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International research suggests that the success of re-entering school for cancer survivors is multifactorial. The quality of the school-family-hospital liaison and the promotion of social links between the child with cancer and his or her classmates appear to be central points. In France, the schooling of children with cancer is not frequently examined, and the teachers' experiences are never discussed. The aim of our study is to investigate the professional practices and experiences of French teachers in kindergarten and primary schools welcoming students with cancer, regarding international studies, to contribute to improving the handling of these children. By using an international survey based on the Delphi method as well as qualitative data, we investigated the point of view of 66 French teachers working in kindergarten and primary schools. Both methods highlight that strong collaboration with parents, the information provided by medical staff, and social connections with classmates constitute needs for interviewed teachers. In parallel, keeping a constant link with the children and their families, raising the awareness of peers, and providing personalized support to the survivor student appear to be major resources for these teachers. In terms of difficulties, both methods attest that teachers request training and more support to manage both survivor students' academic difficulties, peer awareness, and mutual understanding. Besides, qualitative results suggest a lack of efficiency in school-hospital liaison and in institutional support, which might be strengthened through standardization of the re-entry process and systematic monitoring of the school career of these children.

Innovations in medicine have allowed children with cancer to attend school more frequently by increasing survival rates and improving access to outpatient therapies. Children with cancer still miss a significant proportion of school attendance and participation during treatment, thereby disrupting their educational experiences. "Monkey in My Chair" is a program in the United States that connects ill children with their schoolmates during illness-related absences to support their social relationships and eventual school re-entry into the school environment. However, little is known about how this program is perceived and experienced by participating schoolteachers. Therefore, the purpose of this study was to understand teacher perceptions of the Monkey in My Chair program. One hundred and one teachers who participated in the program between 2012 and 2022 completed an electronic survey about their experiences. Overall, participants reported satisfaction with the program and indicated they would recommend it to other teachers. Most preferred and utilized components were the stuffed animal monkey and the perceived sense of connection it created among students. Participants suggested several areas in which the program can be improved, such as requesting more digital program components, expanding beyond the scope of oncology diagnoses, creating more developmentally appropriate materials, and including an instructional video. Future research is needed to understand all stakeholder experiences, including those of children with cancer and their classmates, to continue to evaluate and improve the Monkey in My Chair program.

This study was conducted to determine the perceptions of children, one of whose relatives was undergoing chemotherapy treatment and who participated in education at the House of Compassion, about the patient and hospital perceptions and their views on the House of Compassion. Case study design, one of the qualitative research designs, was used. Criterion sampling, one of the purposeful sampling types, was used to determine the study group. The study group consisted of 20 children who participated in the training at the House of Compassion in a hospital in Ankara and one of whose relatives was undergoing chemotherapy treatment. In the study, "Demographic Information Form" was used to collect information about children and parents, "Child Interview Form" and "Children's Pictures" were used to determine children's perceptions of patients, hospital and House of Compassion. The data obtained were analyzed using the descriptive analysis technique. As a result of the research, it was observed that children knew the definition of the hospital, the personnel working in the hospital, and the practices carried out, and emphasized the healing and therapeutic aspects of the hospital. Children reported coming to the House of Compassion to play games, have fun, and have a good time. It was determined that children felt happy and sound in the House of Compassion and that they liked the House of Compassion. As a result, it can be said that the House of Compassion has positive effects on children's perceptions of the patient and the hospital.

This study aims to investigate Vietnamese pain terms and pain descriptors with a focus on how the McGill Pain Questionnaire (MPQ) words are utilised by the Vietnamese patients. Semi-structured interviews were employed to collect data from twenty-six Vietnamese female cancer patients. The data were analysed using both quantitative and qualitative content analysis. The findings indicated that dau (hurt), nh?c (ache), and dau-nh?c (hurt and ache) are three basic pain terms in Vietnamese, with dau being a super-ordinate pain term. In addition, Vietnamese pain descriptors can be systematically classified into MPQ-VN descriptors and Non-MPQ-VN descriptors, with the latter being used far more frequently than the former. The study also found that MPQ descriptors could not reflect the patients' pain experience comprehensively in the Vietnamese context although the Vietnamese employed the equivalents of MPQ descriptors of different categories. That the limitations of Melzack's (1975) inventory of MPQ descriptors have been validated in Vietnamese has contributed to Vietnamese healthcare professionals' understanding of how the patients communicate about their pain experience using language. The study has also shed lights on applied linguists' research directions which can be extended to areas beyond language education, such as health, therapy, and counselling.

A cancer diagnosis enlivens the question of what it means to live well with the Earth and its multidimensional beings, including the children I teach. A cancer diagnosis provides a necessary push to step out from the confines of a self and toward and into the wild fray of this life. I interpret my lived experiences through the practical philosophy of hermeneutics. Hermeneutics has helped me perform and write my lived experience, which I hope will draw in readers and listeners to a recognition of their inescapable ecological interdependence. Cultivating an ability to listen and interpret the world and the human and more-than-human kinships is important to me. Listening to words that children speak helps me learn to be open to the fullness of life, how life is lived, how life can be remembered and suffered and let go. I am gathering sense of being in the world and of understanding the offering that arrives when I nurture a commitment to care for the Earth.

Despite high survival rates for many adolescent or young adult (AYA) cancer diagnoses, the psychosocial, academic, and vocational repercussions for survivors are profound and enduring. Hospital systems are able to address many AYA needs, but the ability to provide the human connectedness and knowledge that drive long-term school and career planning is lacking. This study assessed a group of AYAs who have or had cancer (n = 108, 54% female, 71% white, mean age 20.6 ± 4.4) to determine the school, career, medical, emotional, and psychosocial needs that are not currently being met by hospital staff and support networks. We identified the most common unmet needs of AYAs, differences between needs of AYAs in active treatment and survivorship, and the role of a career-focused mentoring program developed by the nonprofit organization Connecting Champions (CC) to address the array of unmet AYA needs. We found that the most commonly reported needs were all related to career and school, and that the top needs did not differ significantly throughout the cancer journey. These findings suggest that career and school-based needs are a high priority for AYAs, yet social isolation can make the necessary people or resources inaccessible. The CC mentoring program was reported as effective in attending to unmet needs (with an average score of 95.1/100) and can be a valuable resource for hospital systems, nonprofit organizations, and health insurers to provide personalized, career-focused support to AYAs during cancer treatment and survivorship.

The Accelerate Cancer Education (ACE) summer research program at The University of Kansas Cancer Center (KUCC) is a six-week, cancer-focused, summer research experience for high school students from historically marginalized populations in the Kansas City metropolitan area. Cancer affects all populations and continues to be the second leading cause of death in the United States, and a large number of disparities impact racial and ethnic minorities, including increased cancer incidence and mortality. Critically, strategies to bolster diversity, equity, inclusion, and accessibility are needed to address persistent cancer disparities. The ACE program offers an educational opportunity for a population of students who otherwise would not have easy access onto a medical center campus to make connections with cancer physicians and researchers and provides a vital response to the need for a more diverse and expansive oncology workforce. Students grow their technical, social, and professional skills and develop self-efficacy and long-lasting connections that help them matriculate and persist through post-secondary education. Developed in 2018, the ACE program has trained 37 high school junior and senior students. This article describes the need for and how we successfully developed and implemented the ACE program.

The effective implementation of evidence-based teaching (EBT) in large college courses benefits from the successful use of instructional teams. An instructional team's feedback allows instructors to act based on evidence of student learning, addressing students' needs. This feedback may be particularly important for novice instructors or experienced instructors teaching a class for the first time. This study sought to characterize the nature of an instructional team's feedback as well as its influence on the decisions and actions of a seasoned instructor teaching a new class. Instructional team members provided feedback in the form of anticipations, noticings, and suggestions. Anticipations and suggestions seemed to have the largest impact on the instructor's decisions and actions, while noticings, despite providing insights into student thinking, had a smaller effect. Our findings indicate that an instructional team can provide valuable feedback to instructors when team members have an opportunity to meaningfully participate in the planning and teaching processes.

This study aimed to assess the feasibility of applying two recent phase I meta-analyses methods to protein kinase inhibitors (PKIs) developed in oncology and to identify situations where these methods could be both feasible and useful. This ancillary study used data from a systematic review conducted to identify dose-finding studies for PKIs. PKIs selected for meta-analyses were required to have at least five completed dose-finding studies involving cancer patients, with available results, and dose escalation guided by toxicity assessment. To account for heterogeneity caused by various administration schedules, some studies were divided into study parts, considered as separate entities in the meta-analyses. For each PKI, two Bayesian random-effects meta-analysis methods were applied to model the toxicity probability distribution of the recommended dose and to estimate the maximum tolerated dose (MTD). Meta-analyses were performed for 20 PKIs including 96 studies corresponding to 115 study parts. The median posterior probability of toxicity probability was below the toxicity thresholds of 0.20 for 70% of the PKIs, even if the resulting credible intervals were very wide. All approved doses were below the MTD estimated for the minimum toxicity threshold, except for one, for which the approved dose was above the MTD estimated for the maximal threshold. The application of phase I meta-analysis methods has been feasible for the majority of PKI; nevertheless, their implementation requires multiple conditions. However, meta-analyses resulted in estimates with large uncertainty, probably due to limited patient numbers and/or between-study variability. This calls into question the reliability of the recommended doses.

It has been shown that active learning strategies are effective in teaching complex STEM concepts. In this study, we developed and implemented a laboratory experiment for teaching the concepts of Boolean logic gates, molecular beacon probes, molecular computing, DNA logic gates, microRNA, and molecular diagnosis of hepatocellular carcinoma, which are related to DNA molecular computing, an interdisciplinary cutting-edge research technology in biochemistry, synthetic biology, computer science, and medicine. The laboratory experience takes about110-140 min and consists of a multiple-choice pretest (15 min), introductory lecture (20 min), wet laboratory experiment (60-90min), and a post-test (15 min). Students are tasked to experimentally construct three molecular logic circuits made of DNA oligonucleotides and use them for the fluorescence-based detection of microRNA markers related to diagnostics of hepatocellular carcinoma. The class was taught to undergraduate students from freshman to senior academic levels majoring in chemistry, biochemistry, biotechnology, and biomedical sciences. Students were engaged during the session and motivated to learn more about the research technology. A comparison of students' scores on the pretest and post-test demonstrated improvement in knowledge of the concepts taught. Visual observation of the fluorescence readout led to a straightforward interpretation of the results. The laboratory experiment is portable; it uses inexpensive nontoxic reagents and thus can be employed outside a laboratory room for outreach and science popularization purposes.

The Human Papillomavirus (HPV) vaccine can prevent 90% of cancers caused by HPV. Health care provider recommendations affect vaccine uptake, yet there are a lack of studies examining the impact of the school nurse (SN) in vaccine recommendations. The purpose of this study was to evaluate the impact of adding a SN HPV recommendation to the standard vaccination letter sent to parents/guardians. The rate of vaccination between the intervention and control schools was not statistically significant (Estimate (Std. Error) = -0.3066 (0.2151), p = 0.154). After controlling for age, sex, race, insurance type, and medical practice type, there was no significant difference in the likelihood to receive the HPV vaccine (OR = 1.53, 95% CI: 0.563-4.19 in 2018; OR = 1.34, 95% CI: 0.124-14.54 in 2019. Further work is needed to clarify how school nurses can better promote HPV vaccine, and which adolescent demographic groups (e.g., race, insurance type, provider type) face barriers to HPV vaccine uptake.

Background: The MD Anderson Dysphagia Inventory (MDADI) is a widely used patient-reported outcome measure (PROM) which assesses dysphagia-related quality of life (QoL) in head and neck cancer (HNC). Despite its common use in HNC research and clinical practice, few of its psychometric properties have been reappraised since its inception. The aim of this study was to perform a survey-based qualitative analysis of UK HNC clinicians' perceptions of the content validity of the MDADI, evaluating it across the parameters of relevance, comprehensiveness and comprehensibility as per the COSMIN guideline for PROM assessment. Results: Four themes relating to the content validity of the MDADI were identified: (1) MDADI items lack clarity of definition of the terms 'swallowing', 'eating' and 'dysphagia'; (2) the MDADI is perceived to be overly negative in tone including items that service users may find distressing or disempowering; (3) items in the tool are exclusory to specific subgroups of patients, such as those who are nil by mouth or socially isolated; and (4) modifications to the MDADI were suggested and encouraged to make it more clinically useful and patient-centred. Conclusions: This study indicates that MDADI's content validity is 'insufficient' when rated by COSMIN parameters. This has significant implications for its continued use in HNC research and clinical practice. Further re-evaluation of the content validity of the MDADI is warranted, with potential future amendment of items being indicated if the results of this study are corroborated in subsequent research.

Background: Women with learning disabilities are less likely to access cervical and breast cancer screening when compared to the general population. The Social Ecological Model (SEM) was used to examine the inequalities faced by women with learning disabilities in accessing cervical and breast cancer screening in England, UK. Methods: The findings from a qualitative systematic review and a Q methodology study were triangulated. Framework analysis, in line with the SEM, was used to develop an integrated set of findings. Findings: Women with learning disabilities may lack knowledge of cancer symptoms, and cancer screening, as well as being scared about the process and getting the results. The attitudes of family and paid carers towards screening may influence women with learning disabilities' decisions as to whether screening is seen as favourable; support and training may ensure unbiased perspectives. Barriers were also associated with how cancer screening programmes are designed, such as postal invitations which assumes an ability to read. In addition, screening staff need to be aware of the general needs of people with learning disabilities, such as the benefits of easy-to-read documents. Lastly, multidisciplinary working is required so reasonable adjustments can be embedded into cancer screening pathways. Conclusion: This article highlights multiple methods to reduce the inequalities faced by women with learning disabilities, which can be achieved through reasonable adjustments. Embedding reasonable adjustments can support women with learning disabilities in making an informed decision and accessing screening if they choose to. This may result in women with learning disabilities getting a timely cancer diagnosis.

High-impact practices (HIPs) are educational practices that foster student success. HIPs have not been widely used in cancer education and research despite the need for students to develop key transferable skills and cultivate social responsibility. Our study addresses this need by implementing four community-based learning HIPs within the context of cancer education and research. Each HIP was classified as having low, moderate, or high alignment with the traits of effective HIPs. Undergraduate science students participated in one to four HIPs as a Feedback Participant, General Volunteer, Student Leader, or Cancer Undergraduate Research and Education (CURES) Class Student. We then studied the effect of these HIPs on students' development of knowledge and skills; career interest and preparedness; and social responsibility. Results from self-reported questionnaires showed that HIPs increased students' cancer knowledge and developed their transferable and technical skills. Many students reported that these HIPs strongly impacted their career preparedness; positively influenced their interest in pursuing careers in health or biomedical sciences; and encouraged them to participate in community service activities. Thus, these findings provide new insights into the perceived benefits of HIPs in cancer education and research by undergraduate students.

Background: Traditionally, meta-analysis of time-to-event outcomes reports a single pooled hazard ratio assuming proportional hazards (PH). For health technology assessment evaluations, hazard ratios are frequently extrapolated across a lifetime horizon. However, when treatment effects vary over time, an assumption of PH is not always valid. The Royston-Parmar (RP), piecewise exponential (PE), and fractional polynomial (FP) models can accommodate non-PH and provide plausible extrapolations of survival curves beyond observed data. Methods: Simulation study to assess and compare the performance of RP, PE, and FP models in a Bayesian framework estimating restricted mean survival time difference (RMSTD) at 50 years from a pairwise meta-analysis with evidence of non-PH. Individual patient data were generated from a mixture Weibull distribution. Twelve scenarios were considered varying the amount of follow-up data, number of trials in a meta-analysis, non-PH interaction coefficient, and prior distributions. Performance was assessed through bias and mean squared error. Models were applied to a metastatic breast cancer example. Results: FP models performed best when the non-PH interaction coefficient was 0.2. RP models performed best in scenarios with complete follow-up data. PE models performed well on average across all scenarios. In the metastatic breast cancer example, RMSTD at 50-years ranged from -14.6 to 8.48 months. Conclusions: Synthesis of time-to-event outcomes and estimation of RMSTD in the presence of non-PH can be challenging and computationally intensive. Different approaches make different assumptions regarding extrapolation and sensitivity analyses varying key assumptions are essential to check the robustness of conclusions to different assumptions for the underlying survival function.

Background: Perceptual measures such as speech intelligibility are known to be biased, variant and subjective, to which an automatic approach has been seen as a more reliable alternative. On the other hand, automatic approaches tend to lack explainability, an aspect that can prevent the widespread usage of these technologies clinically. Aims: In the present work, we aim to study the relationship between four perceptual parameters and speech intelligibility by automatically modelling the behaviour of six perceptual judges, in the context of head and neck cancer. From this evaluation we want to assess the different levels of relevance of each parameter as well as the different judge profiles that arise, both perceptually and automatically. Methods and Procedures: Based on a passage reading task from the Carcinologic Speech Severity Index (C2SI) corpus, six expert listeners assessed the voice quality, resonance, prosody and phonemic distortions, as well as the speech intelligibility of patients treated for oral or oropharyngeal cancer. A statistical analysis and an ensemble of automatic systems, one per judge, were devised, where speech intelligibility is predicted as a function of the four aforementioned perceptual parameters of voice quality, resonance, prosody and phonemic distortions. Outcomes and Results: The results suggest that we can automatically predict speech intelligibility as a function of the four aforementioned perceptual parameters, achieving a high correlation of 0.775 (Spearman's [rho]). Furthermore, different judge profiles were found perceptually that were successfully modelled automatically. Conclusions and Implications: The four investigated perceptual parameters influence the global rating of speech intelligibility, showing that different judge profiles emerge. The proposed automatic approach displayed a more uniform profile across all judges, displaying a more reliable, unbiased and objective prediction. The system also adds an extra layer of interpretability, since speech intelligibility is regressed as a direct function of the individual prediction of the four perceptual parameters, an improvement over more black box approaches.

Globally, approximately 400,000 youth are diagnosed with pediatric cancer each year. Treatment-related side effects, psychosocial challenges, and frequent school absences may adversely impact learning and the education experience among these youth. Efforts to enhance interagency collaboration between health care settings and community schools are imperative to facilitate school reintegration. The "Standards for the Psychosocial Care of Children with Cancer and Their Families" outline specific guidelines related to the continuity of education for students impacted by pediatric cancer. In particular, the "Academic Continuity and School Reentry Support" and "Monitoring and Assessment of Neuropsychological Outcomes" standards of care highlighted within this article align with extant programmatic efforts for transitioning hospitalized school-aged children back into community schools. This article aims to describe systematic programmatic efforts within hospital-based psychosocial programs that are consistent with the "Standards for the Psychosocial Care of Children with Cancer and Their Families," as well as interagency collaboration with community schools to support student-centered education for youth impacted by pediatric cancer. Resources for school psychologists, teachers, hospital-based programs, and others involved in student-centered education for pediatric cancer patients and survivors are presented.

Recently, there has been an emphasis on keeping the study of anatomy using donor material confined to the domain of medical and allied healthcare professionals. Given the abundance of both accurate and inaccurate information online, coupled with a heightened focus on health following the COVID-19 pandemic, one may question whether it is time to review who can access learning anatomy using donors. In 2019, Brighton and Sussex Medical School (BSMS) obtained a Human Tissue Authority Public Display license with the aim of broadening the reach of who could be taught using donor material. In 2020, BSMS received its first full-body donor with consent for public display. Twelve workshops were delivered to student groups who do not normally have the opportunity to learn in the anatomy laboratory. Survey responses (10.9% response rate) highlighted that despite being anxious about seeing inside a deceased body, 95% felt more informed about the body. A documentary "My Dead Body" was filmed, focusing on the rare cancer of the donor Toni Crews. Viewing figures of 1.5 million, and a considerable number of social media comments highlighted the public's interest in the documentary. Thematic analysis of digital and social media content highlighted admiration and gratitude for Toni, the value of education, and that while the documentary was uncomfortable to watch, it had value in reminding viewers of life, their bodies, and their purpose. Fully consented public display can create opportunities to promote health-conscious life choices and improve understanding of the human body.

Black men have a greater risk of prostate cancer as well as worse quality of life and more decisional regret after prostate cancer treatment compared to non-Hispanic White men. Furthermore, patients with prostate cancer who primarily obtain information on the internet have significantly more decisional regret compared to other information sources. Our objective was to explore the perspectives of Black patients on the use and impact of the internet for their prostate cancer care. In 2022-2023, we conducted seven virtual focus groups with Black patients with prostate cancer (n = 22). Transcripts were independently analyzed by two experienced researchers using a constant comparative method. Online sources were commonly used by participants throughout their cancer journey, although informational needs varied over time. Patient factors affected use (e.g., physical health and experience with the internet), and family members played an active role in online information-seeking. The internet was used before and after visits to the doctor. Key topics that participants searched for online included nutrition and lifestyle, treatment options, and prostate cancer in Black men. Men reported many downstream benefits with internet use including feeling more empowered in decision-making, reducing anxiety about treatment and providing greater accountability for research. However, they also reported negative impacts such as feeling overwhelmed or discouraged sorting through the information to identify high-quality content that is personally relevant, as well as increased anxiety or loss of sleep from overuse. In summary, online sources have the potential to positively impact the cancer journey by reinforcing or supplementing information from health care providers, but can be harmful if the information is poor quality, not representative, or the internet is overused.

Healthy lifestyle behaviors can improve health-related quality of life (HRQOL) in cancer survivors; but the combination of behaviors most important for HRQOL is not known. This study investigated the patterns of lifestyle behaviors among cancer survivors and differences in HRQOL between behavioral classes. Cancer survivors (n = 2,463) were invited to participate in a cross-sectional survey. Participants (N= 591) were predominately female (63%) and non-Hispanic White (90%). Survey items included self-reported physical activity, diet, smoking, sleep, HRQOL, and demographics. Behavioral classes were estimated by latent class analysis. Differences between classes were assessed by latent class regression. Compared with the "healthy lifestyles" class (higher probabilities of meeting aerobic/strength-based activity guidelines, high fruit/vegetable intake, and no sleep problems; 11% of sample), the "sleep and diet problems with inconsistent physical activity" class (higher probabilities of not meeting strength-based guidelines, low fruit/vegetable intake, some sleep problems; marginally higher probability of meeting aerobic guidelines; 41%) had poorer general and physical HRQOL. The "poor physical activity and diet" class (higher probabilities of not meeting aerobic/strength-based guidelines, low fruit/vegetable intake, and some sleep problems; 48%) had poorer general, physical, and mental HRQOL. Few participants exhibited healthy lifestyle patterns associated with HRQOL. The findings provide opportunities to develop differentiated multiple behavior-change interventions, targeted to two common patterns of behavior. A large subgroup of cancer survivors was susceptible to suboptimal physical activity and diet, warranting interventions exclusively targeting these behaviors. Another subgroup was susceptible to suboptimal physical activity, diet, and sleep, indicating interventions for this group should include strategies targeting these three behaviors.

Community-engaged patient navigation safety net programs are established as an evidence-based approach to address cancer prevention and early detection efforts, but barriers to expand and sustain such programs persist. In addition, few studies describe how these programs impact buy-in among communities and policy change within health care systems and government. We describe how we used the Capacity for Sustainability Framework to guide efforts for program sustainability and community, institutional, and policy level change in a breast cancer screening and patient navigation safety net program. The nine domains of the Capacity for Sustainability Framework were used to develop program logic models, to inform program implementation and quality improvement agendas, and to guide multi-level partner and stakeholder engagement, outreach, and dissemination of outcomes. The program is currently in its seventh year and continues to be annually funded by a city public health department. In 2021, additional 5-year renewable funding from a state public health department was secured. In addition, institutional program support was expanded for patients diagnosed with breast cancer. Program leaders worked with policymakers to draft legislation to support training certification and third-payor reimbursement for patient navigators and community health workers. The program is well-known and trusted among community members, community-based organizations, and providers. Community, organizational, and policy-level outcomes demonstrate that community-engaged patient navigation safety net programs can influence more than individual and interpersonal outcomes and can be sustained over time.

Children with cancer experience recurring hospitalizations and isolation during treatment, which affect their school attendance. This study explores experiences of children with cancer, their classmates, and teachers with using the telepresence robot as a learning mediator in the hybrid classroom during treatment periods. 31 children with cancer (aged 7-17 years), 30 teachers, and 118 classmates participated in interviews and 19 h of participant observations were undertaken in nine classrooms. The Agential Realism Theory and Situational Analysis framed the data analysis. There was a single overarching theme, "Telepresence robot didactic," and five sub-themes (Telepresence mediated learning, school-home collaboration, hybrid robot teaching, intra-actions in class, and inclusive spatiality). This study advocates the complexity of telepresence robot didactics, emphasizing that numerous human and other factors must intra-act and work simultaneously to achieve optimal learning conditions for children during cancer treatment. This includes considerations such as modality availability for the remote child; the teacher's understanding of telepresence robot didactic and hybrid learning; the classmate's ability to involve the remote child in groupwork; the child's own treatment protocol, the robot's functionalities, and spatiality in the class. Strategies for use and the systematic surveillance of telepresence robots are needed to ensure that children during cancer treatment do not lag in academic achievement. This study proposes that children with cancer can continue participating in class while hospitalized or isolated and consequently reduce social and academic setbacks.

It is important for high school female students, to be familiar with their own bodies and regularly examine their own breasts to check for any changes that could potentially be indicative of breast cancer. It is important to educate students about breast self-examination (BSE) as a means of detecting potential breast cancer early. A quasi-experimental pre and post-test design were implemented to evaluate the effectiveness of the educational program on high school female students by comparing the knowledge level obtained before and after the conduction of the educational program. The sociodemographic results of this study found that before conducting the educational program, a large number of participants (76.5%) had poor knowledge about BSE, but after the conduction of the educational program, there was a significant increase in knowledge, with 90.2% showing a positive effect of the program. The test of significance revealed that the increase in BSE knowledge score as a result of the educational program was highly significant (P < 0.000).

The Coronavirus Disease 2019 (COVID-19) pandemic has significantly affected the educational system. Historically, children with hematological and oncological conditions have experienced academic challenges. A retrospective chart review was conducted. Charts reviewed included children with oncology or hematology conditions, whose parents expressed educational concerns and were referred to an educational liaison in the Pediatric Hematology, Oncology, and Stem Cell Transplantation Division. The parental concerns for 102 children (M age = 10.03 ± 4.7; 59.8% male; 43.1% Latinx/ Hispanic) during the first half of the 2021 to 2022 academic year were extracted. Overall, all parents reported at least one concern with the average reporting 2.24 ± 1.34 (range of 1-6 concerns). The most common general concerns regarded: Individualized Education Programs (IEP) or special education evaluations; 504 accommodations; home instruction; school enrollment. Almost half of the parents had additional concerns they specifically attributed to COVID-19. Children with hematological and oncological conditions were experiencing various needs at this time, which likely have continued implications. It is important for educators, school psychologists, and health care providers to remain cognizant of the educational needs of medically vulnerable populations. Children with hematological and oncological conditions benefit from regular evaluation of their needs, as well as proactive forms of intervention.

Cutaneous malignancy is one of the leading causes of cancer-related morbidities and mortalities. Patient self-screening is helpful for early detection. Among educational pedagogies, game-based learning (GBL) has received increasing attention in recent years. We appraised the effectiveness of GBL, using Wordwall, to enhance cognitive performances pertaining to fundamental knowledge of cutaneous malignancies and perspectives on the intervention compared with a digital pamphlet. This multi-center study utilized a quasi-experimental research design and was conducted between February and April 2022. Participants were recruited and randomly assigned into a game group and a pamphlet group with a 1:1 ratio. Fundamental knowledge of cutaneous malignancies was assessed with pre- and post-intervention tests consisting of ten multiple choice questions with four alternative answers. These tests asked about prominent or pathognomonic features of cutaneous malignancies. During the five-day intervention period, recognition scores of participants in the game group were recorded. Perspectives on the interventions were also collected for analysis. A total of 94 participants were included, 60 (63.8%) were female. The mean age was 19.8 years (standard deviation [SD]=0.8). The increase in knowledge scores of the participants in the game group and pamphlet group was 2.57 (SD=1.30) and 2.36 (SD=1.52), respectively. In the game group, the mean best recognition score (13.89, SD=2.83) was significantly higher than the mean first recognition score (9.53, SD=2.48) with a pvalue <0.001. The overall satisfaction among the participants in the game group and pamphlet group was 4.41 (SD=0.57) and 4.23 (SD=0.59), respectively. This study suggests potentiality of GBL to enhance knowledge and recognition performances of common cutaneous malignancies with high satisfaction. Embedding this approach in the primary prevention of cutaneous malignancies might be a promising option to prevent cancer-related morbidities and mortalities.

Background: The COVID-19 pandemic resulted in rapid changes to head and neck cancer (HNC) services. Multidisciplinary team (MDT) face-to-face appointments were converted to telehealth appointments (telephone and video-call) to reduce the risk of COVID-19 transmission. The literature exploring HNC patient experience of these appointment types is limited. Aims: To explore patient experience of telehealth appointments at one UK centre during the COVID-19 pandemic, as well as the variables that may influence patient preference for virtual or face-to-face appointments. Methods & Procedures: A survey-based study design was used, with closed questions and open text options to capture the views of the participants. Quantitative data were analysed using descriptive statistics. Open text data was used to add depth to the findings. Outcomes & Results: A total of 23 participant surveys were returned. Six categories were identified: Usability; Information receiving & giving; Satisfaction; Emotions and comfort; Rapport; and Travel time and cost. Overall, participants gave positive responses to each category and indicated that telehealth appointments met their needs. Areas for clinical consideration are highlighted. Variables such as age, travel distance from hospital site, fear of COVID-19 and information technology (IT) access did not appear to influence patient preference for appointment type. Conclusions & Implications: Going forward, telehealth may be considered for use in combination with face-to-face appointments in the HNC pathway. Areas for further development include a 'telehealth screening tool' that may help to identify those patients most appropriate for these appointment types, or who require support to access them.

Background: Individuals with severe motor and intellectual disabilities have become an aging population, and high cancer morbidity and mortality are critical issues affecting their survival. Cancer screening is a crucial method of resolving this issue; however, a suitable screening method for them has not been established. Methods: We used ultrasonography alone and performed breast cancer screening for women over 30 years old in our facility from 2016 to 2023. We observed the outcomes and calculated the recall/detection rate in this screening. Results: Three cases among 379 tested positive in this screening, all of which underwent radical surgery. They are alive and well without relapse present. We detected these breast cancer cases with a low recall rate. Conclusion: We were able to successfully detect breast cancer cases using ultrasonography alone. Ultrasonography is an effective and feasible tool for breast cancer screening in individuals with severe motor and intellectual disabilities.

The University of Pittsburgh Medical Center Hillman Cancer Center Academy (Hillman Academy) has the primary goal of reaching high school students from underrepresented and disadvantaged backgrounds and guiding them through a cutting-edge research and professional development experience that positions them for success in STEM. With this focus, the Hillman Academy has provided nearly 300 authentic mentored research internship opportunities to 239 students from diverse backgrounds over the past 13 years most of whom matriculated into STEM majors in higher education. These efforts have helped shape a more diverse generation of future scientists and clinicians, who will enrich these fields with their unique perspectives and lived experiences. In this paper, we describe our program and the strategies that led to its growth into a National Institutes of Health Youth Enjoy Science-funded program including our unique multi-site structure, tiered mentoring platform, multifaceted recruitment approach, professional and academic development activities, and a special highlight of a set of projects with Deaf and Hard of Hearing students. We also share student survey data from the past six years that indicate satisfaction with the program, self-perceived gains in key areas of scientific development, awareness of careers in STEM, and an increased desire to pursue advanced degrees in STEM.

Kentucky has the highest cancer incidence and mortality rates in the nation, with rates greatest in the Appalachian region due to poor health behaviors and inequities in social determinants of health. The Appalachian Career Training in Oncology (ACTION) Program at the University of Kentucky Markey Cancer Center engages 20 Appalachian-native high school students annually in cancer education, research, and outreach activities. During the COVID-19 pandemic, programming was disrupted, and alternative activities were implemented, including virtual research experiences. The program's goals were to improve students' biology and cancer content knowledge and research skills and help students make career decisions. Virtual laboratories were used to help accomplish these goals. This study aimed to evaluate the use of virtual laboratories embedded in the program and determine if such experiences helped reach the program's goals. A survey was used to measure students' perceptions of the virtual labs. Results indicated that students perceived they gained content knowledge, obtained research skills, and considered entering science and cancer-related careers. The decision to incorporate virtual laboratories into the ACTION programming during the COVID-19 pandemic was a sound instructional choice. Evidence provided herein gives researchers and program developers information necessary to consider using virtual labs in their programs.

Cancer research training programs build our future biomedical workforce. Training is often centered for students residing close to research institutions, making access more challenging for rural students. A cancer research training program was developed for high school students residing in five geographical regions across Oregon. Training was tiered in duration and intensity across the three years, including a one-week Introduction program and subsequent 10-week summer research training programs (Immersion and Intensive). A total of 60 students participated in in-person and/or virtual training, with Immersion students receiving mentored shadowing experiences in clinical care, public health, and outreach in their home communities. Laboratory rotations at a research-intensive institution enabled students to sample research environments before selecting an area of interest for Intensive training the following summer. Aligning with Self-Determination Theory, the Knight Scholars Program aims to build competence, relatedness, and autonomy of its trainees in biomedical sciences. The program exposed students to a wide range of interprofessional careers and collaborative teams, enabling scholars to envision themselves in various paths. Results show strong gains in interest and research self-efficacy for both Introduction and Immersion scholars, with findings highlighting the importance of representation within mentoring and training efforts.

The Youth Enjoy Science -Teach To Beat Cancer program funded by the National Cancer Institute utilizes the resources of the Case Western Reserve University School of Medicine and Case Comprehensive Cancer Center to provide experiences and training for grade 6-12 teachers so that they are expertly equipped to develop curricular approaches to take back to their classrooms to enhance science education, introduce concepts of cancer biology, encourage cancer risk reduction activities, foster disparity elimination and to motivate middle and high school students to pursue careers in biomedical sciences and cancer research. The program focuses on four aspects of teacher engagement and education: (1) Research Engagement, (2) Curriculum Development, (3) Risk Reduction and Disparity Elimination, and (4) Advocacy for Cancer Research and Cancer Research Careers. This program has been crucial to achieve the National Cancer Institute's goal of educating students from diverse backgrounds underrepresented in biomedical research in the Cleveland area as each teacher influences a significant number of students in their classrooms each year, and are introducing students to cancer biology, exciting them to consider careers in cancer prevention, diagnosis, control, treatment, and research. This article provides an overview of the program including its impact on the teachers and their students.

Objective: Examine factors contributing to high rates of Appalachian female cancer incidences and mortalities by examining cancer literacy and associated sociological influences among Appalachian university students. Participants: This study evaluated Appalachian and non-Appalachian undergraduate students in Eastern Kentucky. Methods: A Qualtrics survey was disseminated which categorized questions into three parts: demographic, female focused cancer literacy, and cancer care access. Results: Overall cancer literacy was low (67.45%, 139 respondents); no difference was found in Appalachian standing. Male students had lower scores (p < 0.05), and both cancer-related majors (p < 0.001) and enhanced academic years (p < 0.05) improved cancer literacy. Limited awareness of mobile cancer screening units was found across respondents, along with, decreased access to health services indicated by Appalachian students (p < 0.05). Conclusions: College students represent a population in need of enhanced cancer education. Improving knowledge about accessing healthcare including cancer screenings could reduce Appalachian cancer rates.

In recent years, single-subject experimental courses have not been able to meet the demands of the comprehensive development of life sciences. This study is based on two fundamental disciplines, molecular biology and metabolomics, with the analysis and intervention of tumor-related genes as the starting point. A comprehensive experimental course has been set up to analyze oncological genetic abnormal induced molecular signature and metabolome feature alterations through in vitro and in vivo experimental validations. This newly designed course combines guide theories and practical instructions. Through database screening, in vitro research and in vivo research, student's research interest and knowledge reserves are greatly enhanced and a foundation is laid for further scientific research in the future.

Using an autoethnographic approach, this article focuses on the experiences of two male dance educators/researchers living with/through terminal cancer. Autoethnographers analyze their 'unique life experiences in the context of the social and cultural institutions that have shaped the world the researcher inhabits.' Drawn from a larger research project, Dance Educators Living With/Through Cancer (DELC), this collaborative duoethnography comprises the co-authors' self-narrative accounts of life with cancer, which were analyzed thematically. The themes presented center on the public and private aspects of living with/through cancer and reflect the authors' cancer experiences along with their social, emotional and physical dis-ease arising from living cancer lives. Explication of resultant impacts on both personal and professional identities seeks to support others with terminal disease in order to lead reflective and meaningful lives while dying.

The aim of this article is to improve physical education (PE) teachers' knowledge about working with children diagnosed with cancer. Physical activity (PA) in this population is extremely important. Not only do these children have an increased risk of co-morbidities compared to healthy peers, but cancer treatment has negative effects on fitness (e.g., loss of muscle mass, impaired balance, cardiac dysfunction). A cancer diagnosis can delay motor-skill development and hinder the development of self-efficacy in sport and activity. PA can be used to attenuate treatment side effects and help children to build fitness, stamina, and confidence, enabling them to (re)join sport or group PA. Using data from a feasibility study, frequency, intensity, time, and type (FITT) recommendations are provided for children undergoing cancer treatment that provide a framework for educators to design action plans.

Mobile mammography units (MMUs) can enhance access to breast cancer screening by providing convenient, cost-effective service, particularly for uninsured and underinsured women. However, prior studies indicate that acceptability concerns about quality and privacy, among other issues, may prevent women from utilizing MMUs. The current study employs a within-participant experimental design exposing participants to messages about different MMU characteristics to determine which characteristics are most effective in persuading them to use an MMU. The study also examined how messaging interacts with participants' ethnic identity to influence outcomes. Data were collected from a diverse sample of uninsured and underinsured women as part of a formative study to promote the utilization of a mobile mammography facility in Central Texas. Results of mixed-effect linear models show that messages about equity, appointment convenience, privacy and comfort, and quality of equipment and staff were rated as more persuasive than messages about convenience of location and language accessibility. However, Hispanic women rated language accessibility higher than other participants did. The results can guide MMU organizers and promotion managers as they determine the best approach to promote mobile mammography services in different communities.

We joined an initiative to engage faculty and undergraduate students in research by scheduling regular early college-level mathematics research presentations with pre- and post-lecture exercises. While our program featured six talks that were predominantly in the mathematical biosciences, the concept of creating themed topics for presentations can be extended to other areas of mathematical research, and the length of the program can also be scaled. This article discusses three of the presentations, including QR codes to access their recordings. The purpose of this article is to present the materials of the talks from this initiative and how faculty members can use the materials for potential explorations with students. The hope is the audience may use these, as presented, for study with students, with minimal start-up investment and to use this as a model for future undergraduate research efforts.

Cancer survivors experience both physical and cognitive changes after treatment that can impact their vocational well-being should they decide to return to work. In this article, we explore the ways in which career counselling interventions can address the challenges faced by cancer survivors as they re-enter the workforce. Four major career-related issues are outlined: physical functioning abilities, changes in cognitive functioning, changing perspectives and support. These issues are addressed using life-career transition and career counselling theories. Theory-informed helping strategies are considered for career counselling cancer survivors as they improve their vocational life and other aspects of personal well-being.

Cancer is an overwhelming and life-altering diagnosis. Receiving this type of diagnosis typically requires traditional medical therapeutics, but relaxation and healing techniques that reduce stress and calm fears are also beneficial. Artmaking and visual journaling are healing techniques used to improve emotional and psychological health among cancer patients (Barrett, 2011; Collie et al., 2006; Heiney et al., 2015; Predeger, 1996). A community setting can offer individuals creative and transformative visual arts experiences that promote healing and lifelong learning (Lawton & La Porte, 2013).

On March 7, 1962 the Royal College of Physicians published a report entitled "Smoking and Health" that made the causal link between smoking and lung cancer clear and explicit. Using a historical data set that contains information on smoking from 1958 to 1965, I find a decrease in smoking for those with more schooling after the report's publication. I do not find a difference in the effect for those with greater access to information (measured by TV ownership or newspaper readership). This suggests the education health gradient is more likely due to processing of information rather than access to information.

Physical activity (PA) is an important facet in survivorship care. Standardized curriculum which teaches undergraduate student exercise leaders how to implement PA programs for childhood cancer survivors have not been developed. Delivery of PA programs are limited by resources, so utilizing students to lead PA sessions is a potentially cost-effective approach. The purpose of this study was to learn how to optimize mentorship of student PA leaders in pediatric oncology. The aims were to report on the level of guidance provided to the student PA leaders, share student PA leaders' reflection of their mentorship and the challenges they faced. Student PA leaders designed and delivered a 31-week, virtual PA program to pediatric cancer survivors (5-18-year-olds). Mentors provided feedback on the recorded sessions. PA leaders were interviewed about their perceptions, their experiences and the type of feedback they valued the most. Student PA leaders received the most feedback during the first 2 weeks of the program, suggesting close oversight is needed during this time. Students valued the feedback on improving PA delivery/instruction the most. Students reported feeling anxious prior to sessions, especially when new content would be introduced because they were unsure how the patients would respond to the new activities. Reinforcing that the leaders have the ability to minimize PA barriers and provide support may help to resolve their anxiety of working with this population. Using a similar approach as presented in this paper may be advantageous in the development of high-performing PA leaders.

Background: Although there are a growing number of studies investigating the benefits of music therapy interventions with patients diagnosed with cancer, few studies have taken an approach that specifically examines indices of perceived well-being in women with breast cancer. Overcoming these challenges can be an important step in the recovery process. Purpose: The purpose of our study was to know the positive influence of responsive music therapy through gong sounds, emitted live, on different areas of well-being of women with breast cancer. Methods: Four individual sessions of responsive music therapy with live gong sounds were conducted in which three women (M = 54; SD = 5.57) participated both in the music therapy program and in the completion of the Functional Assessment of Cancer Therapy-Breast (FACT-B) and a semi-structured interview with ad hoc designed questions about perception of qualitative aspects. Results: The results showed that the music therapy sessions significantly improved, p = 0.043 < 0.05, various domains of perceived well-being in women with breast cancer. Discussion: This article highlights several key benefits associated with music therapy and various indices of well-being in women with breast cancer, identifies the limitations of the study, and discusses the findings. It is considered necessary to replicate this practice in future studies that include a larger sample and age range over longer follow-up periods. Translation for Health Education Practice: The text highlights the importance of considering music therapy as a complementary intervention in comprehensive cancer care programs, which may be relevant to health educators when considering intervention and support approaches for cancer patients. Health education interventions targeting the enhancement of cancer patients' well-being should incorporate music therapy techniques.

Background and objective: The aim of this study is to determine the knowledge, attitudes, and behaviors regarding testicular cancer and testicular self-examination (TSE) among medical faculty students in their last two semesters before beginning clinical practice. This study also investigates their beliefs about the importance and efficacy of these practices in early cancer detection. Materials and methods: This descriptive study was conducted between October 1, 2018, and July 31, 2019, involving both male and female students in the 5th and 6th grades of a medical faculty. A total of 278 students participated, providing insights into their level of awareness and engagement with TSE practices. Results: 52.2% of the students were aware of self-testicular examination, yet only 15.5% of male students reported performing TSE regularly. 13.3% of students reported receiving formal training on this topic during their medical education, and a mere 2.9% observed these examinations demonstrated in clinical settings. Champion's Health Belief Model Scale indicated average sensitivity scores of 11.01 ± 4.36, perceived severity of 20.58 ± 5.92, perceived benefits of 11.46 ± 2.99, perceived barriers at 10.14 ± 4.04, and self-efficacy scores at 18.64 ± 5.26. Conclusion and recommendations: The findings suggest that while medical students recognize the seriousness and benefits of TSE, there is a notable gap in regular practice and educational exposure. Increased educational efforts are recommended to enhance sensitivity and self-efficacy related to testicular cancer screening among future healthcare providers.

Objective: In contrast to previous research that has primarily focused on gender differences in health behaviour compliance, this study explored the association between gender consciousness and sun protection in China - a cultural setting in which there is a pronounced gender bias towards sun protection. These article is the first attempt to examine gender norms concerning sunscreen use among Chinese individuals, encompassing both young women and young men. Design and setting: Cross-sectional analysis conducted on one Chinese campus. Methods: Utilising data from the 2020 cohort of first-year students (549 male students and 1,489 female students) at a local university in Shanghai and employing OLS regression analysis, our analysis sheds light on gendered patterns of sun protection use among young individuals in China. Results: Findings reveal that gender attitudes affect women's sun protection frequency without influencing their choice of specific products. Conversely, men's gender consciousness shapes their sun protection methods but not their overall frequency of sun protection. In addition, despite lower aggregate levels of sun protection, young women exhibit higher heterogeneity in their responses than young men. Socioeconomic status, health awareness and gender consciousness are all significant factors influencing sun protection among female students; however, among men, only health awareness shows a positive correlation with the use of sun protection. Conclusion: The results of this study exhibit some differences from initial expectations, suggesting that the full adoption of sun protection measures is still a work in progress. However, despite the differences identified, findings provide valuable insights to inform future public health efforts to promote sun protection among youth.

Computer Aided Detection (CAD) has been used to help readers find cancers in mammograms. Although these automated systems have been shown to help cancer detection when accurate, the presence of CAD also leads to an over-reliance effect where miss errors and false alarms increase when the CAD system fails. Previous research investigated CAD systems which overlayed salient exogenous cues onto the image to highlight suspicious areas. These salient cues capture attention which may exacerbate the over-reliance effect. Furthermore, overlaying CAD cues directly on the mammogram occludes sections of breast tissue which may disrupt global statistics useful for cancer detection. In this study we investigated whether an over-reliance effect occurred with a binary CAD system, which instead of overlaying a CAD cue onto the mammogram, reported a message alongside the mammogram indicating the possible presence of a cancer. We manipulated the certainty of the message and whether it was presented only to indicate the presence of a cancer, or whether a message was displayed on every mammogram to state whether a cancer was present or absent. The results showed that although an over-reliance effect still occurred with binary CAD systems miss errors were reduced when the CAD message was more definitive and only presented to alert readers of a possible cancer.

Background: This study aimed to determine knowledge and attitudes of self-identified male nursing students who are in a risky age group regarding testicular cancer and testicular self-examination. Method: In this cross-sectional survey, the data was collected on 208 Turkish students between the ages of 18-22 years. The data was collected by using the Champion's Health Belief Model Scale for Testicular Cancer Screenings and the Personal Information Form. Results: The mean age of the participants in this survey conducted in the 2018-2019 academic Spring semester was 21.46 ± 2.031. The mean scores for the subscales were as follows: for perceived susceptibility 11.49 ± 4.70 (min = 5, max = 25), for seriousness 21.04 ± 6.11 (min = 7, max = 35), for self-examination benefits 10.88 ± 3.05 (min = 3, max = 15), for self-examination barriers 11.49 ± 3.75 (min = 5, max = 25) and for self-efficacy subscale 18.12 ± 5.52 (min = 6, max = 30). Also it was determined that 68.6% of the students do not know how to perform self-examination. Students' sensitivity to testicular cancer and related screenings increased with their level of knowledge. Conclusion: The results will explain how students' health beliefs were affected by their individual knowledge level. Nursing students should be exposed to information on testicular self-examination. Therefore, some suggestions are presented according to the health belief model to increase awareness of individuals, especially in the risky group, and improve people's health behaviors.

Background: It is widely accepted that family caregivers are central to the future of cancer care and the impetus is to understand how best to support and empower them. Aims: This study explored the role of the relationship between the caregiver and the child, the level of perceived support, and the self-compassion of the caregiver, on distress and wellbeing in mothers who were the primary caregiver for a child with cancer. Methods: A self-report questionnaire survey of 255 mothers assessed perceived support, attachment to the child, self-compassion and a range of demographic variables including age, education, employment and time since diagnosis. Results: A model was proposed and explored using Hierarchical Multiple Regression Analysis (HMRA) and tested more fully using Structural Equation Modelling. The results of both analyses support the model and show it to be an excellent fit for the data. Conclusions: The findings suggest that the quality of the attachment bond with the child along with mother's ability to be self-compassionate, combined with perceived social support may moderate the impact of care burden on perceived distress for mothers caring for a child with cancer.