Global studies of childhood cancer provide clues to cancer etiology, facilitate prevention and early diagnosis, identify biologic differences, improve survival rates in low-income countries (LIC) by facilitating quality improvement initiatives, and improve outcomes in high-income countries (HIC) through studies of tumor biology and collaborative clinical trials. Incidence rates of cancer differ between various ethnic groups within a single country and between various countries with similar ethnic compositions. Such differences may be the result of genetic predisposition, early or delayed exposure to infectious diseases, and other environmental factors. The reported incidence of childhood leukemia is lower in LIC than in more prosperous countries. Registration of childhood leukemia requires recognition of symptoms, rapid access to primary and tertiary medical care (a pediatric cancer unit), a correct diagnosis, and a data management infrastructure. In LIC, where these services are lacking, some children with leukemia may die before diagnosis and registration. In this environment, epidemiologic studies would seem to be an unaffordable luxury, but in reality represent a key element for progress. Hospital-based registries are both feasible and essential in LIC, and can be developed using available training programs for data managers and the free online Pediatric Oncology Networked Data Base (www.POND4kids.org), which allows collection, analysis, and sharing of data.

Purpose-We assessed the availability and quality of palliative care for children with cancer according to national income per capita.Methods-We surveyed physicians who care for children with cancer using the Cure4Kids website (http://www.cure4kids.org). Queries addressed oncology practice site; reimbursement; specialized palliative care, pain management, and bereavement care; location of death; decisionmaking support; and perceived quality of care. Responses were categorized by low -, middle-, and high-income country (LIC, MIC, HIC).Results-Of 262 completed questionnaires from 58 countries (response rate, 59.8%), 242 were evaluable (55%). Out-of-pocket payment for oncology (14.8%), palliative care (21.9%), and comfort care medications (24.3%) was most likely to be required in LIC (p<0.001). Availability of specialized palliative care services, pain management, bereavement care, and institutional or national decision-making support was inversely related to income level. Availability of highpotency opioids (p=0.018) and adjuvant drugs (p=0.006) was significantly less likely in LIC. Physicians in LIC were significantly less likely than others to report high-quality pain control (p<0.001), non-pain symptom control (p=0.003), and emotional support (p=0.001); bereavement support (p=0.035); interdisciplinary care (p<0.001); and parental participation in decisions (p=0.013). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

The significant increase in the number of individuals with chronic ailments (including the elderly and disabled) has dictated an urgent need for an innovative model for healthcare systems. The evolved model will be more personalized and less reliant on traditional brick-and-mortar healthcare institutions such as hospitals, nursing homes, and long-term healthcare centers. The smart healthcare system is a topic of recently growing interest and has become increasingly required due to major developments in modern technologies, especially in artificial intelligence (AI) and machine learning (ML). This paper is aimed to discuss the current state-of-the-art smart healthcare systems highlighting major areas like wearable and smartphone devices for health monitoring, machine learning for disease diagnosis, and the assistive frameworks, including social robots developed for the ambient assisted living environment. Additionally, the paper demonstrates software integration architectures that are very significant to create smart healthcare systems, integrating seamlessly the benefit of data analytics and other tools of AI. The explained developed systems focus on several facets: the contribution of each developed framework, the detailed working procedure, the performance as outcomes, and the comparative merits and limitations. The current research challenges with potential future directions are addressed to highlight the drawbacks of existing systems and the possible methods to introduce novel frameworks, respectively. This review aims at providing comprehensive insights into the recent developments of smart healthcare systems to equip experts to contribute to the field.

Objective: In developed countries, pharmacists play a crucial role in designing and implementing cancer treatments as part of a multidisciplinary oncology team. However, developing countries have a shortage of pharmacists, and their role is generally limited to dispensing and selling drugs. The aim of this study was to investigate the feasibility of providing clinical pharmacy educational activities via international teleconferencing to improve cancer care in developing countries. Materials and Methods: Meticulous preparation and intense promotion of the workshop were done in Egypt before the telepharmacy conferences began. Multiple connectivity tests were performed to resolve technical problems. Nine telepharmacy conferences were delivered during 3-h sessions that were held on three consecutive days. Talks were subsequently made available via Web streaming. Attendees were requested to complete a survey to measure their satisfaction with the sessions. Results: The teleconference was attended by a total of 345 persons, and it was subsequently reviewed online via 456 log-in sessions from 10 countries. Technical issues (e.g., poor auditory quality) were resolved on the first day of the event. The rate of attendees' responses on the survey was 30.1%, and satisfaction with the event was generally good. Conclusions: Telecommunication is a relatively inexpensive approach that may improve pharmacy practices, especially those used to treat patients with cancer in developing countries. Special attention to patient-based telepharmacy education, including the use of cost-effective technology, should be considered.