Chemoradiation for advanced hypopharyngeal carcinoma: a retrospective study on efficacy, morbidity and quality of life

Chemoradiation (CRT) is a valuable treatment option for advanced hypopharyngeal squamous cell cancer (HSCC). However, long-term toxicity and quality of life (QOL) is scarcely reported. Therefore, efficacy, acute and long-term toxic effects, and long-term QOL of CRT for advanced HSCC were evaluated,using retrospective study and post-treatment quality of life questionnaires. in a tertiary hospital setting. Analysis was performed of 73 patients that had been treated with CRT. Toxicity was rated using the CTCAE score list. QOL questionnaires EORTC QLQ-C30, QLQ-H&N35, and VHI were analyzed. The most common acute toxic effects were dysphagia and mucositis. Dysphagia and xerostomia remained problematic during long-term follow-up. After 3 years, the disease-specific survival was 41%, local disease control was 71%, and regional disease control was 97%. The results indicated that CRT for advanced HSCC is associated with high locoregional control and disease-specific survival. However, significant acute and long-term toxic effects occur, and organ preservation appears not necessarily equivalent to preservation of function and better QOL

Scared Straight and Other Juvenile Awareness Programs for Preventing Juvenile Delinquency: A Systematic Review

Programs like ‘Scared Straight’ involve organized visits to prison facilities by juvenile delinquents or children at risk for becoming delinquent. The programs are designed to deter participants from future offending by providing first-hand observations of prison life and interaction with adult inmates. Results of this review indicate that not only does it fail to deter crime but it actually leads to more offending behavior. Government officials permitting this program need to adopt rigorous evaluation to ensure that they are not causing more harm to the very citizens they pledge to protect

Indigenous Perspectives on Ecosystem Sustainability and Health

Indigenous peoples have been guardians of our global envi-ronment and its medicines for millennia—built on a com-munal view of humanity and its links to the ecosystem. Yet as the new millennium rolls out, Indigenous peoples are among those most marginalized within many nation states, they have the worst health indicators, and their knowledge con-tinues to be threatened as the land and resources they depend on are appropriated, developed, degraded, or destroyed. During the United Nations Decade of the Worlds Indigenous Peoples (1995–2005), one response to these concerning trends was increased scholarly and policy attention to fields such as traditional ecological knowledge, indigenous health, traditional medicines, and biopro-specting (Janes, 1999; Berkes et al., 2000; Merson, 2000; Subramanian et al., 2006). Yet at the end of this UN decade, an invited Lancet series offered a sobering reminder of just how much more needs to be done to improve and promote the health status of Indigenous people worldwide (see Stephens et al., 2006). A significant obstacle to meeting this challenge has been the predictable tendency to study and analyze indigenous perspectives and priorities along tradi-tional disciplinary lines, in effect disaggregating holistic understanding into academic or thematic silos with mini-mal interaction and a disconnect from pressing, intercon-nected realities of health, culture, and ecology. This edition of EcoHealth has been put together with explicit interest in (re)integrating indigenous perspectives on ecosystem sustainability and health. It is timely that the issue was finalized the same week that the United Nations General Assembly adopted the Declaration on the Rights of Indigenous People, after almost 13 years since the draft declaration was proposed in 1994 (United Nations, 2007). The nonbinding declaration passed despite objections fro

Utz Wachil: Findings from an International Study of Indigenous Perspectives on Health and Environment

This article reports previously unpublished results of a collaborative study undertaken in 2003 by health workers of the UK-based organisation Health Unlimited, and by researchers of the London School of Hygiene and Tropical Medicine. This study marked the first of a series of collaborative activities aimed at highlighting the situation of Indigenous peoples, some in the most isolated ecosystems of the planet. While many researchers focus on quantitative analysis of the health and environmental conditions of Indigenous peoples, our 2003 study aimed at exploring the views of Indigenous peoples in isolated communities in five countries on their environment and their health. In this article we look closely at the web of knowledge and belief that underpins Indigenous peoples' concepts of health and well-being, and their relationship to land and the environment. Although many Indigenous people have been forced off their traditional lands and live in rural settlements, towns, and cities, there are still a large number of people living in very small Indigenous communities in remote areas. This article focuses on 20 such communities in six countries. We explore traditional knowledge and practice and its relationship to Western medicine and services. The research findings highlight the importance of Indigenous knowledge systems for the emerging ecohealth community and suggest that we have much to learn from Indigenous peoples in our pursuit of a more holistic science