In 2008, the International Agency for Research on Cancer (IARC) released its World Cancer Report, which indicated that cancer accounts for approximately 12% of all-cause mortality worldwide. IARC ...estimated that globally 7.6 million people died from cancer and that 12.4 million new cases were diagnosed in 2008. The report went on to project that, due to increases in life expectancy, improvements in clinical diagnostics, and shifting trends in health behaviors (e.g. increases in smoking and sedentary lifestyles), in the absence of significant efforts to improve global cancer control, cancer mortality could increase to 12.9 million and cancer incidence to 20 million by the year 2030. Looking deeper into the data, it becomes clear that cancer-related stigma and myths about cancer are important problems that must be addressed, although different from a country to another. Stigmas about cancer present significant challenges to cancer control: stigma can have a silencing effect, whereby efforts to increase cancer awareness are negatively affected. The social, emotional, and financial devastation that all too often accompanies a diagnosis of cancer is, in large part, due to the cultural myths and taboos surrounding the disease. Combating stigma, myths, taboos, and overcoming silence will play important roles in changing this provisional trajectory. There are several reasons that cancer is stigmatized. Many people in our area perceived cancer to be a fatal disease. Cancer symptoms or body parts affected by the disease can cultivate stigma. Fears about treatment can also fuel stigma. There was evidence of myths associated with cancer, such as the belief that cancer is contagious, or cancer may be seen as a punishment. After reviewing these different examples of cultural myths and taboos met in cancer care, we can report these lessons learned: 1. Around the world, cancer continues to carry a significant amount of stigma, myths, and taboos; however, there are opportunities to capitalize upon shifting perceptions and positive change. 2. Awareness of cancer prevention, early detection, treatment, and survival are on the rise; however, too many people still report that they feel uninformed when it comes to cancer. 3. Communication is critical to decreasing cancer-related stigma, raising cancer awareness, and disseminating cancer education. People with a personal history of cancer-especially well-known or celebrity survivors-and multiple mass media channels are key resources for dissemination. 4. The school system represents a potential venue for cancer education, and increasing cancer awareness among children may be an investment with high returns. 5. When facing cancer, people around the world want information and emotional support for themselves and their families. 6. Tobacco use and poor nutrition are widely acknowledged as cancer risks. Programs and policies that help people translate this awareness into action are needed. The global cancer community should capitalize upon positive shifts in attitudes about awareness of cancer and leverage these shifts to develop, and disseminate effective media campaigns and behavioral interventions to decrease the incidence of and morbidity and mortality associated with cancer.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
L’incidence du cancer et la mortalité par cette maladie sont en nette progression dans le monde, et plus particulièrement dans les pays en voie de développement, incluant les pays du Moyen-Orient et ...de l’Afrique du Nord. Les barrières au contrôle du cancer dans ces régions sont d’ordre économique et organisationnel mais aussi dues aux causes culturelles associées à l’ignorance, aux mythes et aux tabous liés au cancer. Il existe plusieurs raisons qui ont stigmatisé le cancer ; la plupart des personnes dans ces régions continuent à considérer que le cancer est une maladie fatale à tous les coups, qu’il peut être contagieux. Il est même parfois considéré comme une punition. Les paroles de patients qui évoquent ces stigmates et ces perceptions sont rapportées. Le rôle de la famille et de la spiritualité est évoqué. Ces mythes et tabous sont un continuel défi pour le contrôle du cancer : ils entraînent un effet contraire aux efforts de sensibilisation et de prévention du cancer. D’où l’objectif n° 5 de la Déclaration universelle de l’UICC de faire disparaître les effets néfastes des mythes et des stigmates. Après avoir passé en revue plusieurs exemples de mythes et de tabous rencontrés dans la pratique, nous rapportons quelques leçons apprises et utiles dans la lutte contre le cancer dans les pays du Moyen- Orient et du nord de l’Afrique.
The incidence of cancer and mortality from this disease are significantly increasing worldwide, especially in developing countries, including countries in the Middle East and North Africa. The obstacles to cancer control in these regions are of an economic and organisational nature, but also have cultural causes associated with ignorance, myths and taboos linked to cancer. There are several reasons for which cancer has been stigmatised; most people in these areas continue to believe that cancer is a fatal disease in all cases, and that it can be contagious. It is even sometimes considered a punishment. The words of patients who describe these stigmas and perceptions are reported in the paper. The role of family and spirituality is also discussed. These myths and taboos are a continual challenge for the control of cancer: they counteract the effect of cancer awareness and prevention efforts. This is the reason for target number 5 of the Universal Declaration of the UICC, which is to eliminate the harmful effects of myths and stigmas. After examining several examples of myths and taboos encountered in practice, we report some useful lessons learned in the fight against cancer in Middle Eastern and North African countries.
Cancer incidence will increase as the population ages; there will be a 50% increase in new cancer cases over the next 20 years, and the biggest rates of increase will occur in the developing world. ...Owing to technical advances in the care of critical illness, as it is the case in elderly people with advanced cancer, physicians, patients and families are often confronted with ambiguous circumstances in which medical advances may inadvertently prolong suffering and the dying process rather than bring healing and recovery. In this review of the ethical issues confronting physicians who care for patients with advanced life-limiting illnesses like cancer, a philosophical debate continues in the medical community regarding the rightness or wrongness of certain actions (e.g. physician-assisted death, euthanasia), while at the same time there is a strong desire to find a common ground for moral discourse that could guide medical decision-making in this difficult period in the lives of our patients. We will discuss how a good palliative care can be an alternative to these ethical dilemmas. Although some issues (e.g. the role of physician-assisted death in addressing suffering) remain very controversial, there is much common ground based on the application of the four major principles of medical ethics, no malfeasance, beneficence, autonomy and justice. Thus, the physician's primary commitment must always be the patient's welfare and best interests, whether the physician is treating illness or helping patients to cope with illness, disability and death. A key skill here is the communication of bad news and to negotiate a treatment plan that is acceptable to the patient, the family and the healthcare team. Attention to psychosocial issues demands involvement of the patients and their families as partners. Physicians should be sensitive to the range of psychosocial distress and social disruption common to dying patients and their families. Spiritual issues often come to the fore. An interdisciplinary healthcare team can help in these areas. The goals of this review are to raise the awareness of doctors, nurses and other members of the healthcare team to the important ethical issues that must be addressed in providing medical care to elderly patients with advanced cancer; and also to encourage members of the healthcare team to take the ethical issues seriously so that we can improve the circumstances of a vulnerable group of patients-the elderly patients with cancer.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
In the study, we investigate the numerical investigation of variable viscous dissipation and source of heat or sink in mixed convective stagnation point flow the unsteady non-homogeneous nanofluid ...under the induced magnetic parameter. Considering similarity conversions, the governing of fundamental boundary of layer non-linear PDEs are transformed to equations of the non-linear differential type that, under appropriate boundary conditions, are numerically solved, and the MATLAB function bvp4c is considered to solve the resulting system. The obtained results are calculated numerically for non-dimensional velocity, temperature, and volume fraction and displayed graphically. Further, numbers of Nusselt and Sherwood and local Skin of friction have been produced and displayed by graphs. A comparison with previous results obtained neglecting the new parameters has been made to show the impact of new external parametes on the phenomneon. The obtained findings agree with those introduced by others if the magnetic field and viscous dissipation are neglected. The results obtained have an important applications in diverse field as chemical engineering, agriculture, medical science, and industries.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
In this paper, the newly developed Fractal-Fractional derivative with power law kernel is used to analyse the dynamics of chaotic system based on a circuit design. The problem is modelled in terms of ...classical order nonlinear, coupled ordinary differential equations which is then generalized through Fractal-Fractional derivative with power law kernel. Furthermore, several theoretical analyses such as model equilibria, existence, uniqueness, and Ulam stability of the system have been calculated. The highly non-linear fractal-fractional order system is then analyzed through a numerical technique using the MATLAB software. The graphical solutions are portrayed in two dimensional graphs and three dimensional phase portraits and explained in detail in the discussion section while some concluding remarks have been drawn from the current study. It is worth noting that fractal-fractional differential operators can fastly converge the dynamics of chaotic system to its static equilibrium by adjusting the fractal and fractional parameters.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Abstract
This study aimed to assess the health literacy (HL) related knowledge, attitude, perceived barriers, and practice among primary care doctors (PCDs) in Malaysia, and to determine the factors ...associated with HL-related practice. A cross-sectional study was conducted using an online questionnaire. Sociodemographic and work-related details were collected. HL-related knowledge, attitude, perceived barriers, and practice were assessed. Descriptive and inferential analyses using linear regression were performed. 373 PCDs were included in the study with a mean (SD) age of 37.9 (8.1) years old. The mean (SD) HL-related knowledge, attitude, and practice scores were 6.89 (1.27), 36.33 (7.04), and 30.14 (4.7), respectively. 90.9% of the participants had good HL-related knowledge scores, and 89.5% had positive HL-related attitude. More than 80% of participants found that “time constraint to implement health literacy screening” and “lack of human resources to administer HL screening tools in their settings” were among the barriers for them to implement HL practices. PCDs of Chinese and other ethnicities had lower HL-related practice scores compared to those of Malay ethnicity (adjusted b = − 1.74; 95% CI − 2.93, − 0.54, and − 2.94; 95% CI − 5.27, − 0.60, respectively). PCDs who had heard of the term “health literacy” were associated with higher HL-related practice scores (adjusted b = 2.32; 95% CI 1.17, 3.47). Age (adjusted b = 0.10; 95% CI 0.04, 0.16) had significant linear positive relationship with HL-related practice. In conclusion, the HL-related knowledge, attitude, and practice among PCDs in Malaysia were at an acceptable level. Along with educating PCDs on HL, the perceived barriers identified need to be addressed to improve the HL-related practice and ultimately patient care.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Ibrutinib, a covalent inhibitor of Bruton Tyrosine Kinase (BTK), is approved for treatment of patients with relapsed/refractory or treatment-naïve chronic lymphocytic leukemia (CLL). Besides directly ...inhibiting BTK, ibrutinib possesses immunomodulatory properties through targeting multiple signaling pathways. Understanding how this ancillary property of ibrutinib modifies the CLL microenvironment is crucial for further exploration of immune responses in this disease and devising future combination therapies. Here, we investigated the mechanisms underlying the immunomodulatory properties of ibrutinib. In peripheral blood samples collected prospectively from CLL patients treated with ibrutinib monotherapy, we observed selective and durable downregulation of PD-L1 on CLL cells by 3 months post-treatment. Further analysis showed that this effect was mediated through inhibition of the constitutively active signal transducer and activator of transcription 3 (STAT3) in CLL cells. Similar downregulation of PD-1 was observed in CD4+ and CD8+ T cells. We also demonstrated reduced interleukin (IL)-10 production by CLL cells in patients receiving ibrutinib, which was also linked to suppression of STAT3 phosphorylation. Taken together, these findings provide a mechanistic basis for immunomodulation by ibrutinib through inhibition of the STAT3 pathway, critical in inducing and sustaining tumor immune tolerance. The data also merit testing of combination treatments combining ibrutinib with agents capable of augmenting its immunomodulatory effects.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Migrants everywhere face several demands for health and maintaining good health and quality of life could be challenging. Iraqis are the second largest refugee group that has sought refuge in the ...recent years, yet little is known about their health related quality of life (HRQOL). The study aims at assessing the HRQOL among Iraqis living in Malaysia.
A self-administered Arabic version of Sf-36 questionnaire was distributed among 300 Iraqi migrants in Malaysia. The questionnaire taps eight concepts of physical and mental health to assess the HRQOL. Univariate analysis was performed for group analysis (t test, ANOVA) and Multiple Linear Regression was used to control for confounding effects.
Two hundred and fifty three participants ranging in age from 18 to 67 years (Mean = 33.6) returned the completed questionnaire. The majority was males (60.1%) and more than half of the respondents (59.5%) were married. Less than half (45.4%) and about a quarter (25.9%) reported bachelor degree and secondary school education respectively and the remaining 28.7% had either a master or a PhD degree.Univariate analysis showed that the HRQOL scores among male immigrants were found to be higher than those of females in physical function (80.0 vs. 73.5), general health (72.5 vs. 60.7) and bodily pain (87.9 vs. 72.5) subscales. The youngest age group had significantly higher physical function (79.32) and lower mental health scores (57.62).The mean score of physical component summary was higher than the mental component summary mean score (70.22 vs. 63.34).Stepwise multiple linear regression, revealed that gender was significantly associated with physical component summary (β = - 6.06, p = 0.007) and marital status was associated with mental component summary (β = 7.08, p = 0.003).
From the data it appears that Iraqi immigrants living in Malaysia have HRQOL scores that might be considered to indicate a relatively moderate HRQOL. The HRQOL is significantly affected by gender and marital status. Further studies are needed to explore determinants of HRQOL consequent to immigration. The findings could be worthy of further exploration.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
PDF
