Quality of life of head and neck cancer patients in urban and regional areas: An Australian perspective.

OBJECTIVE: Head and neck cancer treatment affects quality of life. There are differences in quality of life outcomes and perceived supportive care needs between cancer patients living in metropolitan and regional-remote areas. This study investigated quality of life over the first 6 months following head and neck cancer diagnosis and observed differences in quality of life by geographical location. DESIGN: Prospective observational study. SETTING: Tertiary hospital in Brisbane, Australia. PARTICIPANTS: Newly diagnosed patients who were referred for the diagnosis, and/or treatment of head and neck cancer. MAIN OUTCOME MEASURE(S): Quality of life was measured by the University of Washington Quality of Life Survey, version 4 (UW-QoL). Participants completed the UW-QoL questionnaire prior to starting treatment, 1 month and 6 months post treatment. Metropolitan and regional or remote status was classified according to the Australian Standard Geographic Classification-Remoteness Area system. RESULTS: Ninety-five participants were included at baseline; 49 and 41 participants completed the 1-month and 6-month follow-ups, respectively. Scores in most UW-QoL domains decreased between baseline and 1 month post treatment and increased towards pre-treatment scores at the 6-month follow-up (except for anxiety and saliva). Pain at baseline was significantly worse in the regional-remote participants compared with metropolitan participants. No other statistically significant differences in UW-QoL score by geographical location were observed. CONCLUSION: The findings generally did not support significant differences in quality of life outcome between metropolitan and regional-remote head and neck cancer patients. The difference in pain experience between metropolitan and regional-remote groups requires further investigation.

Smoking behaviour and preferences for cessation support among clients of an Indigenous community-controlled health service.

INTRODUCTION AND AIMS: Reducing smoking prevalence among Indigenous Australians is a vital part of closing the health gap between Indigenous and non-Indigenous Australians. Community-controlled health clinics are an important setting for delivering smoking cessation advice and assistance. This study measured tobacco and e-cigarette use, knowledge of smoking-related health effects, motivations to quit and interest in cessation aids. DESIGN AND METHODS: Clients of Aboriginal & Torres Strait Islander Community Health Service dental clinics in Southeast Queensland (n = 421) completed a brief written questionnaire while in the waiting room. RESULTS: Nearly half (n = 184, 47%) of the participants currently smoked daily, of which 9% (n = 7) currently used e-cigarettes. Few smokers (8%, n = 13) had no intention to quit smoking. For current smokers, previously used quit methods were abrupt cessation (42%, n = 78), nicotine replacement therapies (NRT; 25%, n = 45), prescription medications (23%, n = 43), e-cigarettes (9%, n = 17) and other methods (3%, n = 6). Current smokers were most interested in cutting down (85%, n = 110), abrupt cessation (75%, n = 98) and free NRT (72%, n = 101). Fewer (34%, n = 36) were interested in purchasing NRT for smoking cessation. DISCUSSION AND CONCLUSIONS: Our study found there was interest in accessing smoking cessation aids among the clients of this community-controlled health clinic, particularly if provided free of charge. Embedding smoking cessation advice and assistance into a range of community-controlled health clinics could provide opportunities for addressing the high smoking prevalence among Indigenous Australians.

Beverage consumption in Australian children.

BACKGROUND/OBJECTIVES: While beverages are an important dietary source of water and some essential nutrients, consumption of sweet beverages has increasingly been linked to adverse health outcomes. Currently there is a paucity of longitudinal consumption data on beverage consumption in Australian children. SUBJECTS/METHODS: The Longitudinal Study of Australian Children has run biennially since 2004. Twenty four-hour recall data collected over 6 waves from the birth cohort (aged 0-1 year at baseline) was analysed and demographics were assessed for associations. RESULTS: Five thousand one hundred and seven children participated at baseline, with a 71-90% retention of participants at each wave. Water consumption remained consistent with age over time, with more than 90% consuming more than one glass in the last 24-h. Proportions of fruit juice consumers decreased overall. Soft drink and cordial consumer proportions increased from 1% (0-1 year), to 28% (2 years) and 43% (10 years). Between 2 and 10 years, proportions of consumption of full-cream milk decreased by 8% and for skim milk this proportion increased by 51%. High proportions of consumers of soft drink/cordial was significantly associated with older children, males, children with a medical condition, living in a rural area, low socio-economic status and Indigenous Australians. CONCLUSIONS: Water consumption remained consistently high across the ages, while fruit juice was commonly introduced into the diet early childhood. While proportions of fruit juice consumers decreased after the age of 2 years, proportions of soft drink consumers increased. The findings from this study should assist with surveillance data and inform policy and interventions aimed at reducing consumption of sweet beverages.

Cataract and glaucoma case detection for Vision 2020 programs in Africa: an evaluation of 6 possible screening tests.

PURPOSE: To determine if there is a screening test or a combination of screening tests that may be suitable for cataract and glaucoma case detection in Vision 2020 programs in Africa. METHODS: Design-Screening methods validation study. Setting-Groote Schuur Hospital, Cape Town, South Africa. Subjects-African patients aged 40 years and older with known cataract or with known glaucoma, and accompanying relatives aged 40 years and older with no known eye pathology. Outcome measures-Sensitivity, specificity, positive and negative likelihood ratios, and accuracy of 6 screening tests, used alone and in various combinations. RESULTS: Testing the pinhole visual acuity using a cut point of 6/18 in 1 or both eyes has a sensitivity and specificity greater than 90%, a positive likelihood ratio greater than 10.0, a negative likelihood ratio less than 0.1, and an accuracy greater than 90% for case detection of cataract or glaucoma. Examination of the optic disk with a lens free direct ophthalmoscope using a cut point of 0.7 for the vertical cup:disk ratio combined with testing for an afferent pupil defect has similar values for case detection of glaucoma. CONCLUSIONS: These tests may be suitable for use in Vision 2020 programs in Africa.