1,344 research outputs found

    Promoting Human Wellbeing in a Challenging Global Context

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    This report provides an analysis of the insights offered by the Bellagio Initiative, a global deliberative process implemented by the Institute of Development Studies, Resource Alliance and the Rockefeller Foundation over a period of six months in 2011. The Bellagio Initiative was a process of deliberation about how to meet the challenges to and seize the opportunities for protecting and promoting human wellbeing in the twenty-first century. It consisted of a series of global events that engaged a wide range of policymakers, academics and practitioners from international development and philanthropy. There were three components to the Bellagio Initiative: 1. a series of Commissioned Papers that explored key challenges and opportunities for international development and philanthropy organisations; 2. Global Dialogue meetings attended by a wide spectrum of participants at a range of locations worldwide; 3. a two-week Summit held at the Rockefeller Foundation conference centre in Bellagio, Italy, in November 2011. This report reviews and analyses the key messages from all three of these components before providing a synthesis of the main observations and recommendations in its conclusion.the Rockerfeller Foundatio

    High Prevalence of Iron Overload in Adult Allogeneic Hematopoietic Cell Transplant Survivors

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    Allogeneic hematopoietic cell transplant (HCT) recipients frequently need red blood cell transfusions, and can be at risk for developing iron overload. We studied the prevalence of iron overload in 56 adult allogeneic HCT patients who had survived for a median of 28 (range: 12-151) months from transplant. Patients were initially screened with serum ferritin, and those with serum ferritin >1000 ng/mL underwent R2 magnetic resonance imaging (MRI) of the liver, a sensitive and specific noninvasive imaging technique to measure liver iron concentration (LIC). Iron overload was defined as LIC above normal (>1.8 mg/g dry weight). Nineteen patients had serum ferritin >1000 ng/mL with a median LIC of 7.0 (range: 1.8-28.3) mg/g. The overall prevalence of iron overload was 32% (95% confidence intervals, 20%-46%). The LIC on MRI was moderately correlated with serum ferritin (ρ = .47). Iron overload is a frequent complication of allogeneic transplantation. Serum ferritin is a good screening test but does not reliably predict tissue iron overload, and estimation of LIC should be considered before initiating therapy. More studies are needed to determine the impact of iron overload on long-term morbidity and mortality in allogeneic transplant survivors

    Similar Risks for Chronic Kidney Disease in Long-Term Survivors of Myeloablative and Reduced-Intensity Allogeneic Hematopoietic Cell Transplantation

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    AbstractChronic kidney disease (CKD) in recipients of myeloablative (MA) allogeneic hematopoietic cell transplantation (HCT) has been well characterized. However, the risk of CKD after HCT using reduced-intensity conditioning (RIC) is not well known. We compared the incidence of CKD by conditioning regimen in 221 allogeneic HCT recipients (MA = 117, RIC = 104) who had survived for ≥1 year post-HCT and had no history of CKD pretransplant. CKD was defined as glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for ≥3 months anytime after 180 days post-HCT. The median follow-up was 28 months (range: 12-75) for MA and 25 months (range: 12-67) for the RIC group. The 3-year cumulative incidence rate of CKD was 28% (95% confidence intervals [CI], 19%-36%) in MA and 29% (95% CI, 20%-38%) in the RIC group (P = .44). In multivariate analysis, conditioning regimen intensity had no impact on the risk of developing CKD (relative risk [RR] for MA 1.50 [95% CI, 0.78-2.89] versus the RIC regimen). Factors independently associated with an increased risk of CKD were older age at transplant, acute graft-versus-host disease, cyclosporine use for >6 months, and acute kidney injury in the early posttransplant period. CKD is frequent in long-term adult allogeneic HCT survivors, but RIC is associated with similar risks as MA conditioning. Continuous monitoring of renal function is necessary in allogeneic HCT survivors, and studies exploring prevention strategies are needed

    Consequences of Low Risk and Hazardous Alcohol Consumption among University Students in Australia and Implications for Health Promotion Interventions

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    Background: Hazardous alcohol consumption and associated harms are high among young university students. The university environment is conducive to excessive alcohol consumption with studies finding young university students to drink alcohol at higher levels than their non-university peers. Methods: A random sample of 18 - 24-year-old undergraduate, internal university students completed a survey (n = 2465) to investigate differences in self-reported personal, secondhand and witnessed alcohol-related harms, alcohol expectancies, pre-loading, and friends’ alcohol consumption between low risk and hazardous drinkers. Univariate and multivariate analyses are reported. Results: Almost 40% of students who had consumed alcohol in the past year reported drinking at hazardous levels. Univariate analyses found students who reported hazardous drinking reported significantly higher scores relating to experienced, second-hand, witnessed and academic problems compared to low risk drinkers. Hazardous drinkers were also more likely to pre-load, to drink at higher levels when pre-loading, have more friends who drank alcohol, have more friends who drank at hazardous levels and to score higher on alcohol expectancies. However both low risk and hazardous drinkers experienced a range of harms due to their own drinking including hangover (71.2%), unprotected sex (19.3%), regretted sex (16.8%) and drink-driving (17%).Looking after an intoxicated student (34.3%) and witnessing someone pass out (37.5%) were issues for all drinkers. Experienced alcohol related harms, academic problems, alcohol expectancies, close friends’ level of alcohol consumption, pre-loading in the last four weeks and level of consumption when pre-loading were predictors of hazardous drinking (p < 0.001). Conclusion: Young undergraduate university students are at risk of a range of academic, social, emotional and physical harms associated with their own and other students’ alcohol consumption. There is a need for integrated programs to address university drinking culture and effect positive changes

    Factors driving inequality in prostate cancer survival: a population based study

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    As cancer control strategies have become more successful, issues around survival have become increasingly important to researchers and policy makers. The aim of this study was to examine the role of a range of clinical and socio-demographic variables in explaining variations in survival after a prostate cancer diagnosis, paying particular attention to the role of healthcare provider(s) i.e. private versus public status. Data were extracted from the National Cancer Registry Ireland, for patients diagnosed with prostate cancer from 1998-2009 (N = 26,183). A series of multivariate Cox and logistic regression models were used to examine the role of healthcare provider and socio-economic status (area-based deprivation) on survival, controlling for age, stage, Gleason grade, marital status and region of residence. Survival was based on all-cause mortality. Older individuals who were treated in a private care setting were more likely to have survived than those who had not, when other factors were controlled for. Differences were evident with respect to marital status, region of residence, clinical stage and Gleason grade. The effect of socio-economic status was modified by healthcare provider, such that risk of death was higher in those men of lower socio-economic status treated by public, but not private providers in the Cox models. The logistic models revealed a socio-economic gradient in risk of death overall; the gradient was larger for those treated by public providers compared to those treated by private providers when controlling for a range of other confounding factors. The role of healthcare provider and socio-economic status in survival of men with prostate cancer may give rise to concerns that warrant further investigation

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