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Important aspects highlighted in the scenario of limited resources included the option of docetaxel as treatment preference as first-line treatment in several scenarios, docetaxel retreatment, consideration for reduced doses of abiraterone, and alternative schedules of an osteoclast-targeted therapy.

There was wide-ranging consensus in the treatment for men with mCRPC in both optimal and limited resource settings.
There was wide-ranging consensus in the treatment for men with mCRPC in both optimal and limited resource settings.
To generate and present survey results on important issues relevant to treatment and follow-up of localized and locally advanced, high-risk prostate cancer (PCa) focusing on developing countries.

A panel of 99 PCa experts developed more than 300 survey questions of which 67 questions concern the main areas of interest of this article treatment and follow-up of localized and locally advanced, high-risk PCa in developing countries. A larger panel of 99 international multidisciplinary cancer experts voted on these questions to create the recommendations for treatment and follow-up of localized and locally advanced, high-risk PCa in areas of limited resources discussed in this article.

The panel voted publicly but anonymously on the predefined questions. Each question was deemed consensus if 75% or more of the full panel had selected a particular answer. These answers are based on panelist opinion and not on a literature review or meta-analysis. For questions that refer to an area of limited resources, the developing countries have not been defined, this article will serve as a point of reference when confronted with this disease.Objectives. To determine whether the COVID-19 pandemic affected e-cigarette use among young people in the United States.Methods. Data came from a weekly cross-sectional online survey of youths and young adults (aged 15-24 years). Logistic regression analyses measured odds of past-30-day e-cigarette use (n = 5752) following widespread stay-at-home directives (March 14-June 29, 2020), compared with the pre‒COVID-19 period (January 1-March 13, 2020). Logistic regression among a subsample of current e-cigarette users (n = 779) examined factors associated with reduced use following stay-at-home orders.Results. Odds of current e-cigarette use were significantly lower during the COVID-19 pandemic compared with the pre‒COVID-19 period among youths aged 15 to 17 years (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.54, 0.96) and young adults aged 18 to 20 years (OR = 0.65; 95% CI = 0.52, 0.81). E-cigarette users with reduced access to retail environments had higher odds of reporting reduced e-cigarette use (OR = 1.51; 95% CI = 1.07, 2.14).Conclusions. COVID-19 stay-at-home directives present barriers to e-cigarette access and are associated with a decline in e-cigarette use among young people.Public Health Implications. Findings support the urgent implementation of interventions that reduce underage access to e-cigarettes to accelerate a downward trajectory of youth and young adult e-cigarette use.COVID-19 is ravaging US prisons. Prison residents and staff must be prioritized for vaccination, but a rapidly mutating virus and high rates of continued spread require an urgent, coordinated public health response.Based on knowledge accumulated from the pandemic thus far, we have identified 10 pressing public health priorities for responding to COVID-19 in prisons (1) accelerate population reduction coupled with community reentry support, (2) improve prison ventilation systems, (3) ensure appropriate mask use, (4) limit transfers between facilities, (5) strengthen partnerships between public health departments and prison leadership, (6) introduce or maintain effective occupational health programs, (7) ensure access to advance care planning processes for incarcerated patients and delineation of patient health care rights, (8) strengthen partnerships between prison leadership and incarcerated people, (9) provide emergency mental health support for prison residents and staff, and (10) commit to public accountability and transparency.Dedicated prison leaders cannot accomplish these public health priorities alone. We must mobilize prison leaders, staff, and residents; public health departments; community advocates; and policymakers to work together to address the pandemic's outsized impact in US prisons.Objectives. To estimate the effect of Medicaid expansion on noncitizens' and citizens' participation in the Supplemental Security Income (SSI) program. The Affordable Care Act (ACA) expanded Medicaid eligibility to cover low-income nonelderly adults without children, thus delinking their Medicaid participation from participation in the SSI program.Methods. Using data from the Social Security Administration for 2009 through 2018 (n = 1020 state-year observations) and the Current Population Survey for 2009 through 2019 (n = 78 776 respondents), we employed a difference-in-differences approach comparing SSI participation rates in US states that adopted Medicaid expansion with participation rates in nonexpansion states before and after ACA implementation.Results. Medicaid expansion reduced the SSI (disability) participation of nonelderly noncitizens by 12% and of nonelderly citizens by 2%. Estimates remained robust with administrative and survey data.Conclusions. Medicaid expansion caused a substantially larger decline in the SSI participation of noncitizens, who face more restrictive SSI eligibility criteria, than of citizens. Our estimates suggest an annual savings of $619 million in the federal SSI cost because of the decline in SSI participation among noncitizens and citizens.Objectives. To determine the magnitude of increases in monthly drug-related overdose mortality during the COVID-19 pandemic in the United States.Methods. We leveraged provisional records from the Centers for Disease Control and Prevention provided as rolling 12-month sums, which are helpful for smoothing, yet may mask pandemic-related spikes in overdose mortality. We cross-referenced these rolling aggregates with previous monthly data to estimate monthly drug-related overdose mortality for January through July 2020. We quantified historical errors stemming from reporting delays and estimated empirically derived 95% prediction intervals (PIs).Results. We found that 9192 (95% PI = 8988, 9397) people died from drug overdose in May 2020-making it the deadliest month on record-representing a 57.7% (95% PI = 54.2%, 61.2%) increase over May 2019. Most states saw large-magnitude increases, with the highest in West Virginia, Kentucky, and Tennessee. We observed low concordance between rolling 12-month aggregates and monthly pandemic-related shocks.Conclusions. Unprecedented increases in overdose mortality occurred during the pandemic, highlighting the value of presenting monthly values alongside smoothed aggregates for detecting shocks.Public Health Implications. PCNAI1 Drastic exacerbations of the US overdose crisis warrant renewed investments in overdose surveillance and prevention during the pandemic response and postpandemic recovery efforts. (Am J Public Health. Published online ahead of print April 15, 2021 e1-e8. https//doi.org/10.2105/AJPH.2021.306256).Despite growing evidence that COVID-19 is disproportionately affecting communities of color, state-reported racial/ethnic data are insufficient to measure the true impact.We found that between April 12, 2020, and November 9, 2020, the number of US states reporting COVID-19 confirmed cases by race and ethnicity increased from 25 to 50 and 15 to 46, respectively. However, the percentage of confirmed cases reported with missing race remained high at both time points (29% on April 12; 23% on November 9). Our analysis demonstrates improvements in reporting race/ethnicity related to COVID-19 cases and deaths and highlights significant problems with the quality and contextualization of the data being reported.We discuss challenges for improving race/ethnicity data collection and reporting, along with opportunities to advance health equity through more robust data collection and contextualization. To mitigate the impact of COVID-19 on racial/ethnic minorities, accurate and high-quality demographic data are needed and should be analyzed in the context of the social and political determinants of health.Objectives. To examine SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) epidemiology and risk factors among Federal Bureau of Prisons (BOP) staff in the United States.Methods. We calculated the SARS-CoV-2 case rate among 37 640 BOP staff from March 12 to June 17, 2020, using payroll and COVID-19-specific data. We compared occupational factors among staff with and without known SARS-CoV-2 using multiple logistic regression, controlling for demographic characteristics. We calculated relative risk among staff in stand-alone institutions versus complexes (> 1 institution).Results. SARS-CoV-2 was reported by 665 staff across 59.8% of institutions, a case rate of 1766.6 per 100 000. Working in dorm-style housing and in detention centers were strong risk factors, whereas cell-based housing was protective; these effects were erased in complexes. Occupational category was not associated with SARS-CoV-2.Conclusions. SARS-CoV-2 infection was more likely among staff working in institutions where physical distancing and limiting exposure to a consistent set of staff and inmates are challenging.Public Health Implications. Mitigation strategies-including augmented staff testing, entry and exit testing among inmates, limiting staff interactions across complexes, and increasing physical distancing by reducing occupancy in dorm-style housing-may prevent SARS-CoV-2 infections among correctional staff.Objectives. To document the cumulative childhood risk of different levels of involvement with the child protection system (CPS), including terminations of parental rights (TPRs).Methods. We linked vital records for California's 1999 birth cohort (n = 519 248) to CPS records from 1999 to 2017. We used sociodemographic information captured at birth to estimate differences in the cumulative percentage of children investigated, substantiated, placed in foster care, and with a TPR.Results. Overall, 26.3% of children were investigated for maltreatment, 10.5% were substantiated, 4.3% were placed in foster care, and 1.1% experienced a TPR. Roughly 1 in 2 Black and Native American children were investigated during childhood. Children receiving public insurance experienced CPS involvement at more than twice the rate of children with private insurance.Conclusions. Findings provide a lower-bound estimate of CPS involvement and extend previous research by documenting demographic differences, including in TPRs.Public Health Implications. Conservatively, CPS investigates more than a quarter of children born in California for abuse or neglect. These data reinforce policy questions about the current scope and reach of our modern CPS.The complex and evolving picture of COVID-19-related mortality highlights the need for data to guide the response. Yet many countries are struggling to maintain their data systems, including the civil registration system, which is the foundation for detailed and continuously available mortality statistics. We conducted a search of country and development agency Web sites and partner and media reports describing disruptions to the civil registration of births and deaths associated with COVID-19 related restrictions.We found considerable intercountry variation and grouped countries according to the level of disruption to birth and particularly death registration. Only a minority of the 66 countries were able to maintain service continuity during the COVID-19 restrictions. In the majority, a combination of legal and operational challenges resulted in declines in birth and death registration. Few countries established business continuity plans or developed strategies to deal with the backlog when restrictions are lifted.
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