Disparities in pediatric cancer survivorship care: A systematic review.

BACKGROUND: Childhood cancer survivors (CCS) experience many long-term health problems that can be mitigated with recommended survivorship care. However, many CCS do not have access to survivorship care nor receive recommended survivorship care. We reviewed the empirical evidence of disparities in survivorship care for CCS. METHODS: This systematic review searched PubMed, CINAHL, and PsycINFO for studies on survivorship care for CCS (PROSPERO: CRD42021227965) and abstracted the reported presence or absence of disparities in care. We screened 7945 citations, and of those, we reviewed 2760 publications at full text. RESULTS: A total of 22 studies reported in 61 publications met inclusion criteria. Potential disparities by cancer treatment (N = 14), diagnosis (N = 13), sex (N = 13), and current age (N = 13) were frequently studied. There was high quality of evidence (QOE) of survivorship care disparities associated with non-White race, Hispanic ethnicity, and being uninsured. Moderate QOE demonstrated disparities among CCS who were unemployed and older. Lower QOE was found for disparities based on cancer diagnosis, cancer treatment, age at diagnosis, time since diagnosis, sex, insurance type, income, educational attainment, and geographic area. CONCLUSIONS: We found strong empirical evidence of disparities in survivorship care for CCS associated with race, ethnicity, and insurance status. Multiple other disparate groups, such as those by employment, income, insurance type, education, cancer diagnosis, age at diagnosis, time since diagnosis, cancer treatment, geographic area, sex, and self-identified gender warrant further investigation. Prospective, multilevel research is needed to examine the role of other patient characteristics as potential disparities hindering adequate survivorship care in CCS.

Component analysis of four commercial brands of gutta-percha.

INTRODUCTION: Gutta-Percha, the concrete milky juice of the Sapotaceae family tree, is the most commonly used material for obturation of prepared canal space. Natural 1-4 trans stereochemical structure of Gutta-Percha is taken to a heating- inclusion process of various organic and inorganic elements by manufacturers. The purpose of this study is to detect the presence and percentage of inorganic filler elements and organic phase of various commercial brands and if the locally manufactured brand confonns to standard range of components. MATERIALS AND METHODS: Sample cones, size # 35, from Roeko, Hygienic, DiaDent and AriaDent brands were randomly selected. After burning out in the furnace, organic and inorganic phase percentage and presence of trace elements in each sample were detected and recorded using apparatuses such as SEM, XRF, TGA, IR, NMR, and Ion Chromatography. RESULTS: With slight differences in polymer / filler ratio, 78% ± 2% for organic phase, no significant difference was recorded among these brands. SEM analysis detected Zinc, Barium, and Sulfur in Hygienic, DiaDent, and AriaDent in descending order; in the last two Silicones was also traced, while Zinc was the only element to be identified in Roeko. CONCLUSION: No significant chemical and structural differences among four commercial brands were detected.