization mode. The major changes were observed when pre-treatment and within-treatment samples were compared. Levels of several identified phosphatidylcholines, including (PC34, (PC36 and (PC38 variants, and lysophosphatidylcholines, including (LPC16 and (LPC18 variants, were first significantly decreased and then increased in post-treatment samples. Intensities of changes were correlated with doses of radiation received by patients. Of note, such correlations were more frequent when low-to-medium doses of radiation delivered during conformal RT to large volumes of normal tissues were analyzed. Additionally, some radiation-induced changes in serum lipidome were associated with toxicity of the treatment. Obtained results indicated the involvement of choline-related signaling and potential biological importance of exposure to clinically low/medium doses of radiation in patient’s body response to radiation.

  8. Dietary habits changes and quality of life in patients undergoing chemotherapy for epithelial ovarian cancer. (United States)

    Mardas, Marcin; Jamka, Małgorzata; Mądry, Radosław; Walkowiak, Jarosław; Krótkopad, Marietta; Stelmach-Mardas, Marta


    The aim of this study was to evaluate dietary habit changes in patients undergoing chemotherapy for epithelial ovarian cancer. Sixty one patients undergoing chemotherapy for epithelial ovarian cancer were enrolled to the study and 44 completed. The dietary intake was evaluated by 7-day food records, and the changes in dietary intake and food-preparing methods were estimated based on a 101-item semiquantitative food frequency questionnaire. Nutritional status was checked with the use of body weight and height, waist and hip circumferences, skinfolds and subjective global assessment tool. Quality of life was measured with the use of EORTC QLQ-C30 and EORTC QLQ-OV28. Despite high average body mass index (BMI) (26.7-28.0 kg/m(2)), malnutrition risk was observed in 43.7 and 10.7 % of patients receiving first-line and subsequent-line chemotherapy, respectively (p life did not differ between the studied groups. A lot of dietary habits changes were observed. Women undergoing subsequent-line chemotherapy consumed more frequently rye bread, pasta, buttermilk, vegetable, fruit, oils, nuts, and juices. Women undergoing first-line chemotherapy consumed more milk, cottage cheese, cream, eggs, fish and seafood, meat offal, salty snacks, and jam. Additionally, women undergoing subsequent-line chemotherapy more often applied cooking in water (p habits in a pro healthy direction, and these changes are more expressed in patients undergoing subsequent-line chemotherapy.

  9. Peer, professional, and public: an analysis of the drugs policy advocacy community in Europe. (United States)

    O'Gorman, Aileen; Quigley, Eoghan; Zobel, Frank; Moore, Kerri


    In recent decades a range of advocacy organisations have emerged on the drugs policy landscape seeking to shape the development of policy at national and international levels. This development has been facilitated by the expansion of 'democratic spaces' for civil society participation in governance fora at national and supranational level. However, little is known about these policy actors - their aims, scope, organisational structure, or the purpose of their engagement. Drug policy advocacy organisations were defined as organisations with a clearly stated aim to influence policy and which were based in Europe. Data on these organisations was collected through a systematic tri-lingual (English, French and Spanish) Internet search, supplemented by information provided by national agencies in the 28 EU member states, Norway and Turkey. In order to differentiate between the diverse range of activities, strategies and standpoints of these groups, information from the websites was used to categorise the organisations by their scope of operation, advocacy tools and policy constituencies; and by three key typologies - the type of advocacy they engaged in, their organisational type, and their advocacy objectives and orientation. The study identified over two hundred EU-based advocacy organisations (N=218) which included civil society associations, NGOs, and large-scale alliances and coalitions, operating at local, national and European levels. Three forms of advocacy emerged from the data analysis - peer, professional and public policy. These groups focused their campaigns on practice development (harm reduction or abstinence) and legislative reform (reducing or strengthening drug controls). The findings from this study provide a nuanced profile of civil society advocacy as a policy community in the drugs field; their legitimacy to represent cases, causes, social values and ideals; and their focus on both insider and outsider strategies to achieve their goals. The level of

  10. "We are not really marketing mental health":Mental health advocacy in Zimbabwe


    Reuben Hendler; Khameer Kidia; Debra Machando; Megan Crooks; Walter Mangezi; Melanie Abas; Craig Katz; Graham Thornicroft; Maya Semrau; Helen Jack


    Introduction: Few people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs. Methods: We conducted 30 semi-structured inter...

  11. “We Are Not Really Marketing Mental Health”: Mental Health Advocacy in Zimbabwe (United States)

    Hendler, Reuben; Kidia, Khameer; Machando, Debra; Crooks, Megan; Mangezi, Walter; Abas, Melanie; Katz, Craig; Thornicroft, Graham; Semrau, Maya


    Introduction Few people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs. Methods We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country’s mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions. Results Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy’s importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate (“targets”), what they advocate for (“asks”), how advocates reach their targets (“access”), how they make their asks (“arguments”), and the results of their advocacy (“outcomes”). Discussion Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs. PMID:27607240

  12. Changes in Parents After the Death of a Child from Cancer (United States)

    Gilmer, Mary Jo; Foster, Terrah L.; Vannatta, Kathryn; Barrera, Maru; Davies, Betty; Dietrich, Mary S.; Fairclough, Diane L.; Grollman, Jamie; Gerhardt, Cynthia A.


    Context Few studies have compared multiple perspectives of changes experienced by parents after a child’s death. Objectives This study used interviews with bereaved parents and siblings to examine changes in parents during the first year after the death of a child from cancer. Methods Mothers (n = 36), fathers (n = 24), and siblings (n = 39) from 40 families were recruited from three hospitals in the U.S. and Canada 3-12 months post-death (M = 10.7, SD = 3.5). Semi-structured interviews with open-ended questions were conducted in the home with each participating parent and sibling separately. Content analysis identified emerging themes, and frequencies were compared between each paired set of reports (mother versus sibling, father versus sibling, mother versus father). Results Parents and siblings identified two major categories of change experienced by bereaved parents. These changes occurred in their personal lives (e.g., emotions, perspectives and priorities, physical state, work habits, coping/behaviors, spiritual beliefs, and feeling something is missing) and relationships (e.g., family, others). Ninety-four percent of mothers, 87% of fathers, and 69% of siblings reported parental changes in at least one of these categories. Parents were more likely to report changes in priorities, whereas siblings reported more sadness in parents after the death. Conclusion Positive and negative changes in parents after the death of a child from cancer occur in both personal and relational domains. Additional research is needed to determine the impact of a child’s death on bereaved parents over time and to develop strategies to promote healthy adjustment. PMID:22784555

  13. Glycemic changes after gastrectomy in non-morbidly obese patients with gastric cancer and diabetes. (United States)

    Shen, Zhiyong; Yu, Jiang; Lei, Shangtong; Mou, Tingyu; Hu, Yanfeng; Liu, Hao; Li, Guoxin


    To evaluate the glycemic changes after gastrectomy in non-morbidly obese patients with gastric cancer (GC) and type 2 diabetes mellitus (T2DM). Between December 2011 and June 2014, we included 46 patients with gastric cancer and T2DM of a body mass index (BMI) obese patients experienced an improvement of glycemic control. T2DM resolution happened 3 weeks after surgery. FPG decreased significantly after postoperative day 21 compared to preoperative FPG. 32 patients experienced DM improvement after postoperative day 21. The age and relatively lower preoperative TG patients, who underwent total gastrectomy (Pobese patients may also benefit from metabolic surgery for glycemic control, associated with age, extent of gastrectomy, reconstruction type, and preoperative triglyceride level.

  14. Changes in social function and body image in women diagnosed with breast cancer undergoing chemotherapy

    Directory of Open Access Journals (Sweden)

    Sabrina Nunes Garcia


    Full Text Available The objective of this study was to investigate the impairment of social and emotional functions, body image and future perspective in women with breast cancer undergoing chemotherapeutic treatment. This is a longitudinal research conducted from October 2012 to October 2013 at the chemotherapy unit of a private institution of Oncology located in Curitiba, PR, Brazil. Sociodemographic and clinical questionnaires were applied, Quality of Life Questionnaire Core 30 e Quality of Life Questionnaire – Breast Cancer Module, to 48 women subjected for the first time to chemotherapy, in three different stages of the treatment. Analysis with Friedman`s, Spearman and Kruskal-Wallis nonparametric tests was performed. Changes were observed in social function and body image, which compromised quality of life significantly. Results can subsidize the planning of and adjustments to the care provided to these women by considering the perception about the impact of therapy on QL and their perspectives.

  15. Phase-change material filled hollow magnetic nanoparticles for cancer therapy and dual modal bioimaging. (United States)

    Li, Jinghua; Hu, Yan; Hou, Yanhua; Shen, Xinkun; Xu, Gaoqiang; Dai, Liangliang; Zhou, Jun; Liu, Yun; Cai, Kaiyong


    To develop carriers for anti-cancer drug delivery, this study reports a biocompatible and thermal responsive controlled drug delivery system based on hollow magnetic nanoparticles (HMNPs). The system is constructed simply by filling the hollow interiors of HMNPs with a phase-change material (PCM), namely, 1-tetradecanol, which has a melting point of 38 °C. The system achieves near "zero release" of both hydrophobic paclitaxel (PTX) and hydrophilic doxorubicin hydrochloride (DOX) and precise "on" or "off" drug delivery in vitro to efficiently induce cell apoptosis. Furthermore, the system displays both infrared thermal imaging and magnetic resonance imaging properties. More importantly, the system demonstrates great potential for thermo-chemo combination cancer therapy in vivo when an alternating magnetic field is applied.

  16. Endobronchial Ultrasound Changed the World of Lung Cancer Patients: A 11-Year Institutional Experience. (United States)

    Chen, Chia-Hung; Liao, Wei-Chih; Wu, Biing-Ru; Chen, Chih-Yu; Chen, Wei-Chun; Hsia, Te-Chun; Cheng, Wen-Chien; Tu, Chih-Yen; Hsu, Wu-Huei


    The role of advanced bronchoscopic diagnostic techniques in the detection and staging of lung cancer has increased sharply in recent years. The development of endobronchial ultrasound (EBUS) improved minimally invasive mediastinal staging and diagnosis of peripheral lung lesions (PLLs). We investigated the impact of using EBUS as a diagnostic method for tissue acquisition in lung cancer patients. In a single center observational retrospective study, 3712 subjects were diagnosed with lung cancer from 2003 to 2013 (EBUS was introduced in 2008). Thus, we divided the data into two periods: the conventional bronchoscopy period (2003 to 2007) and the EBUS period (2008 to 2013). A total of 3712 patients were included in the analysis. Comparing the conventional bronchoscopy period with the EBUS period data, there has been a significant reduction in the use of diagnostic modalities: CT-guided biopsy (P < 0.0001) and pleural effusion cytology (P < 0.0001). The proportion of subjects diagnosed using bronchoscopy significantly increased from 39.4% in the conventional period to 47.4% in the EBUS period (P < 0.0001). In the EBUS period, there has also been a significant increase in the proportion of patients proceeding directly to diagnostic surgery (P < 0.0001). Compared to bronchoscopy, the incidence of complications was higher in those who underwent CT guide biopsy. The incidence of iatrogenic pneumothorax significantly decreased in the EBUS period. Advanced bronchoscopic techniques are widely used in the diagnosis of lung cancer. At our institution, the increasing use of EBUS for providing lung cancer diagnosis has led to a significant reduction in other diagnostic modalities, namely CT-guided biopsy and pleural effusion cytology. These changes in practice also led to a reduction in the incidence of complications.

  17. Endobronchial Ultrasound Changed the World of Lung Cancer Patients: A 11-Year Institutional Experience.

    Directory of Open Access Journals (Sweden)

    Chia-Hung Chen

    Full Text Available The role of advanced bronchoscopic diagnostic techniques in the detection and staging of lung cancer has increased sharply in recent years. The development of endobronchial ultrasound (EBUS improved minimally invasive mediastinal staging and diagnosis of peripheral lung lesions (PLLs. We investigated the impact of using EBUS as a diagnostic method for tissue acquisition in lung cancer patients.In a single center observational retrospective study, 3712 subjects were diagnosed with lung cancer from 2003 to 2013 (EBUS was introduced in 2008. Thus, we divided the data into two periods: the conventional bronchoscopy period (2003 to 2007 and the EBUS period (2008 to 2013.A total of 3712 patients were included in the analysis. Comparing the conventional bronchoscopy period with the EBUS period data, there has been a significant reduction in the use of diagnostic modalities: CT-guided biopsy (P < 0.0001 and pleural effusion cytology (P < 0.0001. The proportion of subjects diagnosed using bronchoscopy significantly increased from 39.4% in the conventional period to 47.4% in the EBUS period (P < 0.0001. In the EBUS period, there has also been a significant increase in the proportion of patients proceeding directly to diagnostic surgery (P < 0.0001. Compared to bronchoscopy, the incidence of complications was higher in those who underwent CT guide biopsy. The incidence of iatrogenic pneumothorax significantly decreased in the EBUS period.Advanced bronchoscopic techniques are widely used in the diagnosis of lung cancer. At our institution, the increasing use of EBUS for providing lung cancer diagnosis has led to a significant reduction in other diagnostic modalities, namely CT-guided biopsy and pleural effusion cytology. These changes in practice also led to a reduction in the incidence of complications.

  18. Caregiving experiences predict changes in spiritual well-being among family caregivers of cancer patients. (United States)

    Adams, Rebecca N; Mosher, Catherine E; Cannady, Rachel S; Lucette, Aurelie; Kim, Youngmee


    Although enhanced spiritual well-being has been linked to positive mental health outcomes among family caregivers of cancer patients, little is known regarding predictors of spiritual well-being in this population. The current study aimed to examine caregiving experiences as predictors of change in family caregivers' spiritual well-being during the initial months following the patient's cancer diagnosis. Seventy family caregivers of newly diagnosed cancer patients (74% female, mean age = 59 years) participated in this longitudinal survey. Caregivers completed baseline questionnaires shortly before staying with the patient at an American Cancer Society Hope Lodge. Baseline questionnaires assessed caregiving experiences (i.e., self-esteem related to caregiving, family support for providing care, impact of caregiving on finances, and impact of caregiving on one's schedule). In addition, caregivers' spiritual well-being (i.e., meaning in life, peace, and faith) was assessed at baseline and 4-month follow-up. In univariate analyses, all caregiving experiences studied were associated with one or more aspects of spiritual well-being at 4-month follow-up. However, in the multivariate analysis, the only caregiving experience associated with aspects of spiritual well-being at 4-month follow-up was caregivers' perceptions of family support. Specifically, lack of family support was associated with lower levels of meaning and peace. Findings point to the importance of family support in facilitating the search for meaning and peace shortly after a loved one's cancer diagnosis and suggest that interventions targeting caregivers' support system may enhance their spiritual well-being. Copyright © 2014 John Wiley & Sons, Ltd.

  19. Predicting Patient Advocacy Engagement: A Multiple Regression Analysis Using Data From Health Professionals in Acute-Care Hospitals. (United States)

    Jansson, Bruce S; Nyamathi, Adeline; Heidemann, Gretchen; Duan, Lei; Kaplan, Charles


    Although literature documents the need for hospital social workers, nurses, and medical residents to engage in patient advocacy, little information exists about what predicts the extent they do so. This study aims to identify predictors of health professionals' patient advocacy engagement with respect to a broad range of patients' problems. A cross-sectional research design was employed with a sample of 94 social workers, 97 nurses, and 104 medical residents recruited from eight hospitals in Los Angeles. Bivariate correlations explored whether seven scales (Patient Advocacy Eagerness, Ethical Commitment, Skills, Tangible Support, Organizational Receptivity, Belief Other Professionals Engage, and Belief the Hospital Empowers Patients) were associated with patient advocacy engagement, measured by the validated Patient Advocacy Engagement Scale. Regression analysis examined whether these scales, when controlling for sociodemographic and setting variables, predicted patient advocacy engagement. While all seven predictor scales were significantly associated with patient advocacy engagement in correlational analyses, only Eagerness, Skills, and Belief the Hospital Empowers Patients predicted patient advocacy engagement in regression analyses. Additionally, younger professionals engaged in higher levels of patient advocacy than older professionals, and social workers engaged in greater patient advocacy than nurses. Limitations and the utility of these findings for acute-care hospitals are discussed.

  20. Political Action Day: A Student-Led Initiative to Increase Health Advocacy Training Among Medical Students

    Directory of Open Access Journals (Sweden)

    Harbir Gill


    Full Text Available Background: Health advocacy is a critical aspect of the competent physician's role. It is identified as a core competency by several national physician regulatory organizations, yet few formal training programs exist. We developed an initiative to teach medical students health advocacy skills. Methods: At Political Action Day, students from Alberta medical schools lobbied the provincial government. A day of training seminars preceded Political Action Day that focused on teaching health advocacy and communication strategies. The following day, medical students met with elected representatives at the Legislative Assembly. An entry and exit survey was administered to students. Results: On October 26-27th, 2008, 40 students met with 38/83 (46% elected representatives including the Minister of Health and Wellness. Feedback from students and politicians suggests the event was effective in teaching advocacy skills. This initiative inspired students to be politically active in the future. Conclusions: Political Action Day helps fulfill the health advocacy competency objectives, and requires minimal curriculum time and resources for integration. It is an effective tool to begin teaching advocacy, and should be further expanded and replicated at other Canadian medical schools.

  1. A three-pronged approach to advocacy for sustainable national funding. (United States)

    Hoehn, Karen


    By and large, the financial commitments 179 nations made to the family planning and reproductive health components of ICPD in 1994 were not kept. While donors ramp up support for civil society advocacy in developing countries, in hopes of improving national funding and outcomes, recent trends in advocacy evaluation leave unanswered the broader question of whether/how international campaigning can appropriately and effectively strengthen national-level decision-making. This article provides background regarding the challenges in monitoring developing country contributions; summarizes current donor initiatives to strengthen civil society advocacy; and reviews theoretical approaches to assessing advocacy. The author identifies major advocacy limitations and proposes a three-pronged approach to harmonize international and national advocacy messages for improved, sustained increases in health funding and outcomes, namely, that local accountability is paramount, that national health programmes must be designed as legally binding entitlements, and that pro-health values and norms must be strengthened. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  2. The importance of health advocacy in Canadian postgraduate medical education: current attitudes and issues

    Directory of Open Access Journals (Sweden)

    Alexander Poulton


    Full Text Available Background: Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada’s CanMEDS competency framework. Method: A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. Results:  The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Conclusions: Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.

  3. Histamine prevents radiation-induced mesenchymal changes in breast cancer cells. (United States)

    Galarza, Tamara E; Mohamad, Nora A; Táquez Delgado, Mónica A; Vedoya, Guadalupe M; Crescenti, Ernesto J; Bergoc, Rosa M; Martín, Gabriela A; Cricco, Graciela P


    Radiotherapy is a prime option for treatment of solid tumors including breast cancer though side effects are usually present. Experimental evidence shows an increase in invasiveness of several neoplastic cell types through conventional tumor irradiation. The induction of epithelial to mesenchymal transition is proposed as an underlying cause of metastasis triggered by gamma irradiation. Experiments were conducted to investigate the role of histamine on the ionizing radiation-induced epithelial to mesenchymal transition events in breast cancer cells with different invasive phenotype. We also evaluated the potential involvement of Src phosphorylation in the migratory capability of irradiated cells upon histamine treatment. MCF-7 and MDA-MB-231 mammary tumor cells were exposed to a single dose of 2Gy of gamma radiation and five days after irradiation mesenchymal-like phenotypic changes were observed by optical microscope. The expression and subcellular localization of E-cadherin, β-catenin, vimentin and Slug were determined by immunoblot and indirect immunofluorescence. There was a decrease in the epithelial marker E-cadherin expression and an increase in the mesenchymal marker vimentin after irradiation. E-cadherin and β-catenin were mainly localized in cytoplasm. Slug positive nuclei, matrix metalloproteinase-2 activity and cell migration and invasion were significantly increased. In addition, a significant enhancement in Src phosphorylation/activation could be determined by immunoblot in irradiated cells. MCF-7 and MDA-MB-231 cells also received 1 or 20μM histamine during 24h previous to be irradiated. Notably, pre-treatment of breast cancer cells with 20μM histamine prevented the mesenchymal changes induced by ionizing radiation and also reduced the migratory behavior of irradiated cells decreasing phospho-Src levels. Collectively, our results suggest that histamine may block events related to epithelial to mesenchymal transition in irradiated mammary cancer

  4. Changes in treatment and outcome of oesophageal cancer in Denmark between 2004 and 2013. (United States)

    Kjaer, D W; Larsson, H; Svendsen, L B; Jensen, L S


    Since 2003, care for patients with oesophageal cancer has been centralized in a few dedicated centres in Denmark. The aim of this study was to assess changes in the treatment and outcome of patients registered in a nationwide database. All patients diagnosed with oesophageal cancer or cancer of the gastro-oesophageal junction who underwent oesophagectomy in Denmark between 2004 and 2013, and who were registered in the Danish clinical database of carcinomas in the oesophagus, gastro-oesophageal junction and stomach (DECV database) were included. Quality-of-care indicators, including number of lymph nodes removed, anastomotic leak rate, 30- and 90-day mortality, and 2- and 5-year overall survival, were assessed. To compare quality-of-care indicators over time, the relative risk (RR) was calculated using a multivariable log binomial regression model. Some 6178 patients were included, of whom 1728 underwent oesophagectomy. The overall number of patients with 15 or more lymph nodes in the resection specimen increased from 38·1 per cent in 2004 to 88·7 per cent in 2013. The anastomotic leak rate decreased from 14·8 to 7·6 per cent (RR 0·66, 95 per cent c.i. 0·43 to 1·01). The 30-day mortality rate decreased from 4·5 to 1·7 per cent (RR 0·51, 0·22 to 1·15) and the 90-day mortality rate from 11·0 to 2·9 per cent (RR 0·46, 0·26 to 0·82). There were no statistically significant changes in 2- or 5-year survival rates over time. Indicators of quality of care have improved since the centralization of oesophageal cancer treatment in Denmark. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  5. “More Honoured in the Breach than in the Observance”—Self-Advocacy and Human Rights

    Directory of Open Access Journals (Sweden)

    Gabor Petri


    Full Text Available Background: Since the adoption of the UN Convention on the Rights of Persons with Disabilities (CRPD, human rights have become central for disability advocacy. The CRPD requires that disabled people and their representative organisations (DPOs have a prominent role in the implementation and monitoring of the Convention. However, the representation of people with intellectual disabilities or autistic people is still often indirect, carried out by parents or professionals. Methods: This is a qualitative research which looks at how self-advocates (SAs with intellectual disabilities or autism participate in DPOs and how they see the role of human rights and laws such as the CRPD in their advocacy. Data was collected in the UK and in Hungary between October 2016 and May 2017. A total of 43 advocates (SAs and other advocates were interviewed. For the analysis, thematic analysis was used. Results: findings indicate that most participants have limited knowledge of the CRPD and human rights. Human rights are usually seen as vague and distant ideas, less relevant to everyday lives. SAs may not feel competent to talk about the CRPD. The inclusion of SAs in DPOs is mostly tokenistic, lacking real participation. Conclusions: The CRPD can only bring meaningful change to SAs if they get full membership in DPOs.

  6. Emerging Trends in Cancer Care: Health Plans’ and Pharmacy Benefit Managers’ Perspectives on Changing Care Models (United States)

    Greenapple, Rhonda


    Background Cancer care in the United States is being transformed by a number of medical and economic trends, including rising drug costs, increasing availability of targeted therapies and oral oncolytic agents, healthcare reform legislation, changing reimbursement practices, a growing emphasis on comparative effectiveness research (CER), the emerging role of accountable care organizations (ACOs), and the increased role of personalization of cancer care. Objective To examine the attitudes of health plan payers and pharmacy benefit managers (PBMs) toward recent changes in cancer care, current cost-management strategies, and anticipated changes in oncology practice during the next 5 years. Methods An online survey with approximately 200 questions was conducted by Reimbursement Intelligence in 2011. The survey was completed by 24 medical directors and 31 pharmacy directors from US national and regional health plans and 8 PBMs. All respondents are part of a proprietary panel of managed care decision makers and are members of the Pharmacy and Therapeutics Committees of their respective plans, which together manage more than 150 million lives. Survey respondents received an honorarium for completing the survey. The survey included quantitative and qualitative questions about recent developments in oncology management, such as the impact on their plans or PBMs of healthcare reform, quality improvement initiatives, changes in reimbursement and financial incentives, use of targeted and oral oncolytics, and personalized medicine. Respondents were treated as 1 group, because there were no evident differences in responses between medical and pharmacy directors or PBMs. Results Overall, survey respondents expressed interest in monitoring and controlling the costs of cancer therapy, and they anticipated increased use of specialty pharmacy for oncology drugs. When clinical outcomes are similar for oral oncolytics and injectable treatments, 93% prefer the oral agents, which are

  7. [Health advocacy in violence against women: an experience]. (United States)

    Vives-Cases, Carmen; Alvarez-Dardet, Carlos; Colomer, Concha; Bertomeu, Angustias


    The development of political responses to a problem needs for its construction as a social problem of a continuous epidemiological surveillance system available for the affected public and key decision makers. A women's health advocacy net based initiative was launched in November 2003. Every month the epidemic index of deaths (ratio of deaths in that month and median of deaths occurring the previous 5 years) due to Intimate Partner Violence (IPV) is published in a section called "Violence Alert" of a women's web page. The objective was giving visibility to information contributing to shape the problem. from a population perspective. The initiative was introduced at the beginning to journalists and every month a press release with the index results and a comment on it is circulated. More than half of the months studied (January 2003-December 2004) were epidemic (epidemic indexb > or = 1.25). "Violence alert" has received 2330 visits since then, an average of 65 visits per week. The page attracted media coverage from radio, TV and newspapers.

  8. Changes in knowledge of cervical cancer following introduction of human papillomavirus vaccine among women at high risk for cervical cancer

    Directory of Open Access Journals (Sweden)

    L. Stewart Massad


    Conclusion: Substantial gaps in understanding of HPV and cervical cancer prevention exist despite years of health education. While more effective educational interventions may help, optimal cancer prevention may require opt-out vaccination programs that do not require nuanced understanding.

  9. Changes in employment status and experience of discrimination among cancer patients: findings from a nationwide survey in Korea. (United States)

    Park, Jae-Hyun; Park, Jong-Hyock; Kim, Sung-Gyeong; Lee, Kyung-Sook; Hahm, Myung-Il


    As the number of working cancer patients increases, workplace discrimination and its relationship to changes in employment status among cancer patients is becoming an increasingly important social concern. The aim of this study is to provide a comprehensive overview of the relationship between changes in employment status and discrimination following a diagnosis of cancer. A total of 748 cancer patients, aged 18 years and older, who were employed before receiving a diagnosis of cancer, were enrolled in this study. Patients were recruited from ten cancer centers in Korea. Sociodemographic data, work-related data, and clinical information, as well as information on changes in employment status and incidences of discrimination, were collected from all patients. A change in employment status was reported by 73.4% of the sample, with unemployment being the most common change (46.4%). Forty-two (5.6%) patients reported that they had experienced discrimination in the workplace. Reports of discrimination were only weakly correlated with changes in employment status, but were significantly correlated with forced unemployment. Additional analyses revealed that being female, being from a lower socioeconomic status group and having a disability were risk-factors for unemployment, while being male, being from a higher socioeconomic status group and having a disability were risk-factors for workplace discrimination or forced unemployment. More attention should be paid to vulnerable who are diagnosed with cancer. An individualized and culture-based approach should be taken to minimize undesirable changes in employment status and to reduce discrimination among patients receiving a diagnosis of cancer. Copyright © 2010 John Wiley & Sons, Ltd.

  10. Comparison of doses according to change of bladder volume in treatment of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Kyung Tae [Dept. of Radiologic Technology, Dongnam Health University, Suwon (Korea, Republic of); Min, Jung Whan [Dept. of Radiological Technology, Shingu University, Seongnam (Korea, Republic of)


    In the case of radiation therapy for prostate cancer, a balloon infused with a certain amount of air through the anus is used to reduce rectal dose. Because of the reason, radiation therapy for prostate cancer has acquired CBCT for daily image induction. In order to maintain the anatomical structure most similar to the first CT taken before treatment, it is pretreated, but it can not be said to be perfectly consistent. In two actual treatment regimens, the volume of the bladder was measured as 45.82 cc and 63.43 cc, and the equivalent diameter was 4.4 cm and 4.9 cm. As a result of this study, the mean volume of the bladder was estimated to be 56.2 cc, 105.6 cc by 20 CBCT. The mean dose of CBCT was 1.74% and the mean Bladder mean dose was 96.67%. In case B, PTV mean dose was 4.31%, Bladder mean Dose was estimated to be 97.35%. The changes in the volume of the bladder resulted in changes in the dose of PTV and bladder. The correlation coefficient of bladder dose according to the change of bladder volume showed linearity of mean dose R2= -0.94. The correlation coefficient of the PTV dose according to the volume change of the bladder showed linearity of mean dose R2= 0.04. It was found that the dose change of PTV was larger than that of bladder according to the change of bladder volume.

  11. Distinguishing benign confounding treatment changes from residual prostate cancer on MRI following laser ablation (United States)

    Litjens, G.; Huisman, H.; Elliott, R.; Shih, N.; Feldman, M.; Viswanath, S.; Fütterer, J.; Bomers, J.; Madabhushi, A.


    Laser interstitial thermotherapy (LITT) is a relatively new focal therapy technique for the ablation of localized prostate cancer. However, very little is known about the specific effects of LITT within the ablation zone and the surrounding normal tissue regions. For instance, it is important to be able to assess the extent of residual cancer within the prostate following LITT, which may be masked by thermally induced benign necrotic changes. Fortunately LITT is MRI compatible and hence this allows for quantitatively assessing LITT induced changes via multi-parametric MRI. Of course definite validation of any LITT induced changes on MRI requires confirmation via histopathology. The aim of this study was to quantitatively assess and distinguish the imaging characteristics of prostate cancer and benign confounding treatment changes following LITTon 3 Tesla multi-parametric MRI by carefully mapping the treatment related changes from the ex vivo surgically resected histopathologic specimens onto the pre-operative in vivo imaging. A better understanding of the imaging characteristics of residual disease and successfully ablated tissue might lead to improved treatment monitoring and as such patient prognosis. A unique clinical trial at the Radboud University Medical Center, in which 3 patients underwent a prostatectomy after LITT treatment, yielded ex-vivo histopathologic specimens along with pre- and post-LITT MRI. Using this data we (1) identified the computer extracted MRI signatures associated with treatment effects including benign necrotic changes and residual disease and (2) subsequently evaluated the computer extracted MRI features previously identified in distinguishing LITT induced changes in the ablated area relative to the residual disease. Towards this end first a pathologist annotated the ablated area and the residual disease on the ex-vivo histology and then we transferred the annotations to the post-LITT MRI using semi-automatic elastic registration. The

  12. Clinical Assessment of Sarcopenia and Changes in Body Composition During Neoadjuvant Chemotherapy for Esophageal Cancer. (United States)

    Miyata, Hiroshi; Sugimura, Keijiro; Motoori, Masaaki; Fujiwara, Yoshiyuki; Omori, Takeshi; Yanagimoto, Yoshitomo; Ohue, Masayuki; Yasui, Masayoshi; Miyoshi, Norikatsu; Tomokuni, Akira; Akita, Hirofumi; Kobayashi, Shogo; Takahashi, Hidenori; Yano, Masahiko


    The aim of this study was to assess changes in body composition during neoadjuvant chemotherapy (NAC) and investigate whether chemotherapy-related toxicities affect body composition in patients with esophageal cancer. In ninety-four patients who underwent NAC for esophageal cancer, body composition was assessed before and after NAC. Associations between the incidence of toxicities and change in body composition during NAC were investigated. Forty-four (46.8%) and 50 (53.2%) out of 94 patients were defined as having sarcopenia before and after NAC, respectively. There was no significant difference in the incidence of any toxicity pre-treatment between patients with sarcopenia and those without sarcopenia. No significant reduction in skeletal muscle mass or fat mass was observed in the patients during NAC (p=0.501 and p=0.072). However, patients who experienced grade 4 neutropenia or febrile neutropenia during NAC showed a significantly larger decrease in change of skeletal muscle mass compared to patients who did not experience those toxicities (p=0.013 and 0.036, respectively). The incidence of serious adverse events such as febrile neutropenia and grade 4 neutropenia is associated with a significant reduction of skeletal muscle mass during NAC. We should make an effort to reduce the incidence of adverse events in order to maintain an appropriate body composition during NAC. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  13. A role model program to promote institutional changes for management of acute and cancer pain. (United States)

    Weissman, D E; Griffie, J; Gordon, D B; Dahl, J L


    This report describes an 18-month project to make acute and cancer pain management an institutional priority in Southeastern Wisconsin health-care facilities. Facility-based teams, each of which included a nurse in a leadership position, were recruited to participate in a project based on the Cancer Pain Role Model Program. The project was conducted in three stages: (a) a 1-day conference focusing on basic pain management issues and clinical standards, (b) a preceptorship at the Medical College of Wisconsin, and (c) a follow-up conference focusing on institutional change. Participants completed an Action Plan, outlining activities aimed at changing practice in their facility. Participants from 17 of the 32 participating facilities partially or completely met their Action Plan goals. Lack of ongoing facility commitment, staff turnover and facility closures were cited as reasons for failure to meet goals. Nurses in key positions, provided with strong institutional commitment and given suitable educational training and nurturing, are ideally suited to help facilitate changes in institutional pain practices.

  14. Rat model of cancer-induced bone pain: changes in nonnociceptive sensory neurons in vivo. (United States)

    Zhu, Yong Fang; Ungard, Robert; Zacal, Natalie; Huizinga, Jan D; Henry, James L; Singh, Gurmit


    Clinical data on cancer-induced bone pain (CIBP) suggest extensive changes in sensory function. In a previous investigation of an animal model of CIBP, we have observed that changes in intrinsic membrane properties and excitability of dorsal root ganglion (DRG) nociceptive neurons correspond to mechanical allodynia and hyperalgesia. To investigate the mechanisms underlying changes in nonnociceptive sensory neurons in this model, we have compared the electrophysiological properties of primary nonnociceptive sensory neurons at 2 weeks after CIBP model induction with properties in sham control animals. Copenhagen rats were injected with 10 6 MAT-LyLu rat prostate cancer cells into the distal femur epiphysis to generate a model of CIBP. After von Frey tactile measurement of mechanical withdrawal thresholds, the animals were prepared for acute electrophysiological recordings of mechanically sensitive neurons in the DRG in vivo. The mechanical withdrawal threshold progressively decreased in CIBP model rats. At neurons between CIBP model rats and sham rats. However, at >2 weeks, the Aβ-fiber low-threshold mechanoreceptors (LTMs) in CIBP model rats exhibited a slowing of the dynamics of action potential (AP) genesis, including wider AP duration and lower AP amplitude compared with sham rats. Furthermore, enhanced excitability of Aβ-fiber LTM neurons was observed as an excitatory discharge in response to intracellular injection of depolarizing current into the soma. After induction of the CIBP model, Aβ-fiber LTMs at >2 weeks but not sensory neurons might be involved in the peripheral sensitization and tumor-induced tactile hypersensitivity in CIBP.

  15. Genetic Testing: Challenges and Changes in Testing for Hereditary Cancer Syndromes
. (United States)

    King, Elisabeth; Mahon, Suzanne M


    The practice of genetic testing for hereditary cancer syndromes has changed dramatically in recent years, and patients often approach oncology nurses requesting information about genetic testing.
. This article aims to explore changes in cancer genetics, the role of genetics professionals in providing comprehensive genetic care, and the implications of these new developments in genetics for oncology nurses.
. A literature review was conducted and focused on articles about the updating of genetic tests with panel testing, insurance changes, alternative genetic counseling strategies, and direct-to-consumer genetic testing.
. Oncology nurses play an important role in identifying and referring patients, including those who have tested negative for hereditary susceptibility genes, to genetics professionals. Genetics professionals can assist with insurance issues, interpretation of test results, clarification when a variant of unknown clinical significance is detected, and recommendations for care based on personal and family history and testing results. Oncology nurses can assist families with understanding the limitations of direct-to-consumer genetic testing.

  16. Long-term lifestyle changes after colorectal cancer screening: randomised controlled trial. (United States)

    Berstad, Paula; Løberg, Magnus; Larsen, Inger Kristin; Kalager, Mette; Holme, Øyvind; Botteri, Edoardo; Bretthauer, Michael; Hoff, Geir


    There is uncertainty whether cancer screening affects participant incentives for favourable lifestyle. The present study investigates long-term effects of colorectal cancer (CRC) screening on lifestyle changes. In 1999-2001, men and women drawn from the population registry were randomised to screening for CRC by flexible sigmoidoscopy ('invited-to-screening' arm) or to no-screening (control arm) in the Norwegian Colorectal Cancer Prevention trial. A subgroup of 3043 individuals in the 'invited-to-screening' and 2819 in the control arm, aged 50-55 years, randomised during 2001 had their lifestyle assessed by a questionnaire at inclusion and after 11 years (42% of cohort). The outcome was 11-year changes in lifestyle factors (body weight, smoking status, physical exercise, selected dietary habits) and in total lifestyle score (0-4 points, translating to the number of lifestyle recommendations adhered to). We compared outcomes in the two randomisation arms and attendees with positive versus negative findings. Total lifestyle scores improved in both arms. The improvement was smaller in the 'invited-to-screening' arm (score 1.43 at inclusion; 1.58 after 11 years) compared with the control arm (score 1.49 at inclusion; 1.67 after 11 years); adjusted difference -0.05 (95% CI -0.09 to -0.01; p=0.03). The change in the score was less favourable in screening attendees with a positive compared with negative screening result; adjusted difference -0.16 (95% CI -0.25 to -0.08; pcancer screening programmes. NCT00119912. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  17. Changes in the Submandibular Gland in Patients with Head and Neck Cancer After Radiation Therapy

    DEFF Research Database (Denmark)

    Uchiyama, Y.; Kreiborg, Sven; Murakami, Shumei


    Aim: The purpose of this study was to assess the impairment of the submandibular gland, in terms of changes in volume by computed tomography (CT) and CT value, which was the mean pixel value at a region of interest, in a group of patients with head and neck cancer treated with radiation therapy (RT......). Patients and Methods: Eleven patients treated with RT, where the effective radiation dose to the submandibular gland was known, were included in the study. CT scanning was performed both before and after RT. The average follow-up period after RT was 555 days (range=107-1231 days). Results: The mean volume...

  18. Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer

    DEFF Research Database (Denmark)

    Christensen, Carina Ørts; Cronin-Fenton, Deirdre; Frøslev, Trine


    of chemotherapy, i.e., 4 months. METHODS: Dual-imaging X-ray absorptiometry (DXA) was performed at baseline and after completing anthracycline- and taxane-based chemotherapy to measure BMD in the spine, hip, and forearm in early-stage breast cancer patients. High-dose prednisolone was used at three weekly...... intervals to reduce nausea and vomiting. Patients were advised a daily calcium/vitamin D supplement. Linear regression was used to assess mean percentage change in BMD and 95 % confidence intervals (95 % CI) according to doses of prednisolone, menopausal status, smoking, and BMI. RESULTS: Eight patients...

  19. Jaw mobility changes in patients with upper aerodigestive tract cancer undergoing radiation therapy. (United States)

    Bragante, Karoline; Wienandts, Patrícia; Mozzini, Carolina; Pinto, Rosélie; da Motta, Neiro; Jotz, Geraldo


    Radiation therapy is a therapeutic modality widely used for treatment of upper aerodigestive tract (UADT) neoplasms. However, its action is not restricted to tumor cells, and it may cause a variety of adverse reactions, including reduced jaw mobility. A prospective cohort study was conducted to assess changes in jaw mobility in patients with UADT cancer undergoing radiation therapy. Fifty-six patients completed the study. The results showed a significant reduction in mouth opening (pcancer experience reduced jaw mobility after radiation therapy, which is strongly correlated with mucositis and reduced functional ability.

  20. Global Proteome Changes in Liver Tissue 6 Weeks after FOLFOX Treatment of Colorectal Cancer Liver Metastases

    Directory of Open Access Journals (Sweden)

    Jozef Urdzik


    Full Text Available (1 Oxaliplatin-based chemotherapy for colorectal cancer liver metastasis is associated with sinusoidal injury of liver parenchyma. The effects of oxaliplatin-induced liver injury on the protein level remain unknown. (2 Protein expression in liver tissue was analyzed—from eight patients treated with FOLFOX (combination of fluorouracil, leucovorin, and oxaliplatin and seven controls—by label-free liquid chromatography mass spectrometry. Recursive feature elimination–support vector machine and Welch t-test were used to identify classifying and relevantly changed proteins, respectively. Resulting proteins were analyzed for associations with gene ontology categories and pathways. (3 A total of 5891 proteins were detected. A set of 184 (3.1% proteins classified the groups with a 20% error rate, but relevant change was observed only in 55 (0.9% proteins. The classifying proteins were associated with changes in DNA replication (p < 0.05 through upregulation of the minichromosome maintenance complex and with the innate immune response (p < 0.05. The importance of DNA replication changes was supported by the results of Welch t-test (p < 0.05. (4 Six weeks after FOLFOX treatment, less than 1% of identified proteins showed changes in expression associated with DNA replication, cell cycle entry, and innate immune response. We hypothesize that the changes remain after recovery from FOLFOX treatment injury.

  1. Fractionated changes in prostate cancer radiotherapy using cone-beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Tzung-Chi, E-mail: [Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung City, Taiwan (China); Department of Biomedical Informatics, Asia University, Taichung City, Taiwan (China); Chou, Kuei-Ting [Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung City, Taiwan (China); Yang, Shih-Neng [Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung City, Taiwan (China); Department of Biomedical Informatics, Asia University, Taichung City, Taiwan (China); Chang, Chih-Kai [Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung City, Taiwan (China); Liang, Ji-An [Department of Radiation Oncology, China Medical University Hospital, Taichung City, Taiwan (China); Zhang, Geoffrey [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL (United States)


    The high mobility of the bladder and the rectum causes uncertainty in radiation doses prescribed to patients with prostate cancer who undergo radiotherapy (RT) multifraction treatments. The purpose of this study was to estimate the dose received by the bladder, rectum, and prostate from multifraction treatments using daily cone-beam computed tomography (CBCT). Overall, 28 patients with prostate cancer who planned to receive radiation treatments were enrolled in the study. The acquired CBCT before the treatment delivery was registered with the planning CT to map the dose distribution used in the treatment plan for estimating the received dose during clinical treatment. For all 28 patients with 112 data sets, the mean percentage differences (± standard deviation) in the volume and radiation dose were 44% (± 41) and 18% (± 17) for the bladder, 20% (± 21) and 2% (± 2) for the prostate, and 36% (± 29) and 22% (± 15) for the rectum, respectively. Substantial differences between the volumes and radiation dose and those specified in treatment plans were observed. Besides the use of image-guided RT to improve patient setup accuracy, further consideration of large changes in bladder and rectum volumes is strongly suggested when using external beam radiation for prostate cancer.

  2. Fractionated changes in prostate cancer radiotherapy using cone-beam computed tomography. (United States)

    Huang, Tzung-Chi; Chou, Kuei-Ting; Yang, Shih-Neng; Chang, Chih-Kai; Liang, Ji-An; Zhang, Geoffrey


    The high mobility of the bladder and the rectum causes uncertainty in radiation doses prescribed to patients with prostate cancer who undergo radiotherapy (RT) multifraction treatments. The purpose of this study was to estimate the dose received by the bladder, rectum, and prostate from multifraction treatments using daily cone-beam computed tomography (CBCT). Overall, 28 patients with prostate cancer who planned to receive radiation treatments were enrolled in the study. The acquired CBCT before the treatment delivery was registered with the planning CT to map the dose distribution used in the treatment plan for estimating the received dose during clinical treatment. For all 28 patients with 112 data sets, the mean percentage differences (± standard deviation) in the volume and radiation dose were 44% (± 41) and 18% (± 17) for the bladder, 20% (± 21) and 2% (± 2) for the prostate, and 36% (± 29) and 22% (± 15) for the rectum, respectively. Substantial differences between the volumes and radiation dose and those specified in treatment plans were observed. Besides the use of image-guided RT to improve patient setup accuracy, further consideration of large changes in bladder and rectum volumes is strongly suggested when using external beam radiation for prostate cancer. Copyright © 2015 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  3. A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients. (United States)

    Jansen, Catherine E; Cooper, Bruce A; Dodd, Marylin J; Miaskowski, Christine A


    Evidence for chemotherapy-induced cognitive impairment remains inconclusive. This study was designed to determine the trajectory of cognitive function over time in women with breast cancer, who received doxorubicin and cyclophosphamide (AC) alone or followed by a taxane. Associations between changes in cognitive function and potential covariates including anxiety, depression, fatigue, hemoglobin level, menopausal status, and perception of cognitive function were evaluated. The Repeatable Battery for the Assessment of Neuropsychological Status, Stroop Test, and Grooved Pegboard were used to assess cognitive function in a group of 71 women prior to chemotherapy, a week after completing the last cycle of AC, as well as 1 week and 6 months after the completion of all chemotherapy. Cognitive impairment was found in 23% of women prior to chemotherapy. Hierarchical linear modeling showed significant decreases after receiving chemotherapy followed by improvements 6 months after the completion of chemotherapy in the cognitive domains of visuospatial skill (p cancer diagnosis may be associated with cognitive impairment. While chemotherapy may have a negative impact on cognitive function, chemotherapy-related impairments appear to be more acute than chronic side effects of therapy. Further studies are needed to provide insight into the clinical significance and potential mechanisms of cancer and treatment-related cognitive impairments.

  4. Quantitative changes in human epithelial cancers and osteogenesis imperfecta disease detected using nonlinear multicontrast microscopy (United States)

    Adur, Javier; Pelegati, Vitor B.; de Thomaz, Andre A.; D'Souza-Li, Lilia; Assunção, Maria do Carmo; Bottcher-Luiz, Fátima; Andrade, Liliana A. L. A.; Cesar, Carlos L.


    We show that combined multimodal nonlinear optical (NLO) microscopies, including two-photon excitation fluorescence, second-harmonic generation (SHG), third harmonic generation, and fluorescence lifetime imaging microscopy (FLIM) can be used to detect morphological and metabolic changes associated with stroma and epithelial transformation during the progression of cancer and osteogenesis imperfecta (OI) disease. NLO microscopes provide complementary information about tissue microstructure, showing distinctive patterns for different types of human breast cancer, mucinous ovarian tumors, and skin dermis of patients with OI. Using a set of scoring methods (anisotropy, correlation, uniformity, entropy, and lifetime components), we found significant differences in the content, distribution and organization of collagen fibrils in the stroma of breast and ovary as well as in the dermis of skin. We suggest that our results provide a framework for using NLO techniques as a clinical diagnostic tool for human cancer and OI. We further suggest that the SHG and FLIM metrics described could be applied to other connective or epithelial tissue disorders that are characterized by abnormal cells proliferation and collagen assembly.

  5. Quantitative changes in human epithelial cancers and osteogenesis imperfecta disease detected using nonlinear multicontrast microscopy. (United States)

    Adur, Javier; Pelegati, Vitor B; de Thomaz, Andre A; D'Souza-Li, Lilia; Assunção, Maria do Carmo; Bottcher-Luiz, Fátima; Andrade, Liliana A L A; Cesar, Carlos L


    We show that combined multimodal nonlinear optical (NLO) microscopies, including two-photon excitation fluorescence, second-harmonic generation (SHG), third harmonic generation, and fluorescence lifetime imaging microscopy (FLIM) can be used to detect morphological and metabolic changes associated with stroma and epithelial transformation during the progression of cancer and osteogenesis imperfecta (OI) disease. NLO microscopes provide complementary information about tissue microstructure, showing distinctive patterns for different types of human breast cancer, mucinous ovarian tumors, and skin dermis of patients with OI. Using a set of scoring methods (anisotropy, correlation, uniformity, entropy, and lifetime components), we found significant differences in the content, distribution and organization of collagen fibrils in the stroma of breast and ovary as well as in the dermis of skin. We suggest that our results provide a framework for using NLO techniques as a clinical diagnostic tool for human cancer and OI. We further suggest that the SHG and FLIM metrics described could be applied to other connective or epithelial tissue disorders that are characterized by abnormal cells proliferation and collagen assembly.

  6. Quantitative analysis of collagen change between normal and cancerous thyroid tissues based on SHG method (United States)

    Chen, Xiwen; Huang, Zufang; Xi, Gangqin; Chen, Yongjian; Lin, Duo; Wang, Jing; Li, Zuanfang; Sun, Liqing; Chen, Jianxin; Chen, Rong


    Second-harmonic generation (SHG) is proved to be a high spatial resolution, large penetration depth and non-photobleaching method. In our study, SHG method was used to investigate the normal and cancerous thyroid tissue. For SHG imaging performance, system parameters were adjusted for high-contrast images acquisition. Each x-y image was recorded in pseudo-color, which matches the wavelength range in the visible spectrum. The acquisition time for a 512×512-pixels image was 1.57 sec; each acquired image was averaged four frames to improve the signal-to-noise ratio. Our results indicated that collagen presence as determined by counting the ratio of the SHG pixels over the whole pixels for normal and cancerous thyroid tissues were 0.48+/-0.05, 0.33+/-0.06 respectively. In addition, to quantitatively assess collagen-related changes, we employed GLCM texture analysis to the SHG images. Corresponding results showed that the correlation both fell off with distance in normal and cancerous group. Calculated value of Corr50 (the distance where the correlation crossed 50% of the initial correlation) indicated significant difference. This study demonstrates that SHG method can be used as a complementary tool in thyroid histopathology.

  7. Age-related longitudinal changes in depressive symptoms following breast cancer diagnosis and treatment. (United States)

    Avis, Nancy E; Levine, Beverly; Naughton, Michelle J; Case, L Douglas; Naftalis, Elizabeth; Van Zee, Kimberly J


    Younger women being treated for breast cancer consistently show greater depression shortly after diagnosis than older women. In this longitudinal study, we examine whether these age differences persist over the first 26 months following diagnosis and identify factors related to change in depressive symptoms. A total of 653 women within 8 months of a first time breast cancer diagnosis completed questionnaires at baseline and three additional timepoints (6, 12, and 18 months after baseline) on contextual/patient characteristics, symptoms, and psychosocial variables. Chart reviews provided cancer and treatment-related data. The primary outcome was depressive symptomatology assessed by the Beck Depression Inventory. Among women younger than age 65, depressive symptoms were highest soon after diagnosis and significantly decreased over time. Depressive symptoms remained stable and low for women aged 65 and older. Age was no longer significantly related to depressive symptoms in multivariable analyses controlling for a wide range of covariates. The primary factors related to levels of and declines in depressive symptomatology were the ability to pay for basics; completing chemotherapy with doxorubicin; and decreases in pain, vasomotor symptoms, illness intrusiveness, and passive coping. Increased sense of meaning/peace and social support were related to decreased depression. Interventions to reduce symptoms and illness intrusiveness, improve a sense of meaning and peace, and increase social support, may help reduce depression and such interventions may be especially relevant for younger women.

  8. Impact of baseline BMI and weight change in CCTG adjuvant breast cancer trials. (United States)

    Yerushalmi, R; Dong, B; Chapman, J W; Goss, P E; Pollak, M N; Burnell, M J; Levine, M N; Bramwell, V H C; Pritchard, K I; Whelan, T J; Ingle, J N; Shepherd, L E; Parulekar, W R; Han, L; Ding, K; Gelmon, K A


    We hypothesized that increased baseline BMI and BMI change would negatively impact clinical outcomes with adjuvant breast cancer systemic therapy. Data from chemotherapy trials MA.5 and MA.21; endocrine therapy MA.12, MA.14 and MA.27; and trastuzumab HERA/MA.24 were analyzed. The primary objective was to examine the effect of BMI change on breast cancer-free interval (BCFI) landmarked at 5 years; secondary objectives included BMI changes at 1 and 3 years; BMI changes on disease-specific survival (DSS) and overall survival (OS); and effects of baseline BMI. Stratified analyses included trial therapy and composite trial stratification factors. In pre-/peri-/early post-menopausal chemotherapy trials (N = 2793), baseline BMI did not impact any endpoint and increased BMI from baseline did not significantly affect BCFI (P = 0.85) after 5 years although it was associated with worse BCFI (P = 0.03) and DSS (P = 0.07) after 1 year. BMI increase by 3 and 5 years was associated with better DSS (P = 0.01; 0.01) and OS (P = 0.003; 0.05). In pre-menopausal endocrine therapy trial MA.12 (N = 672), patients with higher baseline BMI had worse BCFI (P = 0.02) after 1 year, worse DSS (P = 0.05; 0.004) after 1 and 5 years and worse OS (P = 0.01) after 5 years. Increased BMI did not impact BCFI (P = 0.90) after 5 years, although it was associated with worse BCFI (P = 0.01) after 1 year. In post-menopausal endocrine therapy trials MA.14 and MA.27 (N = 8236), baseline BMI did not significantly impact outcome for any endpoint. BMI change did not impact BCFI or DSS after 1 or 3 years, although a mean increased BMI of 0.3 was associated with better OS (P = 0.02) after 1 year. With the administration of trastuzumab (N = 1395) baseline BMI and BMI change did not significantly impact outcomes. Higher baseline BMI and BMI increases negatively affected outcomes only in pre-/peri-/early post-menopausal trial patients. Otherwise, BMI

  9. TGF-β Blockade Reduces Mortality and Metabolic Changes in a Validated Murine Model of Pancreatic Cancer Cachexia.

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    Stephanie H Greco

    Full Text Available Cancer cachexia is a debilitating condition characterized by a combination of anorexia, muscle wasting, weight loss, and malnutrition. This condition affects an overwhelming majority of patients with pancreatic cancer and is a primary cause of cancer-related death. However, few, if any, effective therapies exist for both treatment and prevention of this syndrome. In order to develop novel therapeutic strategies for pancreatic cancer cachexia, appropriate animal models are necessary. In this study, we developed and validated a syngeneic, metastatic, murine model of pancreatic cancer cachexia. Using our model, we investigated the ability of transforming growth factor beta (TGF-β blockade to mitigate the metabolic changes associated with cachexia. We found that TGF-β inhibition using the anti-TGF-β antibody 1D11.16.8 significantly improved overall mortality, weight loss, fat mass, lean body mass, bone mineral density, and skeletal muscle proteolysis in mice harboring advanced pancreatic cancer. Other immunotherapeutic strategies we employed were not effective. Collectively, we validated a simplified but useful model of pancreatic cancer cachexia to investigate immunologic treatment strategies. In addition, we showed that TGF-β inhibition can decrease the metabolic changes associated with cancer cachexia and improve overall survival.

  10. TGF-β Blockade Reduces Mortality and Metabolic Changes in a Validated Murine Model of Pancreatic Cancer Cachexia. (United States)

    Greco, Stephanie H; Tomkötter, Lena; Vahle, Anne-Kristin; Rokosh, Rae; Avanzi, Antonina; Mahmood, Syed Kashif; Deutsch, Michael; Alothman, Sara; Alqunaibit, Dalia; Ochi, Atsuo; Zambirinis, Constantinos; Mohaimin, Tasnima; Rendon, Mauricio; Levie, Elliot; Pansari, Mridul; Torres-Hernandez, Alejandro; Daley, Donnele; Barilla, Rocky; Pachter, H Leon; Tippens, Daniel; Malik, Hassan; Boutajangout, Allal; Wisniewski, Thomas; Miller, George


    Cancer cachexia is a debilitating condition characterized by a combination of anorexia, muscle wasting, weight loss, and malnutrition. This condition affects an overwhelming majority of patients with pancreatic cancer and is a primary cause of cancer-related death. However, few, if any, effective therapies exist for both treatment and prevention of this syndrome. In order to develop novel therapeutic strategies for pancreatic cancer cachexia, appropriate animal models are necessary. In this study, we developed and validated a syngeneic, metastatic, murine model of pancreatic cancer cachexia. Using our model, we investigated the ability of transforming growth factor beta (TGF-β) blockade to mitigate the metabolic changes associated with cachexia. We found that TGF-β inhibition using the anti-TGF-β antibody 1D11.16.8 significantly improved overall mortality, weight loss, fat mass, lean body mass, bone mineral density, and skeletal muscle proteolysis in mice harboring advanced pancreatic cancer. Other immunotherapeutic strategies we employed were not effective. Collectively, we validated a simplified but useful model of pancreatic cancer cachexia to investigate immunologic treatment strategies. In addition, we showed that TGF-β inhibition can decrease the metabolic changes associated with cancer cachexia and improve overall survival.

  11. TGF-β Blockade Reduces Mortality and Metabolic Changes in a Validated Murine Model of Pancreatic Cancer Cachexia (United States)

    Rokosh, Rae; Avanzi, Antonina; Mahmood, Syed Kashif; Deutsch, Michael; Alothman, Sara; Alqunaibit, Dalia; Ochi, Atsuo; Zambirinis, Constantinos; Mohaimin, Tasnima; Rendon, Mauricio; Levie, Elliot; Pansari, Mridul; Torres-Hernandez, Alejandro; Daley, Donnele; Barilla, Rocky; Pachter, H. Leon; Tippens, Daniel; Malik, Hassan; Boutajangout, Allal; Wisniewski, Thomas; Miller, George


    Cancer cachexia is a debilitating condition characterized by a combination of anorexia, muscle wasting, weight loss, and malnutrition. This condition affects an overwhelming majority of patients with pancreatic cancer and is a primary cause of cancer-related death. However, few, if any, effective therapies exist for both treatment and prevention of this syndrome. In order to develop novel therapeutic strategies for pancreatic cancer cachexia, appropriate animal models are necessary. In this study, we developed and validated a syngeneic, metastatic, murine model of pancreatic cancer cachexia. Using our model, we investigated the ability of transforming growth factor beta (TGF-β) blockade to mitigate the metabolic changes associated with cachexia. We found that TGF-β inhibition using the anti-TGF-β antibody 1D11.16.8 significantly improved overall mortality, weight loss, fat mass, lean body mass, bone mineral density, and skeletal muscle proteolysis in mice harboring advanced pancreatic cancer. Other immunotherapeutic strategies we employed were not effective. Collectively, we validated a simplified but useful model of pancreatic cancer cachexia to investigate immunologic treatment strategies. In addition, we showed that TGF-β inhibition can decrease the metabolic changes associated with cancer cachexia and improve overall survival. PMID:26172047

  12. Exon-level transcriptome profiling in murine breast cancer reveals splicing changes specific to tumors with different metastatic abilities.

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    Amandine Bemmo


    Full Text Available Breast cancer is the second most frequent type of cancer affecting women. We are increasingly aware that changes in mRNA splicing are associated with various characteristics of cancer. The most deadly aspect of cancer is metastasis, the process by which cancer spreads from the primary tumor to distant organs. However, little is known specifically about the involvement of alternative splicing in the formation of macroscopic metastases. Our study investigates transcript isoform changes that characterize tumors of different abilities to form growing metastases.To identify alternative splicing events (ASEs that are associated with the fully metastatic phenotype in breast cancer, we used Affymetrix Exon Microarrays to profile mRNA isoform variations genome-wide in weakly metastatic (168FARN and 4T07 and highly metastatic (4T1 mammary carcinomas. Statistical analysis identified significant expression changes in 7606 out of 155,994 (4% exons and in 1725 out of 189,460 (1% intronic regions, which affect 2623 out of 16,654 (16% genes. These changes correspond to putative alternative isoforms-several of which are novel-that are differentially expressed between tumors of varying metastatic phenotypes. Gene pathway analysis showed that 1224 of genes expressing alternative isoforms were involved in cell growth, cell interactions, cell proliferation, cell migration and cell death and have been previously linked to cancers and genetic disorders. We chose ten predicted splice variants for RT-PCR validation, eight of which were successfully confirmed (MED24, MFI2, SRRT, CD44, CLK1 and HNRNPH1. These include three novel intron retentions in CD44, a gene in which isoform variations have been previously associated with the metastasis of several cancers.Our findings reveal that various genes are differently spliced and/or expressed in association with the metastatic phenotype of tumor cells. Identification of metastasis-specific isoforms may contribute to the

  13. Swedish nurses' perceptions of influencers on patient advocacy: a phenomenographic study. (United States)

    Josse-Eklund, Anna; Jossebo, Marie; Sandin-Bojö, Ann-Kristin; Wilde-Larsson, Bodil; Petzäll, Kerstin


    A limited number of studies have shown that patient advocacy can be influenced by both facilitators and barriers which can encourage and discourage nurses to act as patient advocates. This study's aim was to describe Swedish nurses' perceptions of influencers on patient advocacy. Interviews with 18 registered nurses from different Swedish clinical contexts were analysed using the phenomenographic method. Ethical revisions were made in accordance with national legislation and guidelines by committees for research ethics at Karlstad University. Three levels of hierarchically related influencers on patient advocacy were found in the descriptive categories. The fundamental influencer, the nurse's character traits, was described in the perceptions that advocacy is influenced by nurse's having a moral compass, having control over the care situation, being protective and feeling secure as a nurse. The second most vital influencer, the nurse's bond with the patient, was expressed in the perceptions of knowing the patient and feeling empathy for the patient. The third level of influencers, the organisational conditions, was described in the perceptions that the organisational structures and organisational culture influence patient advocacy. The results correspond with findings from earlier research but add an understanding that influencers on patient advocacy exist at three hierarchically related levels. The nurse's character traits are the fundamental influencer to patient advocacy, but in order to be comfortable and secure when advocating for patients, nurses also need to be familiar with both the patient and the situation. A supposition could be that all influencers interact, which needs to be further addressed in future studies. © The Author(s) 2014.


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    Carrie Griffin Basas


    Full Text Available Much of the literature in education has focused on the experiences of teachers and school leaders as they encounter students with individualized or “special” learning needs and their families.  This body of literature places the professional at the center of its concern by studying such phenomena as burnout and compassion fatigue.  In this article, the Author argues that this vigilance for the experience of schools has overlooked the material, psychological, and social impact on families that must advocate for their students in the U.S. educational system.   Examining educational conflicts that occur in special education and English Language Learner [ELL] settings, the Author defines this “advocacy fatigue” as the increased strain on resources that comes from continued exposure to system inequities and inequalities.   In the final section of the Article, she identifies strategies for collaboratively addressing educational equity that range from resistance to self-care, community wholeness to professional development.   Une bonne partie de la littérature en matière d’éducation a été consacrée aux expériences que vivent les enseignants et les directeurs d’école lorsqu’ils doivent interagir avec des élèves ayant des besoins d’apprentissage individuels ou « spéciaux » et leurs familles. Cette littérature place le professionnel au cœur des préoccupations en mettant l’accent sur des phénomènes comme l’épuisement professionnel et l’usure de compassion. Dans cet article, l’auteure déplore que l’on ait ainsi occulté les répercussions matérielles, psychologiques et sociales auxquelles font face les familles qui doivent défendre les intérêts de leurs enfants dans le système d’éducation américain. Examinant les conflits pédagogiques qui surviennent dans les milieux de l’éducation spécialisée et de l’apprentissage de l’anglais [ELL], l’auteure définit le phénomène qu

  15. Endometrial Cancer Survivors' Perceptions of Provider Obesity Counseling and Attempted Behavior Change: Are We Seizing the Moment? (United States)

    Clark, Leslie H; Ko, Emily M; Kernodle, Amber; Harris, Ariel; Moore, Dominic T; Gehrig, Paola A; Bae-Jump, Victoria


    To determine patients' perceptions of provider-based counseling and behavior changes made by endometrial cancer survivors. Endometrial cancer survivors (diagnosed from 2011 to 2012) from a single institution were surveyed. Exclusion criteria included persistent or recurrent disease or those actively undergoing treatment. Information collected included demographics, weight assessments, health behaviors, and physician counseling. Statistical analysis was performed using descriptive statistics, Fisher exact test, McNemar test, and the κ statistic as a measure of agreement. Of 233 surveys sent, 46% were returned. Median body mass index was 29.8 kg/m (range, 17.1-64.8 kg/m). Comparing primary care providers with gynecologic oncologists (GOs), 47% (n = 46) versus 25% (n = 23) provided dietary counseling and 62% (n = 60) versus 37% (n = 34) provided physical activity counseling (Fisher exact test, P = 0.001 and P endometrial cancer and obesity. Fifty-two percent of responders attempted weight loss after their diagnosis. Fifty-nine percent of responders reported making changes in their diet. Fifty-six percent of patients made dietary changes within 3 months of diagnosis. Forty-eight percent of responders increased physical activity, with 62% implementing changes within 3 to 6 months of their diagnosis. The responders most likely to attempt weight loss were those who received counseling by a provider. All patients reporting attempted weight loss after their cancer diagnosis report being counseled by either a primary care provider or a GO to lose weight. Weight loss counseling was significantly associated with attempting weight loss (P endometrial cancer survivors report counseling by their GO to lose weight. One half of endometrial cancer survivors reported attempted weight loss. All patients reporting weight loss counseling from their oncologist reported attempted weight loss. Most behavioral change occurred 3 to 6 months after a cancer diagnosis. Obesity in endometrial

  16. Vagal changes following cancer chemotherapy: implications for the development of nausea. (United States)

    Morrow, G R; Andrews, P L; Hickok, J T; Stern, R


    Many physiological changes that occur contemporaneously with nausea are mediated by the autonomic nervous system, but the specific autonomic changes associated with nausea have not been characterized. Cardiac parasympathetic (vagal) activity as indicated by heart rate variability, measured as the standard deviation of successive differences (SDSD) in beat-to-beat intervals, was assessed in 24 women with ovarian cancer immediately prior to and accompanying nausea that occurred following anticancer chemotherapy. A progressive increase in SDSD followed infusion of the chemotherapy agent, indicating a rise in cardiac parasympathetic (vagal) activity, with onset of nausea consistently occurring after the peak activity had been reached, at a time when SDSD was decreasing. An increase in parasympathetic activity seems to set the stage for the expression of nausea but an additional stimulus is apparently needed to finally trigger the event.

  17. SU-F-J-67: Dosimetric Changes During Radiotherapy in Lung Cancer Patients with Atelectasis

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    Guy, C; Weiss, E; Jan, N; Reshko, L; Hugo, G [Virginia Commonwealth University, Richmond, VA (United States); Christensen, G [University of Iowa, Iowa City, IA (United States)


    Purpose: Large geometric changes which occur during thoracic radiotherapy alter normal anatomy and target position and may induce clinically important dose changes. This study investigates variation of organ-at-risk (OAR) dose caused by atelectasis resolution during radiotherapy. Methods: 3D IMRT treatment plans were obtained for 14 non-small-cell lung cancer patients. Dose of the clinical plan was recalculated on a baseline scan in which lung was collapsed and on a midtreatment scan in which lung re-aeration had occurred. The changes in OAR doses were compared between the two time points. RTOG-0617 and inhouse dose-volume constraints were chosen for investigation and included spinal cord, esophagus, heart, and healthy lung. Results: 17 dose metrics were evaluated. The mean (SD) of change in mean lung dose, from baseline to mid-treatment (average taken across all patients), was 0.2 Gy (2.2 Gy) and ranged from −3.2 Gy to 6.0 Gy. 50% of patients experienced relative changes in mean lung dose of greater than 5% of baseline value. The mean (SD) of changes in heart V{sub 40}, V{sub 45}, and V{sup 60} were 3.2% (3.4%), 3.0% (2.9%), and 1.4% (2.1%), respectively, and were significant for the study cohort (Wilcoxon signed-rank test, p=0.0107 for V{sub 40}, p=0.0052 for V{sub 45}, and p= 0.0353 for V{sub 60}. Ranges in changes of Heart V{sub 40}, V{sub 45}, and V{sub 60} were −1.9% to 8.6%, −1.7% to 7.5%, and −2.1% to 4.5%, respectively. The mean (SD) of changes in Esophagus PRV Dmean and V{sub 60} were 0.3 Gy (3.3 Gy) and 0.8% (7.7%), respectively, and ranged from −4.8 Gy to 6.8 Gy for Dmean and −15.2% to 14.6% for V{sub 60}. Conclusion: Patients with atelectasis present at the start of radiotherapy experience significant increases in heart dose. Substantial increases in mean lung dose also occur in a subset of patients. This work supported by the National Cancer Institute of National Institutes of Health under Award Number R01CA166119. Disclosures: Phillips

  18. Exercise-induced biochemical changes and their potential influence on cancer: a scientific review. (United States)

    Thomas, Robert James; Kenfield, Stacey A; Jimenez, Alfonso


    To review and discuss the available international literature regarding the indirect and direct biochemical mechanisms that occur after exercise, which could positively, or negatively, influence oncogenic pathways. The PubMed, MEDLINE, Embase and Cochrane libraries were searched for papers up to July 2016 addressing biochemical changes after exercise with a particular reference to cancer. The three authors independently assessed their appropriateness for inclusion in this review based on their scientific quality and relevance. 168 papers were selected and categorised into indirect and direct biochemical pathways. The indirect effects included changes in vitamin D, weight reduction, sunlight exposure and improved mood. The direct effects included insulin-like growth factor, epigenetic effects on gene expression and DNA repair, vasoactive intestinal peptide, oxidative stress and antioxidant pathways, heat shock proteins, testosterone, irisin, immunity, chronic inflammation and prostaglandins, energy metabolism and insulin resistance. Exercise is one of several lifestyle factors known to lower the risk of developing cancer and is associated with lower relapse rates and better survival. This review highlights the numerous biochemical processes, which explain these potential anticancer benefits. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  19. Using clinical governance levers to support change in a cancer care reform. (United States)

    Brault, Isabelle; Denis, Jean-Louis; Sullivan, Terrence James


    Introducing change is a difficult issue facing all health care systems. The use of various clinical governance levers can facilitate change in health care systems. The purpose of this paper is to define clinical governance levers, and to illustrate their use in a large-scale transformation. The empirical analysis deals with the in-depth study of a specific case, which is the organizational model for Ontario's cancer sector. The authors used a qualitative research strategy and drew the data from three sources: semi-structured interviews, analysis of documents, and non-participative observations. From the results, the authors identified three phases and several steps in the reform of cancer services in this province. The authors conclude that a combination of clinical governance levers was used to transform the system. These levers operated at different levels of the system to meet the targeted objectives. To exercise clinical governance, managers need to acquire new competencies. Mobilizing clinical governance levers requires in-depth understanding of the role and scope of clinical governance levers. This study provides a better understanding of clinical governance levers. Clinical governance levers are used to implement an organizational environment that is conducive to developing clinical practice, as well as to act directly on practices to improve quality of care.

  20. Azadirachta indica exhibits chemopreventive action against hepatic cancer: Studies on associated histopathological and ultrastructural changes. (United States)

    Bharati, Sanjay; Rishi, Praveen; Koul, Ashwani


    The present study was designed to evaluate the anticarcinogenic potential of Azadirachta indica against N-nitrosodiethylamine (NDEA)-induced hepatocarcinogenesis. Further, the associated histopathological and ultrastructural changes were also analyzed. Hepatic cancer model was developed by the intraperitoneal administration of NDEA to mice at weekly intervals, in successive increasing doses, for a period of 8 weeks. Aqueous A. indica leaf extract (AAILE) was administered orally at a dosage of 100 μg/g body weight thrice a week till termination of the study. A relationship between histopathological grading and chemopreventive effect of A. indica had been established at various stages of carcinogenesis. Anticancer activity of A. indica was evaluated in terms of tumor incidence, tumor multiplicity, and survival rate. A significant reduction in tumor incidence (33%), tumor multiplicity (42%), and increase in survival (34%) was observed upon administration of AAILE to NDEA-abused mice. Transmission and scanning electron microscopic investigations showed severe alterations in organelle organization, cellular arrangement, degree of differentiation, cellular metabolism, and morphology of the hepatocytes. These changes appeared to be distinctly delayed upon AAILE supplementation. The results suggest A. indica may have anticancer potential against NDEA-induced hepatic cancer. Copyright © 2011 Wiley Periodicals, Inc.

  1. Exercise-induced biochemical changes and their potential influence on cancer: a scientific review (United States)

    Thomas, Robert James; Kenfield, Stacey A; Jimenez, Alfonso


    Aim To review and discuss the available international literature regarding the indirect and direct biochemical mechanisms that occur after exercise, which could positively, or negatively, influence oncogenic pathways. Methods The PubMed, MEDLINE, Embase and Cochrane libraries were searched for papers up to July 2016 addressing biochemical changes after exercise with a particular reference to cancer. The three authors independently assessed their appropriateness for inclusion in this review based on their scientific quality and relevance. Results 168 papers were selected and categorised into indirect and direct biochemical pathways. The indirect effects included changes in vitamin D, weight reduction, sunlight exposure and improved mood. The direct effects included insulin-like growth factor, epigenetic effects on gene expression and DNA repair, vasoactive intestinal peptide, oxidative stress and antioxidant pathways, heat shock proteins, testosterone, irisin, immunity, chronic inflammation and prostaglandins, energy metabolism and insulin resistance. Summary Exercise is one of several lifestyle factors known to lower the risk of developing cancer and is associated with lower relapse rates and better survival. This review highlights the numerous biochemical processes, which explain these potential anticancer benefits. PMID:27993842

  2. Morphomechanical and structural changes induced by ROCK inhibitor in breast cancer cells. (United States)

    Cascione, Mariafrancesca; De Matteis, Valeria; Toma, Chiara Cristina; Pellegrino, Paolo; Leporatti, Stefano; Rinaldi, Rosaria


    The EMT phenomenon is based on tumour progression. The cells lose their physiologic phenotype and assumed a mesenchymal phenotype characterized by an increased migratory capacity, invasiveness and high resistance to apoptosis. In this process, RHO family regulates the activation or suppression of ROCK (Rho-associated coiled-coil containing protein kinase) which in turn regulates the cytoskeleton dynamics. However, while the biochemical mechanisms are widely investigated, a comprehensive and careful estimation of biomechanical changes has not been extensively addressed. In this work, we used a strong ROCK inhibitor, Y-27632, to evaluate the effects of inhibition on living breast cancer epithelial cells by a biomechanical approach. Atomic Force Microscopy (AFM) was used to estimate changes of cellular elasticity, quantified by Young's modulus parameter. The morphometric alterations were analyzed by AFM topographies and Confocal Laser Scanning Microscopy (CLSM). Our study revealed a significant modification in the Young's modulus after treatment, especially as regards cytoskeletal region. Our evidences suggest that the use of Y-27632 enhanced the cell rigidity, preventing cell migration and arrested the metastasization process representing a potential powerful factor for cancer treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Towards meeting the research needs of Australian cancer consumers

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    Saunders Carla


    Full Text Available Abstract Background There is a growing amount of literature to support the view that active involvement in research by consumers, especially informed and networked consumers, benefits the quality and direction of research itself, the research process and, most importantly, people affected by cancer. Our exploratory project focuses on identifying their priorities and developing a process to assess the research needs of Australian cancer consumers which may be useful beyond the cancer scenario. Methods This project was consumer initiated, developed and implemented, with the assistance of a leading Australian cancer consumer advocacy group, Cancer Voices NSW (CVN. Such direct involvement is unusual and ensures that the priorities identified, and the process itself, are not influenced by other interests, regardless how well-intentioned they may be. The processes established, and data collection via a workshop, followed by a questionnaire to confirm and prioritise findings, and comparison with a similar UK exercise, are detailed in this paper. Results Needs across five topic areas reflecting cancer control domains (prevention and risk; screening and diagnosis; treatment; survivorship; and end of life were identified. Cancer consumers high priority research needs were found to be: earlier diagnosis of metastatic cancers; the extent of use of best practice palliative care guidelines; identifying barriers to cancer risk behaviour change; and environmental, nutrition and lifestyle risk factors for people with cancer. A process for identifying consumers’ research priorities was developed and applied; this may be useful for further investigation in this under-studied area. Conclusion The findings provide a model for developing a consumer derived research agenda in Australia which can be used to inform the strategic direction of cancer research. Consumers have been seeking a workable method to achieve this and have worked in collaboration with a major

  4. A Nutritarian Study to Evaluate the Effectiveness of Lifestyle Changes in Chronic Disease Prevention, Especially Cancer (United States)


    Chronic Disease; Cancer; Cardiovascular Diseases; Diabetes Mellitus; Lifestyle-related Condition; Mental Health Wellness 1; Sleep; Nutritional and Metabolic Disease; Nutrition Related Cancer; Nutritional Imbalance; Thyroid

  5. Changing patterns in place of cancer death in England: a population-based study.

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    Wei Gao

    Full Text Available Most patients with cancer prefer to die at home or in a hospice, but hospitals remain the most common place of death (PoD.This study aims to explore the changing time trends of PoD and the associated factors, which are essential for end-of-life care improvement.The study analysed all cancer deaths in England collected by the Office for National Statistics during 1993-2010 (n = 2,281,223. Time trends of age- and gender-standardised proportion of deaths in individual PoDs were evaluated using weighted piecewise linear regression. Variables associated with PoD (home or hospice versus hospital were determined using proportion ratio (PR derived from the log-binomial regression, adjusting for clustering effects. Hospital remained the most common PoD throughout the study period (48.0%; 95% CI 47.9%-48.0%, followed by home (24.5%; 95% CI 24.4%-24.5%, and hospice (16.4%; 95% CI 16.3%-16.4%. Home and hospice deaths increased since 2005 (0.87%; 95% CI 0.74%-0.99%/year, 0.24%; 95% CI 0.17%-0.32%/year, respectively, p<0.001, while hospital deaths declined (-1.20%; 95% CI -1.41 to -0.99/year, p<0.001. Patients who died from haematological cancer (PRs 0.46-0.52, who were single, widowed, or divorced (PRs 0.75-0.88, and aged over 75 (PRs 0.81-0.84 for 75-84; 0.66-0.72 for 85+ were less likely to die in home or hospice (p<0.001; reference groups: colorectal cancer, married, age 25-54. There was little improvement in patients with lung cancer of dying in home or hospice (PRs 0.87-0.88. Marital status became the second most important factor associated with PoD, after cancer type. Patients from less deprived areas (higher quintile of the deprivation index were more likely to die at home or in a hospice than those from more deprived areas (lower quintile of the deprivation index; PRs 1.02-1.12. The analysis is limited by a lack of data on individual patients' preferences for PoD or a clinical indication of the most appropriate PoD.More efforts are needed to reduce

  6. Frequency of precancerous changes and cervical cancer recorded in three health centres in tuzla canton in period 2010-2011. (United States)

    Jahic, Mahira; Mulavdic, Mirsada; Dautbasic, Fatima; Fejzic, Mara; Jahic, Elmir


    Cervical cancer is the second most common cancer in the world and the leading cause of death. Frequency and mortality are significantly reduced thanks to cytological Papanicolau test (PAP). Regular PAP test can reduce approximately 80% of cases of this cancer. To examine frequency of cervical cancer and changes of cervix, the age of risk for the changes and effect of frequency of PAP test. 3383 PAP (cytological) findings have been retrospectively ana lysed in three Health Centres of Tuzla Canton: Tuzla, Srebrenik and Sapna. During 2010 and 2011 protocols of Health Centers have been analyzed. Analysis of 3383 smears detected the following: abnormal PAP tests in 20.8% (705) and without abnormalities in 79.1% (2678). Normal findings in 9.1% (311), inflammatory changes in 69.6% (2357), ASCUS in 12.9% (438), ASC-H in 0.3% (11), LSIL in 5.4% (183), HSIL in 1.4% (49) and Squamous cell carcinoma in 0.7% (24). Cervical cancer has mostly been found in women from Srebrenik 1.1% (15) and least in women from Tuzla 0.3%(4).The highest number of abnormal findings (ASCUS, ASC-H , LSIL, H SIL and Cc) was also found in women from Srebrenik 39.5% (279). The average age of the examinees with the cancer was 41.7. In 62.5% (15) of women PAP test was performed for the first time and they were diagnosed with cervical cancer. Cervical cancer hasn't been found in women who had PAP test once a year or more. Women with the abnormal findings in their first PAP test and should be persuaded to accept the treatment in order to prevent development of cervical cancer.

  7. China's climate-change policy 1988-2011: From zero to hero?

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    Stensdal, Iselin


    This report describes the evolution of China's domestic climate-change policy over the period 1988-2011, using the Advocacy Coalition Framework (ACF) to explore the policy change. Policy development has been gradual, with the most notable change occurring in 2007, when the National Climate Change Programme elevated climate change to a national policy issue. Within the climate-change policy subsystem there emerged an advocacy coalition - the Climate Change Advocacy Coalition - urging that climate change should be taken into consideration in relevant policies. The ACF points to socioeconomic development and the Climate Change Advocacy Coalition's policy-oriented learning as explanations for the development of climate-change policy in China.(auth)

  8. Association between chronological change of reproductive factors and breast cancer risk defined by hormone receptor status: results from the Seoul Breast Cancer Study. (United States)

    Chung, Seokang; Park, Sue K; Sung, Hyuna; Song, Nan; Han, Wonshik; Noh, Dong-Young; Ahn, Sei-Hyun; Yoo, Keun-Young; Choi, Ji-Yeob; Kang, Daehee


    Lifestyle factors have been chronologically changed into western style ones, which could result in the rapid increase of breast cancer incidence in Korea. It is plausible that reproductive factors through hormonal mechanisms are differentially related to the risk of breast cancer subtypes. We investigated the association of reproductive risk factors on breast cancer by birth year groups and also evaluated the differential associations on the hormone receptor-defined subtypes. Using the data from the Seoul Breast Cancer Study (SeBCS), a multicenter case-control study, 3,332 breast cancer patients and 3,620 control subjects were analyzed. The distribution of subtypes among cases was as follows: 61.0 % estrogen receptor (ER)-positive, 51.9 % progesterone receptor (PR)-positive, and 43.4 % both ER/PR-positive status, respectively. Polytomous logistic regression and Wald tests for heterogeneity have been used across the subtypes. The frequencies of reproductive-related risk factors including early age at menarche, nulligravid, age at first full-term pregnancy (FFTP), duration of estrogen exposure before FFTP (EEBF), less number of children, never breastfeeding, and short duration of breastfeeding has increased as women were born later in both cases and controls, respectively (p trend breast cancer patients, either ER- or PR-positive subtypes were increased in women born in 1960s compared to women born in 1940s. Early age at menarche increased the risk of breast cancer regardless of the subtypes while nulligravid, late age at FFTP, and longer duration of EEBP were associated with hormone receptor-positive cancer risk only (p heterogeneity age at menarche, parity, age at FFTP, and duration of EEBF with breast cancer risk were different based on the hormone receptor status and birth year groups in Korea.

  9. Association between social support, functional status, and change in health-related quality of life and changes in anxiety and depression in colorectal cancer patients. (United States)

    Gonzalez-Saenz de Tejada, M; Bilbao, A; Baré, M; Briones, E; Sarasqueta, C; Quintana, J M; Escobar, A


    The aim of this study was to explore the association between baseline social support, functional status, and change in health-related quality of life (HRQoL) in colorectal cancer patients and change in anxiety and depression measured by Hospital Anxiety and Depression Scale (HADS) at 1 year after surgery. Consecutive patients who were due to undergo therapeutic surgery for the first time for colon or rectal cancer in 9 hospitals in Spain were eligible for the study. Patients completed the following questionnaires before surgery and 12 months afterward: 1 HRQoL instrument, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire; a social support questionnaire, the Duke-UNC Functional Social Support Questionnaire; the Barthel Index, to assess functional status; the HADS, to assess anxiety and depression; and questions about sociodemographic information. General linear models were built to explore the association between social support, functional status, and change in HRQoL and changes in anxiety and depression 12 months after surgery. A total of 947 colorectal cancer patients took part in the study. Patients' functional status, social support, and change in HRQoL were associated with changes in anxiety and depression. Greater social support and improvements in physical, cognitive, and social functioning and in insomnia resulted in improvements in anxiety and depression. No functionally independent patients were associated with lesser improvements in anxiety and depression. Colorectal cancer patients who have more social support, are functionally independent and have higher improvements in HRQoL may have better results in anxiety and depression at 1 year after surgery, adjusting for age, gender, location, occupation, and baseline HADS scores. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Barriers deterring patient advocacy in a Saudi Arabian critical care setting. (United States)

    Mortell, Manfred; Abdullah, Khatijah L; Ahmad, Chean


    To explore the perceptions of patient advocacy among Saudi Arabian intensive care unit (ICU) nurses. Despite advocacy being a crucial role for nurses, its scope is often limited in clinical practice. Although numerous studies have identified barriers to patient advocacy, their recommendations for resolution were unclear. The study employed a constructivist grounded theory methodology, with 13 Saudi Arabian registered nurses, working in critical care, in a tertiary academic teaching hospital. Semi-structured interviews, with broad open-ended questions, and reflective participant journals were used to collect data. All interviews were concurrently analysed and transcribed verbatim. Gender, culture, education, subjugation, communal patronage, organisational support and repercussions, and role-associated risks were all revealed as factors affecting their ability to act as advocates for critically ill patients. Saudi Arabian ICU nurses in the study believed that advocacy is problematic. Despite attempting to advocate for their patients, they are unable to act to an optimal level, instead choosing avoidance of the potential risks associated with the role, or confrontation, which often had undesirable outcomes. Patient advocacy from a Saudi Arabian nursing perspective is contextually complex, controversial and remains uncertain. Further research is needed to ensure patient safety is supported by nurses as effective advocates.

  11. Modulation of Age- and Cancer-Associated DNA Methylation Change in the Healthy Colon by Aspirin and Lifestyle


    Noreen, Faiza; Röösli, Martin; Gaj, Pawel; Pietrzak, Jakub; Weis, Stefan; Urfer, Patric; Regula, Jaroslaw; Schär, Primo; Truninger, Kaspar


    Background Aberrant DNA methylation in gene promoters is associated with aging and cancer, but the circumstances determining methylation change are unknown. We investigated the impact of lifestyle modulators of colorectal cancer (CRC) risk on the stability of gene promoter methylation in the colonic mucosa. Methods We measured genome-wide promoter CpG methylation in normal colon biopsies (n = 1092) from a female screening cohort, investigated the interaction of lifestyle factors with age-depe...

  12. Body mass index and weight change during adulthood are associated with increased mortality from liver cancer: the JACC Study. (United States)

    Li, Yuanying; Yatsuya, Hiroshi; Yamagishi, Kazumasa; Wakai, Kenji; Tamakoshi, Akiko; Iso, Hiroyasu; Mori, Mitsuru; Sakauchi, Fumio; Motohashi, Yutaka; Tsuji, Ichiro; Nakamura, Yosikazu; Mikami, Haruo; Kurosawa, Michiko; Hoshiyama, Yoshiharu; Tanabe, Naohito; Tamakoshi, Koji; Tokudome, Shinkan; Suzuki, Koji; Hashimoto, Shuji; Kikuchi, Shogo; Wada, Yasuhiko; Kawamura, Takashi; Watanabe, Yoshiyuki; Ozasa, Kotaro; Miki, Tsuneharu; Date, Chigusa; Sakata, Kiyomi; Kurozawa, Yoichi; Yoshimura, Takesumi; Fujino, Yoshihisa; Shibata, Akira; Okamoto, Naoyuki; Shio, Hideo


    We investigated the association of baseline body mass index (BMI) and weight change since age 20 years with liver cancer mortality among Japanese. The data were obtained from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). A total of 31 018 Japanese men and 41 455 Japanese women aged 40 to 79 years who had no history of cancer were followed from 1988 through 2009. During a median 19-year follow-up, 527 deaths from liver cancer (338 men, 189 women) were documented. There was no association between baseline BMI and liver cancer mortality among men or men with history of liver disease. Men without history of liver disease had multivariable hazard ratios (HR) of 1.95 (95%CI, 1.07-3.54) for BMI less than 18.5 kg/m(2) and 1.65 (1.05-2.60) for BMI of 25 kg/m(2) or higher, as compared with a BMI of 21.0 to 22.9 kg/m(2). BMI was positively associated with liver cancer mortality among women and women with history of liver disease. Weight change since age 20 years was positively associated with liver cancer mortality among women regardless of history of liver disease. Women with history of liver disease had a multivariable HRs of 1.96 (1.05-3.66) for weight gain of 5.0 to 9.9 kg and 2.31 (1.18-4.49) for weight gain of 10 kg or more, as compared with weight change of -4.9 to 4.9 kg. Both underweight (BMI history of liver disease, and weight gain after age 20 (weight change ≥5 kg) among women with history of liver disease, were associated with increased mortality from liver cancer.

  13. Associations between self-reported post-diagnosis physical activity changes, body weight changes, and psychosocial well-being in breast cancer survivors. (United States)

    Phillips, Siobhan M; McAuley, Edward


    Decreased physical activity and weight gain post-breast cancer diagnosis are associated with negative psychosocial, health, and disease outcomes, but little is known about how these factors interact. The purpose of the present study was to conduct a preliminary examination of the association between post-diagnosis physical activity changes, weight changes, and psychosocial well-being in breast cancer survivors. We examined the association between retrospectively collected, self-reported post-diagnosis changes in physical activity and body weight and post-diagnosis fatigue, anxiety, depression, stress, self-esteem, and health-related quality of life (HRQOL) in breast cancer survivors (N = 1,348) using univariate analyses of covariance with Bonferroni's adjustment. After adjusting for covariates, maintaining and/or increasing physical activity post-diagnosis was significantly (p social, emotional, functional and breast cancer specific well-being and overall HRQOL (effect sizes = 0.23 to 0.60). Maintaining and/or losing weight was significantly (p < 0.05), independently associated with lower fatigue and higher physical self-worth, physical and breast cancer-specific well-being, and overall HRQOL (effect sizes = .28 to 0.87). There were no significant interaction effects between physical activity and body weight changes. This study provides preliminary data to suggest that maintaining or increasing physical activity and controlling weight post-diagnosis may be independently, positively associated with psychosocial well-being and HRQOL in breast cancer survivors. In addition, weight management effects may be larger and more outcome-specific while physical activity effects may be more general. Future research is warranted to replicate and confirm these findings.

  14. Human breast adipose tissue: characterization of factors that change during tumor progression in human breast cancer. (United States)

    Fletcher, Sabrina Johanna; Sacca, Paula Alejandra; Pistone-Creydt, Mercedes; Coló, Federico Andrés; Serra, María Florencia; Santino, Flavia Eliana; Sasso, Corina Verónica; Lopez-Fontana, Constanza Matilde; Carón, Rubén Walter; Calvo, Juan Carlos; Pistone-Creydt, Virginia


    Adipose microenvironment is involved in signaling pathways that influence breast cancer. We aim to characterize factors that are modified: 1) in tumor and non tumor human breast epithelial cell lines when incubated with conditioned media (CMs) from human breast cancer adipose tissue explants (hATT) or normal breast adipose tissue explants (hATN); 2) in hATN-CMs vs hATT-CMs; 3) in the tumor associated adipocytes vs. non tumor associated adipocytes. We used hATN or hATT- CMs on tumor and non-tumor breast cancer cell lines. We evaluated changes in versican, CD44, ADAMTS1 and Adipo R1 expression on cell lines or in the different CMs. In addition we evaluated changes in the morphology and expression of these factors in slices of the different adipose tissues. The statistical significance between different experimental conditions was evaluated by one-way ANOVA. Tukey's post-hoc tests were performed within each individual treatment. hATT-CMs increase versican, CD44, ADAMTS1 and Adipo R1 expression in breast cancer epithelial cells. Furthermore, hATT-CMs present higher levels of versican expression compared to hATN-CMs. In addition, we observed a loss of effect in cellular migration when we pre-incubated hATT-CMs with chondroitinase ABC, which cleaves GAGs chains bound to the versican core protein, thus losing the ability to bind to CD44. Adipocytes associated with the invasive front are reduced in size compared to adipocytes that are farther away. Also, hATT adipocytes express significantly higher amounts of versican, CD44 and Adipo R1, and significantly lower amounts of adiponectin and perilipin, unlike hATN adipocytes. We conclude that hATT secrete a different set of proteins compared to hATN. Furthermore, versican, a proteoglycan that is overexpressed in hATT-CMs compared to hATN-CMs, might be involved in the tumorogenic behavior observed in both cell lines employed. In addition, we may conclude that adipocytes from the tumor microenvironment show a less differentiated

  15. Early hematologic changes during prostate cancer radiotherapy predictive for late urinary and bowel toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Pinkawa, Michael; Djukic, Victoria; Klotz, Jens; Holy, Richard; Eble, Michael J. [RWTH Aachen University, Department of Radiation Oncology, Aachen (Germany); Ribbing, Carolina [RWTH Aachen University, Department of Diagnostic and Interventional Radiology, Aachen (Germany)


    The primary objective of the study was to identify early hematologic changes predictive for radiotherapy (RT)-associated genitourinary and gastrointestinal toxicity. In a group of 91 prostate cancer patients presenting for primary (n = 51) or postoperative (n = 40) curative RT, blood samples (blood count, acute phase proteins, and cytokines) were analyzed before (T1), three times during (T2-T4), and 6-8 weeks after (T5) radiotherapy. Before RT (baseline), on the last day (acute toxicity), a median of 2 months and 16 months (late toxicity) after RT, patients responded to a validated questionnaire (Expanded Prostate Cancer Index Composite). Acute score changes > 20 points and late changes > 10 points were considered clinically relevant. Radiotherapy resulted in significant changes of hematologic parameters, with the largest effect on lymphocytes (mean decrease of 31-45 %) and significant dependence on target volume. C-reactive protein (CRP) elevation > 5 mg/l and hemoglobin level decrease ≥ 5 G/1 at T2 were found to be independently predictive for acute urinary toxicity (p < 0.01, respectively). CRP elevation was predominantly detected in primary prostate RT (p = 0.02). Early lymphocyte level elevation ≥ 0.3G/l at T2 was protective against late urinary and bowel toxicity (p = 0.02, respectively). Other significant predictive factors for late bowel toxicity were decreasing hemoglobin levels (cut-off ≥ 5 G/l) at T2 (p = 0.04); changes of TNF-α (tumor necrosis factor; p = 0.03) and ferritin levels (p = 0.02) at T5. All patients with late bowel toxicity had interleukin (IL)-6 levels < 1.5 ng/l at T2 (63 % without; p = 0.01). Early hematologic changes during prostate cancer radiotherapy are predictive for late urinary and bowel toxicity. (orig.) [German] Das primaere Ziel der Studie war die Identifikation von fruehen haematologischen Veraenderungen mit praediktiver Bedeutung fuer radiotherapieassoziierte genitourinale und gastrointestinale Toxizitaet. In einer

  16. Are changes in breast self-exam recommendations and early misperceptions of breast cancer risk increasing women's future risks? (United States)

    Polek, Carolee; Hardie, Thomas


    Young women, high school age, are exposed to breast cancer messages targeting adult women that can result in misperceptions, increasing future risks. Changes in breast self-exam screening recommendations may reduce nurse practitioner (NP) time addressing breast health. This study characterized misperceived knowledge of breast cancer risk in younger women. A survey (338 high school students aged 14 to 19) was conducted to assess their perceptions of breast cancer etiologies and risk behaviors. Survey results indicated 20% to 50% of students had misperceptions about breast cancer risk, and the mean knowledge score for all items was 65.47%. There were no differences in students with familial breast cancer histories or those instructed in breast self-exam. Approximately 12% reported being fearful, avoiding public health messages, and approximately 20% thought breastfeeding increased breast cancer risk. The findings suggest that school-based programs are not addressing misperceptions related to breast health effectively. A National Cancer Institute survey found that NPs and other providers are the most trusted sources of health information. Given the low rates of breast cancer in young women and recommendations against teaching breast self-exam, it is important for NPs to be knowledgeable about common misperceptions and address them with their patients. ©2015 American Association of Nurse Practitioners.

  17. Neural Changes following Behavioral Activation for a Depressed Breast Cancer Patient: A Functional MRI Case Study

    Directory of Open Access Journals (Sweden)

    Michael J. Gawrysiak


    Full Text Available Functional neuroimaging is an innovative but at this stage underutilized method to assess the efficacy of psychotherapy for depression. Functional magnetic resonance imaging (fMRI was used in this case study to examine changes in brain activity in a depressed breast cancer patient receiving an 8-session Behavioral Activation Treatment for Depression (BATD, based on the work of Hopko and Lejuez (2007. A music listening paradigm was used during fMRI brain scans to assess reward responsiveness at pre- and posttreatment. Following treatment, the patient exhibited attenuated depression and changes in blood oxygenation level dependence (BOLD response in regions of the prefrontal cortex and the subgenual cingulate cortex. These preliminary findings outline a novel means to assess psychotherapy efficacy and suggest that BATD elicits functional brain changes in areas implicated in the pathophysiology of depression. Further research is necessary to explore neurobiological mechanisms of change in BATD, particularly the potential mediating effects of reward responsiveness and associated brain functioning.

  18. Changes in skeletal muscle mass during palliative chemotherapy in patients with advanced lung cancer. (United States)

    Stene, Guro B; Helbostad, Jorunn L; Amundsen, Tore; Sørhaug, Sveinung; Hjelde, Harald; Kaasa, Stein; Grønberg, Bjørn H


    Sarcopenia is a defining feature of cancer cachexia associated with physical decline, poor quality of life and poor prognosis. Thus, maintaining muscle mass is an important aim of cachexia treatment. Many patients at risk for developing cachexia or with cachexia experience side effects of chemotherapy that might aggravate the development of cachexia. However, achieving tumor control might reverse the catabolic processes causing cachexia. There is limited knowledge about muscle mass changes during chemotherapy or whether changes in muscle mass are associated with response to chemotherapy. In this pilot study, patients with advanced non-small cell lung cancer (NSCLC) receiving three courses of palliative chemotherapy were analyzed. Muscle mass was measured as skeletal muscle cross sectional area (SMCA) at the level of the third lumbar vertebrae using CT images taken before and after chemotherapy. In total 35 patients, 48% women, mean age 67 years (range 56-86), participated; 83% had stage IV disease and 71% were sarcopenic at baseline. Mean reduction in SMCA from pre- to post-chemotherapy was 4.6 cm2 (CI 95% -7.3--1.9; pmuscle mass. Sixteen patients remained stable or gained SMCA. Of these, 14 (56%) responded to chemotherapy, while two progressed (p=0.071). Maintaining or gaining SMCA resulted in longer median overall survival (loss: 5.8 months, stable/gain: 10.7 months; p=0.073). Stage of disease (p=0.003), treatment regimen (p=0.023), response to chemotherapy (p=0.007) and SMCA change (p=0.040), but not sarcopenia at baseline, were significant prognostic factors in the multivariate survival analyses. Almost half of the patients had stable or increased muscle mass during chemotherapy without receiving any cachexia treatment. Nearly all of these patients responded to the chemotherapy. Increase in muscle mass, but not sarcopenia at baseline, was a significant prognostic factor.

  19. Changes in the Inflammatory Potential of Diet Over Time and Risk of Colorectal Cancer in Postmenopausal Women. (United States)

    Tabung, Fred K; Steck, Susan E; Ma, Yunsheng; Liese, Angela D; Zhang, Jiajia; Lane, Dorothy S; Ho, Gloria Y F; Hou, Lifang; Snetselaar, Linda; Ockene, Judith K; Hebert, James R


    We examined the associations between changes in dietary inflammatory potential and risk of colorectal cancer (CRC) in 87,042 postmenopausal women recruited from 1993-1998 by the Women's Health Initiative, conducted in the United States. Food frequency questionnaire data were used to compute patterns of change in dietary inflammatory index (DII) scores and cumulative average DII scores over 3 years. Cox regression models were used to estimate hazard ratios for CRC risk. After a median of 16.2 years of follow-up, 1,038 CRC cases were diagnosed. DII changes were not substantially associated with overall CRC, but proximal colon cancer risk was higher in the proinflammatory-change DII group than in the antiinflammatory-stable DII group (hazard ratio = 1.32, 95% confidence interval: 1.01, 1.74). Among nonusers of nonsteroidal antiinflammatory drugs (NSAIDs) (Pinteraction = 0.055), the proinflammatory-stable DII group was at increased risk of overall CRC and proximal colon cancer. Also among nonusers of NSAIDs, risks of overall CRC, colon cancer, and proximal colon cancer were higher in the highest quintile compared with the lowest cumulative average DII quintile (65%, 61%, and 91% higher risk, respectively). Dietary changes toward, or a history of, proinflammatory diets are associated with an elevated risk of colon cancer, particularly for proximal colon cancer and among nonusers of NSAIDs. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail:

  20. Height, weight, weight change, and ovarian cancer risk in the Netherlands Cohort Study on Diet and Cancer

    NARCIS (Netherlands)

    Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den


    Although many studies have been conducted to investigate the relation between anthropometry and the risk of ovarian cancer, their results have been inconsistent. The Netherlands Cohort Study on Diet and Cancer was initiated in 1986. A self-administered questionnaire on dietary habits and other risk