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Background Disparity in cancer survival across countries has been linked to variation in cancer policy delivery but there is lack of empirical evidence for this association. We traced the evolution of cancer policies in 20 jurisdictions in Australia, Canada, Denmark, Ireland, Norway, New Zealand and the UK since 1995 and present the findings of an exploratory analysis linking cancer policy consistency to cancer survival. Methods We systematically searched and analysed national/regional cancer plans and strategies, mapping timelines of cancer policy evolution. For 10 jurisdictions, evidence was synthesised into five categories: oversight function; cancer plan; implementation plan; budget for plan implementation; and evaluation. We assigned scores evaluating whether a category was present or absent, and weighted scores for consistency. Summed scores were correlated with trends in survival from seven cancers between 1995-2014. Results All ten jurisdictions had implemented a high-level structure overseeing, steering or delivering cancer control policies (1995 - 2014); all had also published at least one major cancer plan. There was great variation in oversight mechanisms, ranging from institutionalising cancer control (New South Wales, Ontario) to cancer steering groups or taskforces (Denmark, Northern Ireland, Wales). Frequency and consistency of cancer plans also varied, from a succession of plans that build on each other (Denmark, New South Wales, Ontario) to the publication of isolated plans (New Zealand, Northern Ireland). We found a positive, albeit weak, correlation of cancer policy consistency and improvements in survival over time for six of the seven cancers. Conclusions Jurisdictions that have implemented consistent cancer control policies over time tended to be more successful in improving survival for a wide range of cancers. Our findings can help guide policymakers seeking approaches and frameworks to improve cancer services and, ultimately, cancer outcomes. Key messages • Sustained and consistent strategic cancer planning and investment are crucial for ensuring better patient outcomes, and this requires strong and sustained commitment at all levels. • The findings can help guide policymakers seeking approaches and frameworks to improve cancer services and, ultimately, cancer outcomes.

Background Many countries are experimenting with novel ways of organising and delivering more integrated health and social care. Governance is relatively neglected as a focus of attention in this context but addressing governance challenges is key for successful collaboration. Methods Cross-country case analysis involving document review and semi-structured interviews with 27 local, regional and national level stakeholders in Italy, the Netherlands and Scotland. We used the Transparency, Accountability, Participation, Integrity and Capability (TAPIC) framework to structure our analytical enquiry to explore factors that influence the governance arrangements in each system. Results Governance arrangements ranged from informal agreements in the Netherlands to mandated integration in Scotland. Novel service models were generally participative involving a wide range of stakeholders, including the public, although integration was seen to be driven, largely, from a health perspective. In Italy and Scotland some reversion to ‘command & control’ was reported in response to the imperatives of the Covid-19 pandemic. Policies, budgets, auditing and reporting systems that are clearly aligned at all levels were seen to help with implementing innovations in service organisation. Where alignment was lacking, cooperation and integration was suboptimal, regardless of whether governance arrangements were statutory or not. There was wide recognition of the importance of buy-in. Enablers of greater engagement included visible leadership, time and long-standing working relationships. Lack of suitable indicators and openness to data sharing to measure integration hindered working relationships and thus the successful delivery of integrated services. Conclusions Our study provides important insights into how to more effectively and efficiently govern service delivery structures within care systems. We will discuss approaches to governance that help support more resilient integrated care systems. Key messages • Different governance arrangements face common challenges to greater integration of care. Enablers include strong leadership, inclusivity and openness to work across traditional boundaries. • Meeting the governance challenges of integrated health and social care requires clear lines of accountability, aligned policies, budgets and reporting systems.

Through his reflections on dealing with treatment for brain cancer and the resulting disabilities, the author helps to create an intriguing insight into how his experience was fashioned by the medical, emotional, and multicultural forces he faced. Prominent among the issues discussed are his coping with fear through humor, being able to accept his disabilities, and presenting a hopeful and lighter side to a personal hardship.

Youth experimentation with smoking is commonplace. Most anti-smoking efforts have focused on studying smokers and/or nonsmokers. Less attention has been directed at a significantly large group-ex-smokers. The purpose of this study is to present a profile of the ex-smoker in comparison to his/her smoking or never smoking counterparts. Knowledge about the ex-smoker group could enhance anti-smoking efforts. Data were collected from 5,393 central Illinois school age youth in grades 7–12. Data were analyzed by grade and sex. A variety of attitudinal, behavioral intention, and behavior questions about smoking were developed. Results clearly indicated that the ex-smoker group has a significantly different profile than youths who reported being a smoker or never smoker. Variables where differences were noted included close friends smoke, mother smokes, father smokes, mother would be upset, father would be upset, no one would be upset, best male friend upset, best female friend upset, and that smoking is a health problem. Differences were also noted with respect to believing that smoking helps people relax, is socially o.k. and whether or not separate areas should be designated for smokers. In most cases the ex-smokers more closely resembled the never smokers than the smokers.

The purpose of this study was to identify trends for youths grades seven to 12 with respect to their attitudes, beliefs and behaviors related to smoking and weight. The results of this study indicate that the majority of students believe smoking is a real health problem. However, the strength of this belief decreases with age. The majority of students agree that smoking does not help people relax, however, the strength of this belief also decreases with age. The majority of students also agree that smoking is not socially okay and again the strength of this belief decreases with age. Another interesting finding, differing from the trends previously mentioned, is that of asking permission before smoking. It was consistent that about 75% of students at all grade levels believed that they would ask permission before smoking around others. Another finding consistently supported across the grades more than 80% believed that a separate area should be provided for those who want to smoke in buildings where smoking is permitted. Youths report a significant decline in the percent of their peers that do not smoke as grade level increases. The decline is from 76% at the seventh grade to 39% at the 12th. While students at each grade level report that approximately one-third of their mothers and 43% of their fathers smoke they also indicate that 16% of their fathers and 10% of their mothers have given up the smoking habit. Youths also consistently report that their parents would be upset if they were to smoke.(ABSTRACT TRUNCATED AT 250 WORDS)

The purpose of the study was to assess the relative importance of parental attitudes about smoking and parental smoking behavior as factors associated with youth smoking behavior. Knowledge of the relative importance of each variable could enhance antismoking educational efforts. Data were collected from 5,409 central Illinois school-age youth in grades 7-12. Data were analyzed by sex. A variety of attitudinal, behavioral and behavior intention questions relative to risk factors, including smoking, were developed. Specific questions about parental attitudes, parental behavior, and the youth's smoking behavior were included. Descriptive and chi-square statistical analyses were utilized. Results indicate that both factors are significantly associated with youth smoking behavior. However, it appears that parental attitudes may exert a more significant impact than parental behavior. Whereas parental behavior seems to be associated with a doubling of the youth smoking rate, it appears that parental attitude is associated with an approximately fourfold increase. These results need to be interpreted within the larger context that a number of variables, and not just smoking attitudes and parental behavior have been found to be associated with youth smoking behavior. However, within this overall context it appears that parental attitude toward youth smoking is a more significant factor associated with youth smoking behavior than parental behavior. As such, those involved with youth antismoking educational efforts may find it helpful to include this factor.

(1976). The Relevance of Abraham Maslow's Work to Health Education. Health Education: Vol. 7, No. 3, pp. 25-27.

The purpose of this study was to assess whether an association exists between a student's attitudes and behaviors about selected health risks, such as weight and smoking behavior, and the presence or absence of one or both parents. Data were collected from 5,411 central Illinois school-age youth in grades 7-12. Physical measurements were taken on all students. Also, a variety of attitudinal, behavioral and behavioral intention questions relative to risk factors including smoking and weight were developed. Comparisons for these areas were made between students identified as having both parents versus those having none or one parent. The data were analyzed using the Statistical Package of the Social Sciences (SPSS). Both a descriptive and chi-square statistical analysis were utilized. Results indicated that students with none or one parent report significantly higher health risk behaviors than students with both parents. Students with none or one parent reported being more overweight and having a significantly higher smoking rate. The students also reported significantly greater unfavorable attitudes about smoking and weight. While these findings do not imply a cause and effect relationship, it does appear that the students missing one or both parents are at much higher risk than students with both parents. This knowledge can be useful to those involved in intervention efforts. Identifying students at risk allows educators to focus their efforts on such groups. Further implications of the specific findings of this study are discussed.

(1978). A Brief Historical Summary of Health and the Nature of Humans. Health Education: Vol. 9, No. 1, pp. 6-7.

(1980). Significance of Historical Research in Health Education. Health Education: Vol. 11, No. 6, pp. 40-41.

(1987). The AAHE Scholar Award: Profile of the First Decade. Health Education: Vol. 18, No. 6, pp. 29-30.