Knowledge and Attitudes of Guam Residents Towards Cancer Clinical Trial Participation

Purpose/Background: Currently there are no cancer clinical trials conducted in Guam, but interest is growing. Limited information exists on the knowledge and attitudes of Guam’s population towards cancer clinical research, yet cancer is the second highest cause of death in Guam and among the CHamoru people, Guam’s indigenous population. CHamoru people suffer the highest rates of cancer mortality compared to other ethnic groups in Guam. The purpose of this study was to determine differences in knowledge and attitudes towards cancer clinical trials participation, and attitudes towards traditional medicine. Materials & Methods: A telephone survey instrument was designed, pilot-tested, IRB-approved, and implemented using a third-party marketing company. Questions were adapted from existing surveys and new questions were developed to address unique, Guam-specific interests. Recruited subjects were Guam residents adults 18 years of age and older with telephone service. Guam residents were called from October 6 to 10, 2018 to assess levels of knowledge and attitudes towards cancer clinical trials and the attitudes towards using traditional medicine to treat cancer. Descriptive statistics were computed for demographic variables by response category. Univariate logistic regression was conducted to investigate the bivariate association between a survey question and demographic variables. Odds ratios (ORs) and associated 95% confidence intervals (CIs) were calculated. Multivariable logistic regression model was developed for each question, adjusting for important covariates. Hosmer-Lemeshow tests and c-statistics were used to evaluate goodness of fit. Results: The survey respondents’ (n=152) demographic data closely reflected the US Census ethnicity data for Guam: CHamoru (47.0%), Filipino (26.5%), Caucasian (11.3%) and Other (15.2%). Fifty-three percent understood the term “clinical trial”; 73.7% would be willing to participate if they had cancer, and 59.9% believed they would receive good quality treatment from a clinical trial offered in Guam. Approximately 56.0% thought they would have to pay out-of-pocket expenses; and 67.0% disagreed or were not sure that clinical trial sponsors pay for the study drug while other costs are billed to the insurance company. Physician ethnicity was not important to 100% of Caucasians, but was important to at least 30.0% of non-Caucasians; family support was very important to 94.7% of respondents, while religious community support was important to 55.4%. Approximately 65.1% did not believe that people participating in clinical trials were treated like ‘guinea pigs’. Having college education (OR = 3.26; 95% CI: 1.53 – 6.98) and knowing English language well (OR=5.86; 95% CI: 1.21 – 28.38) were significantly associated with higher aggregated knowledge about clinical trials. Although the majority (67.2%) would seek traditional healing practices if diagnosed with cancer, most (84.9%) did not think a suruhano (CHamoru traditional healer) could treat cancer, and 94.7% did not believe cancer was caused by taotaomo’na (ancient spirits). Discussion/Conclusion: Knowledge and attitudes towards cancer clinical trials and the use of traditional medicine to treat cancer were significantly associated with key demographic variables including ethnicity, income, employment status, place of birth and insurance type. Knowledge about cancer clinical trials was as expected: more participants who are Caucasian, have a higher level of education, were born in U.S., are employed, have a higher income, private insurance, self-report that they speak English well, and do not follow religion, were more aware of what a clinical trial is than the other respondents. Though knowledge about cancer clinical trials is limited, attitudes towards participation in cancer clinical trials offered in Guam were largely positive

Nutritional analysis of a fiesta on Guam

Abstract-Fiestas in Guam are celebrated year round, but documentation of the preparation and nutritional components of foods served at a traditional fiesta on Guam is limited. Food preparation was observed during a fiesta celebrated in the village of Sinajana, Guam. A food scale was used to weigh the ingredients of food dishes. Nutritional analysis software was used to determine the nutrient content of each food dish served. Of the thirty-four dishes that were prepared and served, 32 dishes were analyzed. These dishes comprised 609,210 kcal, 38,761 g protein, 42,883 g carbohydrates, 30,260 g total fat, 10,019 g saturated fat, and 1890 g dietary fiber. More than 95% of the food prepared was potentially consumed. Of the food potentially consumed, 24% of the energy was from protein, 29% of the energy was from carbohydrates, 45% of the energy was from total fat, and 15% of the energy was from saturated fat. Of the top 10 foods contributing the most energy, 8 were totche (fish and meat) dishes. The nutrient availability for fiesta-goers was estimated. The assessment of fiesta nutrient intake is recommended for future research

Perancangan Tabung Vaksin Hewan Berbahan Dasar Polivinil Klorida (PVC) Dengan Mengunakan Elemen Peltier

The vaccine is one of the ways to prevent disease in livestock as an antibody. These vaccines are very vulnerable because it should not be exposed to direct sunlight and should not be frozen. For some types of vaccines should be stored at a temperature 2oC - 8oC. The toughest obstacle when should bring the vaccine to remote areas that are difficult to reach and have no major infrastructure such as adequate road. The cooling tubes planning has the dimensions of the tubes used are 3 inches and 4 inches. High tube 3 inches is 14.6 cm in size and high 4 inches is 19.8 cm made polyvinyl chloride. The planning results retrieved the tensile that occurs in the cooling tube sheath 38,144 kg/〖cm〗^2. Tensile on sheath insulating space 68,766 kg/〖cm〗^2. The shear stress of cooling space cover 0,00093 kg/〖cm〗^2. Shear stress on the cover tube 9,479 kg/〖cm〗^2. Press the voltage going to the metal welding 8,656 kg/〖cm〗^2. Voltage drop bolt permits 74 N/mm2. The shear stress permits 44,4 N/mm2. The diameter bolt required 0,278 m

Facilitator experiences and lessons learned from the Betel nut intervention trial (BENIT)

Abstract Background The Betel Nut Intervention Trial (BENIT; ClinicalTrials.gov - NCT02942745) is the first known randomized intervention trial specifically designed for areca nut chewers in the western Pacific region who want to quit. The current study is a separate, exploratory study that examined the experiences of the BENIT facilitators during its implementation in Guam and Saipan of the Northern Mariana Islands and the extent to which the BENIT protocol was adapted to meet the participants’ and facilitators’ needs. Methods All six BENIT program facilitators completed an online survey consisting of quantitative (Likert scale) and qualitative (open-ended) questions. Survey items were grouped as follows: facilitator demographics, prior training and preparation, BENIT experience, beliefs about the program’s effectiveness, and beliefs about protocol adaptations. Results Most of the facilitators felt prepared to deliver the BENIT program after several weeks of moderately intensive training. Facilitators felt the BENIT program was generally effective and that the “trigger logs” and “self-monitoring logs” worked as intended. However, they also noted that more time and support would have been helpful to overcome some of the obstacles inherent to implementing a novel program. Conclusion The current findings can be used to inform, modify, and tailor subsequent areca nut cessation programs in Micronesian communities and to improve future versions of BENIT

Knowledge and Attitudes of Guam Residents towards Cancer Clinical Trial Participation

(1) Background: Currently there are no cancer clinical trials in Guam, where CHamoru people suffer the highest rates of cancer mortality, and interest to do so is growing. This study investigated the knowledge and attitudes of Guam residents towards cancer clinical trial participation prior to implementation. (2) Methods: A telephone survey was developed, tested, and conducted among Guam resident adults, 18 years of age and older. Survey questions were summarized by descriptive statistics. Logistic regression models were used to investigate the associations between Guam residents’ demographics and their clinical trial knowledge and attitudes. Adjusted odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated. (3) Results: One hundred fifty-two people participated in the survey, most of whom were CHamoru (47.0%). Fifty-three percent had heard the term ‘clinical trial’; 73.7% would take part in a trial if they had cancer; and 59.9% believed they would receive good quality treatment from a trial offered in Guam. CHamoru were more likely than Whites to associate out-of-pocket expenses with clinical trial participation (aOR = 5.34, 95% CI = 1.68–17.00). Physician ethnicity was important to 30% of non-Whites and significantly associated with those who spoke a language other than English (aOR = 3.40, 95% CI = 1.29–8.95). Most people (65.0%) did not believe clinical trials participants were ‘guinea pigs’. (4) Conclusion: Though knowledge about cancer clinical trials is limited, attitudes were primarily positive towards participating in cancer clinical trials offered in Guam. Future delivery of cancer clinical trials will benefit from identifying potential barriers to recruitment and adopting an approach suited to Guam’s population

Betel nut chewing, oral premalignant lesions, and the oral microbiome - Fig 4

<p><b>a.</b> Relative abundance of oral bacteria taxa: current betel nut chewers vs. former/never chewers (FDR-corrected p<0.05). <b>b.</b> Relative abundance of oral bacteria taxa: long-term betel nut chewers (≥10 yrs.) vs. never chewers (FDR-corrected p<0.05). <b>c.</b> Relative abundance of oral bacteria taxa: betel nut chewers with oral lesions vs. chewers/non-chewers without oral lesions (FDR-corrected p<0.05).</p

Prevalence and Predictors of Overweight and Obesity among Young Children in the Children’s Healthy Living Study on Guam

This study is part of the Children&rsquo;s Healthy Living program in U.S. Affiliated Pacific region. The objectives were to estimate overweight and obesity (OWOB) prevalence and identify possible related risk factors among ethnic groups in Guam. In 2013, 865 children (2&ndash;8 years) were recruited via community-based sampling from select communities in Guam. Children&rsquo;s demographic and health behavior information; dietary intake; and anthropometric measurements were collected. Logistic regression, odds ratio, t-tests, and chi-square tests were used to determine differences and assess covariates of OWOB. The results indicate that 58% of children were living below the poverty level, 80% were receiving food assistance, and 51% experienced food insecurity. The majority of children surveyed did not meet recommendations for: sleep duration (59.6%), sedentary screen-time (83.11%), or fruit (58.7%) and vegetable (99.1%) intake, and consumed sugar sweetened beverages (SSB) (73.7%). OWOB affected 27.4% of children. Children affected by OWOB in this study were statistically more likely (p = 0.042) to suffer from sleep disturbances (p = 0.042) and consume marginally higher amounts (p value = 0.07) of SSB compared to children with healthy weight. Among Other Micronesians, children from families who considered themselves &lsquo;integrated&rsquo; into the culture were 2.05 (CI 0.81&ndash;5.20) times more likely to be affected by OWOB. In conclusion, the OWOB prevalence among 2&ndash;8-year-olds in Guam was 27.4%; and compared with healthy weight children, children with OWOB were more likely to have educated caregivers and consume more SSBs. Results provide a basis for health promotion and obesity prevention guidance for children in Guam

Relationship of oral premalignant lesions with betel nut chewing and other factors.

<p>Relationship of oral premalignant lesions with betel nut chewing and other factors.</p