Interim Evaluation of the "Youth in Action" programme in Estonia 2007-2009

Youth in Action is an EU programme, which aims to promote active citizenship, solidarity and tolerance among young Europeans. After three years (2007-2009) of action it is time for interim evaluation of the programme. In Estonia, the programme assessment was carried out by the researchers of the Institute of Sociology and Social Policy at the University of Tartu. The assessment included a secondary analysis of materials relating to the programme, questionnaire-based Internet surveys, interviews with the participants in the programme, and discussions with co-workers of the National Agency for the Youth In Action programme.http://euroopa.noored.ee/files/Programmi%20Euroopa%20Noored%20vahehindamise%20(2007-2009)%20uuring%20inglise%20keeles.pd

Computing Optical Properties of Ultra-thin Crystals

An overview is given of recent advances in experimental and theoretical understanding of optical properties of ultra-thin crystal structures (graphene, phosphorene, silicene, MoS2, MoSe2 , WS2 , WSe2 , h-AlN, h-BN, fluorographene, graphane). Ultra-thin crystals are atomically-thick layered crystals that have unique properties which differ from their 3D counterpart. Because of the difficulties in the synthesis of few-atom-thick crystal structures, which are thought to be the main building blocks of future nanotechnology, reliable theoretical predictions of their electronic, vibrational and optical properties are of great importance. Recent studies revealed the reliable predictive power of existing theoretical approaches based on density functional theory (DFT)

Reproductive factors and risk of mortality in the European Prospective Investigation into Cancer and Nutrition; a cohort study

Abstract Background Reproductive events are associated with important physiologic changes, yet little is known about how reproductive factors influence long-term health in women. Our objective was to assess the relation of reproductive characteristics with all-cause and cause-specific mortality risk. Methods The analysis was performed within the European Investigation into Cancer and Nutrition prospective cohort study, which enrolled >500,000 women and men from 1992 to 2000, who were residing in a given town/geographic area in 10 European countries. The current analysis included 322,972 eligible women aged 25–70 years with 99 % complete follow-up for vital status. We assessed reproductive characteristics reported at the study baseline including parity, age at the first birth, breastfeeding, infertility, oral contraceptive use, age at menarche and menopause, total ovulatory years, and history of oophorectomy/hysterectomy. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for mortality were determined using Cox proportional hazards regression models adjusted for menopausal status, body mass index, physical activity, education level, and smoking status/intensity and duration. Results During a mean follow-up of 12.9 years, 14,383 deaths occurred. The HR (95 % CI) for risk of all-cause mortality was lower in parous versus nulliparous women (0.80; 0.76–0.84), in women who had ever versus never breastfed (0.92; 0.87–0.97), in ever versus never users of oral contraceptives (among non-smokers; 0.90; 0.86–0.95), and in women reporting a later age at menarche (≥15 years versus <12; 0.90; 0.85–0.96; P for trend = 0.038). Conclusions Childbirth, breastfeeding, oral contraceptive use, and a later age at menarche were associated with better health outcomes. These findings may contribute to the development of improved strategies to promote better long-term health in women

Reproductive factors and risk of mortality in the European Prospective Investigation into Cancer and Nutrition; a cohort study.

BACKGROUND: Reproductive events are associated with important physiologic changes, yet little is known about how reproductive factors influence long-term health in women. Our objective was to assess the relation of reproductive characteristics with all-cause and cause-specific mortality risk. METHODS: The analysis was performed within the European Investigation into Cancer and Nutrition prospective cohort study, which enrolled >500,000 women and men from 1992 to 2000, who were residing in a given town/geographic area in 10 European countries. The current analysis included 322,972 eligible women aged 25-70 years with 99 % complete follow-up for vital status. We assessed reproductive characteristics reported at the study baseline including parity, age at the first birth, breastfeeding, infertility, oral contraceptive use, age at menarche and menopause, total ovulatory years, and history of oophorectomy/hysterectomy. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for mortality were determined using Cox proportional hazards regression models adjusted for menopausal status, body mass index, physical activity, education level, and smoking status/intensity and duration. RESULTS: During a mean follow-up of 12.9 years, 14,383 deaths occurred. The HR (95 % CI) for risk of all-cause mortality was lower in parous versus nulliparous women (0.80; 0.76-0.84), in women who had ever versus never breastfed (0.92; 0.87-0.97), in ever versus never users of oral contraceptives (among non-smokers; 0.90; 0.86-0.95), and in women reporting a later age at menarche (≥15 years versus <12; 0.90; 0.85-0.96; P for trend = 0.038). CONCLUSIONS: Childbirth, breastfeeding, oral contraceptive use, and a later age at menarche were associated with better health outcomes. These findings may contribute to the development of improved strategies to promote better long-term health in women

Reproductive factors and risk of mortality in the European Prospective Investigation into Cancer and Nutrition; a cohort study

Background: Reproductive events are associated with important physiologic changes, yet little is known about how reproductive factors influence long-term health in women. Our objective was to assess the relation of reproductive characteristics with all-cause and cause-specific mortality risk. Methods: The analysis was performed within the European Investigation into Cancer and Nutrition prospective cohort study, which enrolled > 500,000 women and men from 1992 to 2000, who were residing in a given town/geographic area in 10 European countries. The current analysis included 322,972 eligible women aged 25-70 years with 99 % complete follow-up for vital status. We assessed reproductive characteristics reported at the study baseline including parity, age at the first birth, breastfeeding, infertility, oral contraceptive use, age at menarche and menopause, total ovulatory years, and history of oophorectomy/hysterectomy. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for mortality were determined using Cox proportional hazards regression models adjusted for menopausal status, body mass index, physical activity, education level, and smoking status/intensity and duration. Results: During a mean follow-up of 12.9 years, 14,383 deaths occurred. The HR (95 % CI) for risk of all-cause mortality was lower in parous versus nulliparous women (0.80; 0.76-0.84), in women who had ever versus never breastfed (0.92; 0.87-0.97), in ever versus never users of oral contraceptives (among non-smokers; 0.90; 0.86-0.95), and in women reporting a later age at menarche (>= 15 years versus < 12; 0.90; 0.85-0.96; P for trend = 0.038). Conclusions: Childbirth, breastfeeding, oral contraceptive use, and a later age at menarche were associated with better health outcomes. These findings may contribute to the development of improved strategies to promote better long-term health in women

Reproductive factors and breast cancer and colorectal cancer incidence and mortality among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Cancers of the breast and colorectum are two of the most frequently diagnosed malignancies worldwide and despite improvements in treatment and survival, are leading causes of death. Reproductive factors, such as age at menarche, childbirth and age at menopause have been consistently linked to risk of developing breast cancer while exposure to exogenous hormones through use of oral contraceptives (OC) and hormone therapy (HT), are associated with increased risk of breast cancer but a reduced risk of colorectal cancer. These observations support the hypothesis that variation in endogenous hormone pathways contribute to breast and colorectal cancer development. However, while a substantial body of literature has established the significance of reproductive factors and exogenous hormone use in the initiation of these tumours, data on their association with mortality among breast and colorectal cancer patients are limited. To further knowledge on the role of reproductive factors and exogenous hormone use on the natural history of breast and colorectal cancer, a comprehensive assessment of these factors in relation to breast and colorectal cancer development as well as survival was undertaken among participants of the European Prospective Investigation into Cancer (EPIC). Specifically, among 150,251 women defined as postmenopausal at study baseline, the association of age at first and last menstruation, history of pregnancy, number of full-term pregnancies, the age at birth of the first and last child, breast feeding, accumulative breast feeding duration, and ever use of oral contraceptives and hormone therapy was investigated in relation to (i) breast cancer incidence, (ii) all-cause and breast cancer-specific mortality amongst breast cancer patients, (iii) colorectal cancer incidence and (iv) all-cause and colorectal cancer-specific mortality among colorectal cancer patients. Statistical analyses were conducted using Cox proportional hazards modelling with adjustment for established breast and colorectal cancer risk factors. In multivariable analyses, a later age at menarche was associated with associated with 11% reduced risk of breast cancer ( hazard ratio [HR] ≥15 vs 12 years = 0.89, 95% confidence intervals [CI]= 0.80-1.00; P-trend=0.0001); older age at menopause was found to be associated with increased risk of breast cancer (>55 vs ≤50 HR=1.27, 95% CI=1.10-1.47; P-trend 4 children were at 26% reduced risk of breast cancer expressing oestrogen receptors (ER) compared to women who had one child (HR=0.74, 95%CI: 0.64-0.86; P-trend=0.002). Breast cancer patients who expressed the ER and had at least one pregnancy were at 57% reduced risk of death compared to nulliparous patients who expressed ER (HR= 0.43, 95%CI: 0.26-0.71). The use of exogenous hormones in the form of oral contraceptives and postmenopausal hormones was found to reduce the risk of developing colorectal cancer in postmenopausal women by 15% (OC users vs non-users HR= 0.85, 95%CI: 0.76-0.95) and 14% (HT users vs non-users HR= 0.86, 95% CI= 0.0.79-0.96). However, it seems that hormone therapy users have 28% higher risk of fatal colorectal cancer compared to non-users (HR=1.28, 95%CI: 1.01-1.61). The results of this large-scale prospective investigation indicate that reproductive factors and use of exogenous hormones influence the development of breast and colorectal cancer and may also be associated with survival among patients with these malignancies. If confirmed in other studies, these findings may be further explored in prognostic modelling and may help inform treatment and surveillance of high-risk groups.Open Acces

Surgical confidence when operating among residents in surgery – a cross-sectional study (SCAR study)

Abstract Background Self-confidence, is one of the critical variables influencing surgical resident’s abilities, and lack of confidence maybe a reason for not entering medical practice immediately. Measuring the level of confidence of senior surgical residents (SSRs) is a crucial step in assessing preparedness to practice. In this study, we aim to measure their confidence level and the factors that might contribute to it. Methods Cross-sectional survey conducted at King Abdulaziz University Hospital on SSRs in Saudi Arabia (SA). We approached 142 SSRs, 127 responded. Statistical analysis was performed using RStudio v 3.6.2. Descriptive statistics were performed using counts and percentages for categorical variables and using mean ± standard deviation for continuous variables. Multivariate linear regression (t-statistics) was used to assess the factors associated with confidence in performing essential procedures, while the association between demographics and residency-related factor with the number of completed cases was tested using Chi-square. The level of significance was determined as 0.05. Results Response rate was 89.4%. Among surveyed residents, 66% had completed < 750 cases as a primary surgeon. More than 90% of SSRs were confident in performing appendectomy, open inguinal hernia repair, laparoscopic cholecystectomy, and trauma laparotomy, while 88% were confident in being on-call in level-I trauma center. No difference was noted in confidence level in relation to the number of performed cases. Residents from the Ministry of Health accounted for 56.3% of the study population and showed a higher confidence level compared to others. 94% of SSRs plan to pursue fellowship training program. Conclusion The study showed that the confidence of SSRs in performing common general surgery procedures was as expected. However, it’s important to recognize that confidence doesn’t necessarily reflect competence. Considering the majority of SSRs planned to pursue fellowship training programs, it may be time to consider changing the structure of surgical training in SA to a modular format to allow earlier and more intensive exposure