Intersectional identities and dilemmas in interactions with health care professionals: An interpretative phenomenological analysis of British gay Muslim men

Individual interviews were conducted with six self-identified Muslim gay men living in London focusing on their experience of health service use. Transcripts were analysed using Interpretative Phenomenological Analysis. Analysis identified two major themes: namely, the close(d) community and self-management with health care professionals, detailing participants’ concerns regarding the risks of disclosing sexuality; and the authentic identity: “you’re either a Muslim or you’re gay, you can’t be both”, which delineated notions of incommensurate identity. Analysis highlights the need for health practitioners to have insight into the complexity of intersectional identities, identity disclosure dynamics, and the negative = consequences of assumptions made, be these heteronormative or faith-related

The use of preoperative radiotherapy in the management of patients with clinically resectable rectal cancer: a practice guideline

BACKGROUND: This systematic review with meta-analysis was designed to evaluate the literature and to develop recommendations regarding the use of preoperative radiotherapy in the management of patients with resectable rectal cancer. METHODS: The MEDLINE, CANCERLIT and Cochrane Library databases, and abstracts published in the annual proceedings of the American Society of Clinical Oncology and the American Society for Therapeutic Radiology and Oncology were systematically searched for evidence. Relevant reports were reviewed by four members of the Gastrointestinal Cancer Disease Site Group and the references from these reports were searched for additional trials. External review by Ontario practitioners was obtained through a mailed survey. Final approval of the practice guideline report was obtained from the Practice Guidelines Coordinating Committee. RESULTS: Two meta-analyses of preoperative radiotherapy versus surgery alone, nineteen trials that compared preoperative radiotherapy plus surgery to surgery alone, and five trials that compared preoperative radiotherapy to alternative treatments were obtained. Randomized trials demonstrate that preoperative radiotherapy followed by surgery is significantly more effective than surgery alone in preventing local recurrence in patients with resectable rectal cancer and it may also improve survival. A single trial, using surgery with total mesorectal excision, has shown similar benefits in local recurrence. CONCLUSION: For adult patients with clinically resectable rectal cancer we conclude that: • Preoperative radiotherapy is an acceptable alternative to the previous practice of postoperative radiotherapy for patients with stage II and III resectable rectal cancer; • Both preoperative and postoperative radiotherapy decrease local recurrence but neither improves survival as much as postoperative radiotherapy combined with chemotherapy. Therefore, if preoperative radiotherapy is used, chemotherapy should be added postoperatively to at least patients with stage III disease

Emissões de óxido nitroso do tanque de aeração de uma estação de tratamento de esgotos com sistema de lodos ativados convencional

Nitrous oxide (N2O) emissions were measured monthly from January to June 2010 in the aeration tank of a wastewater treatment plant (WWTP) in Southeast Brazil. Emissions were lower in summer than winter and were positively related with influent ammonium (NH4+) concentration. The average N2O emission was 1.11 kg N day-1 corresponding to 0.02% of the influent total nitrogen load. The average emission factor calculated for the population served was 2.5 lower than that proposed by the Intergovernmental Panel on Climate Change (IPCC) for inventories of N2O emissions from WWTPs with controlled nitrification and denitrification processes

Emissões de óxido nitroso do tanque de aeração de uma estação de tratamento de esgotos com sistema de lodos ativados convencional

Nitrous oxide (N2O) emissions were measured monthly from January to June 2010 in the aeration tank of a wastewater treatment plant (WWTP) in Southeast Brazil. Emissions were lower in summer than winter and were positively related with influent ammonium (NH4+) concentration. The average N2O emission was 1.11 kg N day-1 corresponding to 0.02% of the influent total nitrogen load. The average emission factor calculated for the population served was 2.5 lower than that proposed by the Intergovernmental Panel on Climate Change (IPCC) for inventories of N2O emissions from WWTPs with controlled nitrification and denitrification processes