What factors shape quality of life for women affected by gynaecological cancer in South, South East and East Asian countries? A critical review.

BACKGROUND: Gynaecological cancers are among the most prevalent cancers worldwide, with profound effects on the lives of women and their families. In this critical review, we explore the impacts of these cancers on quality of life (QOL) of women in Asian countries, and highlight areas for future inquiry. METHODS: A systematic search of the literature was conducted in six electronic databases: Web of Science, Scopus, Global Health (CAB Direct), PsycINFO (Ovid), EBMR (Ovid), and Medline (Ovid). Screening resulted in the inclusion of 53 relevant articles reporting on 48 studies. RESULTS: Most studies were conducted in high and upper-middle income countries in East Asia and used quantitative approaches. Women had predominantly been diagnosed with cervical or ovarian cancer, and most had completed treatment. Four key interrelated domains emerged as most relevant in shaping QOL of women affected by gynaecological cancer: support, including identified needs, sources and forms; mental health, covering psychological distress associated with cancer, risk and protective factors, and coping strategies; sexual function and sexuality, focused on physiological, emotional and relational changes caused by gynaecological cancers and treatments, and the impacts of these on women's identities; and physical health, covering the physical conditions associated with gynaecological cancers and their impacts on women's daily activities. CONCLUSION: QOL of women affected by gynaecological cancer is shaped by their mental and physical health, support, and changes in sexual function and sexuality. The limited number of studies from lower- and middle-income countries in South and Southeast Asia highlights important knowledge gaps requiring future research.

Multiple factors shape the quality of life of women affected by gynaecological cancers in Asian countries as elsewhere. We identified 53 articles reporting on 48 studies, most conducted in high- and upper-middle income East Asian countries, with much less attention to women in lower income countries in South and Southeast Asia. Most studies used quantitative research methods to gain an understanding of the impact on women diagnosed with cervical or ovarian cancer who had completed treatment. Women's quality of life was shaped by their mental and physical health, their support needs, and the changes they experienced in sexual function and sexuality.

A Qualitative Study of Parental Knowledge and Perceptions of Human Papillomavirus and Cervical Cancer Prevention in Rural Central Java, Indonesia: Understanding Community Readiness for Prevention Interventions.

Background: Cervical cancer (CC) is a leading cause of cancer deaths among Indonesian women. Pilot prevention programs, including human papillomavirus (HPV) vaccination for young adolescent girls, and cervical screening for women, have been implemented. However, many communities are yet to receive these interventions, nor targeted education regarding CC prevention. This study explored community readiness and acceptance of HPV vaccination and CC screening, as well as knowledge and perceptions of HPV and CC, to determine facilitators and barriers to upscaling CC prevention in rural Central Java. Methods: Qualitative data collection in October 2015 consisted of four focus group discussions with married women and men, and 22 semi-structured interviews with married women. All 57 participants, 39 women and 15 men, lived in Purworejo Regency in rural Central Java. Results: Most participants had no knowledge of HPV or the causal link between HPV and CC. However, most participants were supportive of vaccinating their children against HPV. Most participants had heard of cervical cancer, although understandings of symptoms and causes were very poor. Less than half of the women interviewed had undergone CC screening. Multiple barriers to screening were reported, including: a dislike of pelvic exams; embarrassment at being screened by a male doctor; anxiety over the cost; fearing a positive result; and being asymptomatic and thus not perceiving the need for screening. Conclusions: Extensive community education about HPV and CC, targeting women and men, adolescents, health workers and teachers, is crucial to support the introduction of the HPV Demonstration Program and the upscaling of CC screening. Low incomes among rural families underline the need for the HPV vaccine to be provided free within the National Immunization Program, and for CC screening to be free at primary health clinics.

Oxidative stress induced by zero-valent iron nanoparticles and Fe(II) in human bronchial epithelial cells.

To identify the mechanism through which nanoparticulate zero-valent iron (nZVI; Fe0(s)) damages cells, a series of experiments were conducted in which nZVI in phosphate-buffered saline (PBS) was exposed to oxygen in the presence and absence of human bronchial epithelial cells. When nZVI is added to PBS, a burst of oxidants is produced as Fe0 and ferrous iron (Fe[II]) are converted to ferric iron (Fe[II]). Cytotoxicity and internal reactive oxygen species (ROS) production in cells exposed to nZVI is equivalent to the response observed when cells are exposed to the same concentration of dissolved Fe(II). Experiments conducted in the absence of cells indicate that the oxidant produced during Fe(II) oxidation reacts with methanol and dimethyl sulfoxide, but not with compounds such as tert-butanol and benzoate that react exclusively with hydroxyl radical. The role of reactive oxidants produced during Fe(II) oxidation in cytotoxicity and internal ROS production is further supported by experiments in which cell damage was limited by the addition of ligands that prevented Fe(II) oxidation and by the absence of cell damage when the nanoparticles were oxidized prior to exposure. The behavior of the oxidant produced by nZVI is consistent with an oxidant such as the ferryl ion, rather than hydroxyl radical.

Ligand-enhanced reactive oxidant generation by nanoparticulate zero-valent iron and oxygen.

The reaction of zero-valent iron or ferrous iron with oxygen produces reactive oxidants capable of oxidizing organic compounds. However, the oxidant yield in the absence of ligands is too low for practical applications. The addition of oxalate, nitrilotriacetic acid (NTA), or ethylenediaminetetraacetic acid (EDTA) to oxygen-containing solutions of nanoparticulate zero-valent iron (nZVI) significantly increases oxidant yield, with yields approaching their theoretical maxima near neutral pH. These ligands improve oxidant production by limiting iron precipitation and by accelerating the rates of key reactions, including ferrous iron oxidation by oxygen and hydrogen peroxide. Product yields indicate that the oxic nZVI system produces hydroxyl radical (OH*) over the entire pH range in the presence of oxalate and NTA. In the presence of EDTA, probe compound oxidation is attributed to OH under acidic conditions and a mixture of OH* and ferryl ion (Fe[IV]) at circumneutral pH.

Polyoxometalate-enhanced oxidation of organic compounds by nanoparticulate zero-valent iron and ferrous ion in the presence of oxygen.

In the presence of oxygen, organic compounds can be oxidized by zerovalent iron or dissolved Fe(II). However, this process is not a very effective means of degrading contaminants because the yields of oxidants are usually low (i.e., typically less than 5% of the iron added is converted into oxidants capable of transforming organic compounds). The addition of polyoxometalate (POM) greatly increases the yield of oxidants in both systems. The mechanism of POM enhancement depends on the solution pH. Under acidic conditions, POM mediates the electron transfer from nanoparticulate zerovalent iron (nZVI) or Fe(II) to oxygen, increasing the production of hydrogen peroxide, which is subsequently converted to hydroxyl radical through the Fenton reaction. At neutral pH values, iron forms a complex with POM, preventing iron precipitation on the nZVI surface and in bulk solution. At pH 7, the yield of oxidant approaches the theoretical maximum in the nZVI/O2 and the Fe(II)/O2 systems when POM is present, suggesting that coordination of iron by POM alters the mechanism of the Fenton reaction by converting the active oxidant from ferryl ion to hydroxyl radical. Comparable enhancements in oxidant yields are also observed when nZVI or Fe(II) is exposed to oxygen in the presence of silica-immobilized POM.

Factors affecting the yield of oxidants from the reaction of nanoparticulate zero-valent iron and oxygen.

The corrosion of zero-valent iron (Fe0(s)) by oxygen (O2) can lead to the oxidation of organic compounds. To gain insight into the reaction mechanism and to assess the nature of the oxidant, the oxidation of methanol, ethanol, 2-propanol, and benzoic acid by the reaction of nanoparticulate zero-valent iron (nZVI) or ferrous iron (Fe[II]) with O2 in the absence of ligands was studied. At pH values below 5, Fe0(s) nanoparticles were oxidized by O2 within 30 min with a stoichiometry of approximately two Fe0(s) oxidized per O2 consumed. The yield of methanol and ethanol oxidation products increased from 1% at acidic pH to 6% at pH 7, relative to nZVI added. Product yields from 2-propanol and benzoic acid were highest under acidic conditions, with little oxidation observed at neutral pH. At pH values below 5, product formation was attributable to hydroxyl radical (OH.) production through the Fenton reaction, involving hydrogen peroxide and Fe(II) produced during nZVI oxidation. At higher pH values, the oxidation of Fe(II), the initial product of nZVI oxidation, by oxygen is responsible for most of the oxidant production. Product yields at circumneutral pH values were consistent with a different oxidant, such as the ferryl ion (Fe[IV]).

Speeding up solar disinfection (SODIS): effects of hydrogen peroxide, temperature, pH, and copper plus ascorbate on the photoinactivation of E. coli.

Solar disinfection, or SODIS, shows tremendous promise for point-of-use drinking water treatment in developing countries, but can require 48 h or more for adequate disinfection in cloudy weather. In this research, we show that a number of low-cost additives are capable of accelerating SODIS. These additives included 100-1000 muM hydrogen peroxide, both at room temperature and at elevated temperatures, 0.5 - 1% lemon and lime juice, and copper metal or aqueous copper plus ascorbate, with or without hydrogen peroxide. Laboratory and field experiments indicated that additives might make SODIS more rapid and effective in both sunny and cloudy weather, developments that could help make the technology more effective and acceptable to users.