Oral squamous cell carcinoma and cultural oral risk habits in Vietnam.

OBJECTIVES: In South-Central Asia, 80% of head and neck cancers are found in the oral cavity and oropharynx. In Vietnam, oral cancer is often not being detected until people experience debilitating circumstances to normal oral function. The aims of the study were to explore the patterns of oral squamous cell carcinoma (OSCC) and its risk indicators, the structure of oral health care in Vietnam and trends in prevalence of cultural risk habits in southern Vietnamese patients. MATERIALS AND METHODS: A retrospective clinical study was performed from 1 July 2005 to 1 April 2006 at Ho Chi Minh City Oncology hospital in Vietnam. Of the 161 cases, 147 subjects were diagnosed with OSCC, including 100 male and 47 female adults aged 24-85 years. Data were collected by a structured interview and clinical examination. RESULTS: Over 40% of the women with OSCC reported chewing betel quid and the most prevalent risk habit in males was smoking (91.0%). Daily alcohol use was reported by 79.0% of males and 2.1% of females. Two-thirds of the cases of OSCC were diagnosed at the 2nd and 3rd stage of cancer. The more advanced stages of cancer were observed in males than in females. The prevalence of tobacco and alcohol use in males with OSCC was higher in this study than in the previous Vietnamese studies. CONCLUSION: High frequency of risk habits in both genders was reported in OSCC Vietnamese patients. A trend of increased tobacco and alcohol use was observed in male OSCC patients. A lower prevalence of later staging in Vietnam was observed in this study than in earlier studies.

The use of cynical humor by medical staff: implications for professionalism and the development of humanistic qualities in medicine.

Humor and laughter in medicine has received much attention in the medical literature. The use of humor by medical students, residents and medical personnel is not uncommon. Laughter can be therapeutic, for patients and practitioners alike. However, when inappropriately directed towards patients humor can be seen as unprofessional, disrespectful and dehumanizing. How physicians interpret their day-to-day professional experiences, and when and how they use humor is influenced by the perspective that is taken, the social distance from the event, culture and context. Some argue that social and physical distance makes it more acceptable to laugh and joke about patients, but not everyone agrees. To laugh with and not at others is the appropriate use of humor in medicine. To cry against the suffering of others and the injustice behind that suffering and not with them in their agony and frustration is the appropriate response to tragedy.

Social constructs of curricular change.

The adoption of problem-based approaches to teaching and learning in dental and medical education requires educators to consider a significantly different role and responsibilities as teacher from what they have experienced previously. This qualitative study explored how some educators experienced and interpreted changes in the newly merged dental and medical curriculum at the University of British Columbia. Our findings present how educators explained and dealt with change. In-depth interviews provided considerable insight into factors influencing the resistance or acceptance to change. The educators' beliefs about teaching and learning and their understanding of the development and implementation process of change mediated these factors. Findings from this study should help administrators, faculty developers, and educators themselves to understand better how curricular change is experienced and to plan effective and appropriate faculty development.