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As a country’s economy70 20 6070 20 EasternMediterraneanMediterraneanMediterranean 60606060 606060 EasternRegionRegionRegion MediterraneanRegionMediterraneanSouthSouthSouthfififiEastEastEast AsiaAsiaAsia improves erectile dysfunction causes drugs order viagra once a day, the mortality of pregnant women and newborns60 6060 RegionRegionSouthRegionfiEast Asia 505060 10 5050 10 RegionRegionRegionSouthfiEast Asia 5050 5050 AfricanRegionSouthfiEast Region Asia 50 AfricanAfricanRegionAfrican RegionRegionRegion declines. Beyond this point, contributing factors for the5050 0 50 0 404040 40404040 AfricanAfrican RegionRegion 40 1990 2012 1990 2012 further extension of life expectancy are the prevention of4040 4040 30303030 30303030 Prepared by Fukai from United Nations, World Population Prospects: the 2012 Revision, 2013Figure 2. In the past 50 years, there 8 has been a great shift in the disease structure and causes of 6 death. Theoretically, if these diseases could be successfully 4 prevented an extension in average life expectancy of around 2 3 to 4 years would be expected in the case of cancer, around 0 1. Change in the percentage of older population (65 years of age and over) in industrialized and developing 10 countries in the case of pneumonia and cerebrovascular diseases Figure 3: Change in the percentage of older population (65Prepared by Fukaifrom United Nations, World Population Prospects; the 2012 Revision, 2013. The survival rate at the age of average life expectancy is approximately 60% for system must take this fact into consideration. Annual transition in the number of deaths among the Japanese by 0 1 2 3 4 5 6 7 8 fgures for 2011 are approximate. The median life expectancy [the number ofNumber of survivors (lx): the number of survivors is calculated on the assumption that 100,000 children die Figure 6: Number of deaths by age among the JapaneseFigure 6. Number of deaths by age among the Japanese years inwhich half the children (50,000 on the complete life table) are expected to survive] is 82. For some reason, when cells and organs stop dividing after completing about 50 cycles of sub(which are made up of cell tissue) can no longer function, division, as seen in almost all organs other than the abovehumans become incapable of maintaining their bodily mentioned ones12. However, all organs age as one gets functions as an individual organism, and this results in older, and the aging of organs manifests itself in the form death. This means that muscle strength, reveals that death occurs when any of the organs that are nerve conduction velocity, lung capacity, and resistance to vital for maintaining life, such as the heart, brain, kidney, disease decline with age, and this decline cannot be avoided or various arteries, can no longer function. For example, when evaluating changes in grip temporal process leading to death varies depending on strength that occur with age in Japanese people, a decrease the disease that causes this decline in organ function. In of about 13kg in men and about 8kg in women has been terms of the length of time during which one functions observed between late-middle age and old age13. Despite such a decline in organ functions due functions that occurs as a person ages. Aging at the organ to aging, the organs function together in a complementary level can be attributed to damage to cells that have almost manner to maintain a condition where everyday living no ability to divide, such as brain and nerve cells as well functions can be performed without any trouble. In other cases, aging occurs when cells a variety of different causes lead to various physical and — 18 — 1. Average life expectancy and healthy life expectancy the world’s average life expectancy as of 2012 is 68 years 5. Aging society and social security in men and 73 years in women, with a mean of 70 years Improvements in pension, medical insurance, and longfor both sexes combined. In contrast to the average life term care insurance programs are essential in order for expectancy of 60 years in men and 63 years in women in the elderly to live a secure life. In Japan, which has become low-income countries, the life expectancy in high-income the world leader in terms of longevity, a universal national countries reaches 76 years and 82 years, respectively. The health insurance and pension system was started in 1961 average life expectancy of both sexes combined is 62 years and has been maintained up to the present time. Japan’s in low-income countries, 66 years in low middle income insurance and pension systems are funded by both insurance countries, 74 years in high middle income countries, and fees and tax revenues, and also effectively redistribute 79 years in high-income countries, indicating that life income among age groups while improving the health expectancy increases with greater economic development. In contrast, healthy life expectancy in those same categories Nevertheless, rapid population aging and a falling birth rate of economic development is 53, 57, 66, and 70 years, pose an enormous fnancial burden on the country18. Healthy life expectancy throughout the world A look at the current state of population aging in Japan as a whole is 62 years16 (Figure 8). There is approximately from a generational perspective reveals that when the “babyan 8-year difference between average life expectancy and boom generation” (born in 1947-1949) turned 65 years healthy life expectancy, and this does not vary with the old in 2012, the number of people aged 65 years and over economic status of the country. As a result, Japan has become a super-aging up to the point at which a person begins to experience society with the percentage of people aged 65 years and over restrictions on their daily living activities at or above Care reaching 24. Future directions for research on the contributions of dental and oral health to a healthy aging society. Conceptual pathway from oral health to healthy longevity Figure 10: Conceptual pathway showing the relationship between dental care/oral health and healthy life expectancyFukaiK. These numbers have been increasing function and condition of each organ, so caution is needed since the start of record-keeping in 195020. This is due when showing causes and results in a simple diagrammatic to the rapid aging of the population accompanied by an form. On the other hand, when providing explanations to improvement in the survival rate, giving rise to issues related policymakers and laypeople, it is necessary to demonstrate to the financial foundation of this system as well as the a simple and easily understandable concept along with its quality of health care and long-term care. This makes it necessary to accumulate individual evidence which supports and/or refnes this pathway. Dental care/oral health and healthy life expectancy Based on the relationship between dental/oral and general [Discussion] health, the following two factors are involved in the pathway Population aging occurring at the global level is an by which dental care and oral health contribute to healthy unavoidable fact. The issue is how to prolong the healthy longevity: (1) prevention of aging and promotion of health period of human life. The survival includes promotion of health through exercise, nutrition, rate at age 80 years is about 80% for women and about 60% and rest. The death rate increases linearly (log conceptual pathway which shows the extent to which dental plot) with age from about 30 years until reaching old age, and oral health as well as the resulting maintenance and and then the rate decreases after reaching about 90 years. The relationship between oral and general health age, and that there is a twofold increase in the probability — 20 — 1. This law is also used as a definition of aging contributions to general health made by dental care and oral (aging means increased susceptibility to death). There is an urgent need to verify makes humans more susceptible to death and diseases. The survival curve becomes markedly longevity, the following four goals should be our priority: rectangular with age22. This is an important point in 1) to increase life expectancy and prevent early death, 2) to understanding why an extension in healthy life expectancy is prevent people from falling into a state of dependency, 3) to needed to bring the average life expectancy of humans closer prevent the decline in living functions due to aging, and 4) to the lifespan limit. To achieve this, preventive measures to promote health from the early years of adulthood based against the main causes of death and health promotion on the life course approach. Specifcally, to further enhance the health of the population, it is necessary [Confict of interest] to improve other risk factors such as hyperglycemia, lack of There are no items applicable to “confict of interest” in exercise, drinking, excess weight and obesity, and high intake this article. It is also important to clarify the diseases that lead to a condition [References] requiring care and to prevent such diseases. Ageing in the twentyIn terms of social security costs, a system that will frst century, A celebration and a challenge. National Institute on Aging, National Institute of Health, lifestyle-related, social security and health system-related, World Health Organization. In fact, in a well-known follow-up study on and oral health to a healthy aging society. Journal of Japanese-Americans investigating the prevalence of ischemic Japan Dental Association 2014; 66 (10): 25-34. Future directions for research on the to have a higher risk of ischemic heart disease and a lower contributions of dental and oral health to a healthy aging risk of cerebrovascular disease than Japanese people living society. Serving patients who may die soon and their heart disease risk factors in Japan and Hawaii. Exp Cell Res 1961; 25: 585of tooth scaling and decreased cardiovascular disease: a 621. Ikeda N, Saito E, Kondo N, Inoue M, Ikeda S, Satoh T, Wada K, Stickley A, Katanoda K, Mizoue T, Noda M, Iso H, Fujino Y, Sobue T, Tsugane S, Naghavi M, Ezzati M, Shibuya K. In order to secure evidence age-related changes in the oral cavity, in the oral health for methods to prevent and treat various diseases and status of the elderly in Japan, in dental care of the elderly, disorders accompanying senescence, it is necessary to in daily life, and in oral health risks for the elderly. This organize the basic points concerning what senescencework clarifed that organic changes in the oral cavity render related changes occur in human oral cavity. However, as an effect on oral functions, and the oral diseases, oral care pointed out by Mjor3 and Russell, Ship et al. Nevertheless, it seems acceptable to try to understand the characteristic changes often observed [Introduction] with the teeth functioning in the elderly as the age-related All living organisms are constantly aging. In this article, a review is frst performed aging that occurs in the process of growth and development while focusing on age-related changes of oral cavity after birth, the aging in the later stages of life, such as accompanying senescence. Atchley the objectives of this study were to perform a literature and Barusch2 defned that the felds of gerontology are based survey about what senescence-related changes occur in the on the following 4 viewpoints: (i) a biological viewpoint to oral cavity in terms of teeth (enamel, dentin, cement and investigate “the causes of physical function deterioration pulp), periodontal tissues, oral mucosa, salivary gland and and treatment methods, and to prevent the diseases and saliva to allow a further search of results of various statistical disorders caused by the deterioration”, (ii) a psychological surveys and to organize the information obtained in this viewpoint for “research of emotion and intelligence”, (iii) way. The literature inclusion criteria were as follows: (i) studies Among the viewpoints defined above, the biological performed focusing on humans, (ii) literature written viewpoint is first of all necessary for the healthcare in English or Japanese and (iii) original articles or paraprofessionals working in the dental field.

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Much research exists on the harmful health effects of betel nut consumption (Zhang and Reichart erectile dysfunction doctor visit buy generic viagra on line, 2007) erectile dysfunction ginseng discount viagra 75 mg line, of which most of it has been epidemiological erectile dysfunction treatment herbal purchase generic viagra on line, with less attention directed at the socioeconomic impacts of it (Croucher and Islam impotence vacuum device cheap viagra, 2002; Williams and others, 2002). The present paper provides an updated examination into betel nut consumption in Honiara, the capital of Solomon Islands, as previous studies are somewhat dated (Wilson and South Pacific Commission, 1983; World Health Organization, 2010). It also discusses the possible negative effects of betel nut consumption in terms of health costs and diversion of income towards betel nut and away from basic necessities and provides a comparison of these with the possible positive impacts in terms of household income from growing, transporting and selling betel nut. Using intercept surveys conducted among 259 adults and 102 schoolchildren based in Honiara, this research seeks to determine the prevalence of betel nut chewing among those two cohorts. It reveals the main motivations for chewing betel nut and the perceived effects that chewers experience. Other data on chewing behaviour, such as frequency and length of chewing and intention to quit are also captured. Among non-consumers, the research captures the main reasons for not partaking in betel nut consumption. Additionally, in-depth interviews were held with medical practitioners in Honiara to understand the frequency and types of 104 Asia-Pacific Development Journal Vol. The paper then concludes by critically evaluating a range of recommendations to minimize the negative impacts of betel nut consumption that may hinder economic development in the island State. The physical effects from chewing betel nut include increased heart rate and sweating. Betel nut consumption also aids digestion and the absorption of food by increasing the muscular activity in the intestines. In developing countries, there is evidence that some people chew betel nut to suppress their appetite. Low-income betel nut chewers may satiate their appetites through betel nut to avoid buying food. The “attraction” of chewing betel nut is that it produces a psycho-stimulating and euphoria-inducing effect for the consumer. The majority of chewers experience those effects within five minutes and the experience lasts for approximately two to three hours (Chu, 1993). Guha (2006) argues that betel leaf has been used to treat various ailments, such as halitosis, boils and abscesses, constipation, headaches, itches, mastitis, conjunctivitis, ringworm and rheumatism. Reid (1985) reports that betel nut consumption has allegedly prevented burping after meals, diarrhoea, dysentery and scurvy. It can increase the capacity for physical exercise and mental sharpness, lessen fatigability and provide a sense of well-being (Deng and others, 2001; Guha, 2006; Hirsch, 1990; Williams and others, 2002). Betel nut has long been used in Chinese medicine, primarily to rid parasites, such as roundworms and tapeworms, in the intestinal tract (Reid, 1985; Zhang and Reichart, 2007). However, because of its addictive nature, chronic daily use often occurs as users attempt to avoid withdrawal symptoms (Gupta and Warnakulasuriya, 2002). In contrast to the reported positive health impacts, betel nut consumption has been proven to cause oral cancer and cancer of the oesophagus. Other research has shown that betel nut consumption leads to asthma (Taylor and others, 1992) and cancer of the pharynx (Lee and others, 2005). There is evidence that it provides a low level of toxicity in chewers (Deng and others, 2001) and can have adverse effects on newborns of chronic betel nut users (Lopez-Vilchez and others, 2006; Senn and others, 2009). Tests done on betel quid chewers show that they tend to have higher blood pressure than non-users and suffer from hypertension (Heck and others, 2012). The spitting of betel nut juice indiscriminately in public places helps transmit and spread respiratory infections (Williams and others, 2002). Users start relatively early in life in the Federated States of Micronesia, 12 years was the mean age of initiation and those school-aged children had already reported symptoms of poor oral health (Oakley, Demaine and Warnakulasuriya, 2005). Betel nut usage is also highly associated with the chewing of tobacco (World Health Organization, 2012). In developing countries, costs associated with betel-nut related illnesses have the potential to drain public funds. Income spent on betel nut among populations in developing countries can divert funds away from basic necessities. These basic necessities, such as electricity and water, may already be too expensive for some households or in limited supply due to poor infrastructure. Thus, household expenditure on betel nut can contribute to an even poorer standard of living. The World Bank (2014a) notes that Solomon Islands currently has one of the lowest rates of electricity access in the world and some of the highest electricity prices (greater than $0. In Honiara, which accounts for about 90 per cent of the country’s electricity generation and consumption, only 64 per cent of the households are grid connected. Maebuta and Maebuta (2009) found that households in Solomon Island squatter settlements spend an average of 8. School fees were perceived to be too high, and, as a result, squatter households could not afford to send their children to school (Maebuta and Maebuta, 2009). In Papua New Guinea, Gibson (2000b) found that the average share of total expenditure spent on betel nut was 3. Gibson notes that, along with fish, banana, and sweet potato, betel nut is one of the most important locally produced items in the diets of people from Papua New Guineans. The mild psychic and euphoric effect can aid the reconciliation process of negotiation among disagreeing tribes. Betel nut consumption is closely linked with speechmaking, authority and politics in Papua New Guinea (Hirsch, 1990). At times, it has been used for healing, gifts and cementing relationships, and as a welcome offering (Chen, Johnson and Taufu, 1999). It has symbolic significance in many cultures and is consumed when paying homage, recognizing courtships, betrothals and marriages and at funerals and 106 Asia-Pacific Development Journal Vol. The production and sale of betel nut can provide an essential source of income for many households in countries where it is consumed. Often, betel nut sellers, who are outside the formal economy, have few other economic alternatives to generate income. Income from betel nut sales go directly towards school fees, food, medicine and other everyday household requirements. Previous estimates were somewhat lower, with 17 per cent of households in 1986 and 30 per cent of households in 1999 reporting that they grew betel nut as a cash crop. The reasons for this growth may include the increased demand for betel nut consumption and/or the monetization of what was once a largely subsistence activity. Increasing urbanization may be contributing to the increased demand for betel nut, as betel nut cannot be grown in sufficient quantity in urban areas. Solomon Islands (2009) reports that, while the rural population grew from 1970 to 2009 by an average of 5. This growth in the urban population may indicate that Solomon Islanders who previously grew their own betel nut on their property in the rural areas may now need to purchase the product while residing in Honiara. While those in Honiara do not directly benefit from the production of betel nut, many residents generate income as a “middleman” between betel nut farmers and end consumers. Betel nut is widely available, with small sellers being found in many locations, as well as in specified markets (Solomon Islands, 2009). Many roadside makeshift stalls sell betel nut, the fruit leaf and lime along with single cigarettes. A recent report (World Health Organization, 2010) estimates that in Solomon Islands, a betel nut seller could earn up to $63. Previous research has found that betel nut consumption in Solomon Islands is common at all levels of society, with most islanders having chewed betel nut at some time in their life (Wilson and South Pacific Commission, 1983). More than 50 per cent of adults were estimated to have chewed betel nut at least once a week. Young children commonly chew the betel nut husk then progress to chewing betel nut. The regular chewing of betel quid was not commonly observed before puberty (Wilson and South Pacific Commission, 1983). In Bangladesh (Heck and others, 2012) and in Taiwan Province of China (Ko and others, 1992), researchers found a negative relationship between betel nut consumption and education level and employment.

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The length of washout period 118 121 erectile dysfunction incidence age viagra 100 mg with mastercard,228 impotence icd 10 buy viagra us,232 for the seven remaining crossover trials ranged from 4 days to erectile dysfunction treatment psychological causes viagra 25 mg cheap 14 days impotence jelqing best viagra 75 mg. The occurrence of total and serious adverse events across the 23 placebo-controlled 215-227,229,230,233-240 trials was reported poorly. For example, in one trial, the proportion of patients who experienced at least one adverse 222 event in the tadalafil and placebo arms were 51. Even though the proportion of patients in one trial was numerically greater in the tadalafil arms (39. Most common adverse events reported across all trials were headache, back pain, dyspepsia, dizziness, nasal congestion, flushing, and myalgia. In general, the occurrence of these events tended to be numerically more frequent in tadalafil arms than in placebo arms. Moreover, a statistically significant higher incidence of these 215,220,222,223,225,226,239 events was reported across several trials in tadalafil versus placebo arms. The majority of the trials reported that tadalafil was well tolerated and that patients had had adverse events mostly of mild or moderate severity. Eleven of the 23 trials did not report whether there had been any occurrence of serious 216,218,219,221,225-227,229,230,237,239 adverse events. Of the 12 trials that reported any occurrence of 215,220,222 serious adverse events, three trials did not specify what these events were. The proportion of patients who withdrew due to adverse events across trials was five–six 217,222,224 215-220,222-227, 229,230,233-240 percent or less and similar across the tadalafil and placebo arms. In general, the results of the 23 placebo-controlled trials showed that patients who received tadalafil (10 or 20 mg) experienced greater improvement in erectile functioning. The corresponding mean treatment 216 237 response change in placebo arms ranged from 0. Furthermore, results of two trials indicated that patients receiving even lower doses of tadalafil (2. In several trials, there was a statistically significant greater mean per-patient percentage of successful intercourse attempts measured at different intervals after dosing in tadalafil arms 217,219,220,224,225,230 compared with placebo arms. The effects of both 215,226-230,237,238 tadalafil doses 20 mg and 10 mg were evaluated in eight trials. In one of these 238 trials, there was an additional randomized arm in which patients received 5 mg tadalafil. In three trials, the incidence of headache was slightly higher in patients receiving 20 mg tadalafil as compared with those receiving 10 mg (or 5 mg) of tadalafil. In the second trial, numerically more patients who received 20 mg tadalafil had headache compared with those who received a 10 mg dose (8. In one 227 trial, compared with those who received 10 mg of tadalafil, patients receiving a 20 mg dose experienced numerically higher rates of dyspepsia (22. The incidence of back pain was numerically slightly higher in patients receiving 20 mg versus those receiving 10 mg of 237 215 tadalafil in one trial (4. Of the eight trials comparing the efficacy/safety profiles of 20 mg and 10 mg tadalafil, the absence or presence of 221,226,227,229,230,237 serious adverse events could not be ascertained for six trials. In the same trial, patients on 20 mg tadalafil had a faster erectogenic response (starting 16 minutes post-dose) than those on 10 mg of tadalafil (starting 26 230 minutes post-dose). For example, there was a statistically significant higher mean perpatient proportion of successful intercourse attempts. Two 214,232 trials compared the efficacy/safety of two dosing regimens of 20 mg tadalafil (on demand therapy versus scheduled therapy). In the first trial, the rate of any adverse events (percentage of patients with at least one adverse event) did not differ between groups who were given tadalafil either on demand or 3 times per week (21. The proportion of patients who withdrew from the on-demand and the 3 times per week dosing regimens were 4. In the second trial, the most frequent adverse events were dyspepsia, headache, back pain and myalgia, observed in two of the 20 patients. The other trial evaluated whether 20 mg tadalafil dosing regimens (on demand versus scheduled on alternate days) differed in improving endothelium-dependent vasodilation of cavernous arteries. There was also a statistically significant improvement in regard to morning erections observed in patients treated with the 61 scheduled dosing regimen (90 percent of the patients; p <0. One of these additionally evaluated the efficacy/safety profile of vardenafil (20 mg). In general, in these trials, all three therapies were well tolerated and had similar safety profiles. There were no statistically significant differences in the incidence of any adverse events between tadalafiland sildenafil-treated groups of patients. In the tadalafil arms the proportion of patients with at least one adverse event across the four trials ranged from 27. Three remaining trials did not report the occurrence or absence of serious adverse events. The total number of withdrawals due to adverse events across the four trials ranged from 121 103,163 two to 12 patients. The proportion of patients who withdrew from tadalafil groups ranged 121 103,241 from one to seven. The respective proportion of patients who withdrew from the 121 103,163 sildenafil arms ranged from one to five. The mean time (in hours) between dosing and sexual attempt was found to be longer for tadalafil than for sildenafil 118,121 (5. In one trial, 73 percent of the patients preferred tadalafil and 27 percent preferred sildenafil (p <0. Similarly, the results from the two other 121,163 trials also indicated that more patients preferred tadalafil (66. In one trial, the reason for 25 percent of men preferring tadalafil to sildenafil was that they could have intercourse again the next day post-dose. Quantitative Synthesis Meta-analysis of Trials A series of meta-analyses was conducted to address the safety and efficacy of 103,118,121,163,214-230,232-240 tadalafil. In addition, two more trials were excluded because 221 relevant numerical data needed for meta-analysis was lacking and an inappropriate dose of 235 tadalafil was used (2. All 16 placebo-controlled randomized trials had parallel-group design and compared the efficacy and safety of tadalafil (10 mg or 20 mg or both) to placebo. The pooled estimate of the relative proportion of patients with improved erection. We explored potential sources of this heterogeneity by examining other trial characteristics. This meta-analysis included six 215,227,229,230,237,238 trials, which compared 10 mg and 20 mg doses of tadalafil and also reported the proportion of patients who developed at least one adverse event. There was no statistically significant heterogeneity across the trials (Chi df=5 = 6. This meta-analysis included four 215,227,229,238 trials, which compared 10 mg of tadalafil to placebo and also reported the proportion of patients who experienced at least one adverse event. The result indicated a statistically significant higher incidence of adverse events in patients treated with 10 mg tadalafil compared with those treated with placebo. There was no statistically significant heterogeneity present across the trials (Chi2df=2 = 0. Assessment of Publication Bias Funnel plots were used to assess the extent of asymmetry. The duration of 114,117,120,248,249,252,253 249,252 117,148,159,248,253 followup of eight trials ranged from 4 weeks to 8 weeks. Of the 12 trials, four were 248-250,253 114,117,120,148,159,251,252 parallel-group and eight were crossover studies. Further information on trial characteristics is provided in (Table F-4, Appendix F). The total and mean (range) numbers of patients randomly assigned to trial arms were 1975 and 179 (12–569), respectively. The 252 248 proportion of Caucasians across these trials ranged from 85 percent to 99 percent. Most commonly reported 114,120,148,159,248,252,253 114, comorbidities among the study participants were diabetes, hypertension, 120,148,159,248,249,252,253 114,249 120,159,248,252,253 ischemic heart disease, and coronary artery disease. The 117,250,251 presence or absence of comorbidities could not be ascertained from three trials.

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Earlyscreeningprovidesthebestprospectsforpreventingthe Health-Inshuti Mu Buzima erectile dysfunction doctor dallas cheap viagra 75mg visa, Oncology erectile dysfunction age range generic viagra 75 mg without a prescription, Burera erectile dysfunction protocol free cheap 25 mg viagra overnight delivery, Rwanda; 4University of Pennsylvania erectile dysfunction medication uk buy 100 mg viagra with visa, morbidity and mortality associated with the disease. Aim: To Background and context: Promoting earlier detection of breast cancer is critical in low-income develop a culturally-sensitive clinical practice guideline that nurses can use countries like Rwanda where symptomatic women face long diagnostic delays and most patients to educate patients appropriately on colorectal cancer. Inthesesettings,promotingearlierclinicaldiagnosisshouldbethe health belief model informed the background, development, and impleinitialprioritybeforescreeningofasymptomaticwomen. Aim: Develop a pilot breast cancer early detection program in a rural mentation of this project. Evidence from peer-reviewed nursing literature Rwandan district to evaluate its clinical and health system impact, identify the most effective and was synthesized in a literature review matrix and then used to develop feasible roles for staff from each health care system level, and inform national policy. We trained 9 hospital-level nurses and doctors in diagnostic breast ultrasound to facilitate evaluation of palpable masses. Outcomes: Trainings significantly Examples of system barriers included financial problems, lack of insurance, improved knowledge and skills among trainees and increased the number of patients with breast and the inability to access care. There was an increase in the proportion of patients with benign clinical practice guideline when providing patient education to African disease and the number of needed ultrasounds and biopsies. Whatwaslearned:A strategytopromoteearlierdetectionofsymptomaticbreastcancerwasfeasibleinaruralRwandan district, effectively strengthened health system capacity to care for patients with breast concerns, and suggests promising impact on patient outcomes. Engagement of key stakeholders in implementation science can help foster evidence-based national cancer control policy. We worked closely with respective Community-Based Primary Healthcare implementedits first evertelevision-ledbowel screening campaign. In a collaborative structure, we have found that the patient is privy to unOutcomes: Adopting a whole-organization approach enabled all facets of the derstanding the level, importance and stage of cancer with other related organization to be involved in a common goal. Results are more controlled and the patient’s health record is captured at the ownership of campaign deliverables, greater engagement of staff across the relevant health institutions. Holistic healthcare services and medical treatments are monitored, measured egies that wouldn’t have been possible had this approach not been adopted. What was learned: the identification of many were still utilizing outdated Pap smear kits. Taking a whole-organization approach resulted in the identifiadigitalageandyet ourequipmentandmachineryisnotstateoftheart. Themobiletruck, cation of existing programs and services to leverage the campaign, inmanyinstances,hastotraveltothemostremoteareaswithpoorroadinfrastructure. This system takes care of approximately 75% of our popCirugia y Medicina, San Pedro Sula, Honduras; 3Liga Contra el Cfiancer, 4 ulation (150 millions). Cancer is a major problem in Brazil and have high mortality Clinical Oncology, San Pedro Sula, Honduras; Liga Contra el Cfiancer, rates mainly because of late diagnosis and lack of information. Besides the mortality Cervical Pathology, San Pedro Sula, Honduras impact, it brings high costs to the health system (public and private) and have poor Background and context: Persistent infection with high-risk human papilloma survival ratesandlostofproductiveworkpeople. Cervical cancer represents developing cancer in general population based on questions and risk factor estaba public health problem in Latin America, and in Honduras is the main cause lishedbymedicalsocietiesandscienceandstratifiesinto3groups:highrisk(lifetime of cancer in women. Half of Honduran women at risk are not systematically riskgreaterthen 20%) moderatedrisk(normal risk but delayed screeningexams) and screened for cervical cancer. Based on the risk or delayed exams, the system generates a personalized lesionswithrapidandefficienttestscanguaranteetimely treatment. Strategy/ strategy to reduce the risk or to ensure the necessary exams are completed. Besides Tactics: Retrospective, descriptive, cross-sectional study at Copfian health this we give general information about the importance of prevention and habits that units(LaEntrada,Florida,TrinidadandSanJuanPlanes),wheretheresultsof canreducetheriskofcancer. What was learned: the prevacertainly will have a better take care of their own life. It continues to Educacion y Servicios, La Paz, Plurinational State of Bolivia have a huge impact on women not only physically but also socially and sexually. Background andcontext: Itisthe thirdleading causeofcancerdeathsamong females inLatin However, the good news, because of its slow progression and cytologic identifiable America and the Caribbean, and yet cervical cancer is almost entirely preventable and precursorsandprovideditisdetectedearlyandmanagedeffectively,itisheraldasone treatable. In a region where many lack even basic access to quality sexual and reproductive of the preventable and treatable forms of cancer. Pap smear remain as a strategy, improving the quality of the laboratory services is 2) Educate populations and increase demand for cervical cancer services by paramount to ensure effective early detection of precancerous lesion. The 3) Improve and standardize clinical protocols and referral pathways by advocating topic has a fair share of several rounds of discussions. Program/Policy process: the planning process involved several discusand other screening and treatment techniques saw an average 7% increase in the number of sions at ministry level, series of workshop to develop the important documents for the direct cervical cancer services provided. Outcomes: Mandate of the way forward of compreresponse to cervical cancer requires the support and collaboration of civil society organihensivestrategyforcervicalcancercontrolprogrambeingapproved. Whatwaslearned: zations, which can deliver direct services and play a catalytic role in advancing technical Malaysia is optimistic that cervical cancer reduction program remain a high-profile recommendationsandpolicydialogue. Sofija1 1GriffithUniversity,SchoolofMedicine,Brisbane,Australia;2SamoaCancer Society, Moto’otua, Samoa Background and context: Cancer is the second most common cause of death in Samoa. Early detection increases the likelihood of successful treatment; however, in Samoa, cancer patients often present late, when treatment options are limited and often reduced to receiving palliative care. Low levels of health literacy in relation to cancer causation, risk factors, and signs and symptoms contribute to poor outcomes for cancer patients in Samoa. Aim: the Vave (Quickly) campaign aimed to increase communityawareness about the signs and symptoms of cancer, and promote early detection. Strategy/ Tactics: this was a 12-month national social marketing campaign designed to ensure maximum population reach across Samoa. The campaign adopted a multipronged approach with three main components: mass and social media coverage; printed resources; and community education. Program/Policy process: the campaign focused on four of the most common cancers in Samoa: stomach, lung, breast, and prostate. Television advertisements and radio scripts were developed for each type of cancer, piloted and broadcast on the main television and radio stations. Community educators delivered a total of 29 face-to-face education sessions across Samoa; these sessions prioritized villages, schools and church groups in areas with poor television and radio coverage. Outcomes: the campaign was successful in increasing awareness of cancer signs and symptoms in the community. Approximately 2000 Samoans (over 1% of the population) received the face-to-face education sessions; analysis of preand postsession questionnaires showed that the sessions were effective in increasing health literacy around cancer signs and symptoms. Limited data on patient visits suggests that the campaign resulted in increased numbers of hospital and general practice visits,andislikelytohavecontributedtotheearlydetectionofsomecancers. What was learned: $ the campaign resulted in an increase in inquiries and requests for check-ups; however, limited availability of medical and screening services must be considered when managing community expectations. Formative research and greater involvement of health professionals throughout the campaign would have prevented some implementation issues. Polo International Atomic Energy Agency, Vienna, Austria Aim and purpose: the session aims at outlining actions that the healthcare community can take to improve the current situation and inform cervix Background and context: In 2012, 560,000 women were diagnosed with cervical cancer cancer control plans. Five-year cervix cancer and will discuss the role of radiotherapy, while showcasing overallsurvivalforallstagescombinedrangesbetween60%-69%,dependingonthecaseexamples of collaboration. Countries with no access to radiotherapy may only Audiences: offer palliative treatment to women diagnosed with locally advanced cervical cancer. Any Healthcare professionals with a special interest in women’s curative attempt for these patients should include the two components of radiotherapy: · concomitant radio-chemotherapy and brachytherapy. Radiotherapy is also a cost-effective cancers/cervix cancer and healthcare services planning. Kennedy Lishimpi Topic, “Case study: Zambia” Ilfinancial and in-kind support from member states, donors and partners. Gupta Metal Health, and Injuries Cancer Aid Society, Advocacy, Lucknow, India; 2Cancer Aid Society, In Charge, Lucknow, India S. Current estimates indicate that every year essential keys needed to advance our understanding carcinogenesis and other disease progression. Strategy/ prevention, diagnosis, and treatment in places where international populations are esTactics:LucknowisthecapitalcityofUttarPradeshthemostpopulousStateof sential to making progress for humankind. It answers their requests action aimed at an effect in Lucknow shall further have impact in the entire (1) byincluding investigatorsfrom bothhigh-, middle-,and lower-income countries; (2) by encouraging multiple chronic conditions to be studied together; and state. Outcomes:Attheendofthetwo-yearplanninggrant,all making a dent on the issue from the very beginning. Governor of Uttar Pradesh being a cancer survivor was the best advocate, Mechanistically, this plan will have several sections, that together will recount thecenter’s scientific impact on the region. The plan will influence researchers, clinicians, patients, stressing during the lecture on the need to address the issue.

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