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Major Burden (major + burden)
Selected AbstractsChanging cancer incidence in Kampala, Uganda, 1991,2006INTERNATIONAL JOURNAL OF CANCER, Issue 5 2010Donald Maxwell Parkin Abstract Incidence rates of different cancers have been calculated for the population of Kyadondo County (Kampala, Uganda) for a 16-year period (1991,2006). This period coincides with continuing social and lifestyle changes and the peak and subsequent wane of the epidemic of HIV-AIDS. There has been an overall increase in the risk of cancer during the period in both sexes, with the incidence rates of cancers of the breast and prostate showing particularly marked increases (4.5% annually). Prostate cancer is now the most common cancer in men. The incidence of cancer of the esophagus, formerly the most common cancer in men and second in frequency in women, has remained relatively constant, whereas the incidence of cancer of the cervix, the most common malignancy in women, continues to increase. Since the early 1990s the incidence of Kaposi sarcoma (KS) in men has declined, and while remaining relatively constant in women, it has been diagnosed at progressively later ages. The rates of pediatric KS have declined by about 1/3rd. The incidence of squamous cell cancers of the conjunctiva has also declined since the mid 1990s. Cancer control in Uganda, as elsewhere in sub-Saharan Africa, involves meeting the challenge of emerging cancers associated with westernization of lifestyles (large bowel, breast and prostate); although the incidence of cancers associated with poverty and infection (liver, cervix, esophagus) shows little decline, the residual burden of the AIDS-associated cancers remains a major burden. [source] Nurse-led vs. conventional physician-led follow-up for patients with cancer: systematic reviewJOURNAL OF ADVANCED NURSING, Issue 4 2009Ruth Lewis Abstract Title.,Nurse-led vs. conventional physician-led follow-up for patients with cancer: systematic review. Aim., This paper is a report of a systematic review of the effectiveness and cost-effectiveness of nurse-led follow-up for patients with cancer. Background., As cancer survivorship increases, conventional follow-up puts a major burden on outpatient services. Nurse-led follow-up is a promising alternative. Data sources., Searches were conducted covering a period from inception to February 2007 of 19 electronic databases, seven online trial registries, five conference proceedings reference lists of previous reviews and included studies. Review methods., Standard systematic review methodology was used. Comparative studies and economic evaluations of nurse-led vs. physician-led follow-up were eligible. Studies comparing different types of nurse-led follow-up were excluded. Any cancer was considered; any outcome measure included. Results., Four randomised controlled trials were identified, two including cost analyses. There were no statistically significant differences in survival, recurrence or psychological morbidity. One study showed better HRQL measures for nurse-led follow-up, but one showed no difference, two showed a statistically significant difference for patient satisfaction, but two did not. Patients with lung cancer were more satisfied with nurse-led telephone follow-up and more were able to die at home. Patients with breast cancer thought patient-initiated follow-up convenient, but found conventional follow-up more reassuring. One study showed the cost of nurse-led follow-up to be less than that of physician-led follow-up, but no statistical comparison was made. Conclusion., Patients appeared satisfied with nurse-led follow-up. Patient-initiated or telephone follow-up could be practical alternatives to conventional care. However, well-conducted research is needed before equivalence to physician-led follow-up can be assured in terms of survival, recurrence, patient well-being and cost-effectiveness. [source] iPAC: An initiative to fight the burden of allergies in childrenPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 2008Philippe A. Eigenmann Allergies and asthma are common diseases in most parts of the world. Together, they represent a major burden on global health, as well as on health costs. However, efficient preventive measures are still lacking, and treatments are mostly symptomatic. The pathogenesis of the "allergic marathon", the progression of the disease throughout childhood into adulthood is only partly understood. In addition, treatment protocols addressing the pathogenesis of the disease are not available to all patients, either due to economical reasons, or to insufficient efficacy or safety of the procedures. This editorial introduces a supplement dedicated to identify directions and means to fight the burden of allergies in childhood. This initiative is coordinated by iPAC (international Pediatric Allergy and Asthma Consortium). [source] On the origin and evolution of the human immunodeficiency virus (HIV)BIOLOGICAL REVIEWS, Issue 2 2001EDWARD C. HOLMES ABSTRACT The human AIDS viruses , HIV-1 and HIV-2 , impose major burdens on the health and economic status of many developing countries. Surveys of other animal species have revealed that related viruses , the SIVs , are widespread in a large number of African simian primates where they do not appear to cause disease. Phylogenetic analyses indicate that these SIVs are the reservoirs for the human viruses, with SIVsm from the sooty mangabey monkey the most likely source of HIV-2, and SIVcpz from the common chimpanzee the progenitor population for HIV-1. Although it is clear that AIDS has a zoonotic origin, it is less certain when HIV-1 and HIV-2 first entered human populations and whether cross-species viral transmission is common among primates. Within infected individuals the process of HIV evolution takes the form of an arms race, with the virus continually fixing mutations by natural selection which allow it to escape from host immune responses. The arms race is less intense in SIV-infected monkeys, where a weaker immune response generates less selective pressure on the virus. Such a difference in virus-host interaction, along with a broadening of co-receptor usage such that HIV strains are able to infect cells with both CCR5 and CXCR4 chemokine receptors, may explain the increased virulence of HIV in humans compared to SIV in other primates. [source] | ||||||||||