Mapping Six New Susceptibility to Colon Cancer ( Scc ) Loci Using a Mouse Interspecific Backcross

Colorectal cancer (CRC) has a complex etiology resulting from the combination of multiple genetic and environmental factors, each with small effects. Interactions among susceptibility modifier loci make many of the loci difficult to detect in human genome-wide association studies. Previous analyses in mice have used classical inbred strains, which share large portions of their genomes due to common ancestry. Herein, we used an interspecific backcross between the Mus musculus strain A/J and the Mus spretus strain SPRET/EiJ to map 6 additional CRC modifier loci (Scc16-21) and 2 suggestive loci. Three loci modify the location of tumors along the proximal-distal axis of the colon. Six CRC modifiers previously mapped in intraspecific crosses were also replicated. This work confirms genetic models suggesting that CRC is caused by many small effect alleles and brings the catalog of reported CRC modifier loci to 23 spread across 13 chromosomes. Furthermore, this work provides the foundation for large population-level epistatic interaction tests to identify combinations of low effect alleles that may have large effects on CRC susceptibility

Quality of life among Latina breast cancer patients: a systematic review of the literature

Introduction The Latino population is the most rapidly growing ethnic minority in the United States and Latinas have higher rates of advanced breast cancer and more rigorous treatments than White women. However, the literature lacks reviews on quality of life among this population of breast cancer patients. Methods A systematic review of the breast cancer quality of life (QOL) literature was conducted among studies that provided a comparison of mental, physical, social, or sexual QOL between Latinas and other racial/ethnic groups. Of the 375 studies reviewed, 20 quantitative studies and two qualitative studies met criteria for inclusion. Results Latinas were more likely to report poor mental, physical, and social QOL, relative to non-Latinas. Only four studies assessed sexual QOL, making it difficult to draw any conclusions. Of these four QOL domains, the largest disparity was found in the area of mental health in which Latinas reported poorer QOL compared to non-Latina Whites and Blacks. Discussion/conclusions Most quantitative studies revealed either that Latinas consistently evidenced significantly lower QOL than non-Latinas on all measures (6 studies) or reported mixed findings in which Latinas generally demonstrated significantly worse QOL on most, but not all, measures (12 studies) included in the study. Explanatory mechanisms including socio-demographic, treatment-related, and culturally-relevant factors are discussed. Implications for research design, measurement, and clinical work are also included. Implications for cancer survivors Although not entirely consistent, data suggest that Latina breast cancer survivors on average experience worse QOL than non-Latina Whites. Understanding ethnic differences in QOL among breast cancer survivors can inform interventions targeted at improving health status for Latinas

No escape? The coordination problem in heritage preservation

Conservation Areas (CAs) are among the most restrictive English planning policies. Designation implies a significant limitation of owners' control over the shape and appearance of their properties. The policy, however, can also be argued to solve a sort of ‘prisoner's dilemma’, in which it might be collectively rational to preserve the character of an area, but an individual homeowner may be tempted to inappropriately alter their property, thus free-riding on nearby properties' character. The net benefit of the policy depends largely on the existence of positive ‘heritage effects’ and acknowledgement from homeowners that policy contributes to neighbourhood stability and the preservation of these positive effects. Our results of a mixed-method analysis of close to 1 million property transactions near to about 8000 CAs and 111 interviews with residents in nine representative CAs in Greater London suggest that positive heritage externalities exist and that residents in CAs tend to value their local environments, acknowledge the need for planning control, and execute their right to object to neighbour's planning request

The Home Care Work Environment for Personal Assistance Service Workers

Occupational injury is a prevalent problem in long-term care. However, there is a noticeable lack of research related to workers providing Personal Assistance Services (PAS) – the personal care and housekeeping tasks that enable elderly and other disabled adults to live in community settings. We conducted a statewide computer assisted telephone survey of PAS providers (n=855) from California's In Home Supportive Services program to describe the homecare environment and its impact on the worker's health and ability to provide care. PAS providers reported on a variety of household and personal care tasks, including client lifting and transfers, as well as on barriers to care delivery. A total of 262 providers (31%) reported musculoskeletal symptoms or acute injuries causing at least moderate pain (defined as ‘prominent’ problems) that had occurred in the prior 12 months; 25% of that group (n=65) reported 12 or more episodes in the previous 12 months of probable work-related musculoskeletal symptoms. Because of these prominent problems, 26 workers missed work, 54 changed their work duties, and 12 had to drop work hours or clients. </jats:p

A Handoff Protocol for Pediatric Trauma Patients at a Rural Level One Trauma Center Reduces Length of Stay

Background The management of the pediatric trauma patient is variable among trauma centers. In some institutions, the trauma surgeon maintains control of the patient throughout the hospital stay, while others transfer to a pediatric specialist after the initial evaluation and resuscitation period. We hypothesized that handoff to the pediatric surgeon would decrease the length of stay by more efficient coordination with pediatric subspecialists and ancillary staff. Methods A retrospective review from October 2014 to October 2018 was conducted at our rural level 1 trauma center analyzing the length of stay across all demographics and trauma triage levels before and after institution of a handoff protocol from adult specialized trauma surgeons to pediatric surgeons within a 24-hour window. Further analysis included emergency department (ED) disposition to include the effect of handoff on the length of stay in the setting of a higher post-ED acuity, that is, disposition of monitored beds. Results 1267 patient charts were analyzed and the mean length of stay was reduced by .38 days ( t = 5.92, P &lt; .0005) across all demographics, trauma triage levels, post-ED dispositions, and mechanisms of injury after institution of our handoff protocol. Conclusion Handoff from adult specialized trauma surgeons to pediatric surgeons within a 24-hour window at a rural level 1 trauma center significantly improved the length of stay by .38 ( t = 5.92, P &lt; .0005) among pediatric trauma patients in all demographics, trauma triage activations levels, mechanisms of injury, and post-ED dispositions acuity levels. </jats:sec