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Background Anal cancer is potentially preventable through screening. For screening to be implemented, the screening procedures must be acceptable to the affected population. The objective of the present study was to measure the acceptability of currently available anal cancer screening tests in a population of women living with hiv who had experienced the tests. Methods The evva study ("Evaluation of Human Immunodeficiency Virus, Human Papillomavirus, and Anal Intraepithelial Neoplasia in Women") is a prospective cohort study of adult women living with hiv in Montreal, Quebec. Participants were screened with cervical or anal hpv testing and cervical or anal cytology every 6 months for 2 years. High-resolution anoscopy (hra) and digital anal rectal examination (dare) were also performed systematically, with biopsies, at baseline and at 2 years. An acceptability questionnaire was administered at the final visit or at study withdrawal. Results Of 124 women who completed the acceptability questionnaire, most considered screening "an absolute necessity" in routine care for all women living with hiv [77%; 95% confidence interval (ci) 69% to 84%]. Yearly anal cytology or anal hpv testing was considered very acceptable by 81% (95% ci 73% to 88%); hra every 2 years was considered very acceptable by 84% (95% ci 77% to 90%); and yearly dare was considered very acceptable by 87% (95% ci 79% to 92%). Acceptability increased to more than 95% with a longer proposed time interval. Pain was the main reason for lower acceptability. Conclusions Most participating women considered anal cancer screening necessary and very acceptable. Longer screening intervals and adequate pain management could further increase the acceptability of repeated screening. 2020 Multimed Inc.Background Cigarette smoking is carcinogenic and has been linked to inferior treatment outcomes and complication rates in cancer patients. Here, we report the results of an 18-month pilot smoking cessation program that provided free nicotine replacement therapy (nrt). Methods In January 2017, the smoking cessation program at our institution began offering free nrt for actively cigarette-smoking patients with cancer. The cost of 4 weeks of nrt was covered by the program, and follow-up was provided by smoking cessation champions. Results From January 2017 to June 2018, 8095 patients with cancer were screened for cigarette use, of whom 1135 self-identified as current or recent smokers. Of those 1135 patients, 117 enrolled in the program and accepted a prescription for nrt. The rates of patient referral and patients attending a referral appointment were significantly higher in 2018-2018 than they had been in 2015-2016 (100% vs. 80.3%, p 10 vs. ≤10 initial cigarettes) was significantly predictive of smoking reduction (odds ratio 5.04; 95% confidence interval 1.46 to 17.45; p = 0.011). Conclusions This pilot study of free nrt demonstrated rates of referral and acceptance of nrt that were improved compared with historical rates, and most referred patients either decreased their use of cigarettes or quit entirely. 2020 Multimed Inc.Sustainability is typically viewed as consisting of three forces, economic, social, and ecological, in tension with one another. In this paper, we address the dangers posed to societal sustainability. The concern being addressed is the very survival of societies where the rights of individuals, personal and collective freedoms, an independent judiciary and media, and democracy, despite its messiness, are highly valued. We argue that, as a result of various technological innovations, a range of dysfunctional impacts are threatening social and political stability. For instance, robotics and automation are replacing human labor and decision-making in a range of industries; search engines, monetized through advertising, have access to, and track, our interests and preferences; social media, in connecting us to one another often know more about us than we ourselves do, enabling them to profit in ways which may not coincide with our well-being; online retailers have not only acquired the ability to track and predicmple utilitarian calculus, complemented by approaches rooted in rights, justice, and the common good. Various options to address the challenges posed by ICTs are considered and evaluated. We argue that regulation may do little more than slow down the damage to society, particularly since societal values and political preferences vary internationally. Firms need to establish ethical standards, imbuing the upholders of these standards with sufficient authority, while creating a culture of morality. User involvement and activism, and shareholders' concerns for the sustainability of societies on whose continued prosperity they depend, are imperative to humanity's ability to decide the future direction of technology. © Springer-Verlag London Ltd., part of Springer Nature 2020.Background Major Depressive Disorder (MDD) is one of the most common mental illnesses and a leading cause of disability worldwide. Electronic Health Records (EHR) allow researchers to conduct unprecedented large-scale observational studies investigating MDD, its disease development and its interaction with other health outcomes. While there exist methods to classify patients as clear cases or controls, given specific data requirements, there are presently no simple, generalizable, and validated methods to classify an entire patient population into varying groups of depression likelihood and severity. Methods We have tested a simple, pragmatic electronic phenotype algorithm that classifies patients into one of five mutually exclusive, ordinal groups, varying in depression phenotype. Ado-Trastuzumab emtansine Using data from an integrated health system on 278,026 patients from a 10-year study period we have tested the convergent validity of these constructs using measures of external validation, including patterns of psychiatric prescriptions, symptom severity, indicators of suicidality, comorbidity, mortality, health care utilization, and polygenic risk scores for MDD. Results We found consistent patterns of increasing morbidity and/or adverse outcomes across the five groups, providing evidence for convergent validity. Limitations The study population is from a single rural integrated health system which is predominantly white, possibly limiting its generalizability. Conclusion Our study provides initial evidence that a simple algorithm, generalizable to most EHR data sets, provides categories with meaningful face and convergent validity that can be used for stratification of an entire patient population.
Homepage: https://www.selleckchem.com/products/trastuzumab-emtansine-t-dm1-.html
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