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Yuen E, Wilson C, Adams J, Kangutkar T, Livingston PM, White VM, Ockerby C, Hutchinson A. Health literacy interventions for informal caregivers: systematic review. BMJ Support Palliat Care 2024:spcare-2023-004513. [PMID: 38326015 DOI: 10.1136/spcare-2023-004513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024]
Abstract
AIM The aim of the systematic review was to identify conceptual models and interventions designed to improve health literacy in caregivers of adults with a chronic disease/disability. METHODS MEDLINE, CINAHL, PsycINFO and Embase were searched for relevant literature. Articles were included if they focused on adults who provided informal care to someone aged 18+ with a chronic disease/disability. Quantitative studies were included if they reported an intervention designed to improve caregiver health literacy (CHL) and assessed outcomes using a validated measure of health literacy. Qualitative and mixed method studies were included if they described a conceptual model or framework of CHL or developed/assessed the feasibility of an intervention. Study quality was appraised using the Mixed Methods Assessment Tool. RESULTS Eleven studies were included. Five studies used pre-post design to assess outcomes of an intervention; four described intervention development and/or pilot testing; two described conceptual models. Two of five studies reported pre-post intervention improvements in CHL; one reported an improvement in one of nine health literacy domains; two reported no improvements following intervention. Interventions predominantly aimed to improve: caregiver understanding of the disease, treatment and potential outcomes, day-to-day care, self-care and health provider engagement. Few interventions targeted broader interpersonal and health service factors identified as influencing CHL. DISCUSSION Evidence on the development and assessment of comprehensive CHL interventions is scarce. Recommendations include the development of interventions that are guided by a CHL framework to ensure they address individual, interpersonal and health service/provider factors that influence CHL.
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Affiliation(s)
- Eva Yuen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Monash Health, Clayton, Victoria, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, LaTrobe University, Bundoora, Victoria, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Victoria, Australia
- Psycho-Oncology Research Unit, Olivia Newton-John Cancer, Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
| | - Joanne Adams
- Violet Vines Marshman Centre for Rural Health Research, La Trobe University, Bendigo, Victoria, Australia
| | - Tejashree Kangutkar
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Patricia M Livingston
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Victoria M White
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | | | - Alison Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
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Stubbs T, White VM, Kong M, Toumbourou JW. Uncovering the advertising and promotional strategies of tobacco companies in Cambodia: recall of below-the-line marketing among young male smokers. Tob Control 2023; 32:614-619. [PMID: 35177539 DOI: 10.1136/tobaccocontrol-2021-057063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/28/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Tobacco companies have used below-the-line marketing in novel ways to promote their brands to youth in low/middle-income countries in Southeast Asia. This study explores how young male smokers in Cambodia experience below-the-line marketing strategies. METHODS Convenience sampling was used to recruit 147 young male smokers (18-24 years) in Cambodia in early 2020. Local research assistants conducted mixed-methods interviews with participants in Khmer or English. Participants recalled exposure to below-the-line marketing strategies and provided in-depth descriptions about their experiences with individual sales promotions. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using thematic analysis. RESULTS 54% of participants recalled exposure to at least one below-the-line marketing strategy, including point-of-sale promotions (32.7%), individual sales promotions (27.9%) and online advertising (14.3%). Participants described individual sales promotions in public settings, and recalled that promoters were mostly female, attractive and targeted young males. Tactics used to encourage young people to accept promotional offers included free cigarettes and sample packets, swapping current cigarettes for new brands and collecting consumer details after interviewing. The brands and product features of cigarettes being promoted were readily described by participants. CONCLUSION This study provides evidence that illegal below-the-line marketing is still occurring in Cambodia, and increased monitoring and enforcement of advertising restrictions is needed.
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Affiliation(s)
- Thomas Stubbs
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Victoria M White
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Mom Kong
- Cambodian Movement for Health, Phnom Penh, Cambodia
| | - John W Toumbourou
- Centre for Drug use, Addictive and Anti-social behaviour Research, School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
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White VM, Alexiadis M, Eroh KD, Ackermann MK, Rodgers S, Langdale LM, Armour NE, Jobling TW, Fuller PJ, Chu S. How social media can help to understand treatment experiences of survivors of rare cancers: Findings from the Granulosa Cell Tumor (GCT) Survivor Sisters Facebook group member survey. Cancer 2023. [PMID: 37011030 DOI: 10.1002/cncr.34767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/22/2022] [Accepted: 11/18/2022] [Indexed: 04/04/2023]
Abstract
BACKGROUND Engaging with online social media consumer groups for rare cancers may help to develop collaborations between consumers and researchers. This study, a collaboration with the Granulosa Cell Tumor-Survivor Sisters (GCT-SS) Facebook group, explores the results of their survey of member's treatment and follow-up experiences. METHODS Members of the closed multinational GCT-SS Facebook group completed a 43-item survey covering symptoms, diagnosis, treatment, recurrence, follow-up, and possible risk factors for GCT. Group members could have adult (aGCT) or juvenile (jGCT) disease. Data was collected via an online survey between 2014 and 2019. RESULTS A total of 743 members (average 4.4 years [SD = 5.9] post-diagnosis) participated including 52 with jGCT. A total of 67% had stage I disease and 8% had stage III-IV at diagnosis, although 30% of aGCT and 25% of jGCT reported recurrent disease at survey completion. A total of 48% of aGCT had laparoscopic surgery, tumor encapsulation was reported by 49%, and tumor bagging reported by 29% overall (37% laparoscopic; 8% open). Recurrence rates were higher when the tumor was cut or ruptured (ruptured: p < .001; cut: p = .01). A total of 19% of aGCT had chemotherapy with this most common for stage II-III disease. Bleomycin, etoposide, and cisplatin protocols became less common over time (diagnosed before 2015: 47% vs. diagnosed post-2015: 21%). CONCLUSIONS This is one of the largest surveys of GCT treatment. Members of the GCT-SS group report treatment patterns generally in line with those found from clinical audits. Using naturally forming consumer groups may assist with developing the evidence base for care and supporting those living with GCT ovarian cancer. PLAIN LANGUAGE SUMMARY This study is a collaboration between members of Granulosa Cell Tumor-Survivor Sisters (GCT-SS) Facebook group and researchers to assess members' experiences of treatment and follow-up. A total of 743 members (52 with juvenile GCT) completed an online survey. A total of 67% had stage I disease at diagnosis. Treatment patterns were generally in line with those found from clinical audits: 95% had surgery and 19% of those with adult GCT had chemotherapy. A total of 30% reported recurrent disease, with recurrence occurring within 5 years of diagnosis for 33%. Using naturally forming consumer groups may assist with developing the evidence base for care and supporting those living with GCT ovarian cancer.
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Affiliation(s)
| | - Maria Alexiadis
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia
| | - Kimberly D Eroh
- GCT-Survivor Sisters, Facebook, Statesville, North Carolina, USA
| | - M Kaye Ackermann
- GCT-Survivor Sisters, Facebook, Statesville, North Carolina, USA
| | - Sue Rodgers
- GCT-Survivor Sisters, Facebook, Statesville, North Carolina, USA
| | - Linda M Langdale
- GCT-Survivor Sisters, Facebook, Statesville, North Carolina, USA
| | - Natasha E Armour
- Rare Ovarian Cancer Inc, Shellharbour, New South Wales, Australia
| | | | - Peter J Fuller
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia
| | - Simon Chu
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia
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Yuen EY, Wilson C, Livingston PM, White VM, McLeod V, Hutchinson AM. Burden prediction in cancer caregivers: role of social support and connectedness. BMJ Support Palliat Care 2023:spcare-2022-004070. [PMID: 36746609 DOI: 10.1136/spcare-2022-004070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/11/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Caregivers play a key role in providing support to people with cancer. However, caregiving can be stressful and demanding, resulting in perceived caregiver burden. Social connectedness is considered partially independent from social support, yet few studies have examined whether social connectedness impacts caregiver burden. The current study sought to examine: (a) associations among social support, social connectedness and burden in a sample of cancer caregivers and (b) the mediating effect of social connectedness on the relationship between social support and caregiver burden. METHODS A descriptive cross-sectional study was conducted. Data were collected as part of a larger project. The sample included 125 caregiver-cancer care recipient dyads. Caregivers completed the Social Connectedness Scale-Revised, the Medical Outcomes Study-Social Support Survey and the Zarit Burden Interview. Descriptive statistics, hierarchical multiple regression and mediation analyses were used to examine relationships between variables. RESULTS Correlation analyses showed higher perceived social support and social connectedness were significantly correlated with lower-reported caregiver burden (p<0.05). The hierarchical regression model showed that both social support and social connectedness were independent predictors of caregiver burden (p<0.001). Social connectedness partially mediated the relationship between social support and caregiver burden. CONCLUSIONS This study provides new evidence that social support buffers the negative effects of burden in caregivers, suggesting these are potentially modifiable factors of caregiver burden. Increased understanding of the factors that contribute to burden among cancer caregivers will inform targeted supportive care strategies to improve psychological health and well-being in this underserved group.
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Affiliation(s)
- Eva Yn Yuen
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety, Institute for Health Transformation, Burwood, VIC, Australia
- Centre for Quality and Patient Safety - Monash Health Partnership, Monash Health, Clayton, VIC, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Psycho-Oncology Research Unit, Austin Health, Heidelberg, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Victoria M White
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Vicki McLeod
- Oncology Unit, Monash Health, Melbourne, Victoria, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety-Barwon Health Partnership, Barwon Health, Geelong, Victoria, Australia
- Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, VIC, Australia
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Vella E, White VM, Livingston P. Does cultural competence training for health professionals impact culturally and linguistically diverse patient outcomes? A systematic review of the literature. Nurse Educ Today 2022; 118:105500. [PMID: 35964378 DOI: 10.1016/j.nedt.2022.105500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 06/02/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To assess the impact of cultural competence training for health professionals on patient outcomes. METHOD A systematic review of cultural competence training interventions for healthcare workers including papers published January 2010 to January 2021, identified through MEDLINE, CINAHL, ERIC and APA PsychINFO. Health conditions were not specified, however, only studies reporting patient outcomes were included. Training frameworks and delivery, measures of health professional cultural competence, and patient outcomes were reviewed. RESULTS Of 7879 unique studies identified, five met inclusion criteria including two randomised control trials, two mixed method and one multi-method pre/post study. Professionals reported the training was beneficial, and some improvements in patient perceptions of health providers' cultural competence were found. However, patient health outcomes did not improve significantly in any study. CONCLUSION Cultural competence training is promoted to improve outcomes of patients from culturally diverse backgrounds; however, few studies assess outcomes when examining training impact. Inconsistencies in theoretical frameworks and training makes it difficult to assess the efficacy of training on patient outcomes. RESULTS Of 7879 unique studies identified, five met inclusion criteria including two randomised control trials, two mixed method and one multi-method pre/post study. Professionals reported the training was beneficial, and some improvements in patient perceptions of health providers' cultural competence were found. However, patient health outcomes did not improve significantly in any study. CONCLUSION Cultural competence training is promoted to improve outcomes of patients from culturally diverse backgrounds; however, few studies assess outcomes when examining training impact. Inconsistencies in theoretical frameworks and training makes it difficult to assess the efficacy of training on patient outcomes. PRACTICE IMPLICATIONS To ascertain the benefits of health professional cultural competence training on patient outcomes, research needs to address the issues of definition, theoretical frameworks and implementation approaches to training.
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Affiliation(s)
| | - Victoria M White
- School of Psychology, Faculty of Health, Deakin University, Burwood 3125, Australia
| | - Patricia Livingston
- School of Psychology, Faculty of Health, Deakin University, Burwood 3125, Australia
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6
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White VM, Lisy K, Ward A, Ristevski E, Clode M, Webber K, Emery J, Ijzerman MJ, Afshar N, Millar J, Gibbs P, Evans S, Jefford M. Disparities in quality of life, social distress and employment outcomes in Australian cancer survivors. Support Care Cancer 2022; 30:5299-5309. [PMID: 35279769 PMCID: PMC9046289 DOI: 10.1007/s00520-022-06914-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 02/12/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To examine how socio-demographic, comorbidities and information needs influence quality of life (QoL) outcomes of survivors of breast, colorectal, or prostate cancer, non-Hodgkin lymphoma or melanoma. METHODS Cross-sectional postal survey with eligible participants identified through a population-based cancer registry. QoL outcomes were assessed by EQ-5D-5L, social difficulties index (SDI) and, for those employed at diagnosis, current employment. Regression analyses explored associations between outcome variables and cancer type, age, time since diagnosis, residential location, socio-economic disadvantage, comorbidities and unmet information needs. Mediation analyses examined whether comorbidities and information needs explained relationships between outcome variables and socio-economic disadvantage. RESULTS 2115 survivors participated. Mean EQ-5D-5L scores (mean = 0.84) were similar to population averages and SDI scores were low for the entire sample (mean = 3.80). In multivariate analyses, being aged over 80, greater socio-economic disadvantage, comorbidities and unmet information needs decreased EQ-5D-5L scores. Higher SDI scores were associated with socio-economic disadvantage, comorbidities and unmet information needs. Not being employed was associated with being aged over 50, more comorbidities and socio-economic disadvantage. Comorbidities but not information needs partially mediated the impact of socio-economic disadvantage on EQ-5D-5L and SDI accounting for 17% and 14% of the total effect of socio-economic disadvantage respectively. Neither comorbidities nor information needs mediated the association between socio-economic disadvantage and employment outcomes. CONCLUSIONS To improve quality of life, survivorship care should be better tailored to address the needs of individuals given their overall health and impact of comorbidities, their age and type of cancer and not simply time since diagnosis.
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Affiliation(s)
- Victoria M. White
- grid.1021.20000 0001 0526 7079School of Psychology, Faculty of Health, Deakin University, Geelong, VIC Australia ,grid.3263.40000 0001 1482 3639Cancer Council Victoria, Melbourne, VIC Australia
| | - Karolina Lisy
- grid.1055.10000000403978434Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,grid.1055.10000000403978434Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XSir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
| | - Andrew Ward
- The Social Research Centre, Melbourne, VIC Australia
| | - Eli Ristevski
- grid.1002.30000 0004 1936 7857Monash Rural Health, Monash University, Warragul, VIC Australia
| | - Melanie Clode
- grid.1055.10000000403978434Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Kate Webber
- grid.1002.30000 0004 1936 7857School of Clinical Sciences, Monash University, Clayton, VIC Australia ,grid.419789.a0000 0000 9295 3933Department of Oncology, Monash Health, Clayton, VIC Australia
| | - Jon Emery
- grid.1008.90000 0001 2179 088XDepartment of General Practice and Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Maarten J. Ijzerman
- grid.1008.90000 0001 2179 088XSir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
| | - Nina Afshar
- grid.3263.40000 0001 1482 3639Cancer Council Victoria, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XCentre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jeremy Millar
- grid.267362.40000 0004 0432 5259Alfred Health Radiation Oncology, Alfred and LaTrobe Regional Hospital, Melbourne, VIC 3004 Australia ,grid.1002.30000 0004 1936 7857School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Peter Gibbs
- Department of Medical Oncology, Western Health, St. Albans, Victoria, Australia ,grid.1042.70000 0004 0432 4889Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC Australia
| | - Sue Evans
- grid.3263.40000 0001 1482 3639Cancer Council Victoria, Melbourne, VIC Australia ,grid.1002.30000 0004 1936 7857School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Michael Jefford
- grid.1055.10000000403978434Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,grid.1055.10000000403978434Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XSir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
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Afshar N, Dashti SG, Te Marvelde L, Blakely T, Haydon A, White VM, Emery JD, Bergin RJ, Whitfield K, Thomas RJS, Giles GG, Milne RL, English DR. Factors Explaining Socio-Economic Inequalities in Survival from Colon Cancer: A Causal Mediation Analysis. Cancer Epidemiol Biomarkers Prev 2021; 30:1807-1815. [PMID: 34272266 DOI: 10.1158/1055-9965.epi-21-0222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/09/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Socio-economic inequalities in colon cancer survival exist in high-income countries, but the reasons are unclear. We assessed the mediating effects of stage at diagnosis, comorbidities, and treatment (surgery and intravenous chemotherapy) on survival from colon cancer. METHODS We identified 2,203 people aged 15 to 79 years with first primary colon cancer diagnosed in Victoria, Australia, between 2008 and 2011. Colon cancer cases were identified through the Victorian Cancer Registry (VCR), and clinical information was obtained from hospital records. Deaths till December 31, 2016 (n = 807), were identified from Victorian and national death registries. Socio-economic disadvantage was based on residential address at diagnosis. For stage III disease, we decomposed its total effect into direct and indirect effects using interventional mediation analysis. RESULTS Socio-economic inequalities in colon cancer survival were not explained by stage and were greater for men than women. For men with stage III disease, there were 161 [95% confidence interval (CI), 67-256] additional deaths per 1,000 cases in the 5 years following diagnosis for the most disadvantaged compared with the least disadvantaged. The indirect effects through comorbidities and intravenous chemotherapy explained 6 (95% CI, -10-21) and 15 (95% CI, -14-44) per 1,000 of these additional deaths, respectively. Surgery did not explain the observed gap in survival. CONCLUSIONS Disadvantaged men have lower survival from stage III colon cancer that is only modestly explained by having comorbidities or not receiving chemotherapy after surgery. IMPACT Future studies should investigate the potential mediating role of factors occurring beyond the first year following diagnosis, such as compliance with surveillance for recurrence and supportive care services.
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Affiliation(s)
- Nina Afshar
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.
- Cancer Health Services Research Unit, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - S Ghazaleh Dashti
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Luc Te Marvelde
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Tony Blakely
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Haydon
- Department of Medical Oncology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Victoria M White
- School of Psychology, Deakin University, Burwood, Victoria, Australia
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Jon D Emery
- Cancer in Primary Care Research Group, Department of General Practice, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Rebecca J Bergin
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Cancer in Primary Care Research Group, Department of General Practice, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Kathryn Whitfield
- Cancer Strategy and Development, Department of Health and Human Services, Melbourne, Victoria, Australia
| | - Robert J S Thomas
- Cancer Strategy and Development, Department of Health and Human Services, Melbourne, Victoria, Australia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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8
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White VM, Pejoski N, Vella E, Skaczkowski G, Ugalde A, Yuen EYN, Livingston P, Wilson C. Improving access to cancer information and supportive care services: A systematic review of mechanisms applied to link people with cancer to psychosocial supportive care services. Psychooncology 2021; 30:1603-1625. [PMID: 34133053 DOI: 10.1002/pon.5744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Previous research has described the low uptake of psychosocial support services in people living with cancer. While characteristics of individuals using services have been examined, mechanisms applied to link individuals to support services are less frequently considered. This review aims to identify the mechanisms used to link people with cancer to support services and assess their impact. METHODS Systematic searches of Pubmed, CINAHL, EMBASE and PsycINFO were conducted up to May 2020. Studies reporting service use associated with mechanisms to link adults with cancer to support services targeting emotional, informational, practical or social support needs were eligible. Eligible study designs included controlled trials, pre-post designs and observational studies. Study quality was assessed and a narrative synthesis of findings undertaken. RESULTS A total of 10 papers (from 8,037 unique titles) were eligible. Testing the feasibility of the linkage mechanism was the primary aim in five (50%) studies. Three linkage mechanisms were identified: (a) outreach from the support service; (b) clinician recommendation/referral; (c) mailed invitation. Outreach was the most successful in connecting people with cancer to services (52%-90% use); clinician recommendation/referral was least successful (3%-28%). The impact of different linkage mechanisms for different demographic groups was not assessed. CONCLUSIONS Outreach from services shows the most potential for increasing access to support services. However, the limited number of studies and limitations in the types of support services people with cancer were linked to, demonstrated the need for further work in this area. Identifying mechanisms that are effective for underserved, high-needs patient groups is also needed.
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Affiliation(s)
- Victoria M White
- School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Natalie Pejoski
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Heidelberg, VIC, Australia
| | - Elizabeth Vella
- School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Gemma Skaczkowski
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Heidelberg, VIC, Australia
| | - Anna Ugalde
- School of Nursing & Midwifery and Institute of Health Transformation, Deakin University, Burwood, VIC, Australia
| | - Eva Y N Yuen
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Heidelberg, VIC, Australia.,School of Nursing & Midwifery and Institute of Health Transformation, Deakin University, Burwood, VIC, Australia.,Monash Health, Clayton, VIC, Australia.,School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Patricia Livingston
- School of Nursing & Midwifery and Institute of Health Transformation, Deakin University, Burwood, VIC, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Heidelberg, VIC, Australia.,School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
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Harrup R, White VM, Coory M, Walker R, Anazodo A, Skaczkowski G, Bibby H, Osborn M, Phillips MB, Conyers R, Thompson K, Orme LM, Pinkerton R, Nicholls W. Treatment and Outcomes for Central Nervous System Tumors in Australian Adolescents and Young Adults: A Population-Based National Study. J Adolesc Young Adult Oncol 2020; 10:202-208. [PMID: 32856982 DOI: 10.1089/jayao.2020.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: While central nervous system (CNS) tumors account for only 10% of adolescent and young adult (AYA) cancers, they are the leading cause of cancer death in this age group. Using national data for Australia, we describe the presentation, treatment, and survival for AYAs diagnosed with CNS tumors. Methods: A population-based study of 15-24 year-olds diagnosed with CNS tumors (low- and high-grade glioma [LGG, HGG], medulloblastoma [MB], primitive neuroectodermal tumors [PNET], ependymoma [EP]) or other (e.g., low-grade neuronal tumor) between 2007 and 2012. Clinical details were extracted from hospital medical records for each patient. Treatment centers were classified as pediatric or adult services. Results: Two hundred seventy-five patients (129 LGG, 77 HGG, 23 MB, 10 PNET, 19 EP, 17 other) were identified, with 17% treated at pediatric hospitals. Symptoms (headache [53%], nausea [31%]) were present for a median of 3 weeks before consulting a health professional. Of LGG patients, 15% had radiotherapy (RT) and 12% chemotherapy (CT). Of HGG patients, 81% had RT and 75% CT. All MB and PNET were managed with surgery, and 74% of MB and 80% of PNET had both RT and CT. Treatment did not differ by treatment center type. Five-year survival for LGG and EP was over 80%, but was 42% for HGG and 20% for PNET. Conclusions: This national, population-based study indicates similar treatment for AYA patients with CNS tumors between pediatric and adult services. Poor outcomes for HGG and PNET patients highlight the need for clinical trials of novel approaches for these tumors.
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Affiliation(s)
- Rosemary Harrup
- Medical Oncology/Haematology, Royal Hobart Hospital, Tasmania, Australia
| | - Victoria M White
- School of Psychology, Deakin University, Victoria, Australia.,Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | - Michael Coory
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
| | - Rick Walker
- Oncology Services Group, Queensland Children's Hospital, Queensland, Australia.,Oncology Unit, Princess Alexandra Hospital, Queensland, Australia.,School of Medicine, University of Queensland, Queensland, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, New South Wales, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Australia
| | - Gemma Skaczkowski
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia.,Department of Rural Health, Allied Health and Human Performance, University of South Australia, Australia
| | - Helen Bibby
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | - Michael Osborn
- Youth Cancer Service, Royal Adelaide Hospital, South Australia, Australia.,Department of Haematology and Oncology, Women's and Children's Hospital, South Australia, Australia
| | - Marianne B Phillips
- Oncology, Haematology & Bone Marrow Transplantation, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Rachel Conyers
- Children's Cancer Centre, The Royal Children's Hospital, Victoria, Australia
| | - Kate Thompson
- Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Victoria, Australia
| | - Lisa M Orme
- Children's Cancer Centre, The Royal Children's Hospital, Victoria, Australia
| | - Ross Pinkerton
- Hummingbird House Children's Hospice, Brisbane, Australia
| | - Wayne Nicholls
- Oncology Services Group, Queensland Children's Hospital, Queensland, Australia.,School of Medicine, University of Queensland, Queensland, Australia
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10
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Heris C, Guerin N, Thomas D, Chamberlain C, Eades S, White VM. Smoking behaviours and other substance use among Indigenous and
non‐Indigenous
Australian secondary students, 2017. Drug Alcohol Rev 2020; 40:58-67. [DOI: 10.1111/dar.13130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Christina Heris
- School of Population and Global Health University of Melbourne Melbourne Australia
| | - Nicola Guerin
- Centre for Behavioural Research in Cancer Cancer Council Victoria Melbourne Australia
| | - David Thomas
- Menzies School of Health Research Darwin Australia
| | | | - Sandra Eades
- School of Population and Global Health University of Melbourne Melbourne Australia
| | - Victoria M. White
- Centre for Behavioural Research in Cancer Cancer Council Victoria Melbourne Australia
- School of Psychology Deakin University Melbourne Australia
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11
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Heris CL, Guerin N, Thomas DP, Eades SJ, Chamberlain C, White VM. The decline of smoking initiation among Aboriginal and Torres Strait Islander secondary students: implications for future policy. Aust N Z J Public Health 2020; 44:397-403. [PMID: 32776634 DOI: 10.1111/1753-6405.13022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 05/01/2020] [Accepted: 06/01/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Smoking is a major cause of preventable illness for Aboriginal and Torres Strait Islander people, with most commencing in adolescence. Understanding trends in youth tobacco use can inform prevention policies and programs. METHODS Logistic regression models examined smoking trends among Aboriginal and Torres Strait Islander and all students aged 12-17 years, in five nationally representative triennial surveys, 2005-2017. Outcomes measured lifetime, past month, past week tobacco use and number of cigarettes smoked daily (smoking intensity). RESULTS Aboriginal and Torres Strait Islander students' never smoking increased (2005: 49%, 2017: 70%) with corresponding declines in past month and week smoking. Smoking intensity reduced among current smokers (low intensity increased 2005: 67%, 2017: 77%). Trends over time were similar for Aboriginal and Torres Strait Islander students as for all students (8-10% annual increase in never smoking). CONCLUSIONS Most Aboriginal and Torres Strait Islander students are now never smokers. Comparable declines indicate similar policy impact for Aboriginal and Torres Strait Islander and all students. Implications for Public Health: Comprehensive population-based tobacco control policies can impact all students. Continued investment, including in communities, is needed to maintain and accelerate reductions among Aboriginal and Torres Strait Islander students to achieve equivalent prevalence rates and reduce health inequities.
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Affiliation(s)
- Christina L Heris
- School of Population and Global Health, the University of Melbourne, Victoria
| | - Nicola Guerin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria
| | | | - Sandra J Eades
- School of Population and Global Health, the University of Melbourne, Victoria
| | | | - Victoria M White
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria.,School of Psychology, Deakin University, Victoria
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12
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Ellis RJ, Del Vecchio SJ, Gallagher KMJ, Aliano DN, Barber N, Bolton DM, Chew ETS, Coombes JS, Coory MD, Davis ID, Donaldson JF, Francis RS, Giles GG, Gobe GC, Hawley CM, Johnson DW, Laird A, Leung S, Malki M, Marco DJT, McNeill AS, Neale RE, Ng KL, Phipps S, Stewart GD, White VM, Wood ST, Jordan SJ. A Simple Clinical Tool for Stratifying Risk of Clinically Significant CKD after Nephrectomy: Development and Multinational Validation. J Am Soc Nephrol 2020; 31:1107-1117. [PMID: 32238473 DOI: 10.1681/asn.2019121328] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 02/17/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Clinically significant CKD following surgery for kidney cancer is associated with increased morbidity and mortality, but identifying patients at increased CKD risk remains difficult. Simple methods to stratify risk of clinically significant CKD after nephrectomy are needed. METHODS To develop a tool for stratifying patients' risk of CKD arising after surgery for kidney cancer, we tested models in a population-based cohort of 699 patients with kidney cancer in Queensland, Australia (2012-2013). We validated these models in a population-based cohort of 423 patients from Victoria, Australia, and in patient cohorts from single centers in Queensland, Scotland, and England. Eligible patients had two functioning kidneys and a preoperative eGFR ≥60 ml/min per 1.73 m2. The main outcome was incident eGFR <45 ml/min per 1.73 m2 at 12 months postnephrectomy. We used prespecified predictors-age ≥65 years old, diabetes mellitus, preoperative eGFR, and nephrectomy type (partial/radical)-to fit logistic regression models and grouped patients according to degree of risk of clinically significant CKD (negligible, low, moderate, or high risk). RESULTS Absolute risks of stage 3b or higher CKD were <2%, 3% to 14%, 21% to 26%, and 46% to 69% across the four strata of negligible, low, moderate, and high risk, respectively. The negative predictive value of the negligible risk category was 98.9% for clinically significant CKD. The c statistic for this score ranged from 0.84 to 0.88 across derivation and validation cohorts. CONCLUSIONS Our simple scoring system can reproducibly stratify postnephrectomy CKD risk on the basis of readily available parameters. This clinical tool's quantitative assessment of CKD risk may be weighed against other considerations when planning management of kidney tumors and help inform shared decision making between clinicians and patients.
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Affiliation(s)
- Robert J Ellis
- Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia .,Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Kidney Disease Research Collaborative, Translational Research Institute, Brisbane, Queensland, Australia
| | - Sharon J Del Vecchio
- Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Kidney Disease Research Collaborative, Translational Research Institute, Brisbane, Queensland, Australia
| | - Kevin M J Gallagher
- Department of Urology, Western General Hospital, Edinburgh, United Kingdom.,University of Edinburgh, Edinburgh, United Kingdom
| | - Danielle N Aliano
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Logan Hospital, Logan, Queensland, Australia
| | - Neil Barber
- Urology Department, Frimley Park Hospital, Frimley, United Kingdom
| | - Damien M Bolton
- Austin Urology, Austin Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Jeff S Coombes
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Michael D Coory
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Ian D Davis
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Eastern Health, Melbourne, Victoria, Australia
| | - James F Donaldson
- Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.,Department of Urology, Western General Hospital, Edinburgh, United Kingdom.,University of Edinburgh, Edinburgh, United Kingdom
| | - Ross S Francis
- Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Graham G Giles
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Glenda C Gobe
- Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Kidney Disease Research Collaborative, Translational Research Institute, Brisbane, Queensland, Australia
| | - Carmel M Hawley
- Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Kidney Disease Research Collaborative, Translational Research Institute, Brisbane, Queensland, Australia
| | - David W Johnson
- Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Kidney Disease Research Collaborative, Translational Research Institute, Brisbane, Queensland, Australia
| | - Alexander Laird
- Department of Urology, Western General Hospital, Edinburgh, United Kingdom.,University of Edinburgh, Edinburgh, United Kingdom
| | - Steve Leung
- Department of Urology, Western General Hospital, Edinburgh, United Kingdom.,University of Edinburgh, Edinburgh, United Kingdom
| | - Manar Malki
- Urology Department, Frimley Park Hospital, Frimley, United Kingdom
| | - David J T Marco
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Palliative Care, St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Alan S McNeill
- Department of Urology, Western General Hospital, Edinburgh, United Kingdom.,University of Edinburgh, Edinburgh, United Kingdom
| | - Rachel E Neale
- Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Queensland University of Technology, Brisbane, Queensland, Australia
| | - Keng L Ng
- Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Urology Department, Frimley Park Hospital, Frimley, United Kingdom
| | - Simon Phipps
- Department of Urology, Western General Hospital, Edinburgh, United Kingdom.,University of Edinburgh, Edinburgh, United Kingdom
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Cambridge, United Kingdom.,Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Victoria M White
- Cancer Council Victoria, Melbourne, Victoria, Australia.,School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Simon T Wood
- Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Susan J Jordan
- Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
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13
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Wu Z, Nguyen NH, Wang D, Lynch BM, Hodge AM, Bassett JK, White VM, Borland R, English DR, Milne RL, Giles GG, Dugué PA. Social connectedness and mortality after prostate cancer diagnosis: A prospective cohort study. Int J Cancer 2019; 147:766-776. [PMID: 31721182 DOI: 10.1002/ijc.32786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/28/2019] [Indexed: 11/11/2022]
Abstract
Men with prostate cancer experience side effects for which a supportive social environment may be beneficial. We examined the association between four measures of social connectedness and mortality after a prostate cancer diagnosis. Male participants in the Melbourne Collaborative Cohort Study in 1990-1994, who developed incident prostate cancer and attended follow-up in 2003-2007, were eligible for the study. Information on social connectedness, collected at follow-up, included (i) living arrangement; (ii) frequency of visits to friends/relatives and (iii) from friends/relatives; (iv) weekly hours of social activities. A total of 1,421 prostate cancer cases was observed (338 all-cause deaths, 113 from prostate cancer), including 867 after follow-up (150 all-cause deaths, 55 from prostate cancer) and 554 before follow-up (188 all-cause deaths, 58 from prostate cancer). Cox models stratified by tumour Gleason score and stage, and sequentially adjusted for socioeconomic, health- and lifestyle-related confounders, were used to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association between social connectedness and all-cause mortality after prostate cancer. Men who reported living alone before diagnosis had higher overall mortality (HR = 1.6, 95% CI: 1.0-2.5), after adjustment for socioeconomic, health and lifestyle confounders. Lower mortality was observed for men with more social activities (p-trend = 0.07), but not in comprehensively adjusted models. Consistent with these findings, men living alone after prostate cancer diagnosis had higher mortality (HR = 1.3, 95% CI: 0.9-1.9). Lower mortality was observed with increasing socializing hours in the age-adjusted model (p-trend = 0.06) but not after more comprehensive adjustment. Our findings suggest that living with someone, but not other aspects of social connectedness, may be associated with decreased mortality for men with prostate cancer.
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Affiliation(s)
- Zimu Wu
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Nga H Nguyen
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Dawei Wang
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Julie K Bassett
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Victoria M White
- Centre for Behavioural Research in Cancer, Cancer Council, Melbourne, VIC, Australia.,School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Ron Borland
- Nigel Gray Fellowship group, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Pierre-Antoine Dugué
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
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14
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White VM, Guerin N, Williams T, Wakefield MA. Long-term impact of plain packaging of cigarettes with larger graphic health warnings: findings from cross-sectional surveys of Australian adolescents between 2011 and 2017. Tob Control 2019; 28:e77-e84. [DOI: 10.1136/tobaccocontrol-2019-054988] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/02/2019] [Accepted: 05/15/2019] [Indexed: 11/04/2022]
Abstract
ObjectiveTo assess the long-term impact of plain packaging (PP) of cigarettes with larger graphic health warnings (HW) introduced in December 2012 on adolescents’ relevant tobacco-related perceptions.MethodsCross-sectional school-based surveys of 12 to 17 year olds in 2011 (n=4413), 2013 (n=4423), 2014 (n=4576) and 2017 (n=4266). Students rated the character of four popular cigarette brands, indicated their agreement regarding brand differences in smoking ease, quitting, addictiveness, harmfulness and pack attractiveness and positive/negative perceptions of pack image. The frequency of students reading, attending to, thinking and talking about HW was assessed. Responses of students seeing cigarette packs in the previous 6 months (2011: 63%; 2013: 67%, 2014: 56%, 2017: 56%) were examined.ResultsSmoking prevalence declined from 2011 to 2017. Among students who had recently seen packs, cigarette packs were rated less positively and more negatively in 2017 than in 2011 (p<0.001) with ratings similar between 2013 and 2017. Positive character ratings for each brand reduced between 2011 and 2013 (ps<0.05) with further reductions between 2013 and 2017 (ps<0.05). Fewer students agreed, and more were uncertain, that brands differed in their smoking ease, addictiveness, harmfulness and pack attractiveness in 2017 than 2011. The frequency of students reading, attending, talking or thinking about HW did not change between 2011 and 2017.ConclusionsPP’s initial impact in reducing adolescent’s positive perceptions of cigarette packs and brand differences continued in the following years with tobacco packaging less appealing to young people in 2017 than 2011 and students more uncertain about brand differences.
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15
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Ellis RJ, White VM, Bolton DM, Coory MD, Davis ID, Francis RS, Giles GG, Gobe GC, Neale RE, Wood ST, Jordan SJ. Tumor size and postoperative kidney function following radical nephrectomy. Clin Epidemiol 2019; 11:333-348. [PMID: 31191028 PMCID: PMC6511655 DOI: 10.2147/clep.s197968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/02/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Chronic kidney disease (CKD) following nephrectomy for kidney tumors is common, and both patient and tumor characteristics may affect postoperative kidney function. Several studies have reported that surgery for large tumors is associated with a lower likelihood of postoperative CKD, but others have reported CKD to be more common before surgery in patients with large tumors. Objective: The aim of this study was to clarify inconsistencies in the literature regarding the prognostic significance of tumor size for postoperative kidney function. Study design and setting: We analyzed data from 944 kidney cancer patients managed with radical nephrectomy between January 2012 and December 2013, and 242 living kidney donors who underwent surgery between January 2011 and December 2014 in the Australian states of Queensland and Victoria. Multivariable logistic regression was used to assess the primary outcome of CKD upstaging. Structural equation modeling was used to evaluate causal models, to delineate the influence of patient and tumor characteristics on postoperative kidney function. Results: We determined that a significant interaction between age and tumor size (P=0.03) led to the observed inverse association between large tumor size and CKD upstaging, and was accentuated by other forms of selection bias. Subgrouping patients by age and tumor size demonstrated that all patients aged ≥65 years were at increased risk of CKD upstaging, regardless of tumor size. Risk of CKD upstaging was comparable between age-matched living donors and kidney cancer patients. Conclusion: Larger tumors are unlikely to confer a protective effect with respect to postoperative kidney function. The reason for the previously reported inconsistency is likely a combination of the analytical approach and selection bias.
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Affiliation(s)
- Robert J Ellis
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane, QLD, Australia
| | - Victoria M White
- Cancer Council Victoria, Melbourne, VIC, Australia
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Damien M Bolton
- Department of Urology, Austin Health, Melbourne, VIC, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Michael D Coory
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Ian D Davis
- Eastern Health Clinical School, Monash University and Eastern Health, Melbourne, VIC, Australia
- Department of Urology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Ross S Francis
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane, QLD, Australia
| | - Graham G Giles
- Cancer Council Victoria, Melbourne, VIC, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Glenda C Gobe
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane, QLD, Australia
| | - Rachel E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Simon T Wood
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Kidney Disease Research Collaborative, Translational Research Institute, Brisbane, QLD, Australia
- Department of Urology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Susan J Jordan
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
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16
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Ellis RJ, White VM, Bolton DM, Coory MD, Davis ID, Francis RS, Giles GG, Gobe GC, Marco DJT, Neale RE, Wood ST, Jordan SJ. Incident Chronic Kidney Disease After Radical Nephrectomy for Renal Cell Carcinoma. Clin Genitourin Cancer 2019; 17:e581-e591. [PMID: 30975606 DOI: 10.1016/j.clgc.2019.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/12/2019] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) after surgery for kidney cancer is common, and is associated with increased morbidity and mortality. This study aimed to identify factors associated with incident CKD in patients managed with radical nephrectomy. PATIENTS AND METHODS All patients diagnosed with renal cell carcinoma between January 2012 and December 2013 were ascertained from state-based cancer registries in Queensland and Victoria. Information on patient, tumor, and health service characteristics was obtained via chart review. Multivariable logistic regression was used to evaluate exposures associated with incident CKD (estimated glomerular filtration rate [eGFR] <60 mL per minute per 1.73 m2) at 12 months after nephrectomy. RESULTS Older age (adjusted odds ratio [aOR] per 5-year increase, 1.5; 95% confidence interval [CI], 1.4-1.6), male sex (aOR, 1.4; 95% CI, 1.0-2.0), obese compared with not obese (aOR, 1.8; 95% CI, 1.2-2.7), rural compared with urban place of residence (aOR, 1.8; 95% CI, 1.1-3.0) were associated with a higher risk of incident CKD. Lower preoperative eGFR was also associated with a higher risk of incident CKD. Management in private compared with public hospitals was also associated with a higher risk of CKD (aOR, 1.6; 95% CI, 1.2-2.2). Factors related to tumor size and cancer severity were also associated with worse postoperative kidney function, although it is likely this was a consequence of selection bias. CONCLUSION Patient characteristics have the strongest associations with incident CKD after radical nephrectomy. Potential risk factors were reasonably similar to recognized CKD risk factors for the general population. Patients who undergo nephrectomy who have CKD risk factors might benefit from ongoing postoperative screening for deterioration of kidney function.
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Affiliation(s)
- Robert J Ellis
- QIMR Berghofer Medical Research Institute, Brisbane, Australia; Princess Alexandra Hospital, Brisbane, Australia; University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia.
| | - Victoria M White
- Cancer Council Victoria, Melbourne, Australia; Deakin University, Geelong, Australia
| | - Damien M Bolton
- Austin Health, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | | | - Ian D Davis
- Monash University, Melbourne, Australia; Eastern Health, Melbourne, Australia
| | - Ross S Francis
- Princess Alexandra Hospital, Brisbane, Australia; University of Queensland, Brisbane, Australia
| | - Graham G Giles
- Cancer Council Victoria, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - Glenda C Gobe
- Princess Alexandra Hospital, Brisbane, Australia; University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia
| | - David J T Marco
- University of Melbourne, Melbourne, Australia; Centre for Palliative Care, Melbourne, Australia
| | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Simon T Wood
- Princess Alexandra Hospital, Brisbane, Australia; University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia
| | - Susan J Jordan
- QIMR Berghofer Medical Research Institute, Brisbane, Australia; University of Queensland, Brisbane, Australia
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17
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White VM, Orme LM, Skaczkowski G, Pinkerton R, Coory M, Osborn M, Bibby H, Nicholls W, Conyers R, Phillips MB, Harrup R, Walker R, Thompson K, Anazodo A. Management of Sarcoma in Adolescents and Young Adults: An Australian Population-Based Study. J Adolesc Young Adult Oncol 2019; 8:272-280. [PMID: 30822262 DOI: 10.1089/jayao.2018.0136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: While overall survival (OS) for cancer in adolescents and young adults (AYA) has improved, there has been little change in AYA survival for several types of sarcomas. Using national data for Australia we describe (1) the treatment centers caring for AYA sarcoma, (2) treatments provided, and (3) survival outcomes. Procedure: National population-based study assessing treatment of 15-24 year-olds diagnosed with soft tissue sarcoma (STS), bone sarcoma (BS), and Ewing family tumors (ET) between 2007 and 2012. Treatment details were abstracted from hospital medical records. Treatment centers were classified as pediatric or adult specialist AYA/sarcoma center, or other adult. Cox proportional hazard regression analyses examined associations between type of treatment center and OS. Results: Sixty-one hospitals delivered treatment to 318 patients (135 STS; 91 BS, 92 ET), with 9%, 22%, and 17% of STS, BS, and ET, respectively, treated at pediatric and 62%, 59%, and 71% at adult specialist hospitals. Of 18-24 year-olds, 82% of BS, 90% of ET, and 73% of rhabdomyosarcomas at adult specialist centers were on a trial or standard protocol, compared with 42%, 89%, and 100%, respectively, at nonspecialist adult hospitals. After adjusting for disease and patient characteristics, survival was not associated with treatment center type for any disease type. However, ET survival was poorer for patients not receiving a standard chemotherapy protocol. Conclusions: Around 10% of AYA sarcoma patients attending adult hospitals were not on a standard protocol. Poorer survival for ET patients not on a standard protocol highlights the importance of ensuring all patients receive optimal care.
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Affiliation(s)
- Victoria M White
- 1 Center for Behavioral Research in Cancer, Cancer Council Victoria, Melbourne, Australia.,2 School of Psychology, Deakin University, Melbourne, Australia
| | - Lisa M Orme
- 3 Children's Cancer Center, The Royal Children's Hospital, Melbourne, Australia.,4 Peter MacCallum Cancer Center, Melbourne, Australia
| | - Gemma Skaczkowski
- 1 Center for Behavioral Research in Cancer, Cancer Council Victoria, Melbourne, Australia.,5 School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,6 Olivia Newton-John Cancer Wellness & Research Center, Austin Health, Heidelberg, Australia
| | - Ross Pinkerton
- 7 Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Michael Coory
- 3 Children's Cancer Center, The Royal Children's Hospital, Melbourne, Australia
| | | | - Helen Bibby
- 1 Center for Behavioral Research in Cancer, Cancer Council Victoria, Melbourne, Australia
| | - Wayne Nicholls
- 7 Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Rachel Conyers
- 3 Children's Cancer Center, The Royal Children's Hospital, Melbourne, Australia.,4 Peter MacCallum Cancer Center, Melbourne, Australia
| | | | | | - Rick Walker
- 7 Children's Health Queensland Hospital and Health Service, Brisbane, Australia.,11 Princess Alexandra Hospital, Brisbane, Australia
| | - Kate Thompson
- 4 Peter MacCallum Cancer Center, Melbourne, Australia
| | - Antoinette Anazodo
- 12 Kids Cancer Center, Sydney Children's Hospital, Sydney, Australia.,13 Nelune Comprehensive Cancer Center, Prince of Wales Hospital, Randwick, Australia.,14 School of Women's and Children's Health, University of New South Wales, Kensington, Australia
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18
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Marco DJT, White VM. The impact of cancer type, treatment, and distress on health-related quality of life: cross-sectional findings from a study of Australian cancer patients. Support Care Cancer 2019; 27:3421-3429. [PMID: 30661203 DOI: 10.1007/s00520-018-4625-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 12/19/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE This study examined the mediating effects of cancer type, treatment, and distress on health-related quality of life (HRQoL) for early diagnosis cancer patients. Results were interpreted with respect to established thresholds for clinical meaningfulness. METHODS A cross-sectional design was used. Patients completed surveys collecting demographics, cancer type, treatment, comorbid conditions, distress (HADS), and HRQoL (FACT-G). Hierarchical multivariate regressions examined associations between cancer type, treatment, and distress on HRQoL. Established minimum differences were used to identify clinically meaningful changes in HRQoL. RESULTS Of the 1183 patients surveyed, 21% were classified as having elevated anxiety and 13% had elevated depression. Our sample reported significantly lower physical and emotional well-being compared to population norms. Patients with prostate, melanoma, gynaecological, and urological cancers had higher HRQoL scores than those with colorectal cancer. However, when effects for treatment type and distress were considered, differences between cancer types became non-significant. Anxiety and depression were associated with lower HRQoL scores as was chemotherapy. Only depression, anxiety, and chemotherapy were associated with clinically meaningful decreases in HRQoL scores. CONCLUSIONS While statistically significant differences in HRQoL were found between different cancer types, only chemotherapy, anxiety, and depression produced clinically meaningful poorer HRQoL scores. In practice, clinically meaningful differences could promote a shift in resources toward interventions where a positive effect on patient well-being is appreciated by both the patient and health professional.
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Affiliation(s)
- David J T Marco
- Centre for Palliative Care, St Vincent's Hospital, Melbourne, Victoria, 3065, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Victoria M White
- School of Psychology, Deakin University, Melbourne, Victoria, 3125, Australia.
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, 3004, Australia.
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19
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White VM, Skaczkowski G, Pinkerton R, Coory M, Osborn M, Bibby H, Nicholls W, Orme LM, Conyers R, Phillips MB, Harrup R, Walker R, Thompson K, Anazodo A. Clinical management of Australian adolescents and young adults with acute lymphoblastic and myeloid leukemias: A national population-based study. Pediatr Blood Cancer 2018; 65:e27349. [PMID: 30039912 DOI: 10.1002/pbc.27349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/23/2018] [Accepted: 06/10/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND While several studies have examined the treatment of adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL), studies of acute myeloid leukemia (AML) are rare. Using national data for Australia, we describe (i) the number and type of treatment centers caring for AYAs, (ii) induction/first-line treatments, and (iii) survival outcomes. PROCEDURE National population-based study assessing treatment of 15- to 24-year-olds diagnosed with ALL or AML between 2007 and 2012. Treatment details were abstracted from hospital medical records. Treatment centers were classified as pediatric or adult (adult AYA-focused or other adult; and by AYA volume [high/low]). Cox proportional hazard regression analyses examined associations between treatment and overall, event-free, and relapse-free survival outcomes. RESULTS Forty-seven hospitals delivered induction therapy to 351 patients (181 ALL and 170 AML), with 74 (21%) treated at pediatric centers; 70% of hospitals treated less than two AYA leukemia patients per year. Regardless of treatment center, 82% of ALL patients were on pediatric protocols. For AML, pediatric protocols were not used in adult centers, with adult centers using a non-COG 7+3-type induction protocol (51%, where COG is Cooperative Oncology Group) or an ICE-type protocol (39%, where ICE is idarubicin, cytarabine, etoposide). Exploratory analyses suggested that for both ALL and AML, AYAs selected for adult protocols have worse overall, event-free, and relapse-free survival outcomes. CONCLUSIONS Pediatric protocols were commonly used for ALL patients regardless of where they are treated, indicating rapid assimilation of recent evidence by Australian hematologists. For AML, pediatric protocols were only used at pediatric centers. Further investigation is warranted to determine the optimal treatment approach for AYA AML patients.
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Affiliation(s)
- V M White
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.,School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - G Skaczkowski
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.,School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Heidelberg, Victoria, Australia
| | - R Pinkerton
- Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - M Coory
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - M Osborn
- Royal Adelaide Hospital, South Australia, Adelaide, Australia
| | - H Bibby
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - W Nicholls
- Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - L M Orme
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - R Conyers
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M B Phillips
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - R Harrup
- Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - R Walker
- Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - K Thompson
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - A Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia
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20
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White VM, Marco DJT, Bolton D, Papa N, Neale RE, Coory M, Davis ID, Wood S, Giles GG, Jordan SJ. Age at diagnosis and the surgical management of small renal carcinomas: findings from a cross-sectional population-based study. BJU Int 2018; 122 Suppl 5:50-61. [PMID: 30307688 DOI: 10.1111/bju.14585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To describe the use of partial nephrectomy (PN) for patients with stage T1a renal cell carcinoma (RCC) by age group (<65 and ≥65 years) in two Australian states. MATERIALS AND METHODS All adults diagnosed with RCC in 2012 and 2013 were identified through population-based cancer registries in the Australian states of Queensland and Victoria. For each patient, research assistants extracted patient, tumour and treatment data from medical records. Percentages of patients treated by PN were determined for the two age groups. Multivariable logistic regression analyses examined factors associated with PN. Clinicians treating RCC were sent surveys to assess attitudes towards PN. RESULTS Data were collected on 956 patients (Victoria: n = 548; Queensland: n = 404) with stage T1a RCC. Of those undergoing surgery (n = 865), PN was more common for those aged <65 years (61%) than for those aged ≥65 years (44%), with this difference significant after adjusting for patient, tumour (odds ratio 0.50, 95% confidence interval 0.36-0.70). There were significant interactions between age and treatment centre volume (P < 0.05) and residential state (P < 0.05). PN was less likely for younger patients treated at lower-volume hospitals (<24 patients a year) but hospital volume was not associated with PN for older patients. PN was less likely for older patients in Queensland than Victoria. In multivariable analyses, age was not related to laparoscopic surgery. Queensland clinicians were less likely than those from Victoria to agree that PN was the treatment of choice for most T1aN0M0 tumours (P < 0.001). CONCLUSIONS In Australia, patients aged > 65 years with small renal cancers were less likely to be treated by PN than younger patients. The variation in the surgical procedure used to treat older T1a RCC patients by state and hospital volume indicates that better evidence is needed to direct practice in this area.
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Affiliation(s)
- Victoria M White
- Deakin University, Burwood, Vic., Australia.,Cancer Council Victoria, Melbourne, Vic., Australia
| | - David J T Marco
- Centre for Palliative Care, St Vincent's Hospital, Fitzroy, Vic., Australia.,University of Melbourne, Parkville, Vic., Australia
| | | | | | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,School of Public Health, The University of Queensland, Brisbane, Qld, Australia
| | | | - Ian D Davis
- Eastern Health Clinical School, Monash University, Box Hill, Vic, Australia.,Eastern Health, Box Hill, Vic, Australia
| | - Simon Wood
- Centre for Kidney Disease Research, Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia.,Department of Urology, Princess Alexandra Hospital, Brisbane, Qld, Australia.,Translational Research Institute, Brisbane, Qld, Australia
| | - Graham G Giles
- Cancer Council Victoria, Melbourne, Vic., Australia.,University of Melbourne, Parkville, Vic., Australia
| | - Susan J Jordan
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,School of Public Health, The University of Queensland, Brisbane, Qld, Australia
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21
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Ahn T, Ellis RJ, White VM, Bolton DM, Coory MD, Davis ID, Francis RS, Giles GG, Gobe GC, Hawley CM, Johnson DW, Marco DJT, McStea M, Neale RE, Pascoe EM, Wood ST, Jordan SJ. Predictors of new-onset chronic kidney disease in patients managed surgically for T1a renal cell carcinoma: An Australian population-based analysis. J Surg Oncol 2018; 117:1597-1610. [PMID: 29790163 DOI: 10.1002/jso.25037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 02/09/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND New-onset chronic kidney disease (CKD) following surgical management of kidney tumors is common. This study evaluated risk factors for new-onset CKD after nephrectomy for T1a renal cell carcinoma (RCC) in an Australian population-based cohort. METHODS There were 551 RCC patients from the Australian states of Queensland and Victoria included in this study. The primary outcome was new-onset CKD (eGFR <60 mL/min per 1.73 m2 ) and the secondary outcome was new-onset moderate-severe CKD (<45 mL/min per 1.73 m2 ). Multivariable logistic regression was used to evaluate associations between patient, tumor and health-service characteristics and these outcomes. RESULTS Forty percent (219/551) of patients developed new-onset CKD, and 12% (68/551) experienced new-onset moderate-severe CKD. Risk factors for new-onset CKD were age, lower preoperative eGFR, tumor size >20 mm, radical nephrectomy, lower hospital caseloads (<20 cases/year), and rural place of residence. The associations between rural place of residence and low center volume were a consequence of higher radical nephrectomy rates. CONCLUSION Risk factors for CKD after nephrectomy generally relate to worse baseline health, or likelihood of undergoing radical nephrectomy. Surgeons in rural centres and hospitals with low caseloads may benefit from formalized integration with specialist centers for continued professional development and case-conferencing, to assist in management decisions.
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Affiliation(s)
- Thomas Ahn
- Princess Alexandra Hospital, Brisbane, Australia
| | - Robert J Ellis
- Princess Alexandra Hospital, Brisbane, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Australia.,University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | - Victoria M White
- Cancer Council Victoria, Melbourne, Australia.,Deakin University, Geelong, Australia
| | - Damien M Bolton
- Austin Health, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | | | - Ian D Davis
- Monash University, Melbourne, Australia.,Eastern Health, Melbourne, Australia
| | - Ross S Francis
- Princess Alexandra Hospital, Brisbane, Australia.,University of Queensland, Brisbane, Australia
| | - Graham G Giles
- Cancer Council Victoria, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Glenda C Gobe
- Princess Alexandra Hospital, Brisbane, Australia.,University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | - Carmel M Hawley
- Princess Alexandra Hospital, Brisbane, Australia.,University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | - David W Johnson
- Princess Alexandra Hospital, Brisbane, Australia.,University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | | | - Megan McStea
- University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Elaine M Pascoe
- University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | - Simon T Wood
- Princess Alexandra Hospital, Brisbane, Australia.,University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | - Susan J Jordan
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.,University of Queensland, Brisbane, Australia
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22
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Oberoi DV, White VM, Seymour JF, Prince HM, Harrison S, Jefford M, Winship I, Hill DJ, Bolton D, Millar J, Wong Doo N, Kay A, Giles G. Distress and unmet needs during treatment and quality of life in early cancer survivorship: A longitudinal study of haematological cancer patients. Eur J Haematol 2017; 99:423-430. [DOI: 10.1111/ejh.12941] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2017] [Indexed: 01/22/2023]
Affiliation(s)
| | - Victoria M. White
- Cancer Council Victoria; Melbourne Vic. Australia
- Deakin University; Burwood Vic. Australia
| | - John F. Seymour
- The University of Melbourne; Parkville Vic. Australia
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | - H. Miles Prince
- The University of Melbourne; Parkville Vic. Australia
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | - Simon Harrison
- The University of Melbourne; Parkville Vic. Australia
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | - Michael Jefford
- The University of Melbourne; Parkville Vic. Australia
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | | | - David J. Hill
- Cancer Council Victoria; Melbourne Vic. Australia
- The University of Melbourne; Parkville Vic. Australia
| | | | | | | | - Anne Kay
- North Eastern Melbourne Integrated Cancer Service; Heidelberg Vic. Australia
| | - Graham Giles
- Cancer Council Victoria; Melbourne Vic. Australia
- The University of Melbourne; Parkville Vic. Australia
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23
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White VM, Durkin SJ, Coomber K, Wakefield MA. What is the role of tobacco control advertising intensity and duration in reducing adolescent smoking prevalence? Findings from 16 years of tobacco control mass media advertising in Australia. Tob Control 2015; 24:198-204. [PMID: 23988860 DOI: 10.1136/tobaccocontrol-2012-050945] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine how the intensity and duration of tobacco control advertising relate to adolescent smoking prevalence. METHODS Australian students (aged 12-17 years) participating in a national survey conducted triennially between 1993 and 2008 (sample size range 12 314-16 611). The outcome measure was students' smoking in the previous 4 weeks collected through anonymous, self-completed surveys. For each student, monthly targeted rating points (TRPs, a measure of television advertising exposure) for tobacco control advertising was calculated for the 3 and 12 months prior to surveying. For each time period, cumulative TRPs exposure and exposure to three intensity levels (≥100 TRPs/month; ≥400 TRPs/month; ≥800 TRPs/month) over increasing durations (eg, 1 month, 2 months, etc) were calculated. Logistic regression examined associations between TRPs and adolescent smoking after controlling for demographic and policy variables. RESULTS Past 3-month cumulative TRPs were found to have an inverse relationship with smoking prevalence. Low TRPs exposure in the past 12 months was positively associated with adolescent smoking prevalence. However, smoking prevalence reduced with cumulative exposure levels above 5800 cumulative TRPs. Additionally, exposure to ≥400 TRPs/month and ≥800 TRPs/month were associated with reduced likelihood of smoking, although the duration needed for this effect differed for the two intensity levels. When intensity was ≥400 TRPs/month, the odds of smoking only reduced with continuous exposure. When intensity was ≥800 TRPs/month, exposure at levels less than monthly was associated with reductions in smoking prevalence. CONCLUSIONS Both antismoking advertising intensity and duration are important for ensuring reductions in adolescent smoking prevalence.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kerri Coomber
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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24
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White VM, Young MA, Farrelly A, Meiser B, Jefford M, Williamson E, Ieropoli S, Duffy J, Winship I. Randomized controlled trial of a telephone-based peer-support program for women carrying a BRCA1 or BRCA2 mutation: impact on psychological distress. J Clin Oncol 2014; 32:4073-80. [PMID: 25403211 DOI: 10.1200/jco.2013.54.1607] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To assess the effectiveness of a telephone-based peer-delivered intervention in reducing distress among women with a BRCA1 or BRCA2 gene mutation. The intervention involved trained peer volunteers contacting women multiple times over a 4-month period to provide informational, emotional, and practical support. METHODS Three hundred thirty-seven participants completed the baseline questionnaire, and those reporting interest in talking to other mutation carriers were randomly assigned to either the usual care group (UCG; n = 102) or the intervention group (IG; n = 105). Participants and researchers were not blinded to group allocation. Two follow-up questionnaires were completed, one at the end of the intervention (4 months after random assignment, time 2) and one 2 months later (time 3). Outcomes included breast cancer distress (primary outcome), unmet information needs, cognitive appraisals about mutation testing, and feelings of isolation. RESULTS There was a greater decrease in breast cancer distress scores in the IG than UCG at time 2 (mean difference, -5.96; 95% CI, -9.80 to -2.12; P = .002) and time 3 (mean difference, -3.94; 95% CI, -7.70 to -0.17; P = .04). There was a greater reduction in unmet information needs in the IG than UCG (P < .01), with unmet needs being lower in the IG than UCG at time 2. There was a greater reduction in Cognitive Appraisals About Genetic Testing stress subscale scores in the IG than UCG (P = .02), with significantly lower scores among the IG than UCG at time 2 (P < .01). CONCLUSION The intervention is effective in reducing distress and unmet information needs for this group of women. Identifying strategies for prolonging intervention effects is warranted.
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Affiliation(s)
- Victoria M White
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia.
| | - Mary-Anne Young
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Ashley Farrelly
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Bettina Meiser
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Michael Jefford
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Elizabeth Williamson
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Sandra Ieropoli
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Jessica Duffy
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Ingrid Winship
- Victoria M. White, Ashley Farrelly, and Michael Jefford, Cancer Council Victoria; Elizabeth Williamson and Ingrid Winship, The University of Melbourne; Ingrid Winship, Royal Melbourne Hospital; Elizabeth Williamson, Monash University, Melbourne; Mary-Anne Young and Michael Jefford, Peter MacCallum Cancer Centre, East Melbourne; Sandra Ieropoli, Early in Life Mental Health Service, Monash Health Mental Health Program, Clayton, Victoria; Bettina Meiser, Prince of Wales Clinical School, The University of New South Wales, Sydney; and Jessica Duffy, Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
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25
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Abstract
Global genome nucleotide excision repair (GG-NER) is responsible for identifying and removing bulky adducts from non-transcribed DNA that result from damaging agents such as UV radiation and cisplatin. Xeroderma pigmentosum complementation group C (XPC) is one of the essential damage recognition proteins of the GG-NER pathway and its dysfunction results in xeroderma pigmentosum (XP), a disorder involving photosensitivity and a predisposition to cancer. To better understand the identification of DNA damage by XPC in the context of chromatin and the role of XPC in the pathogenesis of XP, we characterized the interactome of XPC using a high throughput yeast two-hybrid screening. Our screening showed 49 novel interactors of XPC involved in DNA repair and replication, proteolysis and post-translational modifications, transcription regulation, signal transduction, and metabolism. Importantly, we validated the XPC-OTUD4 interaction by co-IP and provided evidence that OTUD4 knockdown in human cells indeed affects the levels of ubiquitinated XPC, supporting a hypothesis that the OTUD4 deubiquitinase is involved in XPC recycling by cleaving the ubiquitin moiety. This high-throughput characterization of the XPC interactome provides a resource for future exploration and suggests that XPC may have many uncharacterized cellular functions.
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Affiliation(s)
- Abigail Lubin
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33156, USA; E-Mails: (A.L.); (L.Z.); (H.C.); (V.M.W.)
| | - Ling Zhang
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33156, USA; E-Mails: (A.L.); (L.Z.); (H.C.); (V.M.W.)
| | - Hua Chen
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33156, USA; E-Mails: (A.L.); (L.Z.); (H.C.); (V.M.W.)
| | - Victoria M. White
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33156, USA; E-Mails: (A.L.); (L.Z.); (H.C.); (V.M.W.)
| | - Feng Gong
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33156, USA; E-Mails: (A.L.); (L.Z.); (H.C.); (V.M.W.)
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Coory M, White VM, Johnson KS, Hill DJ, Jefford M, Harrison S, Winship I, Millar J, Giles GG. Systematic review of quality improvement interventions directed at cancer specialists. J Clin Oncol 2013; 31:1583-91. [PMID: 23530093 DOI: 10.1200/jco.2012.46.0253] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Summary evidence on the effectiveness of quality improvement interventions (QIIs) directed at cancer specialists is needed for two reasons. First, there are some innovations over which only cancer specialists have control (eg, surgical technique or chemotherapy regimen). Second, implementation of QIIs has opportunity costs; the time and money spent on an ineffective QII might be better spent on direct patient care. METHODS Medical Subject Headings and text words for "quality improvement" were combined with those for "neoplasm" to search MEDLINE, PsycINFO, CINAHL, and EMBASE from January 1990 to August 2012 for studies of QIIs directed at cancer specialists (eg, medical/radiation oncologist, surgeon). All study designs were included. RESULTS Five thousand seven hundred eighty-one articles were screened, but only 12 met the inclusion criteria, including three cluster randomized controlled trials (cRCTs), seven uncontrolled before-and-after comparisons, and two cross-sectional studies. All 12 studies were conducted in response to concerns about quality of care. No cRCT showed a benefit of the QIIs tested. Some uncontrolled before-and-after and cross-sectional studies reported a benefit from the QII, but these studies are difficult to interpret because of concerns about uncontrolled confounding. Interventions in all studies were multifaceted, but descriptions of different components were limited, and only one study examined their separate impact. CONCLUSION The published evidence about how to facilitate timely and consistent adoption of new clinical knowledge by cancer specialists into everyday clinical practice is thin. More investment is needed in research about the solution (QIIs) to match the investment in research about the problem (inconsistent/slow adoption of innovative cancer treatments).
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Affiliation(s)
- Michael Coory
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
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Affiliation(s)
- John P Pierce
- University of California, San Diego, La Jolla, CA 92093-0901, USA.
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White VM, Warne CD, Spittal MJ, Durkin S, Purcell K, Wakefield MA. What impact have tobacco control policies, cigarette price and tobacco control programme funding had on Australian adolescents' smoking? Findings over a 15-year period. Addiction 2011; 106:1493-502. [PMID: 21401766 DOI: 10.1111/j.1360-0443.2011.03429.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To assess the impact of tobacco control policies relating to youth access, clean indoor air and tobacco advertising at point-of-sale and outdoors, in addition to cigarette price and per capita tobacco control spending, on adolescent smoking prevalence. DESIGN Repeated cross-sectional surveys. Logistic regression analyses examined association between policies and smoking prevalence. SETTING Australia, 1990-2005. PARTICIPANTS A nationally representative sample of secondary students (aged 12-17 years) participating in a triennial survey (sample size per survey range: 20 560 to 27 480). MEASUREMENTS Students' report of past-month smoking. In each jurisdiction, extent of implementation of the three policies for the year of the survey was determined. For each survey year, national per capita tobacco control spending was determined and jurisdiction-specific 12-month change in cigarette price obtained. FINDINGS Extent of implementation of the three policy areas varied between states and over the survey years. Multivariate analyses that adjusted for demographic factors, year and all tobacco control variables showed that 12-month cigarette price increases [odds ratio (OR): 0.98, 95% confidence interval (CI): 0.97-0.99], greater per capita tobacco control spending (OR: 0.99, 95% CI: 0.98-0.99) and stronger implementation of clean indoor air policies (OR: 0.93, 95% CI: 0.92-0.94) were associated with reduced smoking prevalence. CONCLUSIONS Adult-directed, population-based tobacco control policies such as clean indoor air laws and increased prices of cigarettes, implemented as part of a well-funded comprehensive tobacco control programme are associated with lower adolescent smoking.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer, The Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria, Australia.
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White VM, Macvean ML, Grogan S, D'Este C, Akkerman D, Ieropoli S, Hill DJ, Sanson-Fisher R. Can a tailored telephone intervention delivered by volunteers reduce the supportive care needs, anxiety and depression of people with colorectal cancer? A randomised controlled trial. Psychooncology 2011; 21:1053-62. [PMID: 21769989 DOI: 10.1002/pon.2019] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 05/30/2011] [Accepted: 05/31/2011] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective was to assess the effectiveness of a volunteer-delivered tailored telephone-based intervention in reducing prevalence of unmet supportive care needs, elevated levels of anxiety and depression among people with colorectal cancer over a 9-month period. METHODS There were 653 participants who completed the baseline questionnaire and were randomised to usual care (n = 341) or intervention (n = 306). Three follow-up questionnaires were completed at 3-monthly intervals (response rates: 93%, 87%, 82%, respectively). All four questionnaires contained the Supportive Care Needs Survey (SCNS), Hospital Anxiety and Depression Scale (HADS) and checklists for colorectal cancer symptoms and use of support services. The intervention consisted of trained volunteers providing emotional support, service referral and information and was delivered after completion of each of the first three questionnaires. Primary outcomes were prevalence of moderate to high SCNS needs and elevated levels (scores of 8+) of HADS anxiety and depression. RESULTS Over the study period, SCNS needs decreased similarly for both groups, and prevalence of elevated depression did not change for either group. There was a greater reduction in the prevalence of elevated anxiety in the intervention than usual care group (p < 0.01), with the intervention group decrease mainly occurring between baseline and the first follow-up survey (p < 0.01). However, the prevalence of elevated anxiety was similar between the two groups at each follow-up point. CONCLUSIONS The intervention had no effect on supportive care needs or depression, although it may be associated with a greater reduction in anxiety. Future research should test the intervention with patients closer to diagnosis.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer Council, The Cancer Council Victoria, Carlton, Victoria, Australia.
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Livingston PM, Craike MJ, White VM, Hordern AJ, Jefford M, Botti MA, Lethborg C, Oldroyd JC. A nurse-assisted screening and referral program for depression among survivors of colorectal cancer: feasibility study. Med J Aust 2011; 193:S83-7. [PMID: 21542453 DOI: 10.5694/j.1326-5377.2010.tb03935.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To test the feasibility and acceptability of a telephone-based program to screen survivors of colorectal cancer (CRC) for distress, and to refer distressed patients to their treating health service. DESIGN, SETTING AND PARTICIPANTS A prospective, multicentre study involving 59 patients with CRC recruited from six public and private health services in Melbourne, Victoria, from 15 June 2008 to 22 September 2009. Patients who had completed adjuvant chemotherapy for CRC were contacted (7-10 days after recruitment [outcall one] and again 4 weeks later [outcall two]) by the Cancer Council Victoria's helpline nurse, and screened for distress with the Distress and Impact Thermometer (DIT); participants were given tailored information and support and those with distress scores of > or = 5, and impact scores of > or = 4, were referred for follow-up. Telephone interviews were conducted 4 weeks after outcall two. Participating helpline and health service staff were surveyed on the feasibility and acceptability of the service. MAIN OUTCOME MEASURE Anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS). RESULTS Of the 59 patients (87%) who agreed to participate, 63% were men; their mean age was 59 years (SD, 9.5 years). HADS depression decreased significantly from baseline (mean score, 4.93; SD, 4.22) to follow-up (mean score, 3.84; SD, 4.10; Z = -2.375; P = 0.02). However, there was no significant difference in HADS anxiety between baseline (mean score, 5.29; SD, 4.11) and follow-up (mean score, 4.78; SD, 3.65). Outcall one generated two referrals (4% of participants) and outcall two generated four referrals (8%); five of these six participants took up the referrals. Satisfaction with the program among participants was high; 82% found outcall one "quite or very helpful" and 79% found outcall two "quite or very helpful". Helpline and health service staff reported a straightforward process that did not adversely affect workloads. CONCLUSION This model of care carries the potential to meet ongoing psychosocial needs of survivors of CRC.
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Affiliation(s)
- Patricia M Livingston
- Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University, Melbourne, VIC.
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Abstract
OBJECTIVE To qualitatively project the future health burden of tobacco from present-day young adult smoking behavior. METHODS Population surveys in California (2002) and nationally (1978-80, 2001-03). RESULTS In 2002, 40% of California young adult smokers were nondaily smokers, 24% had quit at some time for >or=6 months, 45% said they smoked less now than previously, and 68% thought they would quit within 5 years. Interest in quitting was high, and most were actively engaged in the smoking cessation process. Young adult smoking behavior changed from 1978-80 to 2001-03. CONCLUSION The future health burden from smoking will be less for the current generation of young adults.
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Affiliation(s)
- Elizabeth A Gilpin
- Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA, USA
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Livingston PM, White VM, Hayman J, Maunsell E, Dunn SM, Hill D. The psychological impact of a specialist referral and telephone intervention on male cancer patients: a randomised controlled trial. Psychooncology 2009; 19:617-25. [DOI: 10.1002/pon.1609] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
This research estimates the prevalence of alcohol use among Australian secondary students in 1996 and examines trends in alcohol prevalence over a 12-year period. A national randomly selected representative sample of 434 secondary schools participated in the 1996 study. Eghty students were selected randomly from each school and completed a questionnaire anonymously. Current drinking (drinking alcohol in the week before the survey) increased with age from 17% of boys and 10% of girls aged 12 to 56% of boys and 50% of girls aged 17. Comparisons with data collected by similar surveys in 1984, 1987, 1990 and 1993 showed that while fewer 12-15-year-olds were current drinkers in 1996 than in 1984 or 1987, the 1996 proportion was no different from the 1993 proportion. In 1996, there were more hazardous drinkers among male current drinkers aged 12-15 than in any other survey period. Among 16-and 17-year-olds, there were more current drinkers in 1996 than in 1993 or 1990, and more male and female current drinkers were drinking at hazardous levels in 1996 than in 1987 and 1990. Extrapolating from the 1996 findings, nearly 424000 students aged 12-17 years were current drinkers.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer, Cancer Control Research Institute, Anti-Cancer Council of Victoria, Victoria, Australia
| | - David J Hill
- Centre for Behavioural Research in Cancer, Cancer Control Research Institute, Anti-Cancer Council of Victoria, Victoria, Australia
| | - Tessa R Letcher
- Centre for Behavioural Research in Cancer, Cancer Control Research Institute, Anti-Cancer Council of Victoria, Victoria, Australia
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Abstract
The prevalence of alcohol consumption among Australian secondary students in 1993 was estimated from a survey of 22 696 students aged between 12 and 17 years. A random, representative sample of schools from all education systems (government, Catholic and independent) was selected and a sample of 80 students from each school was randomly selected from predetermined year levels. Students completed an anonymous, self-administered survey on their drinking behaviours. Results showed that drinking was common, with 46% of female and 50% of male 17-year-olds having drunk on at least one of the 7 days prior to the survey (defined as current drinkers). Among 12-17-year-olds who were current drinkers, 27% of males had five or more alcoholic drinks on at least one drinking ("heavy drinking") while 43% of girls had had three or more drinks ("heavy drinking"). Among current drinkers aged 12-15 years, 10% of boys and 12% of girls had "binged" (for boys drinking eight or more drinks in one session, for girls having six or more drinks at one session) while among current drinkers aged 16 and 17 years the corresponding proportions were 33% of boys and 30% of girls. After controlling for age, sex, school type and state, the proportion of 12-15-year-olds who were current drinkers rose from 24% to 26% between 1990 and 1993. Among 16 and 17-year-olds, the proportion of current drinkers in 1993 (47%) was the same as that found in 1990, although there were more heavy drinkers and binge drinkers in 1993 than in 1990.
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Affiliation(s)
- V M White
- Centre for Behavioural Research in Cancer, Anti-Cancer Council of Victoria, 1 Rathdowne Street, Carlton South, VIC, 3053, Australia
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Hoey LM, Ieropoli SC, White VM, Jefford M. Systematic review of peer-support programs for people with cancer. Patient Educ Couns 2008; 70:315-37. [PMID: 18191527 DOI: 10.1016/j.pec.2007.11.016] [Citation(s) in RCA: 260] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Revised: 11/21/2007] [Accepted: 11/23/2007] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To identify models of peer support for cancer patients and systematically review evidence of their effectiveness in improving psychosocial adjustment. METHODS CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE and PsychINFO databases were used to identify relevant literature published from 1980 to April 2007. Data on characteristics of the peer-support program, sample size, design, measures, and findings were extracted and papers were also rated with respect to research quality (categories 'poor', 'fair' or 'good'). RESULTS Forty-three research papers that included data from at least 1 group were reviewed in detail, including 26 descriptive papers, 8 non-randomized comparative papers, and 10 papers reporting eight randomized controlled trials (RCTs). Five models of peer support were identified: one-on-one face-to-face, one-on-one telephone, group face-to-face, group telephone, and group Internet. CONCLUSION Papers indicated a high level of satisfaction with peer-support programs; however, evidence for psychosocial benefit was mixed. PRACTICE IMPLICATIONS One-on-one face-to-face and group Internet peer-support programs should be given priority when considering ways to offer peer support. Nevertheless, the other models discussed in this review should not be dismissed until further research is conducted with a wide range of cancer populations.
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Affiliation(s)
- Louisa M Hoey
- Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Australia
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Macvean ML, White VM, Sanson-Fisher R. One-to-one volunteer support programs for people with cancer: a review of the literature. Patient Educ Couns 2008; 70:10-24. [PMID: 17904782 DOI: 10.1016/j.pec.2007.08.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2006] [Revised: 08/06/2007] [Accepted: 08/12/2007] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To conduct a systematic review of literature reporting on the use of volunteers in support programs for people with cancer. METHODS PsycINFO, Medline and CINAHL were used to identify papers published up to April 2007 reporting one-to-one support programs using volunteers. Program data were extracted from the papers, which were rated on research quality and descriptions of the program, volunteers and support recipients. RESULTS Twenty-eight papers were reviewed. Nineteen (69%) reported peer-support programs, with four (14%) pertaining to the Reach to Recovery program for women with breast cancer, and eight (28%) describing other peer-support programs for women with breast cancer. Few papers described the programs sufficiently to enable a good understanding of support recipients, volunteers, and what transpired between volunteers and support recipients. Twenty papers (71%) were research studies: 10 (36%) with one group descriptive data, 6 (21%) were non-randomized comparative studies and 4 (14%) were randomized controlled trials. CONCLUSION While most papers reported that programs were beneficial, few presented data from studies using rigorous research methodologies to support these claims. PRACTICE IMPLICATIONS Using volunteers in cancer care may have merits; however, papers need to provide more information regarding these programs and further evidence is required to determine their effectiveness.
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Dixon HG, Scully ML, Wakefield MA, White VM, Crawford DA. The effects of television advertisements for junk food versus nutritious food on children's food attitudes and preferences. Soc Sci Med 2007; 65:1311-23. [PMID: 17587474 DOI: 10.1016/j.socscimed.2007.05.011] [Citation(s) in RCA: 148] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2006] [Indexed: 11/19/2022]
Abstract
Television (TV) food advertising has attracted criticism for its potential role in promoting unhealthy dietary practices among children. Content analyses indicate junk food advertising is prevalent on Australian children's TV; healthy eating is rarely promoted. This paper presents (a) a cross-sectional survey examining associations between children's regular TV viewing habits and their food-related attitudes and behaviour; and (b) an experiment assessing the impact of varying combinations of TV advertisements (ads) for unhealthy and healthy foods on children's dietary knowledge, attitudes and intentions. The experimental conditions simulated possible models for regulating food ads on children's TV. Participants were 919 grade five and six students from schools in Melbourne, Australia. The survey showed that heavier TV use and more frequent commercial TV viewing were independently associated with more positive attitudes toward junk food; heavier TV use was also independently associated with higher reported junk food consumption. The experiment found that ads for nutritious foods promote selected positive attitudes and beliefs concerning these foods. Findings are discussed in light of methodological issues in media effects research and their implications for policy and practice. It is concluded that changing the food advertising environment on children's TV to one where nutritious foods are promoted and junk foods are relatively unrepresented would help to normalize and reinforce healthy eating.
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Affiliation(s)
- Helen G Dixon
- Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Australia.
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White VM, English DR, Coates H, Lagerlund M, Borland R, Giles GG. Is cancer risk associated with anger control and negative affect? Findings from a prospective cohort study. Psychosom Med 2007; 69:667-74. [PMID: 17766690 DOI: 10.1097/psy.0b013e31814d4e6a] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the associations between anger control and negative affect and the risk of five common cancers and total cancers. Possible associations between emotional states and the risk of cancer have long been postulated. METHODS Prospective cohort study with average follow-up of 9 years. A total of 19,730 adults (99% aged between 40 and 69 years) answered questions on negative affect and anger control at baseline. A total of 1952 cancers were diagnosed, including 352 breast cancers, 318 prostate cancers, 88 lung cancers, 280 colorectal cancers, and 261 melanomas. RESULTS After adjustment for potential confounders, there was no significant association between anger control or negative affect and risk of breast cancer, melanoma, or total cancers. Weak associations were identified between anger control and prostate cancer, hazards ratio (HR) 1.17 (1.04-1.30) for a 1-unit increase in the standardized scale, negative affect, and lung cancer, HR 1.24 (1.01-1.52) and colorectal cancer, HR 1.14 (1.01-1.28). There was no evidence of an interaction effect between anger control and negative affect. CONCLUSIONS Results suggest that anger control and negative affect are not associated with breast cancer, melanoma, or total cancer risk, although they may have a small role in risk of prostate, colorectal, and lung cancer. Although more research is needed to confirm these latter associations, the results suggest that if affective states are associated with cancer development, the association may differ for different cancers and argue against the use of total cancer as an outcome measure for studies in this area.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer, The Cancer Council Victoria, 1 Rathdowne Street, Carlton Vic 3053, Australia.
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Macvean ML, White VM, Pratt S, Grogan S, Sanson-Fisher R. Reducing the unmet needs of patients with colorectal cancer: a feasibility study of The Pathfinder Volunteer Program. Support Care Cancer 2006; 15:293-9. [PMID: 16947039 DOI: 10.1007/s00520-006-0128-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Accepted: 07/05/2006] [Indexed: 10/24/2022]
Abstract
GOALS OF THE WORK Many cancer patients experience unmet needs and elevated levels of anxiety and depression. This paper describes a volunteer-delivered intervention to reduce the psychosocial needs of cancer patients and presents findings from a feasibility study of this intervention. MATERIALS AND METHODS The telephone-based intervention, called the Pathfinder Program, involves the assignment of volunteers to patients to assist them in addressing their needs as identified in questionnaires. Fifty-two patients with colorectal cancer were involved in the feasibility study, with 18 in the intervention. Sixty-two percent of the sample was male and the mean age was 64 years. Patients' needs were assessed using The Supportive Care Needs Survey, a colorectal cancer symptom checklist, and the Hospital Anxiety and Depression Scale. All patients completed baseline questionnaires (Time 1) and 47 completed Time 2 questionnaires 3 months later. MAIN RESULTS The most common needs were fear of the cancer spreading and returning, concerns about the worries of others, gas or wind, changes in weight, and bowel problems such as diarrhea, constipation, and pain. A statistically significant Time 1 to Time 2 decrease in supportive care needs and depression was found for the intervention group. CONCLUSIONS The Pathfinder Program has been found to be feasible, acceptable for patients, and has the potential to reduce needs and depression. A larger, randomized controlled trial is needed to determine the impact of this program on colorectal symptoms and anxiety.
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Affiliation(s)
- Michelle L Macvean
- The Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria, 3053, Australia
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White VM, White MM, Freeman K, Gilpin EA, Pierce JP. Cigarette promotional offers: who takes advantage? Am J Prev Med 2006; 30:225-31. [PMID: 16476638 DOI: 10.1016/j.amepre.2005.11.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Revised: 11/04/2005] [Accepted: 11/04/2005] [Indexed: 11/18/2022]
Abstract
BACKGROUND Promotional offers on cigarettes (e.g., dollar-off, multipack discounts) composed the largest share of tobacco industry marketing expenditures, totaling $8.9 billion, or 72% of the total budget in 2002. Internal industry documents indicate that young adults, potential quitters, and other price-sensitive groups are the targets of these marketing tactics. How effective they are in actually reaching these groups in the general population of smokers has not yet been investigated. METHODS Data were from 4618 current smokers responding to the large, random-digit-dialed population-based 2002 California Tobacco Survey. The characteristics were identified of smokers who reported that they used these offers "every time I see one." RESULTS Thirty-five percent of smokers used promotional offers every time they saw one. Multivariate analyses identified young adults, women, African Americans, those with higher daily cigarette consumption, and those worried about cigarette costs as more likely to use promotional offers at every opportunity. Smokers most committed to quitting were no more likely to use promotional offers than those with no intention to quit. Cigarette brand was highly correlated with age and race/ethnicity, and therefore was not included in the multivariate analysis. Those who smoked menthol cigarettes and Camels, more often young adults and African Americans, were much more likely than those of other brands to use promotional offers. CONCLUSIONS With the exception of smokers intending to quit, cigarette promotional offers are effectively reaching most industry-targeted groups. Importantly, young adults, who have the greatest long-term customer potential, are responding.
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Affiliation(s)
- Victoria M White
- Centre for Behavioral Research in Cancer, The Cancer Council Victoria, Carlton, Victoria, Australia
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Abstract
When faced with high cigarette prices, smokers can potentially control cigarette expenditures by limiting consumption or seeking cheaper cigarettes. The present study examined both these options and whether the use of price-minimizing strategies (the second option) could counteract a further price increase without smokers having to reduce consumption. Data for 5,109 smokers who purchased manufactured cigarettes were from the 2002 cross-sectional, population-based, random-digit-dialed California Tobacco Survey. We used logistic regression to examine which smokers used consumption-limiting or price-minimizing strategies, and multiple linear regression to determine how much price-minimizing strategies reduced the average price paid per pack. Overall, 32.3% of California smokers said they limited consumption and 74.1% used at least one of the five price-minimizing strategies identified: choosing cheaper retail outlets (61.1%), using promotional offers (35.2%), choosing cheaper brands (28.7%), purchasing by the carton (27.7%), and using low-tax or nontaxed sources (6.3%). Different groups of smokers used different strategies. Except for the use of promotional offers, all price-minimizing strategies significantly reduced the price paid per pack. Carton purchasers saved 1.01 US dollars/pack, and those buying from low-tax or nontaxed sources saved 1.23 US dollars/pack. However, pack buyers were reluctant to purchase cartons, mostly because they thought they might smoke too much, or because they considered the upfront cost unaffordable. The average California smoker could potentially save 0.33-0.66 US dollars/pack or 6.00-12.00 US dollars/month by using other price-minimizing strategies. Reducing consumption by 3 cigarettes/day could save a smoker 18.00 US dollars/month. Whereas price-minimizing strategies appeared to save money, cutting consumption could save even more. Thus further substantial tax increases would likely have the desired effect.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Australia
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Abstract
Recent evidence indicates that higher smoking rates among young adults in the United States may be related in part to increased initiation during young adulthood. The tobacco industry, restricted from overtly targeting adolescents, appears to be focusing on young adults. Thus it is important to estimate the percentage and identify the characteristics of the young adult population (aged 18-29 years) at risk for future smoking. This group would include all current established smokers (smoked at least 100 cigarettes in their lifetime), current experimenters, former established smokers, and former experimenters at risk for smoking again, as well as never-smokers who do not rule out future smoking. Using data from the population-based 2002 California Tobacco Survey (N = 9,364 young adults aged 18-29 years), we designated groups of young adults at risk and identified factors associated with risk. Altogether, 86.7+/-1.5% of current and former established smokers were at risk for future smoking, and 59.6+/-4.3% of former established smokers were at risk. Over half (52.2+/-2.0%) of all experimenters but only 9.0+/-1.2% of never-smokers were at risk. Overall, 43.0+/-1.2% of the young adult population was at risk. Although different demographic and other factors were associated with risk among former established smokers, experimenters, and never-smokers, three factors were consistently associated in each group: Younger age, not having a smoke-free home, and going to bars and clubs. We conclude that the group of young adults at risk for future smoking is sizable and presents a fertile target for tobacco industry efforts to promote smoking. Counter-efforts might include promotion of smoke-free environments.
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Affiliation(s)
- Elizabeth A Gilpin
- Cancer Prevention and Control Program, Rebecca and John Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA 92093-0645, USA
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Abstract
OBJECTIVE Recently, the tobacco industry has focused marketing efforts on young adults through bar and club promotions, such as advertising and distribution of free cigarettes in these settings. This study estimates the fraction of the California young adult population that might be exposed and potentially influenced by these efforts. DESIGN AND PARTICIPANTS Data were from 9364 young adult (18-29 years) respondents to the cross sectional population based 2002 California Tobacco Survey. As background, we analysed social smoking (only smoke with other smokers), and enjoyment of smoking while drinking. Our main focus was on bar and club attendance, what was observed in bars and clubs, and how this might differ according to respondents' risk for future smoking. RESULTS Social smokers comprised 30.0 (2.2)% of all current smokers, including experimenters. Nearly three quarters (74.5 (2.3)%) of current smokers/experimenters said they enjoyed smoking while drinking. About one third (33.8 (1.2)%) of all young adults said they attended bars and clubs at least sometimes; attendance was significantly higher among smokers and those at risk for future smoking. Close to 60% (57.9 (2.2)%) of bar and club attenders reported seeing cigarette advertising and promotions in these settings. Again, smokers and those at risk were more likely to report seeing such advertising and promotions in these settings. CONCLUSIONS About 20% of all young adults and about 30% of those at risk for future smoking (including current smokers) were exposed to tobacco advertising and promotions in bars and clubs. These California results may be conservative, but nonetheless indicate that the group potentially influenced is sizable.
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Affiliation(s)
- E A Gilpin
- Cancer Center, University of California, San Diego, La Jolla, California 92093-0645, USA
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Livingston PM, White VM, Roberts SB, Pritchard E, Hayman J, Gibbs A, Hill DJ. Women's satisfaction with their breast prosthesis: what determines a quality prosthesis? Eval Rev 2005; 29:65-83. [PMID: 15604120 DOI: 10.1177/0193841x04269640] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The aim of this study is to determine what factors constitute a quality prosthesis and ascertain which factors affect prosthesis satisfaction. Sixty-four women who received full funding for their prosthesis and 38 women who received their hospital's usual funding were recruited. Women rated the information provided about breast prostheses very highly, with 85% reporting that it was "very good" or "excellent." Satisfaction was significantly associated with how well the prosthesis fit (1 week, p = .001; 3 months, p = .01), level of comfort (3 months, p=.005), and appearance of the prosthesis when worn (6 months, p = .001). Quality was significantly associated with how well it fit (1 week, p = .001; 3 months, p = .001), how natural it felt (1 week, p = .001; 6 months, p = .01), the weight of the prosthesis (3 months, p = .003), and appearance when worn (6 months, p = .03). The results will be used to improve women's access to a quality prosthesis.
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Abstract
This study examines the impact of passive and active parental consent procedures on the type of adolescents participating in a school-based survey examining substance use. Schools recruited from a random sample of metropolitan schools were assigned to passive or active parental consent condition. Results showed that participation rates in active consent schools were lower than in passive consent schools for junior students (60% vs. 80%) but not senior students. Although consent condition had limited impact on prevalence estimates among older students, among younger students estimates of cannabis use and ecstasy use were higher in the passive consent condition than the active consent condition. Active consent procedures introduce some degree of selection bias into studies of adolescents' substance use and may compromise the external validity of prevalence estimates produced, especially among younger students.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer, Anti-Cancer Council of Victoria
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Toumbourou JW, Williams IR, White VM, Snow PC, Munro GD, Schofield PE. Prediction of alcohol-related harm from controlled drinking strategies and alcohol consumption trajectories. Addiction 2004; 99:498-508. [PMID: 15049749 DOI: 10.1111/j.1360-0443.2004.00689.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies. PARTICIPANTS One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993. DESIGN Longitudinal follow-up across five waves of data collection. SETTING Post high school in Victoria, Australia. MEASUREMENTS Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour. FINDINGS Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. FINDINGS revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21. CONCLUSIONS Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.
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Affiliation(s)
- J W Toumbourou
- Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, Australia.
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Abstract
AIMS To incorporate a psychosocial model of tobacco smoking into a behaviour genetic design to examine genetic and environmental influences on variation in smoking involvement. DESIGN Longitudinal twin study. SETTING AND PARTICIPANTS Twins initially aged between 13 and 18 years and registered with the Australian Twin Registry were surveyed three times between 1988 and 1996. A total of 414 pairs of identical and same-sex fraternal twin pairs participated in all three surveys, aged between 20 and 25 at wave 3. Biometric modelling estimated the influence of genetic and environmental factors in determining variation in smoking at each wave, both before and after adjusting for perceived smoking behaviours of peers and parents. MEASUREMENTS Twins answered a questionnaire on their own smoking status and reported on the use of tobacco by parents and friends as they perceived it, at each survey wave. FINDINGS At all three surveys, current smokers were more likely to have parents who smoked and to have smokers among their peers. Genes and environmental factors, both common and unique, contributed to variation in smoking behaviours. However, after controlling for the smoking behaviours of peers and parents, the role of genes in determining variation in smoking involvement was reduced by 100% at wave 1 and by 30% at wave 2. Friends' smoking reduced the magnitude of the common environment variance by 11%, 30% and 40% at waves 1, 2 and 3, respectively. Parents' smoking behaviours explained part of the common environment. Biometric modelling of the covariation between smoking involvement and peer smoking suggested that genes might influence smoking involvement at wave 1 by influencing choice of peers. CONCLUSION Environmental factors play the greatest role in determining variation in tobacco smoking among adolescents and young adults. Among adolescents, genes may influence variation in smoking behaviours indirectly by influencing choice of peers. However, genes seem to have a direct influence on variations in the smoking behaviours of young adults.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Victoria, Australia.
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Abstract
A cohort of 3300 students from high schools across Victoria, Australia, were surveyed regarding their patterns of alcohol consumption from mid-1993 to 1995. The first wave of data was collected halfway through the students' final year of school (year 12). Students were then resurveyed 3 months following school completion and on two subsequent occasions, each separated by 6-month intervals. Analysis of the four waves of data indicated that five longitudinal patterns (trajectories) characterized temporal trends in male and female alcohol use through the transition from high school. Stable non-use trajectories were evident for 17% of males and 16% of females. Trajectories of less than weekly use characterized 45% of females and 46% of males, and showed little tendency to escalate toward harmful use. Among those using alcohol on a weekly or more frequent basis in high school, with few exceptions, use continued with at least the same frequency, but the quantity of alcohol consumed tended to escalate over time toward harmful levels. Overall, findings indicate that patterns of alcohol use tend to be stable over time, and more frequent alcohol use during the final year of high school tends to precede potentially harmful alcohol use following high school. Encouraging those high school students who consume alcohol once per week or more often to use alcohol on a less than weekly basis may be a valuable yet neglected harm minimization strategy.
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White VM, Hill DJ, Effendi Y. Patterns of alcohol use among Australian secondary students: results of a 1999 prevalence study and comparisons with earlier years. J Stud Alcohol 2003; 64:15-22. [PMID: 12608479 DOI: 10.15288/jsa.2003.64.15] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study was initiated to estimate the prevalence of alcohol use among Australian secondary students in 1999 and to examine changes in that prevalence over a 15-year period between 1984 and 1999. METHOD A randomly selected representative sample of approximately 400 secondary schools across Australia participated in the study. At each school, up to 80 randomly selected students completed a pencil-and-paper questionnaire anonymously. RESULTS The use of alcohol by secondary students was widespread in 1999. By the age of 15, 44% of boys and 36% of girls had consumed alcohol in the week before the survey. Among 16 and 17 year olds, about 50% had consumed alcohol in this time period. Of 16 and 17 year olds who had consumed alcohol in the past week, around 35% had drunk at hazardous levels. Long-term trends in alcohol use showed declines during the late 1980s but increases through the 1990s. While the proportion of hazardous drinkers among 12-15 year olds had not changed throughout the 1990s, the proportion among 16 and 17 year olds had increased over the period of the survey. The proportion of current drinkers buying the last alcoholic drink consumed had decreased since 1987, although there was no change between 1996 and 1999 among 16 and 17 year olds. CONCLUSIONS Alcohol is widely used by secondary students in Australia, and significant proportions of the student population drink at hazardous levels.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer, Cancer Control Research Institute, The Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia.
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Abstract
BACKGROUND In the present paper we describe the presentation and management of ductal carcinoma in situ (DCIS) of the breast in women in Australia in 1995. This representative, national data set provides a historical comparator for studies examining DCIS management that follow. METHODS Surgeons identified by population-based cancer registries as having treated a new diagnosis of DCIS between 1 April and 30 September 1995 completed a questionnaire on the presentation and management of each case. RESULTS Two hundred and five surgeons supplied treatment details on 418 DCIS tumours in 415 women. Half of all tumours were detected at Breast Screen clinics and a further 25% were detected at other mammography centres. Twenty-six percent of tumours were palpable at presentation, 33% were multifocal and 55% were high grade (including comedocarcinoma). Breast conserving therapy (BCT) rather than mastectomy was utilized in 260 (62%)of cases. Tumours that were of low grade, small in size and not multifocal were more likely to be treated by BCT. Surgeons seeing six or moreDCIS cases in the 6-month period were more likely to utilize BCT. Of the conservatively treated cases, 22% were referred for a radiation oncology consultation. The most common reasons for treating DCIS with mastectomy were that the tumour was too extensive or multifocal (63%), it extended to margins of the specimen (42%), or patient concerns about recurrence (34%). CONCLUSIONS In 1995 the majority of DCIS was treated with breast conserving surgery alone. Surgeons treating more DCIS cases were more likely to perform conservative surgery than surgeons treating only one DCIS case in the study period.
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Affiliation(s)
- Dace Shugg
- Menzies Centre for Population Health Research, University of Tasmania, Hobart, Tasmania, Australia
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