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Feasibility Study of Case-Finding for Breast Cancer by Community Health Workers in Rural Bangladesh
Chowdhury, Touhidul Imran,Love, Richard Reed,Chowdhury, Mohammad Touhidul Imran,Artif, Abu Saeem,Ahsan, Hasib,Mamun, Anwarul,Khanam, Tahmina,Woods, James,Salim, Reza Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.17
Background: Mortality from breast cancer is high in low- and middle-income countries, in part because most patients have advanced stage disease when first diagnosed. Case-finding may be one approach to changing this situation. Materials and Methods: We conducted a pilot study to explore the feasibility of population-based case finding for breast cancer by community health workers (CHWs) using different data collection methods and approaches to management of women found to have breast abnormalities. After training 8 CHWs in breast problem recognition, manual paper data collection and operation of a cell-phone software platform for reporting demographic, history and physical finding information, these CHWs visited 3150 women >age 18 and over they could find-- from 2356 households in 8 villages in rural Bangladesh. By 4 random assignments of villages, data were collected manually (Group 1), or with the cell-phone program alone (Group 2) or with management algorithms (Groups 3 and 4), and women adjudged to have a serious breast problem were shown a motivational video (Group 3), or navigated/accompanied to a breast problem center for evaluation (Group 4). Results: Only three visited women refused evaluation. The manual data acquisition group (1) had missing data in 80% of cases, and took an average of 5 minutes longer to acquire, versus no missing data in the cell phone-reporting groups (2,3 and 4). One woman was identified with stage III breast cancer, and was appropriately treated. Conclusions: Among very poor rural Bangladeshi women, there was very limited reluctance to undergo breast evaluation. The estimated rarity of clinical breast cancer is supported by these population-based findings. The feasibility and efficient use of mobile technology in this setting is supported. Successor studies may most appropriately be trials focusing on improving the suggested benefits of motivation and navigation, on increasing the numbers of cases found, and on stage of disease at diagnosis as the primary endpoint.
Paule-Mercado, Ma. Cristina A.,Salim, Imran,Lee, Bum-Yeon,Memon, Sheeraz,Sajjad, Raja Umer,Sukhbaatar, Chinzorig,Lee, Chang-Hee Elsevier 2018 Ecological Indicators Vol.93 No.-
<P><B>Abstract</B></P> <P>Understanding the influence of land use and land cover (LULC) change in stormwater runoff is important for watershed management. In this study, integration of 31 storm events, monthly monitoring of LULC change, Pearson’s correlation, multiple linear regression analysis (MLR) and Personalized Computer Storm Water Management Model (PCSWMM) were applied to quantify the influence of LULC change on stormwater quality from mixed LULC catchment with ongoing land development in Yongin, South Korea. Due to ongoing land development in the catchment, bare land and urban LULC were exponentially increased while agriculture, forest, grassland and water LULC decreased in spatial extent. The correlation analysis showed that stormwater quality was positively correlated to bare land (0.595; Cl – 0.891; TSS, <I>p</I> < 0.05) and urban (0.768; TN – 0.987; TSS, <I>p</I> < 0.05); negatively correlated to forest (−0.593; Cu – 0.532; BOD<SUB>5</SUB>, <I>p</I> < 0.05) and grassland (−0.587; TSS – 0.512; BOD<SUB>5</SUB>, <I>p</I> < 0.05) and; either positively or no correlation to agriculture (0.064; Cu – 0.871; TSS, <I>p</I> < 0.05) and water (−0.131; Cl – 0.221; TP, <I>p</I> < 0.05). Furthermore, the MLR analysis showed that combinations of different LULC were able to describe the overall stormwater quality of the catchment. Moreover, the LULC scenario analysis demonstrate that under dominant agriculture (S1), bare land (S2) and urban areas (S5), the average pollutant concentrations would increase by as much as 13.22% (Cl; S2; pre-) to 59.25% (TSS; S5; early-active); while under dominant forest (S3) and grassland (S4) the average pollutant concentration would decrease by as much as −53% (Pb; S3; late-active) to −3.22% (BOD<SUB>5</SUB>; S4; pre-). These findings explained that the variability of pollutant concentrations in different phase of land development was affected by expansion of bare land and urban spatial extent, increase of hydrological characteristics (total rainfall and average rainfall intensity) and massive soil activities (soil digging and soil transfer). Therefore, results of this study will provide scientific information to establish a cost-effective stormwater management, development of empirical model, and designing monitoring strategies and guidelines to minimize the negative impact of LULC change on stormwater runoff.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Long-term LULC and stormwater monitoring advanced the current watershed management. </LI> <LI> PCSWMM was used to evaluate the influence of land development on stormwater runoff. </LI> <LI> Land development influences the variability of pollutant concentration in runoff. </LI> <LI> Conversion of vegetation to bare land and urban is the major stormwater stressor. </LI> <LI> Expansion of vegetation cover was not enough to achieve the water quality criteria. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>