Evaluating the Needs of Cancer Survivors through Focus Groups and Surveillance Data

Abstract: Introduction As cancer prevention and treatment advances, cancer survival rates continue to increase. The growing population of cancer survivors have unique needs that must be addressed to improve quality of life throughout the cancer-care continuum. Methods Using data compiled from the 2015 Michigan Behavioral Risk Factor Survey (MiBRFS), the Cancer Registry, and focus groups, several areas of need amongst cancer survivors were identified. Results In focus groups cancer survivors identified the 27 needs that fell into three categories: improving health-related behavior, utilizing health care services, and receiving emotional support. The MiBRFS provided population estimates for 10 of the 27 needs that were identified by the survivors. Conclusions As the cancer survival rate increases, providers and public health workers must implement and promote services that provide care to patients from diagnosis to post-treatment. A population surveillance system, in conjunction with focus groups, can shed light onto the exact needs that must be addressed. Surveillance data can demonstrate the impact of public health interventions, like tobacco cessation policies and system change projects, which ultimately impact the health and quality of life of cancer survivors

Evaluating the Needs of Cancer Survivors through Focus Groups and Surveillance Data

Introduction As cancer prevention and treatment advances, cancer survival rates continue to increase. The growing population of cancer survivors have unique needs that must be addressed to improve quality of life throughout the cancer-care continuum. Methods Using data compiled from the Michigan cancer registry, the Michigan Behavioral Risk Factor Survey (MiBRFS), and focus groups, several areas of need amongst cancer survivors were identified. The cancer registry provides information on incidence and survival rates to help understand the burden of cancer; this Quantitative data from the Michigan cancer registry and MiBRFS can supplement the qualitative data gained from the focus groups. Results In focus groups cancer survivors identified the 27 needs that fell into three categories: improving health-related behavior, utilizing health care services, and receiving emotional support. The MiBRFS provided population estimates for 10 of the 27 needs that were identified by the survivors. Conclusions As the cancer survival rate increases, providers and public health workers must implement and promote services that provide care to patients from diagnosis to post-treatment. A population surveillance system, in conjunction with focus groups, can shed light on the exact needs that must be addressed. Surveillance data can demonstrate the impact of public health interventions, like tobacco cessation policies and system change projects, which ultimately impact the health and quality of life of cancer survivors

Activation of SGK1 in endometrial epithelial cells in response to PI3K/AKT inhibition impairs embryo implantation

Background: Serum & Glucocorticoid Regulated Kinase 1 (SGK1) plays a fundamental role in ion and solute transport processes in epithelia. In the endometrium, down-regulation of SGK1 during the window of receptivity facilitates embryo implantation whereas expression of a constitutively active mutant in the murine uterus blocks implantation. Methods/Results: Here, we report that treatment of endometrial epithelial cells with specific inhibitors of the phosphoinositide 3-kinase (PI3K)/AKT activity pathway results in reciprocal activation of SGK1. Flushing of the uterine lumen of mice with a cell permeable, substrate competitive phosphatidylinositol analogue that inhibits AKT activation (AKT inhibitor III) resulted in Sgk1 phosphorylation, down-regulation of the E3 ubiquitin-protein ligase Nedd4-2, and increased expression of epithelial Na+ channels (ENaC). Furthermore, exposure of the uterine lumen to AKT inhibitor III prior to embryo transfer induced a spectrum of early pregnancy defects, ranging from implantation failure to aberrant spacing of implantation sites. Conclusion: Taken together, our data indicate that the balanced activities of two related serine/threonine kinases, AKT and SGK1, critically govern the implantation process

Lessons Learned from Revising the Cancer Plan for Michigan

Comprehensive Cancer Control (CCC) programs are a collaborative method to address cancer burden. Each CCC program is required to have a cancer plan to guide activities to reduce the cancer burden in their jurisdiction and should reflect the most recent research and evidence-based strategies. In 2015, Michigan set out to revise its CCC plan that met the needs of its coalition while using a participatory process involving its network of approximately 100 stakeholders. A collaborative approach involving multiple workgroups was used to develop the criteria and content for the CCC plan. The Michigan Department of Health and Human Services (MDHHS) staff did the research and the coalition workgroups finalized the objectives and strategies to include in the plan. The coalition\u27s leadership oversaw the process and approved the final CCC plan. The resulting CCC plan was brief, yet comprehensive, and based on data and research. The structured process resulted in a data driven CCC plan with input from stakeholders throughout the process. The Cancer Plan for Michigan is measurable and provides a clear method for assessing progress on reducing the cancer burden. The planning and support from MDHHS staff allowed for stakeholders to have focused conversations and use their time efficiently. A formal evaluation of the process was not conducted and will be adopted in the future

Observed Reductions in Schistosoma mansoni Transmission from Large-Scale Administration of Praziquantel in Uganda: A Mathematical Modelling Study

To date schistosomiasis control programmes based on chemotherapy have largely aimed at controlling morbidity in treated individuals rather than at suppressing transmission. In this study, a mathematical modelling approach was used to estimate reductions in the rate of Schistosoma mansoni reinfection following annual mass drug administration (MDA) with praziquantel in Uganda over four years (2003-2006). In doing this we aim to elucidate the benefits of MDA in reducing community transmission.Age-structured models were fitted to a longitudinal cohort followed up across successive rounds of annual treatment for four years (Baseline: 2003, TREATMENT: 2004-2006; n = 1,764). Instead of modelling contamination, infection and immunity processes separately, these functions were combined in order to estimate a composite force of infection (FOI), i.e., the rate of parasite acquisition by hosts.MDA achieved substantial and statistically significant reductions in the FOI following one round of treatment in areas of low baseline infection intensity, and following two rounds in areas with high and medium intensities. In all areas, the FOI remained suppressed following a third round of treatment.This study represents one of the first attempts to monitor reductions in the FOI within a large-scale MDA schistosomiasis morbidity control programme in sub-Saharan Africa. The results indicate that the Schistosomiasis Control Initiative, as a model for other MDA programmes, is likely exerting a significant ancillary impact on reducing transmission within the community, and may provide health benefits to those who do not receive treatment. The results obtained will have implications for evaluating the cost-effectiveness of schistosomiasis control programmes and the design of monitoring and evaluation approaches in general

Estimation of changes in the force of infection for intestinal and urogenital schistosomiasis in countries with Schistosomiasis Control Initiative-assisted programmes

The last decade has seen an expansion of national schistosomiasis control programmes in Africa based on large-scale preventative chemotherapy. In many areas this has resulted in considerable reductions in infection and morbidity levels in treated individuals. In this paper, we quantify changes in the force of infection (FOI), defined here as the per (human) host parasite establishment rate, to ascertain the impact on transmission of some of these programmes under the umbrella of the Schistosomiasis Control Initiative (SCI)

LEFTY2 inhibits endometrial receptivity by downregulating Orai1 expression and store-operated Ca²+ entry

Early embryo development and endometrial differentiation are initially independent processes, and synchronization, imposed by a limited window of implantation, is critical for reproductive success. A putative negative regulator of endometrial receptivity is LEFTY2, a member of the transforming growth factor (TGF)-β family. LEFTY2 is highly expressed in decidualizing human endometrial stromal cells (HESCs) during the late luteal phase of the menstrual cycle, coinciding with the closure of the window of implantation. Here, we show that flushing of the uterine lumen in mice with recombinant LEFTY2 inhibits the expression of key receptivity genes, including Cox2, Bmp2, and Wnt4, and blocks embryo implantation. In Ishikawa cells, a human endometrial epithelial cell line, LEFTY2 downregulated the expression of calcium release-activated calcium channel protein 1, encoded by ORAI1, and inhibited store-operated Ca2+ entry (SOCE). Furthermore, LEFTY2 and the Orai1 blockers 2-APB, MRS-1845, as well as YM-58483, inhibited, whereas the Ca2+ ionophore, ionomycin, strongly upregulated COX2, BMP2 and WNT4 expression in decidualizing HESCs. These findings suggest that LEFTY2 closes the implantation window, at least in part, by downregulating Orai1, which in turn limits SOCE and antagonizes expression of Ca2+-sensitive receptivity genes