Cancer awareness among adolescents in Britain: a cross-sectional study

Background: Little is known about adolescents’ cancer awareness and help-seeking behaviour in Britain. This study assessed adolescents’: awareness of cancer symptoms, common cancers, and the relationship between cancer and age; anticipated delay and perceived barriers to seeking medical advice; and examined variation by age, gender, ethnicity and whether individuals knew someone with cance

Co-constructing sexual recovery after prostate cancer : a qualitative study with couples

Though only one person in a partnership experiences cancer, these data indicated the extent to which prostate cancer treatment also impacts on partners. The study indicates that adjustment to erectile dysfunction (ED) takes time, but is a highly significant event in couples' lives and its importance should not be under-estimated. Consequently, we suggest that relational models of care should be considered, whereby side-effects are recognised as impacting on both members of the partnership (for example ED, or lack or ejaculate). Supportive care in this context, therefore, may best be based on a relational approach using language and interventions that are appropriate to the patient and their situation

A systematic review and narrative summary of family-based smoking cessation interventions to help adults quit smoking

Background: Smoking is the most significant preventable cause of morbidity and early mortality in the world. The family is an influential context in which smoking behaviour occurs. Methods: A systematic review and narrative summary of family-based interventions to help adults quit smoking was conducted. Results: Eight controlled trials were included. Risk of bias was high. The smoking-related outcome of the intervention was self-reported smoking status/abstinence, validated by objective measures (including saliva thiocynate or breath carbon monoxide). Follow-up ranged from six weeks to five years. The main target groups were: pregnant women (1), pregnant women who smoked (2), men at risk of cardiovascular disease (2), adult smokers (1), parents who smoked (1) and couples who both smoked (1). Interventions included family members but most did not go further by drawing on family, systemic or relational theories to harness the influence of family on smoking behaviour. Only three studies directly compared the effects on smoking behaviour of a family-based (i.e. interventions that involve a member of the family) versus an individual-based (i.e. interventions that use behaviour change techniques that focus on the individual) intervention. None of these studies found significant differences between groups on the smoking behaviour of the main target group. Conclusions: We have yet to develop family-based smoking cessation interventions that harness or re-direct the influence of family members on smoking behaviour in a positive way. Thus, it is likely that individualised-approaches to smoking cessation will prevail.Publisher PDFPeer reviewe

Increased cancer awareness among British adolescents after a school-based educational intervention: a controlled before-and-after study with 6-month follow-up

Background: There is a lack of evidence around the effectiveness of school-based interventions designed to raise adolescents' cancer awareness. To address this deficit this study assessed the impact of an intervention delivered in the United Kingdom by Teenage Cancer Trust on: recall (open question) and recognition (closed question) of cancer warning signs; knowledge of common childhood, teenage, male and female cancers; awareness of the relationship between cancer and age; anticipated medical help-seeking delay; perceived barriers to seeking medical advice about cancer; and examined variation of intervention effect by gender and whether adolescents reported that they knew someone with cancer. Methods: The Cancer Awareness Measure (CAM) was completed by 422 adolescents (male: 221, 52.4%) aged 11-17 years old (mean age=13.8, standard deviation=1.26) two weeks before and two weeks after the intervention in three schools, and on two occasions four weeks apart in a fourth (control) school. Intervention schools were followed-up 6-months post-intervention. Results: Recognition of nine common cancer warning signs significantly increased two weeks after the intervention (4.6 to 6.8, p less than 0.001) and was maintained at 6-month follow-up (6.2, p less than 0.001). Endorsement of emotional barriers to help-seeking 'not confident to talk about symptoms' (53% to 45%, p=0.021) and 'worried about what the doctor might find' (70% to 63%, p=0.021) significantly decreased two weeks after the intervention but changes were not maintained at 6-months. The intervention had a greater impact on females and those who knew someone with cancer. Conclusions: The intervention is an effective way to raise adolescents' cancer awareness, especially of cancer symptoms. Further development and evaluation is required to maximise intervention impact, particularly on barriers to help-seeking behaviour

Couple-based psychosexual support following prostate cancer surgery: results of a feasibility pilot randomized control trial

Surgery for prostate cancer can result in distressing side effects such as sexual difficulties, which are associated with lower levels of dyadic functioning. The study developed and tested an intervention to address sexual, relational, and emotional aspects of the relationship after prostate cancer by incorporating elements of family systems theory and sex therapy

When doctors and parents disagree on how to treat a sick child the emotional and financial costs can be huge

First paragraph: When a child is sick and parents and doctors disagree about what to do next, who is best placed to make that decision? This is a tricky but not uncommon question – with a number of recent high-profile legal cases highlighting the limits of parents’ rights to decide what treatments should be offered.https://theconversation.com/when-doctors-and-parents-disagree-on-how-to-treat-a-sick-child-the-emotional-and-financial-costs-can-be-huge-12467

The Swiss NEHAP: why it ended

While European countries tend to increase the importance given to their national environmental health action plan (NEHAP), Switzerland stopped implementing its NEHAP in 2007. This study investigates the reasons for this surprising decision. The results provide an explanation of a relatively unique case and should inform any person interested in understanding common obstacles in the making and implementation of coordinated environmental health policies and programs. Data used in this study have been obtained from interviews conducted among experts of the Swiss environmental health policies and from survey results provided by the WHO Regional Office for Europe. Findings show that financial constraints were only partly responsible for the abandonment of the NEHAP and that many of the shortcomings observed arose from the creation and the functioning of the Environmental and Health Section at the Federal Office of Public Health, which was devoted to the NEHAP. Lack of scientific knowledge and capacity to build intersectoral collaboration, compounded by a limited conception of environmental health, resulted in a lack of political awareness of environmental health issues. In consequence, the study highlights the necessity of a true interdisciplinary and intersectoral approach for environmental health policies. Policy makers should also be concerned with the creation of relevant systems of indicators, since they appear to be fundamental to the success of environmental health policie

Opportunities and Challenges to Increase Inter- and Transdisciplinarity: A Qualitative Study of the FloodRISE Project

Background: The FloodRISE project, which started in 2013 in Southern California, aimed at better understanding how to promote resilience to coastal flooding. It was based on a cross-disciplinary approach, involving several research teams and local communities. Purpose: We conducted a qualitative study of the first phase of the project (2013-2015) in order to analyze its inter- and transdisciplinary aspects. Setting: We conducted this evaluation as a visiting postdoctoral researcher at UCI, not participating in the FloodRISE project. Intervention: Not applicable. Research design: We conducted 18 semi-structured interviews with members of the three project teams - modeling, social ecology and integration & impact - at UCI in 2015. Data were analyzed and interpreted to identify key aspects of the collaboration within and between project teams, as well as their relationship to local stakeholders. Findings: The analysis showed that an intensive dialogue-based method of interaction and the presence of boundary researchers played a fundamental role in bridging the conceptual and methodological gaps between social and engineering sciences. These results thus exemplify several possibilities for developing more efficient interactions between researchers in a cross-disciplinary project. However, any cross-disciplinary project should: carefully evaluate potential for participants to become boundary researchers, since participants with multiple disciplinary expertise may be underemployed; improve researchers’ level of readiness, in order to facilitate further interaction and increase time efficiency; and clearly address remoteness issues to avoid lower collaboration between central and peripheral locations. Keywords: interdisciplinarity; transdisciplinarity; qualitative study; project evaluation; flood ris

Effect of a reduction in glomerular filtration rate after nephrectomy on arterial stiffness and central hemodynamics: rationale and design of the EARNEST study

Background: There is strong evidence of an association between chronic kidney disease (CKD) and cardiovascular disease. To date, however, proof that a reduction in glomerular filtration rate (GFR) is a causative factor in cardiovascular disease is lacking. Kidney donors comprise a highly screened population without risk factors such as diabetes and inflammation, which invariably confound the association between CKD and cardiovascular disease. There is strong evidence that increased arterial stiffness and left ventricular hypertrophy and fibrosis, rather than atherosclerotic disease, mediate the adverse cardiovascular effects of CKD. The expanding practice of live kidney donation provides a unique opportunity to study the cardiovascular effects of an isolated reduction in GFR in a prospective fashion. At the same time, the proposed study will address ongoing safety concerns that persist because most longitudinal outcome studies have been undertaken at single centers and compared donor cohorts with an inappropriately selected control group.<p></p> Hypotheses: The reduction in GFR accompanying uninephrectomy causes (1) a pressure-independent increase in aortic stiffness (aortic pulse wave velocity) and (2) an increase in peripheral and central blood pressure.<p></p> Methods: This is a prospective, multicenter, longitudinal, parallel group study of 440 living kidney donors and 440 healthy controls. All controls will be eligible for living kidney donation using current UK transplant criteria. Investigations will be performed at baseline and repeated at 12 months in the first instance. These include measurement of arterial stiffness using applanation tonometry to determine pulse wave velocity and pulse wave analysis, office blood pressure, 24-hour ambulatory blood pressure monitoring, and a series of biomarkers for cardiovascular and bone mineral disease.<p></p> Conclusions: These data will prove valuable by characterizing the direction of causality between cardiovascular and renal disease. This should help inform whether targeting reduced GFR alongside more traditional cardiovascular risk factors is warranted. In addition, this study will contribute important safety data on living kidney donors by providing a longitudinal assessment of well-validated surrogate markers of cardiovascular disease, namely, blood pressure and arterial stiffness. If any adverse effects are detected, these may be potentially reversed with the early introduction of targeted therapy. This should ensure that kidney donors do not come to long-term harm and thereby preserve the ongoing expansion of the living donor transplant program.<p></p&gt

Prostate cancer: Exploring the reasons for timing of presentation and diagnosis. Summary Report

There has been little research looking specifically at the reasons for the timing of when men are diagnosed with prostate cancer. This study investigated the profile of men diagnosed in Greater Glasgow over a two-year period (2008-9). This report explores the experiences of men before they were diagnosed and includes what triggered them or prevented them from presenting their symptoms to a healthcare professional. The study is based on clinical information of the patient population, a postal survey and interview data