The changing pattern of ano-rectal cancer, squamous cell carcinoma of the eye, and Hodgkin’s lymphoma as non-AIDS-defining cancers, by HIV status, in Tanzania over 11 years (2002-2012): a retrospective case-report study

Abstract Background In Tanzania, 5.1% of adults aged 15-49 are infected with HIV. While rates of HIV-related malignancies have declined globally with antiretroviral therapy (ART), including Tanzania, rates of non-AIDS-defining cancers (NADCs) are believed to have increased. Therefore, we determined trends of three NADCs in Tanzania: ano-rectal cancer, squamous cell carcinoma of the eye, and Hodgkin’s lymphoma. Methods This study was conducted at the Ocean Road Cancer Institute (ORCI) in Dar es Salaam. All medical records of patients diagnosed with ano-rectal cancer, squamous cell carcinoma of the eye, and Hodgkin’s lymphoma between 2002 and 2012 were reviewed regarding HIV status, cancer clinical characteristics and management. Analysis was conducted to determine trends and proportions in these three NADCs and patient characteristics. Results We identified 980 NADCs. The relative proportion of these three NADCs at ORCI out of all cancers treated increased from 2.37% in 2002 to a peak of 4.34% in 2009. The prevalence of HIV in patients diagnosed with these NADCs also increased—from 6.67% in 2002 to 20.87% in 2010—and 85% of squamous cell carcinoma of the eye cancer patients with a reported HIV status were HIV-positive. Conclusions The frequency and proportions of these three NADCs in Tanzania have increased over the past 11 years, as has the prevalence of HIV positivity amongst these NADC patients. The current and possibly increasing burden of NADCs in Tanzania and other low- and middle-income countries with high HIV rates should be a focus for future cancer prevention and control and HIV therapy programs.http://deepblue.lib.umich.edu/bitstream/2027.42/111050/1/13027_2014_Article_524.pd

Violence and Reconciliation in Colombia: The Personal and the Contextual

In the aftermath of war and large-scale violence, how can nations function as societies? How can people learn to live together again? Or, have the foundations of trust, civility, and predictability upon which fully functioning societies depend been irrevocably damaged? If we want to understand why reconciliation does or does not take root, we must begin by understanding the perspectives and interests of individuals. In this article, I develop such a model of individual attitudes towards reconciliation. In particular, I analyse the determinants of individual beliefs about reconciliation, with a particular emphasis on the impact of violence in Colombia. I combine survey data from the Latin American Public Opinion Project survey on individual attitudes regarding reconciliation with data on political violence to measure the extent to which individuals live in environments characterised by violence and how this shapes their opinions about reconciliation

Assisted reproductive technology use after adolescent and young adult cancer in North Carolina

Background: Adolescents and young adults (AYAs) diagnosed with cancer have a high rate of survival, underscoring the importance of addressing their survivorship challenges. Methods: We used a data linkage between the North Carolina (NC) Central Cancer Registry and the Society for Assisted Reproductive Technology to identify AYA (aged 15-39 years) women diagnosed with cancer in NC during 2004-2015 who used assisted reproductive technology (ART). In Aim 1, we used conditional logistic and log-binomial regression to estimate odds ratios (ORs) and prevalence ratios (PRs) for the likelihood of using fertility preservation (FP). In Aim 2, we used linear regression to examine the association between FP and time to cancer treatment. In Aim 3, we used modified Poisson regression to estimate risk ratios (RRs) for pregnancy and birth after cancer treatment with the use of ART. Results: Aim 1: Women less likely to use FP were older (ages 25-29 vs. 35-39: OR = 6.27, 95% CI: 3.35, 11.73); non-Hispanic Black (vs. non-Hispanic White: PR = 0.44, 95% CI: 0.24, 0.79); parous (vs. nulliparous: PR = 0.24, 95% CI: 0.13, 0.45); or lived in areas that were non-urban (vs. urban: PR = 0.12, 95% CI: 0.04, 0.37) or of lower socioeconomic status (SES) (vs. highest SES: PR = 0.39, 95% CI: 0.25, 0.61). Aim 2: FP was associated with a 9 - 33.5-day delay to cancer treatment across all cancer types, including women with breast cancer who received adjuvant chemotherapy (β = 15.5 days, 95% CI: 6.5, 24.5) and women with hematologic malignancies (β = 13.8 days, 95% CI: 7.1, 20.4). Aim 3: Women who initiated ART before cancer treatment for FP may be more likely to have a live birth given pregnancy relative to women who initiated ART after cancer treatment without FP (age-adjusted RR = 1.47, 95% CI: 0.98, 2.23). Conclusions: Sociodemographic disparities exist in FP use after cancer. FP can delay cancer treatment by up to 4.5 weeks, but may increase likelihood of live birth after pregnancy. These data add to a sparse evidence base around fertility after cancer and may contribute to more informed decision-making for patients and providers.Doctor of Philosoph

Should clinicians recommend e-cigarettes to their patients who smoke? No

Clinicians should not routinely recommend electronic nicotine delivery devices (ENDS), such as e-cigarettes, to their patients who smoke. The wisdom of this evidenced-based recommendation stems from 4 key issues: inadequate safety, poor effectiveness, little regulation, and an ethical framework to do no harm

Provider satisfaction with an inpatient tobacco treatment program: results from an inpatient provider survey

Background: Hospitalization offers an optimal environment for ensuring that patients receive evidence-based treatment. An inpatient tobacco treatment program can deliver interventions broadly, but minimal research has examined the impacts of a consult program on inpatient providers. The Nicotine Dependence Program at the University of North Carolina has provided an inpatient tobacco treatment consult service since 2010. Objective: The program sought feedback from inpatient providers to examine factors that prompted tobacco treatment consult orders, the impact on provider counseling behavior, provider satisfaction, and suggested program improvements. Design: Providers who had ordered a tobacco treatment consult received an online anonymous survey. Setting: The University of North Carolina Hospital is an academic medical facility with 803 beds and over 37,000 inpatient admissions annually from all 100 counties in North Carolina. Approximately 20% of these inpatients report current use of any tobacco product. Patients/participants: Medical providers who ordered inpatient tobacco treatment consults from July 2012 to June 2013 (n=265) received the survey, with 118 providers responding (44.5% response rate). Results: Almost all providers reported being satisfied with the consult program and believed it was effective. Key factors in provider satisfaction included ease of accessing the service, saving provider time, and offering patients evidence-based tobacco use treatment. The consult program increased the likelihood of providers prescribing tobacco cessation medications at discharge, as well as following up at post-discharge appointments. Conclusion: This is some of the first research to show provider satisfaction, program usage, and outcomes with an inpatient tobacco treatment program and demonstrates the important impact of implementing tobacco treatment services within hospitals

With or without force? : European public opinion on democracy promotion

A Large part of the education provided at colleges and universities of today requires for thestudent to be more independent in their studies. This demands that the physical space,where the students choose to study, is designed in a way that can encourage and supportlearning. It seems as though that many of the learning spaces of today don’t always meetthe students’ needs. The university library at the University of Umeå is currently planningto design new learning spaces for the students. The aim of this study is to examine how thephysical learning space can be designed to engage and encourage the students in theirlearning process. Based on literature describing learning spaces we have initially identified three mainareas to examine- Learning, Information Technology and Learning space design. Theseareas are all important features in the design of new learning spaces. With informationdrawn from that literature we conducted an empirical study at the library of the Universityof Umeå. The empirical study was carried out through observations and focus groupinterviews. To give us more insight about the students’ thoughts about the learning spacewe also compared our findings with a survey conducted by the library personnel in 2008and 2010. The result of our study shows that there are some areas to be improved in theexisting learning space. The students are working more collaboratively which requiresmore group areas. Our study also shows that flexibility, more student interaction and asocial and engaging environment are all important features in the design of new learningspaces

Perceptions and Experiences with Flavored Non-Menthol Tobacco Products: A Systematic Review of Qualitative Studies

Although a few countries have banned flavored cigarettes (except menthol), flavors in most tobacco products remain unregulated across the globe. We conducted a systematic review of qualitative studies examining perceptions of and experiences with flavored non-menthol tobacco products. Of 20 studies on flavored tobacco products included in our qualitative systematic review, 10 examined hookah, six examined e-cigarettes, two examined little cigars and cigarillos (LCCs), and three examined other tobacco products, including cigarettes. The majority of studies, regardless of product type, reported positive perceptions of flavored tobacco products, particularly among young adults and adolescents. In six studies that assessed perceptions of harm (including hookah, LCCs, and other flavored tobacco products), participants believed flavored tobacco products to be less harmful than cigarettes. In studies that examined the role of flavors in experimentation and/or initiation (including three studies on e-cigarettes, one hookah study and one LCC study), participants mentioned flavors as specifically leading to their experimentation and/or initiation of flavored tobacco products. Given that many countries have not yet banned flavors in tobacco products, these findings add to existing research on why individuals use flavored tobacco products and how they perceive harm in flavored tobacco products, providing further support for banning non-menthol flavors in most tobacco products

Impact of non-menthol flavours in tobacco products on perceptions and use among youth, young adults and adults: a systematic review

This systematic review examines the impact of non-menthol flavours in tobacco products on tobacco use perceptions and behaviours among youth, young adults and adults

The tobacco 21 movement and electronic nicotine delivery system use among youth

Cigarette smoking prevalence in the United States has significantly decreased over the past few decades to 15.1% among adults 1 and 9.3% among high school students. Declines are a result of a variety of tobacco control initiatives, including limits on tobacco marketing, higher per-unit cost of tobacco products, clean air legislation, mass media campaigns, and reductions in youth access. At the same time, use of electronic nicotine delivery systems (ENDS) has rapidly increased. The role of ENDS in reducing or exacerbating population-level morbidity and mortality from tobacco products remains hotly contested. The increased use of ENDS, and the fact that smoking remains the leading cause of preventable death in the United States indicate that additional policy interventions are needed to work toward the tobacco “endgame.” One such intervention is raising the minimum legal sales age (MLSA) to 21 years. As more states and localities enact Tobacco 21 laws, it is important to consider how such policies, initially designed to decrease combustible cigarette and other tobacco use, will interact with ENDS use patterns among youth