In the present study DNA damage was measured in peripheral blood lymphocytes from polyposis coli and colorectal cancer patients, treated with different dietary and environmental compounds and compared with lymphocytes from healthy individuals. In addition, confounding factors such as age, gender, alcohol intake and smoking habits were taken into consideration. The assays used in this study included the Comet assay, the Micronucleus assay, the Micronucleus ¿ FISH assay and the sister chromatid exchange assay. The food mutagens, PhIP and IQ, as well as titanium dioxide nanoparticles (TiO2 NPs) induced a dose dependent increase in the DNA damage and chromosomal abnormalities in all tested groups regardless of confounding factors. Prior to experiments physicochemical characterisation of nanoparticles was conducted. In the presence of the flavonoids, quercetin and rutin that were acting in an antioxidant manner, the DNA damage resulting from the highest doses of food mutagens was significantly reduced. Thus, dietary supplementation with flavonoid-rich vegetables and fruits may prove very effective in protection against oxidative stress. The polyposis coli and colon cancer patients were more susceptible to food mutagens, PhIP and IQ, as well as TiO2 NPs, and in the majority of cases had a higher level of DNA damage in the Comet assay and higher cytogenetic damage in the Micronucleus assay. In the final project, twelve frequently encountered (NewGeneris) chemical compounds were evaluated to establish their damaging potential in lymphocytes and spermatozoa from healthy donors. The highest damage was produced by DNA reactive aldehydes, food mutagens and benzo[a]pyrene when assessed with the neutral and alkaline Comet assay with and without metabolic activation. / EU NewGeneris Programme and United Kingdom - India Education and Research Initiative (UKIERI)

With the increasing number of breast cancer survivors, there is a need to enhance health education to help survivors make informed decisions about maximizing their quality of life. YouTube is one of the most popular video applications that can be used for public health education. Nonetheless, there is little research on the content of health-related information that is uploaded to YouTube relevant to breast cancer survivors. This study was intended to help fill that gap in knowledge by describing the sources, formats, and content conveyed in the most widely viewed YouTube videos on breast cancer. YouTube was searched with a cleared browsing history using the key search term “breast cancer.” The resulting videos were sorted by view count. Videos were then screened for inclusion and exclusion criteria, yielding a sample of 100 videos with the most views. Video title, link, number of views, and date of upload were coded along with content included in each video. The inter- and intra-rater reliability was acceptable (Kappa’s = .79 and .97, respectively). The sample of 100 videos was collectively viewed 135,311,626 times, suggesting that the subject of breast cancer is a popular topic on YouTube. Nearly half of the sample videos (n = 45) were uploaded by television news/media agencies. Combined/multiple formats were the most popular format (n = 61), followed by still images/text (n = 48). General information on cancer was found to be the most common (n = 71), followed by screening for breast cancer occurrence/ recurrence (n = 62), and cancer treatments/breast cancer treatments (n = 45). Several of the content categories were rarely covered in the most-watched videos—for example, cancer rehabilitation recommendations, returning to work after cancer treatment, and financial burden/management of cancer. Thus, while topics such as breast cancer screening are widely covered, topics for breast cancer survivors regarding maximizing their quality of life are less widely covered. Few videos (n = 3) contained misinformation, but these videos were viewed millions of times, emphasizing the need for ongoing monitoring to identify and remove misinformation. The findings of this study indicated that YouTube videos on breast cancer gained over 135 million views. YouTube can be a great media channel for public health education. Nonetheless, there is significant need for more high-quality YouTube videos to be created to help breast cancer survivors navigate their cancer journey.

The adverse effects of cancer treatment on health-related quality of life (HRQL) are the primary concern of elderly women diagnosed with breast cancer. The interplay of transient and progressive functional impairments caused by cancer therapies, alongside the accelerated physical declines associated with the normal aging process, are all negatively correlated to HRQL. This study compared the HRQL trajectories between cases and controls for ten years after diagnosis. The cancer group included 1467 women (age ≥ 65), diagnosed with primary breast cancer, registered in the Surveillance Epidemiology and End Results (SEER) cancer registry, and completed the Medicare Health Outcomes Survey (MHOS) before and after diagnosis. Controls were frequency-matched to cases with a 1:1 ratio on age and socio-economic variables. Participants reported their HRQL using SF-36/VR12 questionnaire, which was summarized into two summary scores (physical component summary (PCS) and mental component summary (MCS) and eight domain scores: physical functioning (PF), general health (GH), bodily pain (BP), role-limitation physical (RP), social functioning (SF), mental health (MH), role-limitation emotional (RE), and vitality (VT). Hierarchical Linear Modelling was utilized to assess the fixed effects of time, group, and the interaction between time and group (Time*Group) on HRQL trajectories. At the time of cancer diagnosis, cases fared worse than controls in all of the HRQL domains and summary scores. Group and time were majorly significant for PCS, PF, GH, BP, and RP, while only group was predominantly significant for mental domains (MCS, SF, MH, RE, VT). Time was also significant for SF and VT, while Time*Group was only significant for RE. Cases showed remarkable gains over controls across time in MCS, RE, MH, VT, SF, and PF. The need for intervention in improving physical health iii HRQL among older women is validated. On the other hand, the remarkable gains of cases over controls on mental domains of HRQL provoke future research to explore further patient perception on benefit-finding caused by the diagnosis and experience of cancer.

No description available.

Yes / Pain experienced by many patients with advanced cancer is often not well controlled and community pharmacists are potentially well placed to provide support. The study objective was to explore the views and experiences of patients with advanced cancer about community pharmacies, their services and attitudes towards having a community pharmacist pain medicines consultation. Purposive sampling of GP clinical information systems was used to recruit patients with advanced cancer, living in the community and receiving opioid analgesics in one area of England, UK between January 2015 and July 2016. Thirteen patients had a semi-structured interview which was audio-recorded and transcribed verbatim. Data were analysed deductively and inductively using Framework Analysis and incorporating new themes as they emerged. The framework comprised Pain management, Experiences and expectations, Access to care and Communication. All patients reported using one regular community pharmacy citing convenience, service and staff friendliness as influential factors. The idea of a community pharmacy medicines consultation was acceptable to most patients. The idea of telephone consultations was positively received but electronic media such as Skype was not feasible or acceptable for most. Patients perceived a hierarchy of health professionals with specialist palliative care nurses at the top (due to their combined knowledge of their condition and medicines) followed by GPs then pharmacists. Patients receiving specialist palliative care described pain that was better controlled than those who were not. They thought medicines consultations with a pharmacist could be useful for patients before referral for palliative care. There is a need for pain medicines support for patients with advanced cancer, unmet need appears greater for those not under the care of specialist services. Medicines consultations, in principle, are acceptable to patients both in-person and by telephone, the latter was perceived to be of particular benefit to patients less able to leave the house. / National Institute of Health Research programme grant

L’efficacité de la thérapie cognitive est bien démontrée pour traiter la dépression dans la population générale, mais n’a jamais été vérifiée auprès d’hommes atteints d’un cancer de la prostate. L’objectif de cette étude pilote est d’évaluer l’efficacité de la thérapie cognitive pour l’humeur dépressive auprès de quatre hommes atteints d’un cancer de la prostate avancé à l’aide d’un protocole à cas unique expérimental A-B à niveaux de base multiples. Les résultats des analyses de séries chronologiques portant sur des données quotidiennes montrent que la thérapie cognitive améliore significativement la tristesse chez trois des quatre participants ainsi que l’anxiété et la fatigue chez deux des quatre participants. Les analyses visuelles des courbes illustrant les données recueillies hebdomadairement appuient ces résultats en montrant une amélioration de l’humeur dépressive, de l’anxiété, du sommeil, de la fatigue et de la qualité de vie chez trois des quatre participants. La thérapie cognitive pour l’humeur dépressive semble donc être associée à des bénéfices pour plusieurs patients dans cette population.

This study used a qualitative research design to explore and identify, from participant's perspective, the aspects of a breast cancer support group that facilitate a quality experience of support.

Background: The relationship between informational support and use of health care services among individuals newly diagnosed with cancer remains little documented despite its importance for optimal care delivery. Aim: To document the role of informational support in light of patterns of health services used by women and men newly diagnosed with cancer. Method: A sequential mixed methods approach (i.e., quantitative-qualitative) was conducted among women and men newly diagnosed with either breast or prostate cancer. First, an existing quantitative database was used to determine whether an intervention relying on multimedia tool as a complement to the provision of usual cancer informational support to patients (N = 250) would modify subsequent health care service use. A follow-up qualitative inquiry with distinct individuals also newly diagnosed (N = 20) was conducted to explore this relationship further. Next, the resulting quantitative and qualitative findings were merged and reanalyzed using a quantitative-hierarchical approach to enhance our understanding of the phenomenon. Findings: Several personal and contextual factors were found to qualify the relationship between cancer informational support and health service use. Although quantitative analyses showed no significant differences in terms of overall reliance on health care services among participants who received more intense cancer informational support as opposed to those who received care as usual, several sex differences were noted in terms of number of visits to health care professionals, time spent with nurses and satisfaction with cancer information received. Qualitative findings revealed that participants reported a variety of experiences pertaining to cancer information received (e.g., positive, unsupportive or mixed) as well as several processes at play (e.g., cancer information seen as enabling, confirming, or conflicting). These differences in informational support, in turn, influenced their subsequent service utilization (e.g., more phone calls made to health professionals, reduction in face-to-face visits, reluctance to use cancer-related services). The mixed data analysis clarified further the findings allowing a broader perspective to emerge. Conclusion: Findings underscore that the relationship between cancer information and use of services is not as straightforward as initially anticipated. These findings provide initial insights that may inform future research on the topic and assist health care providers in optimizing their cancer informational interventions to guide patients in their reliance on health care services.

Family-centered care (FCC) is important within the practice of pediatric oncology nurses. Such nurses face challenges and barriers when attempting to provide FCC. The purpose of this study was to understand the experiences of pediatric oncology nurses in relation to FCC; identify how pediatric oncology nurses implemented FCC into their practice; identify what facilitated and enabled pediatric oncology nurses to implement FCC; and discern the barriers and challenges that were present in their setting when implementing FCC. A qualitative approach utilizing person-centered interviewing was used to collect data. Nurses (N=20) from the Alberta Children‟s Hospital were recruited through purposeful convenience sampling and were then interviewed. Five major themes were identified from the data set: ACH support f FCC, How participants defined FCC, Establishing FCC, Enhancing FCC, and Barriers and Challenges to providing FCC. Recommendations for future research and implications for practice and education are offered. / xii, 191 leaves ; 29 cm

Introduction: The European Union (EU) is a political and economic confederation <p>composed by 27 member states (EU-27). The EU implemented several standardizations in laws, <p>justice and home affairs and shares the consensus that health care should be regulated by the <p>state. A high level of human protection should be ensured in all its member states. European <p>health systems are funded and managed by each national government and for historical <p>reasons health policy and health expenditure are not homogeneous. <p>Whereas cancer incidence is dependent on factors such as population age, life-style and <p>genetic predisposition, cancer mortality in general is dependent on the efficacy of health <p>systems in providing cancer prevention, efficient screening methods and treatments. <p>Around 20% of the breast cancers show amplification/overexpression of HER2 that is <p>associated with a more aggressive disease and worse clinical outcome. By targeting the HER2 <p>receptor trastuzumab has significantly improved overall survival and changed the natural <p>course of this disease. <p>Objectives: This study aims to evaluate (1) the association of health expenditure with <p>breast cancer outcome, (2) to explore to which degree the differences in breast cancer survival <p>are related to the speed of uptake of trastuzumab and its determinants and (3) to evaluate the <p>real usage of trastuzumab and its relation to breast cancer survival in the EU. <p>Results: Breast cancer survival was found strongly correlated with health expenditure. A <p>clear cutoff divides Western and Eastern Europe in that regard, with western countries showing <p>higher health expenditure and higher breast cancer survival than Eastern Europe. Trastuzumab <p>reimbursement was faster in Western European countries, a factor associated with higher <p>health expenditure and better health policy performance. Trastuzumab uptake is increasing all <p>over Europe in the last 12 years, however it is still being under used in Eastern countries while <p>in Western Europe the uptake is sufficient to treat virtually all patients in need of the drug. <p>Conclusion: Important discrepancies in breast cancer survival exist in the EU. Western <p>Europe has higher breast cancer survival and higher health expenditure than Eastern Europe. <p>This can be partially explained by the faster approval and increased uptake of trastuzumab in <p>Western countries. Higher health expenditure and better health policy performance were <p>factors linked to faster reimbursement and uptake of trastuzumab. / Doctorat en sciences médicales / info:eu-repo/semantics/nonPublished