Live broadcast of Global Cancer Care symposium, 8 February 2014

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The Global Oncology Initiative is hosting a symposium, Global Cancer Care: Challenges and Opportunities, on Saturday, 8 February, from 8:00 a.m – 6:00 p.m EST.

A live broadcast will be available on the symposium page.

Symposium topics include:

  • Burden of cancer in low- and middle-income countries
  • Barriers to cancer therapies in low-resource settings
  • Innovative solutions to improve access to cancer care

Keynote presenters include:

  • Thomas Gross, MD, PhD, deputy director of science, NCI Center for Global Health
  • Rifat Atun, MBBS, MBA, professor of international health management, Imperial College London
  • Paul Farmer, MD, PhD, professor of global health and social medicine, Harvard Medical School and co-founder, Partners in Health

Online participation is encouraged. Presenters will answer questions submitted electronically or via social media. Questions may be submitted by using Twitter hashtag #askGlobalOnc, or sending email to studentsforgo@gmail.com.

Follow Global Oncology on Twitter (@GlobalOnc) and Facebook.

The Global Oncology Initiative is an academic and community-­based organization based in Boston, Massachusetts, USA, leading efforts in global oncology and working to improve cancer care and research in resource-sensitive settings.

Smoking down in the U.S.

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The proportion of adults in the United States who smoke declined from 20.9 percent in 2005 to 18.1 percent in 2012, according to data from the 2012 National Health Interview Survey.

Creative Commons license, photo by smorchon on FlickrThe smoking rate in 2012 was significantly higher among males (20.5 percent) than females (15.8 percent) and among persons aged 18–24 years (17.3 percent), 25–44 years (21.6 percent), and 45–64 years (19.5 percent) than among those aged 65 years or older (8.9 percent).

The decline in smoking is encouraging and likely reflects the success of tobacco control efforts across the country, according to researchers. For example: the 2009 Family Smoking Prevention and Tobacco Control Act granted the Food and Drug Administration the authority to regulate the manufacture, distribution, and marketing of tobacco products; the 2009 Children’s Health Insurance Program Reauthorization Act raised the federal tax rate for cigarettes from $0.39 to $1.01 per pack; and the 2010 Patient Protection and Affordable Care Act provided expanded coverage for evidence-based smoking-cessation treatments. Also, in 2012 the Center for Disease Control and Prevention (CDC) debuted Tips from Former Smokers (TIPS), the first federally funded, nationwide, paid-media tobacco education campaign in the United States. During the campaign, calls to the quitline portal 1-800-QUIT-NOW increased 132 percent, and the number of unique visitors to a smoking cessation website (www.smokefree.gov) increased 428 percent. An estimated 1.6 million quit attempts were attributable to the campaign.

Additionally, smoking prevalence was:

  • highest among adults of multiple races (26.1 percent) and lowest among Asians (10.7 percent);
  • highest among persons with a graduate education development certificate (41.9 percent) and lowest among those with a graduate (5.9 percent) or undergraduate (9.1 percent) degree;
  • higher among persons living below the poverty level (27.9 percent) than those living at or above this level (17 percent); and
  • higher among people living in the South (19.7 percent) and Midwest (20.6 percent) than those in the West (14.2 percent) and Northeast (16.5 percent).

Citation:
1. Agaku IT, King BA, Dube SR. Current Cigarette Smoking Among Adults—United States, 2005–2012. Morbidity and Mortality Weekly Report 2014; 63(02): 29-34. (open access)

Investing in fruits, vegetables can save lives, reduce health care costs

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Increasing the consumption of fruits and vegetables could save more than 100,000 lives and $17 billion in health care costs from heart disease each year in the United States, according to a new report by the Union of Concerned Scientists.

11 trillion reward - UCS reportThe report, The $11 Trillion Dollar Reward, explains that better federal agricultural policies, designed to encourage production of healthy food instead of processed junk foods, will help reap those benefits.

If Americans consumed just one additional serving of fruits or vegetables a day, the nation would save $5 billion in health care expenditures and prevent 30,301 heart disease and stroke deaths annually. And if Americans were to go a step further and eat a full 2.5 cups of vegetables and two cups of fruit daily, as recommended by federal dietary guidelines, it could prevent 127,261 deaths each year and save $17 billion in medical costs. The economic value of the lives saved from cardiovascular diseases is an astounding $11 trillion, according to the report.

The report researchers advocate for cost-effective policies that increase access to and reduce the cost of domestically grown fruits and vegetables for consumers, especially for low-income consumers who are hardest hit by cardiovascular disease and other diet-related illnesses. Low-income neighborhoods–where some 30 million Americans reside–are often far from grocery stores and other sources of fresh produce, hindering access.

Current federal agricultural policies channel taxpayer dollars into subsidies for commodity crops, such as corn and soybeans, which are used as feed for livestock, biofuels and as processed food ingredients. These policies offer few incentives for farmers to grow fruits and vegetables–effectively discouraging production of the very foods federal dietary guidelines recommend.

A three-minute video produced by UCS summarizes how we can achieve an $11 trillion reward through forward-looking agricultural policies.

Citation:
1. O’Hara JK. The $11 Trillion Reward: How Simple Dietary Changes Can Save Lives and Money, and How We Get There. Cambridge, Mass.: Union of Concerned Scientists, 2013.

Three years of tobacco control progress averts smoking-related deaths

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Between 2007 and 2010, 41 countries and territories implemented tobacco control policies that will collectively result in 15 million fewer smokers and prevent nearly 7.5 million smoking-related deaths globally by 2050, according to a World Health Organization (WHO) study.

Cigarette, photo by Ferran Jorda on Flickr, Creative Commons licenseThese findings demonstrate the magnitude of the actions already taken by countries and underscore the potential for millions of additional lives to be saved with continued adoption of MPOWER policies. To assist countries with implementing Framework Convention on Tobacco Control (FCTC) obligations, in 2008 the WHO introduced the MPOWER package of evidence-based tobacco control measures. The MPOWER package includes: Monitoring tobacco use and tobacco control policies; Protecting people from the dangers of tobacco smoke; Offering help to quit tobacco; Warning the public about the dangers of tobacco; Enforcing bans on tobacco advertising, promotion and sponsorship; and Raising tobacco taxes. The goal of the MPOWER package is to reduce smoking-attributable deaths, which are projected to rise to 8.3 million annually by 2030.

The largest number of smoking-related deaths was averted as a result of increased cigarette taxes (3.5 million), smoke-free air laws (2.5 million), health warnings (700,000), cessation treatments (380,000), and bans on tobacco marketing (306,000).

“It is imperative that the public health community continue to advocate for MPOWER policies of the highest level,” the study concluded.

Citation:
1. Levy DT, Ellis JA, Mays D, Huang A-T. Smoking-related deaths averted due to three years of policy progress. Bulletin of the World Health Organization 2013; 91:509-518. (open access)

Physical activity recommendations for children

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Physical activity recommendations in early childhood should be a focus of future cardiovascular disease prevention efforts, according to a study of 3,000 children age 2-9 years from eight European countries.

The age and sex of the children are important factors in determining the right physical activity requirements. Boys age six years or younger need at least 60 minutes of moderate-to-vigorous physical activity per day, whereas boys age 6-9 years need at least 80 minutes. Girls in either age group need approximately 15 minutes less. Recommendations should also include 20 minutes of vigorous physical activity per day in all children.

Clinicians should avoid using generalized physical activity guidelines and evaluate children at risk of cardiovascular disease on a case-by-case basis, the researchers said.

Citation:
1. Jiménez-Pavón D, Konstabel K, Bergman P, et al. Physical activity and clustered cardiovascular disease risk factors in young children: a cross-sectional study (the IDEFICS study). BMC Medicine 2013; 11: 172. (open access)
2. McMurray RG. Insights into physical activity and cardiovascular disease risk in young children: IDEFICS study. BMC Medicine 2013; 11: 173. (open access)

Positive impact of mass media campaign on bed net use in Cameroon

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A mass media health education intervention in support of investments in malaria control commodities such as insecticide-treated mosquito bed nets can result in significant, large-scale positive health changes, according to a study conducted in Cameroon.

Bed net, Photo by Gates Foundation on Flickr, Creative Commons licenseThe study found that Cameroonians with at least one bed net in their household were more likely to use the bed nets after being exposed to the “KO Palu” (Knock Out Malaria) national campaign. Approximately 298,000 adults and more than 221,000 of their children under age five slept under a bed net because of the knowledge, motivation, and/or timely reminder provided by KO Palu NightWatch activities.

The health communication program cost less than $0.16 per adult reached, and less than $1.62 per additional person protected by a net.

According to the World Health Organization’s World Malaria Report 2011, every one of Cameroon’s 19.6 million citizens is at risk of malaria, with 71 percent of them living in high transmission areas. More than 1.8 million suspected cases of malaria were recorded countrywide in 2010, along with over 4,500 recorded malaria-attributed deaths. Malaria was estimated to be responsible for 19 percent of under-five child deaths in 2008, more than any other single cause.

Citation:
1. Bowen HL. Impact of a mass media campaign on bed net use in Cameroon. Malaria Journal 2013; 12: 36. (open access)

mHealth in the developing world: Is it effective?

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The use of mobile communication technology has been shown to improve access to health services and medical information, but two systematic reviews published in PLoS Medicine indicate a lack of evidence that mHealth is an effective solution to health challenges in the developing world.

Photo by kiwanja on Flickr, Creative Commons licenseThe majority of studies on mHealth effectiveness are conducted in industrialized countries and may not apply to low- and middle-income countries. According to the systematic reviews, three out of 75 trials that aimed to assess whether mobile technology interventions could improve health behavior or disease management were from developing countries.

Previous studies in sub-Saharan Africa have found mobile phone text messaging to improve adherence to HIV treatment, while others have shown their failure to do so. The new reviews found that for disease management, the only two mHealth applications with sufficient evidence of benefit are ones related to adherence to antiretroviral therapy and smoking cessation.

The reviews call for additional rigorous mHealth tests in low- and middle-income settings.

Citations:
1. Free C, Phillips G, Galli L, et al. The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review. PLoS Medicine 2013; 10(1): e1001362. (open access)
2. Free C, Phillips G, Watson L, et al. The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis. PLoS Medicine 2013; 10(1): e1001363. (open access)
3. Tatalovic M. “Evidence lacking on mHealth effectiveness in poor countries.” SciDevNet: 15 Jan 2013.

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