Cancer Disparities: Unmet Challenges in the Elimination of Disparities

http://dx.doi.org/10.1158/1055-9965.EPI-11-062

Think globally, act locally - reducing environmental impacts of transport

This paper presents a pragmatic approach for reducing the environmental impacts of transport in the German Federal State Saxony. The aim is to use the potential of pricing measures for effectively reducing environmental impacts of transport. They are combined with less-effective but more accepted non-pricing measures in a policy package. The development of this approach starts with the calculation of the current external costs of transport in the case study area. Second, a policy package reducing these external costs is composed. Third, the development of the external costs is assessed and compared in two scenarios, a BAU-scenario and the policy scenario where measures reducing the environmental impacts of transport are implemented. Fourth, the public and political acceptability of this policy package are investigated. The results show that it is possible to develop a policy package that is effective for reducing the environmental impacts as well as acceptable to the public and politicians. Therefore, such a package approach is suitable to guide future political decisions and actions towards a more sustainable transport sector

Smokers’ beliefs about the tobacco control potential of “a gene for smoking”: A focus group study

BACKGROUND: Several genetic variations associated with nicotine dependence and lung cancer exist. Translating this knowledge into tobacco control policy relies on smokers’ perceptions of the implications of the research. This study explored smokers’ beliefs about the tobacco control uses for research examining genomics, smoking, and addiction. METHOD: Smokers (N = 85) participated in one of thirteen focus groups and one interview, stratified by race (eight black, six white) and education (seven < Bachelor’s degree, seven ≥ Bachelor’s degree). Data were analyzed by two independent coders using standard analysis and validation techniques. RESULTS: Nearly all groups suggested using genetic information for youth-oriented tobacco prevention education. Beliefs about the effectiveness of such actions varied. Many participants believed that providing smokers personalized genetic testing results or informing them about the existence of a gene would not motivate people to quit. All smokers emphasized the need for improved smoking cessation treatment options. Using genomics research to develop gene therapies and personalized drug treatments were also mentioned, yet perceptions of such treatments were mixed. Whereas some participants viewed the possibility positively, others expressed concern about cost and access. Participants who were skeptical of the effectiveness of using genetic information for tobacco control noted that the harms of tobacco use are widely known and genetic information does not add much of a deterrent. CONCLUSION: Participants generated several possible tobacco control uses for genomics research findings. Our findings suggest that tobacco control experts should consult with smokers prior to implementing tobacco control measures. The potential public health benefits of genetics and genomics research related to tobacco use cannot be realized until communication strategies that are most likely to encourage and support tobacco avoidance decisions, and minimize mistrust and backlash, are identified

Analysis and performance evaluation of an axial-field brushless PM machine utilising soft magnetic composites

Copyright © 2007 IEEEOne of the major research activities in electric machines involves the use of alternative magnetic materials. Soft magnetic composites (SMC) offer the advantages of 3D magnetic flux paths and low-cost manufacturing. This paper examines the analysis and modelling of a prototype axial-field permanent magnet machine which uses SMC. Measured parameters and performance with an inverter is compared to 3D finite-element simulations. © 2007 IEEE

Motherhood, psychological risks, and resources in relation to alcohol use disorder: Are there differences between black and white women?

Rates of alcohol use disorders (AUD) are generally low among women who have ever had children (mothers) compared to women who have never had children (nonmothers), presenting a motherhood advantage. It is unclear if this advantage accrues to “Black” and “White” women alike. Using National Epidemiological Survey on Alcohol and Related Conditions (NESARC) wave 2 cross-sectional data that is rich in alcohol use and psychological measures, we examined the following: (a) if motherhood is protective for past-year AUD among Black (N = 4,133) and White women (N = 11,017); (b) potential explanatory psychological mechanisms; and (c) the role of race. Prevalence of a past-year DSM-IV AUD was lower among White mothers compared to White nonmothers, but this same advantage was not observed for Black women. Perceived stress was a risk for all women, but race-ethnic segregated social networks and perceived discrimination predicted current AUD for Black mothers. Unlike White mothers, current psychological factors but not family history of alcohol problems predicted AUD for Black mothers. Future prospective studies should address the mechanisms by which race, motherhood, and psychological factors interactively affect AUD in women

A method for achieving reciprocity of funding in community-based participatory research

BACKGROUND: The St. Louis Komen Project was conceived to address disparities in breast cancer treatment and outcomes between African-American and White women in St. Louis, Missouri. Our goal was to apportion tasks and funding through a process to which all researcher partners had input and to which all could agree, thus eliminating institutionalized inequalities. METHODS: This paper describes the collaborative process and resulting division of responsibilities, determination of costs, and ultimate allocation of funds and resources, as well as the documentation employed to achieve funding reciprocity and equal accountability. RESULTS: Both communication and documentation are critical. Although the Memoranda of Understanding employed are not a panacea, they codify roles and expectations and promote trust. The process of developing financial transparency set the tone for subsequent steps in the research process. CONCLUSIONS: The exhaustive planning process and project-specific procedures developed by its partners have helped the project foster reciprocity, facilitate participation, and equitably distribute resources

Breast reconstruction after mastectomy at a comprehensive cancer center

BACKGROUND: Breast reconstruction after mastectomy is an integral part of breast cancer treatment that positively impacts quality of life in breast cancer survivors. Although breast reconstruction rates have increased over time, African American women remain less likely to receive breast reconstruction compared to Caucasian women. National Cancer Institute-designated Comprehensive Cancer Centers, specialized institutions with more standardized models of cancer treatment, report higher breast reconstruction rates than primary healthcare facilities. Whether breast reconstruction disparities are reduced for women treated at comprehensive cancer centers is unclear. The purpose of this study was to further investigate breast reconstruction rates and determinants at a comprehensive cancer center in St. Louis, Missouri. METHODS: Sociodemographic and clinical data were obtained for women who received mastectomy for definitive surgical treatment for breast cancer between 2000 and 2012. Logistic regression was used to identify factors associated with the receipt of breast reconstruction. RESULTS: We found a breast reconstruction rate of 54 % for the study sample. Women who were aged 55 and older, had public insurance, received unilateral mastectomy, and received adjuvant radiation therapy were significantly less likely to receive breast reconstruction. African American women were 30 % less likely to receive breast reconstruction than Caucasian women. CONCLUSION: These findings suggest that racial disparities in breast reconstruction persist in comprehensive cancer centers. Future research should further delineate the determinants of breast reconstruction disparities across various types of healthcare institutions. Only then can we develop interventions to ensure all eligible women have access to breast reconstruction and the improved quality of life it affords breast cancer survivors

Ontology-driven conceptual modeling: A'systematic literature mapping and review

All rights reserved. Ontology-driven conceptual modeling (ODCM) is still a relatively new research domain in the field of information systems and there is still much discussion on how the research in ODCM should be performed and what the focus of this research should be. Therefore, this article aims to critically survey the existing literature in order to assess the kind of research that has been performed over the years, analyze the nature of the research contributions and establish its current state of the art by positioning, evaluating and interpreting relevant research to date that is related to ODCM. To understand and identify any gaps and research opportunities, our literature study is composed of both a systematic mapping study and a systematic review study. The mapping study aims at structuring and classifying the area that is being investigated in order to give a general overview of the research that has been performed in the field. A review study on the other hand is a more thorough and rigorous inquiry and provides recommendations based on the strength of the found evidence. Our results indicate that there are several research gaps that should be addressed and we further composed several research opportunities that are possible areas for future research

Prioritizing Strategic IT Projects with Tropos

One of the daily tasks of an enterprise architect is to prioritize strategic IT projects. To achieve a business-IT alignment, this prioritization needs to be based on business strategies and goals. Therefore, business goals and their traceability to strategic IT projects are relevant for the enterprise architect. However, surpris-ingly little formalisations and reasoning techniques have been developed in the enterprise architecture domain. In this paper we show that the popular goal modelling technique Tropos together with its formal reasoning techniques can support the enterprise architect when prioritizing strategic IT projects. We prove the feasibility of our work with a tool implementation of the proposed modelling language and its corresponding algorithms; and demon-strate their usefulness with the help of an example taken from the enterprise architecture literature