"It's just presence," the contributions of aboriginal and Torres Strait Islander health professionals in cancer care in Queensland

© 2018 de Witt, Cunningham, Bailie, Percival, Adams and Valery. Objectives: The aim of this research was to explore health professionals' perspectives on the provision of follow-up cancer care for Aboriginal and Torres Strait Islander patients in Queensland. Methods: Semi-structured interviews were conducted with Indigenous and non-Indigenous health professionals who had experience providing care for Indigenous cancer patients in the primary health care and hospital setting. Results: Participants were recruited from six Aboriginal Community Controlled Health Services (n = 17) and from a tertiary hospital (n = 9) across urban, regional, and remote geographical settings. Culturally safe care, psychological support, determining patient needs, practical assistance, and advocating for Indigenous health were identified as enablers to support the needs of Indigenous patients when accessing cancer care, and Indigenous health professionals were identified as the key enabler. Conclusion: Indigenous health professionals significantly contribute to the provision of culturally competent follow-up cancer care by increasing the accessibility of follow-up cancer care services and by supporting the needs of Indigenous cancer patients. All health professionals need to work together and be sufficiently skilled in the delivery of culturally competent care to improve the Indigenous cancer journey and outcomes for Indigenous people. Effective organizational policies and practices are crucial to enable all health professionals to provide culturally competent and responsive cancer care to Indigenous Australians

Barriers to lung cancer care: health professionals' perspectives.

PURPOSE: Globally, lung cancer is the most common cancer and the leading cause of cancer death. Problematically, there is a wide variation in the management and survival for people with lung cancer and there is limited understanding of the reasons for these variations. To date, the views of health professionals across relevant disciplines who deliver such care are largely absent. The present study describes Australian health professionals' views about barriers to lung cancer care to help build a research and action agenda for improving lung cancer outcomes. METHODS: Qualitative semi-structured interviews were undertaken with a multidisciplinary group of 31 Australian health professionals working in lung cancer care for an average of 16 years (range 1-35 yrs.; SD = 10.2) seeing a mean of 116 patients annually. RESULTS: Three superordinate themes were identified: illness representations, cultural influences, and health system context. Illness representations included three themes: symptoms attributed as smoking-related but not cancer, health-related stigma, and therapeutic nihilism. Cultural influence themes included Indigenous health care preferences, language and communication, and sociodemographic factors. Health system context included lack of regional services and distance to treatment, poor care coordination, lack of effective screening methods, and health professional behaviours. CONCLUSIONS: Fractured and locally isolated approaches routinely confound responses to the social, cultural and health system complexities that surround a diagnosis of lung cancer and subsequent treatment. Improving outcomes for this disadvantaged patient group will require government, health agencies, and the community to take an aggressive, integrated approach balancing health policy, treatment priorities, and societal values

Angular dependence of metamagnetic transitions in DyAgSb2

Journals published by the American Physical Society can be found at http://journals.aps.org/Measurementsof the magnetization of DyAgSb2 reveal a complex system of up to 11 well-defined metamagnetic states for the field applied within the basal plane. Measurements of the magnetization vs the angle the applied field makes with respect to the [110] axis show the Dy3+ moments are constrained to lie along one of the four [110] directions within the basal plane. From the angular dependence of the critical fields and plateau magnetizations, the net distribution of the moments may be deduced for each state. Finally, the coupling constants are calculated within the framework of the "four-position clock model." [S0163-1829(99)04302-7]

Identification of Australian Aboriginal and Torres Strait Islander Cancer Patients in the Primary Health Care Setting.

BACKGROUND: Aboriginal and Torres Strait Islander Australians have poorer cancer outcomes and experience 30% higher mortality rates compared to non-Indigenous Australians. Primary health care (PHC) services are increasingly being recognized as pivotal in improving Indigenous cancer patient outcomes. It is currently unknown whether patient information systems and practices in PHC settings accurately record Indigenous and cancer status. Being able to identify Indigenous cancer patients accessing services in PHC settings is the first step in improving outcomes. METHODS: Aboriginal Medical Centres, mainstream (non-Indigenous specific), and government-operated centers in Queensland were contacted and data were collected by telephone during the period from 2014 to 2016. Participants were asked to (i) identify the number of patients diagnosed with cancer attending the service in the previous year; (ii) identify the Indigenous status of these patients and if this information was available; and (iii) advise how this information was obtained. RESULTS: Ten primary health care centers (PHCCs) across Queensland participated in this study. Four centers were located in regional areas, three in remote areas and three in major cities. All participating centers reported ability to identify Indigenous cancer patients attending their service and utilizing electronic Patient Care Information Systems (PCIS) to manage their records; however, not all centers were able to identify Indigenous cancer patients in this way. Indigenous cancer patients were identified by PHCCs using PCIS (n = 8), searching paper records (n = 1), and combination of PCIS and staff recall (n = 1). Six different types of PCIS were being utilized by participating centers. There was no standardized way to identify Indigenous cancer patients across centers. Health service information systems, search functions and capacities of systems, and staff skill in extracting data using PCIS varied between centers. CONCLUSION: It is crucial to be able to easily identify Indigenous cancer patients accessing health services in the PHC setting to monitor progress, improve and evaluate care, and ultimately improve Indigenous cancer outcomes. It is also important for PHC staff to receive adequate training and support to utilize PCISs efficiently and effectively

Angular dependence of metamagnetic transitions in HoNi2B2C

Journals published by the American Physical Society can be found at http://journals.aps.org/Detailed measurements of M(2 K, H, theta) of HoNi2B2C, where theta is the angle that the applied field H makes with the [110] axis while remaining perpendicular to the crystallographic c axis, reveal three metamagnetic transitions with angular dependences H-c1 = (4.1 +/- 0.1 kG)/cos(theta), H-c2 = 8.4 +/- 0.2 kG/cos(phi), and H-c3 = (6.6 +/- 0.2 kG)/sin(phi), where phi = theta-45 is the angle from the [100] axis. The high-field saturated moment, M(sat) approximate to 10 mu(B)cos theta is consistent with the local moments being confined to the [110] direction. The locally saturated moments for fields between H-ci (i = 1, 2, 3) also manifest angular dependences that are consistent with combinations of local moments along [110] axes. Analysis of these data lead us to infer that the net distribution of moments is (up arrow down arrow up arrow down arrow up arrow down arrow) for H up arrow up arrow-->) for H-c2 up arrow up arrow-->) for H-c2 H-c3

Stage at diagnosis for childhood solid cancers in Australia: A population-based study

BACKGROUND: Stage of cancer at diagnosis is one of the strongest predictors of survival and is essential for population cancer surveillance, comparison of cancer outcomes and to guide national cancer control strategies. Our aim was to describe, for the first time, the distribution of cases by stage at diagnosis and differences in stage-specific survival on a population basis for a range of childhood solid cancers in Australia. METHODS: The study cohort was drawn from the population-based Australian Childhood Cancer Registry and comprised children (<15 years) diagnosed with one of 12 solid malignancies between 2006 and 2014. Stage at diagnosis was assigned according to the Toronto Paediatric Cancer Stage Guidelines. Observed (all cause) survival was calculated using the Kaplan-Meier method, with follow-up on mortality available to 31 December 2015. RESULTS: Almost three-quarters (1256 of 1760 cases, 71%) of children in the study had localised or regional disease at diagnosis, varying from 43% for neuroblastoma to 99% for retinoblastoma. Differences in 5-year observed survival by stage were greatest for osteosarcoma (localised 85% (95% CI = 72%-93%) versus metastatic 37% (15%-59%)), neuroblastoma (localised 98% (91%-99%) versus metastatic 60% (52%-67%)), rhabdomyosarcoma (localised 85% (71%-93%) versus metastatic 53% (34%-69%)), and medulloblastoma (localised 69% (61%-75%) versus metastases to spine 42% (27%-57%)). CONCLUSION: The stage-specific information presented here provides a basis for comparison with other international population cancer registries. Understanding variations in survival by stage at diagnosis will help with the targeted formation of initiatives to improve outcomes for children with cancer

Estadificación del cáncer infantil para registros de base poblacional

La recogida de información internacional fiable sobre estadificación de cáncer infantil por los registros de cáncer de base poblacional es esencial para el análisis epidemiológico y la realización de comparaciones evaluativas internacionales explicativas de la incidencia y los resultados asistenciales. En 2014 la Unión International Contra el Cáncer (UICC), el Dana-Farber Cancer Institute y el Hospital for Sick Children de Toronto, convocaron una reunión de consenso para abordar la ausencia de información consistente en la estadificación del cáncer infantil en los registros de cáncer poblacionales. Para cada subconjunto de los grupos/subgrupos diagnósticos mayores de cáncer infantil, en la reunión fueron revisados todos los sistemas de estadificación específicos de cada enfermedad utilizados habitualmente y se recomendó el más adecuado para utilizar en los registros de cáncer de base poblacional. Los sistemas de estadificación recomendados están enumerados como Guías de Toronto para la Estadificación del Cáncer Pediátrico. Las Guías recomiendan sistemas de estadificación específicos para la Leucemia Linfoblástica Aguda, Leucemia Mieloblástica Aguda, Linfoma de Hodgkin, Linfoma no-Hodgkin, Neuroblastoma, Tumor de Wilms, Rabdomiosarcoma, Sarcomas de Tejidos Blandos no-Rabdomiosarcoma, Osteosarcoma, Sarcoma de Ewing, Retinoblastoma, Hepatoblastoma, Tumor de Células Germinales (Cáncer Testicular y Ovárico), Meduloblastoma y Ependimoma. En este texto se proporcionan descripciones detalladas de los sistemas de estadificación recomendados en las Guías, para ayudar a los registros poblacionales de cáncer a recoger información internacionalmente consistente y comparable sobre el estadio del cáncer infantil al diagnóstico utilizando los documentos clínicos disponibles. La viabilidad y validez de estas Guías se ha evaluado con éxito en la práctica2. Están avaladas por el proyecto Factores pronósticos TNM de la UICC y publicadas en la Clasificación TNM de los Tumores Malignos UICC 8ª edición

In vitro culture of Plasmodium berghei-ANKA maintains infectivity of mouse erythrocytes inducing cerebral malaria

<p>Abstract</p> <p>Background</p> <p>Infection with <it>Plasmodium berghei </it>is a widely used model of murine malaria and a powerful tool for reverse genetic and pathogenesis studies. However, the efficacy of <it>in vitro </it>reinvasion of erythrocytes is generally low, limiting <it>in vitro </it>studies.</p> <p>Methods</p> <p><it>Plasmodium berghei </it>ANKA-infected blood obtained from a susceptible infected mouse was cultured in various conditions and <it>in vitro </it>parasitaemia was measured every day to evaluate the rate of reinvasion.</p> <p>Results</p> <p>High quality culture media were used and reinvasion rates were improved by vigorous orbital shaking of the flask and increasing density of the medium with gelatin.</p> <p>Discussion</p> <p>Using these settings, reinvasion of normal mouse erythrocytes by the parasite was obtained <it>in vitro </it>over two weeks with preservation of the infectivity <it>in vivo</it>.</p

A study of head and neck cancer treatment and survival among indigenous and non-indigenous people in Queensland, Australia, 1998 to 2004

Background: Overall, Indigenous Australians with cancer are diagnosed with more advanced disease, receive less cancer treatment and have poorer cancer survival than non-Indigenous Australians. The prognosis for Indigenous people with specific cancers varies however, and their prognosis for cancers of the head and neck is largely unknown. We therefore have compared clinical characteristics, treatment and survival between Indigenous and non-Indigenous people diagnosed with head and neck cancer in Queensland, Australia. Methods: Rates were based on a cohort of Indigenous people (n = 67), treated in public hospitals between 1998 and 2004 and frequency-matched on age and location to non-Indigenous cases (n = 62) also treated in the public health system. Data were obtained from hospital records and the National Death Index. We used Pearson's Chi-squared analysis to compare categorical data (proportions) and Cox proportional hazard models to assess survival differences.Results: There were no significant differences in socioeconomic status, stage at diagnosis or number and severity of comorbidities between Indigenous and non-Indigenous patients, although Indigenous patients were more likely to have diabetes. Indigenous people were significantly less likely to receive any cancer treatment (75% vs. 95%, P = 0.005) and, when cancer stage, socioeconomic status, comorbidities and cancer treatment were taken into account, they experienced greater risk of death from head and neck cancer (HR 1.88, 1.10, 3.22) and from all other causes (HR 5.83, 95% CI 1.09, 31.04).Conclusion: These findings show for the first time that Indigenous Australians with head and neck cancer receive less cancer treatment and suggest survival disparity could be reduced if treatment uptake was improved. There is a need for a greater understanding of the reasons for such treatment and survival disparities, including the impact of the poorer overall health on cancer outcomes for Indigenous Australians