USE OF ORAL CHEMOTHERAPEUTIC MEDICATIONS IN NON-TRADITIONAL AMBULATORY SETTINGS

Background: Cancer is the second leading cause of death in economically developed countries. The use and availability of oral treatment for cancer has increased dramatically in the past 10 years. Few studies have described the use of oral chemotherapy in non-traditional ambulatory settings by health care professionals across different specialties. Objective: The purpose of this study is to describe the usage of oral chemotherapeutic medications in ambulatory settings. Methods: Cross sectional study of 2007 NAMCS Survey analysis involving 21,761 subjects aged 18 years and above with cancer who participated in the 2007 National Ambulatory Medical Survey (NAMCS). Main Outcome Measure: Physician-reported use of oral chemotherapeutic medications (includes all major drug classes) as indicated on questionnaire for 2007 NAMCS survey. Results: Health care providers in non-traditional settings are less likely to prescribe oral chemotherapy than in traditional ambulatory settings (Adjusted odds ratio (AOR)=0.65{95% confidence interval: 0.61-0.69}). The study results suggest that oncologists are prescribing oral anti-cancer drugs the most as compared to other physician specialties. Conclusion: Health care providers in non-traditional settings are less likely to prescribe oral chemotherapy than in traditional ambulatory settings. Primary care physicians may have limited experience in monitoring and prescribing these potentially toxic medications. Clear guidelines are required for the use of oral chemotherapy medications, considering the potential for their use in non-traditional ambulatory settings and by non-oncologists

Indian Pediatric Oncology Group (InPOG) – Collaborative research in India comes of age

AbstractTreatment of children with cancer on clinical trials, often in the context of national and international co-operative groups, is one of the cornerstones of pediatric oncology treatment and has been shown to improve outcomes of children with cancer. While enrolling children with cancer in prospective multi-centre trials has become the norm in high-income countries, it has remained an exception in low and middle-income countries until recently. In this article, we briefly review the global landscape of pediatric oncology co-operative groups and then discuss the Indian scenario including more recent developments of the formation and galvanization of the Indian Pediatric Oncology Group (InPOG). The mission of InPOG is to improve the outcomes of children with cancer in India by collaborative research. A roadmap for the development and conduct of an InPOG study has been created and 21 disease-specific subcommittees have been formed. Multi-centre studies on Hodgkin lymphoma and acute lymphoblastic leukemia are currently recruiting and several others are under development

Transcatheter Aortic Valve Replacement: Comprehensive Review and Present Status

Aortic stenosis is the most common valvular heart disease in the developed world. About 7% of the population over age 65 years suffers from degenerative aortic stenosis. The prognosis of patients with symptomatic severe aortic stenosis is dismal without valve replacement. Even though the American College of Cardiology recommends aortic valve replacement to treat this condition as a class I recommendation, approximately one third of these patients over the age of 75 years are not referred for surgery. Typically, this is from concern about prohibitive surgical risk associated with patient frailty, comorbidities, age, and severe left ventricular dysfunction

Matlab Based Theft Detection

In this innovative project we are going to present security system that is based on IR Sensor which is interface with the MATLAB software. It displays the status of security on the computer screen also. When any person comes in the range of IR then this security system will automatically detect that person and at the same time it captures the image of that person. It will alert the owner by sending him the text message on his mobile phone. The person will get the information about the unknown detected person through captured image that is been stored in the software. This system is beneficial for preventing and detecting theft at banks, security system at the border of the country, home security, office security etc.Matlab Based Theft Detectio

Determinants of Full Breastfeeding at 6 Months and Any Breastfeeding at 12 and 24 Months among Women in Sydney: Findings from the HSHK Birth Cohort Study

The aim of this study was to report on breastfeeding duration up to 24 months and determine the predictors of breastfeeding duration among women in South Western Sydney, one of the most culturally diverse and socioeconomically disadvantaged regions of New South Wales (NSW), Australia. Mother–infant dyads (n = 1035) were recruited to the Healthy Smiles Healthy Kids birth cohort study. Study data were collected through telephone interviews at 2, 4, 8, 12, and 24 months postpartum. Cox proportional hazards models were used to determine factors associated with the risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. The majority of mothers (92.3%) had initiated breastfeeding. At six months, 13.5% of infants were fully breastfed, while 49.9% received some breast milk. Only 25.5% and 2.9% of infants received some breast milk at 12 and 24 months, respectively. Lower maternal education level, lower socioeconomic status, full-time employment, maternal smoking during pregnancy, and caesarean delivery were associated with increased risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. Older maternal age and partner’s preference for breastfeeding were associated with an increased likelihood of continuing any breastfeeding at 12 and 24 months. These findings present a number of opportunities for prolonging breastfeeding duration in disadvantaged communities in NSW

Perceptions and practices of oral health care professionals in preventing and managing childhood obesity

In this study, we aimed to explore the perceptions of oral health care professionals (OHCPs) on childhood overweight and obesity screening and management in oral health settings in the Greater Sydney region in New South Wales, Australia. OHCPs involved in the Healthy Smiles Healthy Kids (HSHK) birth cohort study were purposively selected for this nested qualitative study. A sample of 15 OHCPs completed the face-to-face interviews, and thematic analysis was undertaken to identify and analyse the contextual patterns and themes. Three major themes emerged: (1) obesity prevention and management in dental practice; (2) barriers and enablers to obesity prevention and management in dental settings; and (3) the role of oral health professionals in promoting healthy weight status. This study found that OHCPs are well-positioned and supportive in undertaking obesity screening and management in their routine clinical practice. However, their practices are limited due to barriers such as time constraints, limited knowledge, and limited referral pathways. Strategies including capacity building of OHCPs, development of appropriate training programs and resources, and identification of a clear specialist referral pathway are needed to address the current barriers. This study provides an insight into opportunities for the oral health workforce in promoting healthy weight status among children

How do mothers living in socially deprived communities perceive oral health of young children? : a qualitative study

This qualitative study aims to explore and gain an in-depth understanding of the knowledge and perceptions of mothers living in Greater Western Sydney (GWS), one of Australia’s most socioeconomically disadvantaged regions, regarding the factors that influence oral health of young children. Mother–child dyads (n = 45) were purposively selected from a population-based cohort study in GWS. Semi-structured in-depth interviews were audio-recorded, transcribed verbatim, and subsequently analyzed using thematic analysis. Five main themes emerged from the interviews: (1) beliefs about child oral health and first set of teeth; (2) awareness and attitudes towards oral health services; (3) identification of caries risk and protective factors; (4) broader cultural and social class influences on childhood oral health practices; and (5) the influence of parental self-confidence, self-efficacy, and perceived control. Overall, mothers reported having limited knowledge and awareness on the importance of baby teeth, child’s first dental visit, and seeking oral health care. Oral health and preventative practices in children were reported to be influenced by past dental experiences, culture and social class, and parental factors. The empirical findings of this study bring our attention to the critical factors that influence child oral health and the opportunities for co-creating child oral health promotion by targeting mothers

Cellular interaction of folic acid conjugated superparamagnetic iron oxide nanoparticles and its use as contrast agent for targeted magnetic imaging of tumor cells

The purpose of the study was to develop tumor specific, water dispersible superparamagnetic iron oxide nanoparticles (SPIONs) and evaluate their efficacy as a contrast agent in magnetic resonance imaging (MRI). We have developed SPIONs capped with citric acid/2-bromo-2-methylpropionic acid which are compact, water dispersible, biocompatible having narrow range of size dispersity (8–10 nm), and relatively high T2 relaxivity (R2 = 222L · mmol−1 · sec−l). The targeting efficacy of unconjugated and folic acid-conjugated SPIONs (FA-SPIONS) was evaluated in a folic acid receptor overexpressing and negative tumor cell lines. Folic acid receptor-positive cells incubated with FA-SPIONs showed much higher intracellular iron content without any cytotoxicity. Ultrastructurally, SPIONs were seen as clustered inside the various stages of endocytic pathways without damaging cellular organelles and possible mechanism for their entry is via receptor mediated endocytosis. In vitro MRI studies on tumor cells showed better T2-weighted images in FA-SPIONs. These findings indicate that FA-SPIONs possess high colloidal stability with excellent sensitivity of imaging and can be a useful MRI contrast agent for the detection of cancer

Transcatheter versus surgical aortic valve replacement in intermediate risk patients: a meta-analysis

BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been approved in patients with high or prohibited surgical risk for surgery for treatment of severe symptomatic aortic stenosis. Prospective studies examining the benefits of TAVR in intermediate risk patients are ongoing. Other smaller studies including lower risk patients have been conducted, but further meta-analysis of these studies is required to draw more broad comparisons. METHODS: A Medline search was conducted using standard methodology to search for clinical trials and observational studies including intermediate risk patients. We limited our meta-analysis to studies matching patient populations by propensity scores or randomization and examined clinical outcomes between TAVR and surgical aortic valve replacement (SAVR). RESULTS: Analysis of the TAVR and SAVR cohorts revealed no significant differences in the outcomes of 30-day [OR (95% CI): 0.85 (0.57, 1.26)] or 1-year mortality [OR (95% CI): 0.96 (0.75, 1.23)]. A trend towards benefit with TAVR was noted in terms of neurological events and myocardial infarction (MI) without statistical significance. A statistically significant decrease in risk of post-procedural acute renal failure in the TAVR group [OR (95% CI): 0.52 (0.27, 0.99)] was observed, but so was a significantly higher rate of pacemaker implantations for the TAVR group [OR (95% CI): 6.51 (3.23, 13.12)]. CONCLUSIONS: We conclude that in intermediate risk patients undergoing aortic valve replacement, the risk of mortality, neurological outcomes, and MI do not appear to be significantly different between TAVR and SAVR. However, there appears to be a significant reduction in risk of acute renal failure at the expense of an increased risk of requiring a permanent pacemaker in low and intermediate risk patients undergoing TAVR compared to SAVR

Diet, nutrition, and oral health : what influences mother's decisions on what to feed their young children?

The purpose of this study was to learn about mothers’ experiences with food choices for their pre-school children in underprivileged communities in Greater Western Sydney (GWS). A total of 20 mother-child dyads living in GWS were recruited to a qualitative study from an ongoing birth cohort study. Participants’ houses were visited for semi-structured interviews, which were recorded, transcribed verbatim, and analysed thematically. The interviews yielded five main themes: (i) food choices, nutrition, and health; (ii) accessibility and availability of foods (iii) buying time for parents; (iv) child’s age and their preference on food choices; (v) conditioning certain behaviours by family and cultural factors. Nutrition literacy, child’s preferences, unhealthy food intake by family members, child’s demand, advertising and availability of harmful foods, and time constraints were all mentioned as hurdles to mothers making appropriate meal choices for their children. However, some identified facilitators were promoting parents’ knowledge, increasing access to health educational materials, upskilling mothers to providing healthier alternatives, regulating the marketing of unhealth foods. Although, the present study identified critical factors that influence mothers’ food choices for their young children, making healthy food choices is a complex practice as it is shaped by individual, social and environmental influences