ABSTRACT
As the rate of new mouth cancer diagnoses continues to increase in the UK, awareness of risk factors and signs and symptoms remains low. This paper focuses on studies showing UK public awareness of risk factors, including alcohol, tobacco and human papillomavirus, as well as public understanding of signs and symptoms of mouth cancer. It includes a review of the effectiveness of campaigns in raising awareness of mouth cancer and examples of campaigns targeting other common cancers or risk factors that may provide useful learning ahead of upcoming mouth cancer campaigns. In addition, the awareness of the wider healthcare team and the importance of their role in identifying mouth cancer is explored. Current live campaigns in the UK are highlighted ahead of future initiatives now that the Mouth Cancer Action Charter has been launched and two new coalitions have been established.
Subject(s)
Mouth Neoplasms , Humans , Mouth Neoplasms/diagnosis , Mouth Neoplasms/etiology , Mouth Neoplasms/prevention & control , Health Personnel , Risk Factors , United Kingdom , Delivery of Health Care , Awareness , Health Knowledge, Attitudes, PracticeABSTRACT
BACKGROUND: Venous thromboembolism (VTE) complicates â¼1.2 of every 1000 deliveries. Despite these low absolute risks, pregnancy-associated VTE is a leading cause of maternal morbidity and mortality. OBJECTIVE: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and others in decisions about the prevention and management of pregnancy-associated VTE. METHODS: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations. RESULTS: The panel agreed on 31 recommendations related to the treatment of VTE and superficial vein thrombosis, diagnosis of VTE, and thrombosis prophylaxis. CONCLUSIONS: There was a strong recommendation for low-molecular-weight heparin (LWMH) over unfractionated heparin for acute VTE. Most recommendations were conditional, including those for either twice-per-day or once-per-day LMWH dosing for the treatment of acute VTE and initial outpatient therapy over hospital admission with low-risk acute VTE, as well as against routine anti-factor Xa (FXa) monitoring to guide dosing with LMWH for VTE treatment. There was a strong recommendation (low certainty in evidence) for antepartum anticoagulant prophylaxis with a history of unprovoked or hormonally associated VTE and a conditional recommendation against antepartum anticoagulant prophylaxis with prior VTE associated with a resolved nonhormonal provoking risk factor.