The subject of the master's thesis is identification and quantification of the cost of Treatment of Cervical Cancer. The aim is to quantify the costs of specific medical procedures, make the research on the issue of Cervical Cancer and determine the costs and benefits of nationwide vaccination against the HPV.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-12T15:56:43Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertação_Anna_Jessica_PPGG.pdf: 2035458 bytes, checksum: 6a4bc578c9eaea104302f33af03c3f21 (MD5) / Made available in DSpace on 2017-07-12T15:56:43Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertação_Anna_Jessica_PPGG.pdf: 2035458 bytes, checksum: 6a4bc578c9eaea104302f33af03c3f21 (MD5) Previous issue date: 2016-03-04 / CNPQ / A infecção pelo Papilomavírus Humano, além de representar uma doença sexualmente transmissível altamente disseminada, é responsável por 5% dos cânceres em humanos, destacando o câncer cervical com altos índices de incidência e mortalidade. Embora comprovadamente eficazes, as vacinas vigentes não combatem infecções já estabelecidas e apresentam um elevado custo de produção. Esse cenário revela a necessidade de estratégias vacinais alternativas. O presente trabalho propõe a expressão de diferentes genes recombinantes em Escherichia coli, uma plataforma biotecnológica econômica, de fácil manipulação e de alto rendimento. Os genes recombinantes utilizados foram: L1 de HPV16 e construções quiméricas basedas na substituição de epítopos da oncoproteína E5 na alça h4 e na região C-terminal de L1, com potencial para geração de antígenos profiláticoterapêuticos e na substituição de epítopos da proteína L2 na região da alça h4 para avaliação de possível neutralização cruzada. Após subclonagem em pGEM-T, esses genes foram clonados em vetor de expressão pAE e linhagens de Escherichia coli BL21 e Rosetta foram transformadas com os vetores de expressão gerados. A confirmação da produção das proteínas se deu por Western blot, a partir de extratos de culturas induzidas com IPTG. Otimizações nos protocolos de indução, lise e preparo das amostras foram realizadas ao longo dos experimentos. Os resultados obtidos demonstraram a produção dos antígenos recombinantes, e deverão ser validados em futuros ensaios imunológicos quanto à capacidade de induzir respostas imunes em animais desafiados. / Human papillomavirus infection, besides to represent a widespread sexually transmitted disease, is responsible for 5% of cancers in humans, highlighting cervical cancer with high rates of incidence and mortality. Although proven effective, the existing vaccines do not eliminate infections already established and have a high cost of production. This scenario shows the need for alternative vaccine strategies. This study proposes the expression of different recombinant genes in Escherichia coli, an economic, easy handling and high performance biotechnology platform. Recombinant genes used were: L1 of HPV16 and chimeric basedas constructions in replacement E5 oncoprotein epitopes on h4 loop and L1 C-terminal region, with the potential to generate prophylactic-therapeutic antigens and replacing L2 protein epitopes in loop region h4 for evaluation of possible cross-neutralization. After subcloning in pGEM-T, these genes were cloned into vector pAE expression and Escherichia coli BL21 and Rosetta were transformed with the expression vectors generated. Confirmation of protein production was performed by Western blot from extracts of cultures induced with IPTG. Optimizations in the induction protocols, lysis and preparation of the samples were carried out throughout the experiments. The results demonstrated the production of recombinant antigens and should be validated in future immunological assays for the ability to induce immune responses in challenged animals.

Thesis (M.A.) / INTRODUCTION: Cervical cancer exists as the second most common cancer among women world wide, and in numerous countries is the leading type of female cancer. Specifically, Zambia has one of the highest mortality rates and cervical cancer incidence rates. The goal of this study is to analyze the published literature on preventative techniques for cervical cancer in resource-deprived areas of sub-Saharan Africa by focusing on the correlation between the Human Papilloma Virus (HPV), Acquired Immunodeficiency Syndrome (AIDS), and cervical cancer; the accuracy and feasibility of “screen and treat” clinics; and socio-economic and geographical barriers. RESULTS: Correlations exists between the prevalence of HIV, HPV, and cervical cancer in sub-Saharan Africa, and a clear association exists between HPV and cervical cancer. The deliverance of HPV vaccines as well as educational programs has helped to improve this medical problem. Main screening methods for cervical cancer include the Pap smear, naked eye visual inspection of the cervix after the application of either diluted acetic acid (VIA), Lugol’s iodine (VILI), or with a magnifying device (VIAM), colposcopy, and tests for HPV markers. Studies indicate that the VILI screening test has the highest level of sensitivity with the LEEP method also of importance. The procedure is relatively low cost and is easy to implement when excising lesions. Major risk factors and determinants of cervical cancer can help to explain the underlying barriers of access to care. Women’s misconceptions regarding cervical cancer, gender inequality in African nations, socio-economic status, and foreign aid all play major roles the cervical cancer screening process. A lack of proper education, especially among women in sub-Sahara Africa, has led to misconceptions about the causes of cervical cancer. Studies have found that some women associated cervical cancer with prostitution, a Satanic curse, and other bad behavior. Gender inequality also plays a significant role since the Zambia government had reported that a husband would have absolute rights over children and reproductive rights over his wife once he had made payments for a bride. Geographical barriers also exist as the terrain in Zambia is swamp-like and heavy flooding throughout the year is common. After flooding occurs, communities become physically separated. Furthermore, there are correlations between high incidence rates of cervical cancer and high poverty as it has been shown that the largest number of people living on less than $1.25 dollars per day is that of sub-Saharan Africa. DISCUSSION: Studies have indicated that virtually all of cases of cervical cancer are caused by HPV, implying that HPV testing and detection would largely prevent the progression of lesions. Ultimately, this would reduce the high incidence rate of cervical cancer in Zambia and in other Sub-Saharan African countries. In areas where cytology programs are either non-existent or not efficient, HPV testing approaches should be evaluated and implemented, and they should be based off of the HIV/AIDS infrastructure that has already been established. In regards to the screening approaches, VIAM and VIA are the only two tests that are also practical, affordable, and available. Affordability is the major concern when implementing screening programs in sub-Saharan Africa; for this reason, either VIAM and VIA would arguably be the best options as long as they were effective. VIA would be considered the most appropriate method in terms of screening procedures as the method has the advantage of giving immediate results that can be applied to large populations. Lastly, the lack of proper education, including sex education, has in part led to drastic misconceptions about the causes of cervical cancer. Women hold negative beliefs about cervical cancer since they associate it with being unclean and view it as a reflection of bad behavior. Geographical barriers also play a role; the physical inaccessibility of the clinic discourages women to come to the clinic for screenings. Home visits by physicians and/or the utilization of community health workers may help to eliminate this particular barrier of access. This strategy would be especially beneficial to residents of rural areas since they are more likely to live farther away from institutionalized clinics and screen and treat facilities and are also more likely to be in a state of extreme poverty.

Cervical Cancer is a preventable disease. Sadly it is a cause morbidity and mortality of women in poor socio-economic settings worldwide, largely due to avoidable factors. This amounts to a gross violation of the rights to life and access to healthcare of vulnerable populations of women. Awareness, sensitisation and mobilisation of the civil society could be crucial in influencing change in political will and healthcare policies to address the needs of HIV infected women, in particular, given their susceptibility to the development of cervical cancer. This work advocates for the South African government to further commit resources towards the prevention of cervical cancer, including hysterectomy in women at high risk of developing cervical cancer before it ensues. / Mini Dissertation (MPhil)--University of Pretoria, 2019. / Public Law / MPhil / Unrestricted

Bakgrund: Livmoderhalscancer är en av världens vanligaste cancerform hos kvinnor. Det finns olika behandlingsmetoder beroende på kvinnans cancerstadium och hälsotillstånd. Vid samtliga behandlingar uppkommer vanligen biverkningar av olika  karaktär, som påverkar kvinnorna på olika sätt. Sjuksköterskan har som ansvar att informera och stötta kvinnor som drabbats av livmoderhalscancer och arbeta utifrån ett holistiskt förhållningssätt. Syfte: Syftet var att beskriva kvinnors upplevelse av behandling mot livmoderhalscancer. Metod: En litteraturöversikt gjord med kvalitativ och induktiv ansats baserad på tolv artiklar med kvalitativ data användes. Artikelsökningen gjordes i Medline, Cinahl, samt Psycinfo. Resultat: Resultatet redovisade två kategorier med tillhörande sex subkategorier. Kategorierna var: Upplevelse av behandlingens inverkan på kropp och själ, samt det psykosociala behovet. Biverkningar som uppkom efter behandling yttrades i både på fysisk, psykisk och social karaktär och ledde till omfattande utmaningar för kvinnor att hantera. Kvinnor upplevde behov av olika typer av stöd och att samtliga förändringar påverkade dem själva och sin relation med omgivningen både positivt och negativt. Slutsatser: Kvinnor som genomgått behandling mot livmoderhalscancer upplevde ett försämrat hälsotillstånd. Litteraturöversikten hoppas ge sjukvårdspersonal ökad kunskap i hur de ska bemöta och stötta kvinnor med livmoderhalscancer, samt främja vårdförloppet för kvinnorna och dess närstående. / Background: Cervical cancer is one of the most common cancers in the world for women. In all treatments side effects can occur, which affect women in different ways. The nurse is responsible for informing and supporting women affected by cervical cancer and work from a holistic perspective. Aim: The purpose was to describe women's experience of treatment for cervical cancer. Method: A literature review made with a qualitative and inductive approach based on twelve articles with qualitative data were used. The article search was done in Medline, Cinahl, and Psycinfo. Results: The result presented two categories with six subcategories. The categories were: The experience of the treatment's effect on body and soul, and the psychosocial needs. Side effects that arose affected both physical, mental and social levels. Conclusion: Women who have gone through treatment for cervical cancer experienced an deteriorated health condition as a result of treatments. The literature review hopes to give healthcare professionals an insight into how to respond to and support women with cervical cancer and promote the care process for the relatives and the woman.

Health is one of the most important issues in the lives of human beings and has a direct effect on the well-being of a country’s citizens and its economy. Researchers emphasise the role of communication in maintaining health and well-being, and in preventingdisease by changing behaviour. In a multilingual society such as South Africa, health communication documents are often translated for distribution to different language groups. However, the translation of health-related communication documents, specifically for use by low-literate target audiences, poses many challenges, especially in cases where there is a considerable distance between the source text and the target cultures. Translators who work in the field of health communication require specific strategies that will enable them to effectively transfer health-related information that is steeped in cultural meaning while taking into consideration aspects such as stigma and taboo. This study explores the challenges faced during the translation from English into isiZulu of a photonovel called An ounce of prevention, a health document about cervical cancer originally developed for a Latin American audience. This text relies heavily on cultural elements to convey messages. Through an overview of Christiane Nord’s model of Functionality +Loyalty (2005), as well as Larkey and Hecht’s (2010) model of Effects of Narratives as Culture-Centric Health Promotion, a set of analytic heuristics was distilled and applied as a tool to systematically identify cultural elements in the photonovel to ensure that a translation into isiZulu would be culturally acceptable to a Zulu target audience. The purpose of analytic heuristics is to assist translators’ understanding of the communicative situation in which the source text was produced. Once they have been equipped with necessary knowledge of the communication situation and have a sound understanding of the photonovel as a text, translators should be able to systematically identify culture-specific elements in the source text. Thereafter they can establish the cultural distance between the source text culture and the target text communication situation to ensure that all narrative characteristics from both the personal and socio-cultural levels of the narrative inform the concepts of transportation, identification and social profiling. Translators are thus equipped to make informed decisions regarding the translation of specific challenges identified in the source text that would make the target text culturally unacceptable to the target culture. Once the heuristics have been applied to excerpts from the photonovel that pose intercultural challenges, it is concluded that cultural elements and linguistic norms have been successfully identified in the source text and have been appropriately re-contextualised in the target text to ensure that the original message is conveyed. It is assumed that the analytic heuristics will also be useful in ensuring the effective translation of other culture-centric texts without changing the original message. / Mini Dissertation (MA)--University of Pretoria, 2018. / African Languages / MA / Unrestricted

Background: Cervical cancer among Black women is a major individual and public health concern. Despite advancements in medical technology and policy, disparities in cervical cancer diagnosis and mortality still exist between White and Black women, with Black women having higher rates of diagnosis (10.0 vs 7.1 per 100,000) and mortality (4.1 vs 2.0 per 100,000). Previous studies have focused heavily on barriers to obtaining cervical cancer screening among Black women and efforts to improve screening rates. Despite speculation by researchers that gaps in receipt of quality follow-up care may contribute to disparities, its role in disparate mortality rates between Black and White women has yet to be formally studied. Purpose: The goals of the present research were to (1) assess differences in Pap screening rates and (2) rates of adherence to recommended follow-up care after abnormal Pap results between Black and White women, (3) evaluate how specific factors of the Health Belief Model (HBM) influence the decision-making process for obtaining Pap screening and (4) receiving recommended follow-up Pap care, and (5) evaluate the role of ethnic centrality as a factor in health decision-making. Results: Results indicated that HBM facets functioned similarly in predicting engagement in Pap screening and follow-up care, although there were differences in the influence of different facets by race. Ethnic centrality showed little applicable influence on adherence to follow-up care among Black women. An exploratory analysis revealed that doctor recommendation was the most influential factor predicting follow-up care use for both racial groups. Conclusion: The present study offers support for increased education and training on provider recommendation of appropriate follow-up care, as well as effective provider communication of results and services using messaging that appeals to the values and concerns of patients.

Knowledge and attitudes to HPV immunisation IV Author: Tereza Jelínková Thesis supervisor: PharmDr. Eva Zimčíková, Ph.D. Introduction HPV infection is one of the most common sexually transmitted diseases causing, apart from genital warts, other malignancies, most often cervical cancer. The most effective way of prevention is vaccination. So far, there have been 3 types of vaccines, most recent one being the nonavalent vaccine providing up to 90 % protection against cervical cancer- causing HPV, in contrast to the previously available 70 % protection from bivalent or quadrivalent vaccines. Aims The main aim of this thesis was to investigate the knowledge and attitudes towards vaccination against HPV, and knowledge about HPV in general, among secondary school students. Furthermore, to determine their vaccination status and compare the findings with data from previous theses, including a comparison of their knowledge about HPV and relevant prevention. Methodology The data was obtained by means of a questionnaire survey, which took place at three secondary schools. In December 2017 at Gymnázium in Mladá Boleslav, then during June 2018 at Gymnázium in Brandýs nad Labem, and finally in September 2018 at Gymnázium Chotěboř. The obtained data was recorded in a Microsoft Excel spreadsheet and then...

Thesis (MPH.) -- University of Limpopo, 2020 / Background of the study: Cervical cancer is a disease that is described as the state of overgrowth of tissue resulting from the disorganisation of cell division that is preceded by several earlier cervical changes, especially at the squamocolumnar junction of the cervix. Factors such as HPV, which is a sexually transmitted infection (STI), low socioeconomic status (SES), intercourse at a very early age, numerous childbirths, poverty and limited access to health care, are some of the contributing risk factors for cervical cancer. Most women in developing countries only seek professional help once the malignancy is already at an advanced stage. Purpose of the study: The aim of the study was to investigate the determinants of cervical cancer in patients seen in the gynaecology clinic at Mankweng hospital. And the objectives were: to profile the sociodemographic characteristics; to profile the contributory risk factors; and, to determine the association of risk factors for cervical cancer with the socio-demographic characteristics of the patients seen in the gynaecology clinic at Mankweng hospital. Research methodology: A quantitative, cross-section descriptive study, which has been validated and used in several studies globally, was conducted at Mankweng hospital, which is a tertiary referral academic hospital in the Limpopo Province, following all cervical cancer patients consulting at gynaecology outpatient clinic during the study period. Data were collected using a structured questionnaire and entered into computer software and analysed. Research findings: Thirty-seven percent of the women who participated in this study were single, 27% were married, 27% widowed and only 9% were divorced. Nearly half (46%) of the participants had secondary education and only 8% had tertiary education. The majority (91%) of the women were unemployed and only 9% were employed. The majority (40%) of the women were at stage II cervical cancer. Nearly two-thirds (62%) had had multiple partners. At the time of the study, 94% of the participants did not have multiple partners. Nearly two-thirds (64%) of the participants had heard about Pap smears before their current diagnosis and 62% of the participants had had a Pap smear before the current results. Few participants smoked cigarette (2%) or used contraceptive (3%). The young age group, single, divorced, with secondary and v tertiary education were more likely to be HIV positive. And the elderly, divorced, widowed and less educated were more likely to have high parity. Recommendations and conclusions: Information about the risk factors for developing cervical cancer, specifically the transmission of HPV, needs to be disseminated to young people. Rather than initiating cervical screening by age group, which may result in young women being refused screening irrespective of their risk, cervical screening guidelines should stipulate the initiation of cervical screening and HPV vaccine from the age of 15 onwards. Present study suggests that young women may be more prone to HPV and HIV due to the fact that young women who are single or divorced, with tertiary education were more likely to have multiple partners, which places them in a risk-based cervical screening target group. A final recommendation and conclusion is that a long-term, in-depth study on cervical cancer in young women in relation to the presence of the risk-factors should be carried out. Attempts should be made to reach women who rarely visit health care services.

Human papillomavirus is the most frequently occurring sexually transmitted infection and has been recognized as the necessary cause of cervical cancer. Understanding the shift in public awareness caused by recent changes to cervical prevention is critical to addressing cervical cancer disparities in Appalachia. Since the human papillomavirus vaccine was approved for prevention, little data have been collected regarding human papillomavirus risk assessment and vaccine perceptions among Appalachian women. The purpose of the authors in this study was to investigate communication and cultural issues via a social scripting framework that could influence human papillomavirus vaccine uptake among southern Appalachian women; and explore participants' perceptions of human papillomavirus, cervical cancer, and the vaccine. A qualitative, descriptive design was employed to examine these issues in eight counties in northeast Tennessee and southwest Virginia. Thirty-nine women aged 18-49 years participated in a single individual interview or focus group session from October 2007 through August 2008. Interview and focus group data were audio-taped and transcribed verbatim. Two major themes emerged from the data: the human papillomavirus vaccine protection dilemma and spheres of silence surrounding the human papillomavirus vaccine protection dilemma. Study findings suggested areas for future research and may assist healthcare professionals in approaching southern Appalachian women as they make decisions regarding cervical cancer prevention.