An examination of cancer risk beliefs among adults from Toronto's Somali, Chinese, Russian and Spanish-speaking communities.

Canada's growing ethnocultural diversity challenges health professionals to develop culturally sensitive cancer prevention strategies. Little is known about the ethnocultural specificity of cancer risk beliefs. This qualitative pilot study examined cancer risk beliefs, focusing on diet, among adults from Toronto's Somali, Chinese, Russian, and Spanish-speaking communities.Group interviews (n = 4) were conducted with convenience samples of adults (total n = 45) from four ethnocultural communities (total 45 participants).The constant comparison method of data analysis identified three common themes: knowledge of cancer risk factors, concern about the food supply, and the roles of spiritual and emotional well-being. Two areas of contrasting belief concerning specific mediators of cancer risk were identified.Findings support the investigation of cultural-specific health promotion strategies emphasizing both the maintenance of traditional cancer protective eating practices and the adoption of additional healthy eating practices among new Canadians. More research is needed to enhance our understanding of ethnoculturally specific cancer risk beliefs and practices to ensure the cultural relevance of programming.

Greater patient activation, defined as having the knowledge, skills, and confidence to manage one's health, is associated with cancer control behaviors. Cancer risk beliefs may be associated with patient activation, and delineating this relationship could inform cancer control interventions across diverse patient subgroups. This study examines associations between cancer risk beliefs, language preference, and patient activation within a multilingual urban primary care setting. Patients 18years and older within a New York City public hospital serving a large proportion of non-native-born Americans were surveyed regarding their cancer risk beliefs and patient activation in Haitian Creole, Spanish, or English based on language preference during a health care visit. The sample (N=460) included 150 Haitian Creole speakers, 159 Spanish speakers, and 151 English speakers and was primarily non-White (92%). Most participants (84%) had not been born in the United States. Cancer risk beliefs differed across language preference. Beliefs that cancer could be avoided by minimizing thoughts about cancer risk were significantly higher in Haitian Creole speakers than in others; reported negative emotion when thinking about cancer risk was higher in Spanish and English than in Haitian Creole speakers. These cancer risk beliefs were positively related to patient activation, even when controlling for language preference. Cancer risk beliefs differ across language preference and are related to patient activation, making them potentially important in cancer control. Consideration of language represents important demographic stratification for understanding the frequency and relevance of different beliefs about cancer and patient activation.

Objective To explore the effects of health belief model system nursing education on lymphedema risk-reduction behavior, incidence and quality of life in post-operation breast cancer patients. Methods A total of 225 patients who were underwent surgery by inclusion criteria and then were randomly divided into the intervention group (n=109) and the control group(n=106). The control group was given routine education, while the intervention group was given health belief model system education in addition routine education.Patients were followed up for at least 12 months, and the implementation of lymphedema risk-reduction behavior, quality of life, and the incidence of lymphedema of two groups were compared. Results The implementation of lymphedema risk-reduction behavior were higher in intervention group than that in control group with statistically significantly difference(P<0.05). The incidence of lymphedema was 16.5% in intervention group, 37.7% in control group, the difference was significantly in two groups.Scores for general quality of life(107.81±10.10), emotional well-being(19.72±3.74), functional well-being(18.58±3.34), social/family well-being(21.85±3.69), concerns specific to breast cancer patients(24.47±3.59) were higher in intervention group than those in control group((101.07±10.54), (18.48±3.63), (14.79±3.22), (20.39±4.82), (23.10±4.78))(P<0.05). Conclusion Health belief model system nursing intervention can improve the implementation of lymphedema risk-reduction behavior, decrease the incidence of lymphedema and increase long-term quality of life of the breast cancer patients. Key words: Breast cancer; Lymphedema; Health belief model

This thesis is interested in understanding the new migration patterns and changing geographies of multiculture taking place in the UK outside of the larger established cities and towns by investigating Milton Keynes (MK) as a new multicultural city space. Using a case study of MK's Ghanaian and Somali communities it explores how BME communities establish themselves as part of the wider local community and examines the ways in which local policy-makers and practitioners have responded to an increasingly multicultural and ethnically diverse population. The research focuses upon local sites of community construction such as schools, provision for young people and religious centres, reflecting, among other things, the particular formal and informal roles played by these sites. The thesis finds that people within MK are not living the 'parallel lives' crisis of the community cohesion discourse, but rather 'living apart' at times and also 'living together' at others, reinforcing the significance of place-based understandings in the context of new multicultural geographies. The research found that young people of Ghanaian and Somali origin often reflected positively on the sense of community present within MK's residential areas and demonstrated processes of negotiation and of both 'mixing' and 'non-mixing' within certain distinct social and geographic contexts. It also found that, in seeking to manage the emergent multicultural population, policy-makers and practitioners generally rely on identifying community organisations (and their leaders) with whom they can liaise. In doing so they may overlook the significant diversity of experiences which exist within the Ghanaian and Somali communities (and the extent to which these are subject to change) and are therefore less likely to deliver appropriate resources and interventions. The research findings indicated that how people themselves manage multiculture is much more fluid and able to be negotiated than cohesion discourses and formal policy makers imagine and assume.

Background: Globally, cervical cancer is one of the most common cancers among women. The risk of invasive cervical cancer remains high among sub-Saharan African immigrant (SSAI) women in the US despite being a preventable cancer. Women's knowledge about cervical cancer risk factors and preventive behaviors has been found to be related to the uptake of Pap screening and engagement in other healthy behaviors. Given the high prevalence of human papillomavirus (HPV) infection and other cervical cancer risks among SSAI women, it is critical that SSAI women be well informed and knowledgeable regarding their cervical cancer risk and prevention. The purpose of this study is to assess SSAI women's knowledge of cervical cancer risk factors, HPV, and cervical cancer screening. Methods: This study was a quantitative analysis of cross-sectional survey of 108 English-speaking SSAI women aged 21 and above recruited from Lexington and Frankfort, Kentucky, between October and December 2016. Information on demographics, screening behavior, and cervical cancer knowledge was collected. A knowledge scale including 14 questions about facts and common myths related to cervical cancer and HPV was used. Total knowledge scores were calculated for participants. Analysis was conducted to identify factors associated with knowledge scores. Results: Participants' mean age was 34 ± 9 years, 56% had a college degree, 65% reported that their income was adequate, and 54% had lived in the U.S for more than 5 years. The composite knowledge score was 7.8 ±3.6 with a maximum score of 14. In bivariate analysis, length of residence in the U.S (P= 0 .001), ever had Pap screening (P &amp;lt; 0.001), health insurance (P &amp;lt; 0.001), having primary provider (P = 0.020), and health provider recommendation for cervical cancer screening (P = 0.006) were associated with knowledge. In multiple regression analysis, longer length of residence in the U.S (P = 0.044) and ever having a Pap screening (P = 0.007) remained significantly associated with cervical cancer knowledge. Conclusions: Findings show a limited knowledge of cervical cancer risk factors and the role of HPV in cervical cancer. Future research should further explore and understand how length of residence in the US and having had a Pap screening are related to cervical cancer risks knowledge. The gaps in women's knowledge points to the need for targeted educational interventions to address knowledge needs of SSAI women to encourage cervical cancer screening prevention and timely detection. Citation Format: Adebola Adegboyega, Adaeze Aroh, Jennifer Hatcher. Knowledge of cervical cancer risk factors and screening among sub-Saharan African immigrant women [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B097.

&lt;p&gt;Background: The relationship between cancer-related fatigue (CRF), anxiety, and health-related quality of life (HRQOL) over time is poorly understood in cancer patients due to a dearth of longitudinal studies. While the presence of CRF and anxiety are known to negatively impact HRQOL over time, the relationship between CRF and anxiety is equivocal, with some studies providing evidence for the impact of anxiety on CRF over time, and others noting the opposite relationship. In addition, while CRF and HRQOL are known to be correlated, the role of anxiety as a mediator or moderator in this relationship has yet to be explored. Methods: Participants (N = 202) recruited from Princess Margaret Cancer Centre completed a package of self-report questionnaires at baseline and three months post-baseline (follow-up). The four aims of this study were to (1) describe the different trajectories of CRF that develop between these two time points; (2) examine the direction of the relationship between CRF and anxiety over time; (3) examine how each CRF trajectory differentially predicts change in each of the following four domains of HRQOL over time: Physical, functional, social, and emotional wellbeing; and (4) examine the extent to which anxiety mediates and/or moderates the relationship between CRF trajectory and change in HRQOL over time. Results: For the first aim, four groups of CRF trajectories emerged: 54% of participants endorsed belonging to the CRF always present group, 16% to the CRF subsided group, 21% to the CRF developed group, and 9% to the CRF never present group. For the second aim, CRF trajectory was found to predict anxiety change over time, and not the other way around. For the third aim, results showed that as CRF developed, functional and physical wellbeing decreased; in contrast, as CRF subsided, functional, physical, and emotional wellbeing improved. However, CRF trajectory was not associated with change in social wellbeing over time. For the fourth aim, change in anxiety did not moderate the relationship between CRF trajectory and change in any of the four HRQOL domains. However, increased anxiety over time indirectly accounted for reduced functional, emotional, and physical wellbeing in individuals who developed CRF. In addition, increased anxiety indirectly accounted for reduced functional and emotional wellbeing in individuals whose CRF was always present. However, anxiety did not mediate the relationship between CRF trajectory and change in social wellbeing over time. Discussion: Divergent trajectories of CRF appear to differentially impact both anxiety and HRQOL over time, and changes in anxiety may mediate the detrimental effect of CRF development and maintenance on changes in the following HRQOL domains over time—functional, physical, and emotional wellbeing. However, a single domain of HRQOL—social wellbeing—appears to be unrelated to changes in CRF over time. Strategies targeting cognitions and behavioural strategies related to managing anxiety (e.g., psychoeducation, psychotherapy) may be useful in addressing worsening HRQOL commonly reported in cancer patients who endorse CRF.&lt;/p&gt;

&lt;p&gt;Background: The relationship between cancer-related fatigue (CRF), anxiety, and health-related quality of life (HRQOL) over time is poorly understood in cancer patients due to a dearth of longitudinal studies. While the presence of CRF and anxiety are known to negatively impact HRQOL over time, the relationship between CRF and anxiety is equivocal, with some studies providing evidence for the impact of anxiety on CRF over time, and others noting the opposite relationship. In addition, while CRF and HRQOL are known to be correlated, the role of anxiety as a mediator or moderator in this relationship has yet to be explored. Methods: Participants (N = 202) recruited from Princess Margaret Cancer Centre completed a package of self-report questionnaires at baseline and three months post-baseline (follow-up). The four aims of this study were to (1) describe the different trajectories of CRF that develop between these two time points; (2) examine the direction of the relationship between CRF and anxiety over time; (3) examine how each CRF trajectory differentially predicts change in each of the following four domains of HRQOL over time: Physical, functional, social, and emotional wellbeing; and (4) examine the extent to which anxiety mediates and/or moderates the relationship between CRF trajectory and change in HRQOL over time. Results: For the first aim, four groups of CRF trajectories emerged: 54% of participants endorsed belonging to the CRF always present group, 16% to the CRF subsided group, 21% to the CRF developed group, and 9% to the CRF never present group. For the second aim, CRF trajectory was found to predict anxiety change over time, and not the other way around. For the third aim, results showed that as CRF developed, functional and physical wellbeing decreased; in contrast, as CRF subsided, functional, physical, and emotional wellbeing improved. However, CRF trajectory was not associated with change in social wellbeing over time. For the fourth aim, change in anxiety did not moderate the relationship between CRF trajectory and change in any of the four HRQOL domains. However, increased anxiety over time indirectly accounted for reduced functional, emotional, and physical wellbeing in individuals who developed CRF. In addition, increased anxiety indirectly accounted for reduced functional and emotional wellbeing in individuals whose CRF was always present. However, anxiety did not mediate the relationship between CRF trajectory and change in social wellbeing over time. Discussion: Divergent trajectories of CRF appear to differentially impact both anxiety and HRQOL over time, and changes in anxiety may mediate the detrimental effect of CRF development and maintenance on changes in the following HRQOL domains over time—functional, physical, and emotional wellbeing. However, a single domain of HRQOL—social wellbeing—appears to be unrelated to changes in CRF over time. Strategies targeting cognitions and behavioural strategies related to managing anxiety (e.g., psychoeducation, psychotherapy) may be useful in addressing worsening HRQOL commonly reported in cancer patients who endorse CRF.&lt;/p&gt;

This research project is about social change, and major hindrances to it, in Somalia. Drawing from Somali studies, migration/diaspora studies, and development communication, Somali diaspora members are proposed here as new (old) social change agents. The underpinning question is how they frame, promote, and communicate social change in their home country. Within this (ex) diaspora, those with an Italophone background could make up, I argue, a distinguished sub-group: the Italophone Somali diaspora, which is a major finding in itself. They are educated, at least in relative terms compared to the majority of their contemporaries, they are Italophone (among others), and they have been inspired by a modernization ideal. After addressing characteristics and background of this particular group of people, I explore their voices about social change and the main challenges they are confronted with. I first define, as rooted in the accounts of my interviewees (permanent and transitory diaspora members, returnees), the current main actors in the Somali social arena. These pertain to the so-called outer world, a notion that I put forward for the purpose of this research. Yet, the real battle for social change, I posit, is fought at the level of the inner world: the world of thoughts, beliefs, hopes, and fears. At this level, three main social institutions regulate Somali society: clan, tradition, and Islam. (Overlapping) rules and normative codes derive from these institutions, which embody forms of social or mass control. Within this understanding, and from an Italophone Somali diaspora perspective, social change is conceived as the lessening of the pervasive social control associated with these institutions. The impact of these forces, and especially of the new religious code in force, is far-reaching, resulting in a pervasive state of fear and widespread self-censorship that are full of implications for communication for social change. Within this framework, I then discuss the role that the Italophone Somali diaspora sub-group assigns to three (potential) vectors of social change. First, the Somali Diaspora as a whole, with its distinctive social change capital, as I call it. This is a form of socio-cultural capital, with a pro-active potential, that works as a source of inspiration for promoting social change. Second, development communication as a vector of social change in itself, and as pursued in practice by the members of the Italophone Somali diaspora. Messages and strategies of their “civic engagement” in Somalia are analysed with respect to the constraints deriving from the main social institutions. Third, education in its broad sense, which plays a paramount role in shaping the mindset and the socio-cultural capital of the Italophone Somali diaspora, in explaining current forms of communication for social change, and in constituting, in their eyes, the ultimate source of any possible social change in Somalia today.

Can cancer risk information raise awareness without increasing anxiety? A randomized trial

BackgroundBreast cancer is the most common cancer among women in both the developed and the developing world. The incidence of breast cancer in Karachi, Pakistan is 69.1 per 100,000 with breast cancer presentation in stages III and IV being common (≥ 50%). The most pragmatic solution to early detection lies in breast cancer education of women. Nurses constitute a special group having characteristics most suited for disseminating breast cancer information to the women. We assessed the level of knowledge of breast cancer risk factors among registered female nurses in teaching hospitals of Karachi. We also identified whether selected factors among nurses were associated with their knowledge of breast cancer risk factors, so that relevant measures to improve knowledge of nurses could be implemented.MethodsA cross-sectional survey was conducted in seven teaching hospitals of Karachi using stratified random sampling with proportional allocation. A total of 609 registered female nurses were interviewed using a structured questionnaire adapted from the Stager's Comprehensive Breast Cancer Knowledge Test. Knowledge of breast cancer risk factors was categorized into good, fair and poor categories. Ordinal regression was used to identify factors associated with risk knowledge among nurses.ResultsThirty five percent of nurses had good knowledge of risk factors. Graduates from private nursing schools (aOR = 4.23, 95% CI: 2.93, 6.10), nurses who had cared for breast cancer patients (aOR = 1.41, 95% CI: 1.00, 1.99), those having received a breast examination themselves (aOR = 1.56, 95% CI: 1.08, 2.26) or those who ever examined a patient's breast (aOR = 1.87, 95% CI: 1.34, 2.61) were more likely to have good knowledge.ConclusionA relatively small proportion of the nursing population had good level of knowledge of the breast cancer risk factors. This knowledge is associated with nursing school status, professional breast cancer exposure and self history of clinical breast examination. Since only about one-third of the nurses had good knowledge about risk factors, there is a need to introduce breast cancer education in nursing schools particularly in the public sector. Continuing nursing education at the workplace can be of additional benefit.

Light therapy and mood in breast cancer.

Doctors in different countries have various approaches to bioethical problems. Oncologists face ethical dilemmas during their daily practice with newly diagnosed cancer patients, particularly with regards to the disclosure of information about their diagnosis and prognosis. Medical literature suggests that most patients want to be told the truth about a diagnosis of cancer. 1,2 In Saudi Arabia this issue is still not clear among physicians, patients and their families. Full disclosure of the presence of cancer to newly diagnosed patients is not well accepted by the majority of families. Most family members of cancer patients request that their patient should not be informed about the diagnosis of cancer and its prognosis. This attitude will, inevitably, influence the decision of a majority of doctors in giving cancer patients information about diagnosis, prognosis, treatment options and the side effects of treatment. This study has been conducted to provide some guidelines and draw some conclusions with regards to the issue of disclosure of information to patients diagnosed with cancer in our community.

Objective To investigate the health belief of colorectal cancer and its screening in relatives of patients with hereditary colorectal cancer, and to analyze its influencing factors. Methods Totally 148 blood relatives of patients with hereditary colorectal cancer hospitalized in the Department of Colorectum of a Class Ⅲ Grade A hospital in Guangzhou from December 2016 to May 2018 were selected using convenient sampling, and investigated with the self-made general information questionnaire and Chinese Colorectal Cancer Health Belief Scale (CCCHBS) . SPSS 20.0 was used for statistical analysis. Results The colorectal cancer health belief of blood relatives of patients with hereditary colorectal cancer totaled (3.37±0.35) in which the perception and acceptance levels of screening benefits, health motives and self-efficacy of colorectal cancer were higher, while the perception levels of severity of colorectal cancer, barriers against colorectal screening and susceptibility were lower. Multivariate linear regression analysis revealed that household income per capita, educational background, with commercial medical insurance or not and the number of blood relatives with cancer were the influencing factors for health belief levels, which accounted for 41.9% of the total variance. Conclusions The health belief in blood relatives of patients with hereditary colorectal cancer remain at a medium level. Medical and nursing workers should pay attention to the blood relatives of patients with hereditary colorectal cancer with lower educational background, lower household income and less blood relatives with cancer, take measures to improve their health belief levels, and facilitate colorectal cancer screening behaviors so as to prevent and control colorectal cancer in a better manner. Key words: Colorectal neoplasms; Health attitude; Hereditary; Blood relatives; Health belief

Physical and Psychological Factors Influencing Fatigue and Quality of Life in Multiple Myeloma Survivors: Preliminary Results from the Mascot Lifestyle Study

Objective: The general public’s knowledge of the risk factors for head and neck cancer is insufficient. The level of awareness of such risk factors amongst the otolaryngology clinic patient population has not yet been elucidated in the literature. Method: This individual cohort study took place at a tertiary academic center. A survey was designed and administered to all patients who presented to otolaryngology clinic from 2017 to 2018 to assess knowledge of head and neck cancer risk factors. The main outcome measures were percentage of correct responses for each cancer risk factor and comparison of percent correct between cancer and non-cancer patients. Results: A total of 510 patients were enrolled in the study including 69 patients (13.5%) with a history of head and neck cancer. The most well recognized risk factors by all patients were cigarettes (83.7%) and chewing tobacco (77.5%). Twenty-nine percent of patients correctly identified alcohol as a risk factor. Additional risk factors were poorly recognized. Cancer patients had a similar or better correct response rate than non-cancer patients except for chewing tobacco (68.1% vs 78.9% respectively). Conclusion: The general otolaryngology clinic population, especially patients with a history of head and neck cancer, demonstrated improved knowledge of some risk factors for head and neck cancer, but insufficient awareness of alcohol and HPV transmissible behaviors.