Knowledge of the signs and symptoms and risk factors of lung cancer in Australia: Mixed methods study

© 2016 Crane et al. Background: Lung cancer is the leading cause of cancer death in Australia. There is potential that health promotion about the risks and warning signs of lung cancer could be used to reduce delays in symptom presentation when symptoms are first detected. This study investigated knowledge, attitudes and beliefs which might impact help-seeking behaviour and could provide insight into possible public health interventions in New South Wales (NSW). Methods: A convergent mixed method study design was used wherein data from 16 qualitative focus groups of residents (40+ years), purposefully recruited and stratified by smoking status, age and geography (metropolitan/regional), were compared with a CATI administered population-wide telephone survey (n = 1,000) using the Cancer Research UK cancer awareness measure (LungCAM). Qualitative findings were analysed thematically using NVIVO. Logistic regression analysis was used to investigate predictors of symptom knowledge in STATA. Findings were integrated using triangulation techniques. Results: Across focus groups, haemoptysis was the only symptom creating a sense of medical urgency. Life experiences evoked a 'wait and see' attitude to any health deterioration. Perceived risk was low amongst those at risk with current smokers preferring to deny their risk while former smokers were generally unaware of any ongoing risk. The quantitative sample consisted of females (62 %), 40-65 years (53 %), low SES (53 %), former (46 %) and current smokers (14 %). In quantitative findings, haemoptysis and dyspnoea were the most recognised symptoms across the sample population. Age (<65 years), sex (female) and high socio-economic status contributed to a higher recognition of symptoms. Smoking was recognised as a cause of lung cancer, yet ever-smokers were less likely to recognise the risk of lung cancer due to second-hand smoke (OR 0.7 95 % CI 0.5-0.9). Conclusion: While there was some recognition of risk factors and symptoms indicative of lung cancer, there was disparity across the sample population. The qualitative findings also suggest that knowledge may not lead to earlier presentation; a lack of urgency about symptoms considered trivial, and smoking-related barriers such as stigma may also contribute to time delays in presentation. Public health interventions may be required to increase awareness of risk and emphasise the importance of seeking medical attention for ongoing symptoms

Challenges and solutions to cancer-related financial toxicity according to Australian health professionals: qualitative results from a national survey

Purpose: To qualitatively explore Australian healthcare professionals’ perspectives on how to improve the care and management of cancer-related financial toxicity, including relevant practices, services, and unmet needs. Methods: We invited healthcare professionals (HCP) who currently provide care to people with cancer within their role to complete an online survey, which was distributed via the networks of Australian clinical oncology professional associations/organisations. The survey was developed by the Clinical Oncology Society of Australia’s Financial Toxicity Working Group and contained 12 open-ended items which we analysed using descriptive content analysis and NVivo software. Results: HCPs (n = 277) believed that identifying and addressing financial concerns within routine cancer care was important and most believed this to be the responsibility of all HCP involved in the patient’s care. However, financial toxicity was viewed as a “blind spot” within a medical model of healthcare, with a lack of services, resources, and training identified as barriers to care. Social workers reported assessment and advocacy were part of their role, but many reported lacking formal training and understanding of financial complexities/laws. HCPs reported positive attitudes towards transparent discussions of costs and actioning cost-reduction strategies within their control, but feelings of helplessness when they perceived no solution was available. Conclusion: Identifying financial needs and providing transparent information about cancer-related costs was viewed as a cross-disciplinary responsibility, however, a lack of training and services limited the provision of support. Increased cancer-specific financial counselling and advocacy, via dedicated roles or developing HCPs’ skills, is urgently needed within the healthcare system

Analyzing and modeling the 2D surface tracking patterns of polymeric insulation materials

The structure and topography of surface tracking patterns generated on the surface of unfilled and filled samples of polyester resin using the international standard procedure (IEC 587, Inclined-plane Tracking Test) have been studied. The effect of contaminant now rate, applied voltage and the percentage content of particulate zinc oxide on tracking behavior has been determined. Three alternative mathematical algorithms have been used to establish the fractal dimensions of the tracking patterns as a function of the above three parameters, To model the surface hacking patterns, two methods have been applied. Firstly, a resistive network has been used in which the insulator surface is assumed to consist of imaginary vertically and horizontally placed resistors. This model is capable of producing several types of trees observed in insulating materials. However, the surface tracking patterns are mostly unbranched and it is not possible to produce realistic images with this model. The second method, Brownian motion, is mainly a recursive technique and does not take Laplacian field values into account. The resolution of the images is high, hence the simulated patterns are almost indistinguishable from the real images

Neural networks to analyze surface tracking on solid insulators

Surface tracking on solid insulators is one of the most severe breakdown mechanisms associated with polymeric materials under long term service conditions. A wide range of relays can detect failure in a transmission line and prevent a total breakdown in the systems, but due to the non-healing characteristics of solid insulators, in most cases it might be too late to save the insulator after tracking initiation and growth. The method described here is employed mainly in detecting several conditions, such as discharges, leakage current, dry conditions, severe damage and tracking initiation. Initially a BPN (back propagation network) type NN (neural network) is trained with different signal types. Due to the nature of NN, which always require similar values of input nodes, the system uses the FFT (fast Fourier transform) of the input signal, which might have high amplitude frequency components other than the fundamental frequency depending on the condition of the surface. The system works on a real time basis and warns the user with the first indication of severe damage on the surface and can protect the insulator from excessive damage

Predictors of teacher intervention in indirect bullying at school and outcome of a professional development presentation for teachers

© 2013 Taylor & Francis. This study with 326 girls-school teachers developed and tested a model of predictors of the likelihood that teachers will intervene in indirect bullying, and evaluated a professional development presentation. Teachers responded to bullying vignettes before and after a presentation on indirect bullying (Experimentals) or adolescent mental health (Controls). In accord with the model, perceived seriousness of indirect bullying mediated between empathy for victims and likelihood of intervening. Self-efficacy also had a direct effect on likelihood of intervention, though level of knowledge of the impact of indirect bullying made only a small contribution. Compared with Controls, the Experimental Group scored more highly, after the presentation, on perceived seriousness of indirect bullying, empathy for victims, likelihood of intervening and self-efficacy, but not on knowledge of impact. It is concluded that teacher education about indirect bullying may be most effective if it focuses on feelings rather than facts, and provides practical intervention strategies

Knowledge, attitudes and beliefs about lung cancer in three culturally and linguistically diverse communities living in Australia: A qualitative study

Issue addressed Knowledge, attitudes and beliefs about lung cancer among Chinese, Vietnamese and Arabic-speaking communities in Sydney, New South Wales (NSW) are explored. Methods Seven focus groups were completed with a total of 51 participants (smokers and non-smokers) from three culturally and linguistically diverse communities (CALD). Five topics were discussed and translated summaries from focus groups were thematically analysed. Results There were variations in perceived susceptibility to lung cancer between the CALD groups and between smokers and non-smokers. Fatalistic views towards lung cancer were apparent across all three CALD communities. There were low levels of awareness of lung cancer signs and symptoms, with the exception of haemoptysis. Differences in help-seeking behaviour and levels of trust of general practitioners (GP) were apparent. Conclusion Limited awareness of the signs and symptoms of lung cancer, combined with cultural perceptions about cancer, impacted on attitudes towards help-seeking behaviour in these three CALD communities. So what? The prevalence of smoking among Chinese men, Vietnamese men and Arabic-speaking communities in NSW puts them at increased risk of lung cancer. Health promotion initiatives for lung cancer should be tailored for CALD communities and could focus on increasing knowledge of key symptoms, awareness that ex-smokers are at risk and awareness of the diagnostic pathway including the importance of avoiding delays in help-seeking. © 2014 Australian Health Promotion Association