Cancer-Related Risk Factors and Incidence of Major Cancers by Race, Gender and Region; Analysis of the NIH-AARP Diet and Health Study

Background: Racial disparities in the incidence of major cancers may be attributed to differences in the prevalence of established, modifiable risk factors such as obesity, smoking, physical activity and diet. Methods: Data from a prospective cohort of 566,398 adults aged 50–71 years, 19,677 African-American and 450,623 Whites, was analyzed. Baseline data on cancer-related risk factors such as smoking, alcohol, physical activity and dietary patterns were used to create an individual adherence score. Differences in adherence by race, gender and geographic region were assessed using descriptive statistics, and Cox proportional hazards models were used to determine the association between adherence and cancer incidence. Results: Only 1.5% of study participants were adherent to all five cancer-related risk factor guidelines, with marked race-, gender- and regional differences in adherence overall. Compared with participants who were fully adherent to all five cancer risk factor criteria, those adherent to one or less had a 76% increased risk of any cancer incidence (HR: 1.76, 95% CI: 1.70 – 1.82), 38% increased risk of breast cancer (HR: 1.38, 95% CI: 1.25 – 1.52), and doubled the risk of colorectal cancer (HR: 2.06, 95% CI: 1.84 – 2.29). However, risk of prostate cancer was lower among participants adherent to one or less compared with those who were fully adherent (HR: 0.79, 95% CI: 0.75 – 0.85). The proportion of cancer incident cases attributable to low adherence was higher among African-Americans compared with Whites for all cancers (21% vs. 19%), and highest for colorectal cancer (25%) regardless of race. Conclusion: Racial differences in the proportion of cancer incidence attributable to low adherence suggests unique opportunities for targeted cancer prevention strategies that may help eliminate racial disparities in cancer burden among older US adults

Progettazione di un datamart per la gestione delle chiamate nei call center in un'azienda di Telecomunicazioni.

Il CRM (Customer Relationship Management) è uno strumento strategico utilizzato per rispondere alle esigenze aziendali in termini di competitività e raggiungimento degli obiettivi tra cui quello inerente alla soddisfazione e alla fidelizzazione della clientela. Le due componenti principali e complementari allo stesso tempo sono il CRM Analitico e il CRM operativo: quest'ultimo infatti fornisce all'Analitico i dati da elaborare, il quale, permette di acquisire la conoscenza necessaria per interagire con i clienti. In particolare studieremo un caso di CRM Analitico relativo all'analisi del servizio offerto al cliente, in termini di chiamate in entrata in un call center, analizzeremo il datamart progettato dall'azienda di telecomunicazioni, riprogetteremo lo stesso attraverso tecniche di datawarehouse e svilupperemo un algoritmo di calcolo delle metriche per rilevare in maniera efficace la soddisfazione del cliente

Availability of Healthcare Resources and Epithelial Ovarian Cancer Stage of Diagnosis and Mortality Among Blacks and Whites

Background: The purpose of this study is to examine whether racial disparities in epithelial ovarian cancer stage at diagnosis and survival may be explained by geographic availability of healthcare resources among Blacks and Whites. Methods: Data from the Surveillance, Epidemiology and End Results (SEER) database was used to identify White and Black women ages 40 years and above diagnosed with epithelial ovarian cancer between 2000 and 2010. Data on county-level availability of healthcare resources was obtained from the Area Resource File. Multi-level regression models, overall and stratified by race and age, were used to examine the associations of health care access (HCA) and socioeconomic status (SES) with stage at diagnosis while Cox proportional hazards models were used to examine the association with survival. Results: Among 46,423 women diagnosed with epithelial ovarian cancer, Blacks were more likely to reside in counties with fewer average number of oncology hospitals (p \u3c 0.05) and hospitals with ultrasound (p \u3c 0.001), but higher number of medical doctors (p \u3c 0.0001) and Ob/Gyn (p \u3c 0.001). Black patients had higher odds of late stage diagnosis of epithelial ovarian cancer (OR: 1.13, 95% CI: 1.04–1.25) and higher risk of epithelial ovarian cancer mortality (HR: 1.25, 95% CI: 1.19–1.32) compared with White patients after accounting for differential availability of healthcare resources. Among Black patients, residing in counties with fewer medical doctors was associated with increased odds of late stage diagnosis (OR: 1.86, 95% CI: 1.10–3.13), and the racial disparity in late stage diagnosis and mortality was larger among patients ages \u3c 65 years compared with older patients. Cconclusion: Racial disparities in availability and utilization of healthcare resources likely contributes to adverse epithelial ovarian cancer outcomes among Black women in the US

Developing Effective Cancer Pain Education Programs

Pain is prevalent, burdensome, and undertreated in individuals with cancer across the disease trajectory. Providing patients and family caregivers psychosocial support and education to manage cancer pain is a core component of quality care that can result in significant clinical benefit. In this review, we (1) outline an approach for developing and assessing the effectiveness of education programs for adults with cancer pain; (2) discuss considerations for tailoring programs to the needs of diverse populations and those with limited health literacy skills; (3) describe the resource needs and costs of developing a program; and (4) highlight innovative approaches to cancer pain education. We conclude with recommendations for future research and the next generation of educational interventions

The Allopregnanolone Response to Acute Stress in Females: Preclinical and Clinical Studies

The neuroactive steroid allopregnanolone ((3 alpha,5 alpha)-3-hydroxypregnan-20-one or 3 alpha,5 alpha-THP) plays a key role in the response to stress, by normalizing hypothalamic-pituitary-adrenal (HPA) axis function to restore homeostasis. Most studies have been conducted on male rats, and little is known about the allopregnanolone response to stress in females, despite that women are more susceptible than men to develop emotional and stress-related disorders. Here, we provide an overview of animal and human studies examining the allopregnanolone responses to acute stress in females in the context of stress-related neuropsychiatric diseases and under the different conditions that characterize the female lifespan associated with the reproductive function. The blunted allopregnanolone response to acute stress, often observed in female rats and women, may represent one of the mechanisms that contribute to the increased vulnerability to stress and affective disorders in women under the different hormonal fluctuations that occur throughout their lifespan. These studies highlight the importance of targeting neuroactive steroids as a therapeutic approach for stress-related disorders in women

Fresco Paintings: Development of an Aging Model from 1064 nm Excited Raman Spectra

In this study, we proposed a preliminary kinetic model applied to the carbonation process of fresh lime with the intention to realize a diagnostic tool for aged fresco paintings. The model can be useful, in particular, in the fields of conservation and restoration of ancient lime wall paintings. The dating procedure was achieved through the analysis of 1064 nm excited Raman spectra collected on artificially aged lime samples in addition to ancient samples taken from literature and covering a period of two thousand years. The kinetic model was developed monitoring the concentration of emitting defective centers related to the intensity of 780 cm−1 calcium hydroxide band as a function of the time and depth. This preliminary model shows how Raman spectroscopy, especially NIR micro-Raman, is advantageous for diagnostics and conservation in the cultural heritage field

Mortalití infantile in Africa: un approccio infermieristico al Kwashiorkor

Lo studio operativo quinquennale si pone come ambizioso obiettivo quello di ridurre l'incidenza del kwashiorkor (marasma infantile) attraverso un approccio olistico esclusivamente infermieristico alle famiglie che vivono il problema nella realtí  straniera del Kenya rurale. Progetto finanziato dal fondo "Tesi cooperazione internazionale" dell' ERSU Sardegna, basato su un viaggio effettuato a luglio/agosto 2012 volto all'osservazione dell'ambiente , dei pazienti, della patologia e della cultura locale. Attraverso l'utilizzo del problem solving potrebbe essere ridotta l'incidenza del kwahiorkor usando come strumento la prevenzione primaria sotto forma di conoscenza: ovvero la consegna di una serie di brochures realizzata in Italia e distribuita direttamente dagli infermieri locali in servizio presso il Consolata Hospital di Nyeri ad ogni puerpera ospedalizzata, contenenti una guida al corretto svezzamento basata sulle linee guida OMS e personalizzata per l'economia e la cultura -anche alimentare- locale, appresa durante il viaggio sovracitato. L'efficacia dello studio verrí  poi valutata per 5 anni a intervalli regolari di un anno, rapportando l'incidenza di kwashiorkoar ospedalizzato presso la stessa struttura col numero di brochures consegnate e confrontando questo risultato con i tassi di incidenza rilasciati dalle organizzazioni non governative per la stessa zona d'interesse.Parole chiave: Kwashiorkor, marasma, prevenzione primaria, infermiere, PEM. Child mortality in Africa: a nursing approach to KwashiorkorThe five year operative study points the ambitious aim of reducing kwashiorkor's incidence through an holistic approach to the families that live the issue in the rural Kenya reality. The project had been financed with the "Tesi cooperazione internazionale" funds of ERSU Sardegna, based on a trip made in July/August 2012 that was aimed at observing the environment, the patients, the pathology and the local culture. Using the problem solving method, the kwashiorkor's incidence could be decreased with the primary prevention tool as a form of knowledge through brochures made in Italy and delivered directly by the local nurses of the Consolata Hospital in Nyeri to women who have just given birth. The brouchure contains a guide to the correct way of weaning, based on the OMS's guide lines and customized for the local economy and culture (food culture too), learned during the trip. The effectiveness of the study will be valuated for 5 years (with regular pauses of a year each) comparing the Hospitalized Kwashiorkor's incidence, to the number of brochures delivered and then comparing these results to the incidence rates released by the NGO for the same zone of interest.Keywords: Kwashiorkor, marasma, primary prevenction, nurse, PEM

Mortalità infantile in Africa: un approccio infermieristico al Kwashiorkor

Lo studio operativo quinquennale si pone come ambizioso obiettivo quello di ridurre l'incidenza del kwashiorkor (marasma infantile) attraverso un approccio olistico esclusivamente infermieristico alle famiglie che vivono il problema nella realtà straniera del Kenya rurale. Progetto finanziato dal fondo "Tesi cooperazione internazionale" dell' ERSU Sardegna, basato su un viaggio effettuato a luglio/agosto 2012 volto all'osservazione dell'ambiente , dei pazienti, della patologia e della cultura locale. Attraverso l'utilizzo del problem solving potrebbe essere ridotta l'incidenza del kwahiorkor usando come strumento la prevenzione primaria sotto forma di conoscenza: ovvero la consegna di una serie di brochures realizzata in Italia e distribuita direttamente dagli infermieri locali in servizio presso il Consolata Hospital di Nyeri ad ogni puerpera ospedalizzata, contenenti una guida al corretto svezzamento basata sulle linee guida OMS e personalizzata per l'economia e la cultura -anche alimentare- locale, appresa durante il viaggio sovracitato. L'efficacia dello studio verrà poi valutata per 5 anni a intervalli regolari di un anno, rapportando l'incidenza di kwashiorkoar ospedalizzato presso la stessa struttura col numero di brochures consegnate e confrontando questo risultato con i tassi di incidenza rilasciati dalle organizzazioni non governative per la stessa zona d'interesse.Parole chiave: Kwashiorkor, marasma, prevenzione primaria, infermiere, PEM. Child mortality in Africa: a nursing approach to KwashiorkorThe five year operative study points the ambitious aim of reducing kwashiorkor's incidence through an holistic approach to the families that live the issue in the rural Kenya reality. The project had been financed with the "Tesi cooperazione internazionale" funds of ERSU Sardegna, based on a trip made in July/August 2012 that was aimed at observing the environment, the patients, the pathology and the local culture. Using the problem solving method, the kwashiorkor's incidence could be decreased with the primary prevention tool as a form of knowledge through brochures made in Italy and delivered directly by the local nurses of the Consolata Hospital in Nyeri to women who have just given birth. The brouchure contains a guide to the correct way of weaning, based on the OMS's guide lines and customized for the local economy and culture (food culture too), learned during the trip. The effectiveness of the study will be valuated for 5 years (with regular pauses of a year each) comparing the Hospitalized Kwashiorkor's incidence, to the number of brochures delivered and then comparing these results to the incidence rates released by the NGO for the same zone of interest.Keywords: Kwashiorkor, marasma, primary prevenction, nurse, PEM

Effects of supplementation with vegetable extracts on physicochemical, antioxidant and microbiological properties of yogurts

The objective of this work was the evaluation of physico-chemical properties, antioxidant capacity and microbiological vitality of in laboratory prepared yogurts, whose fermentation was conducted in presence or in absence of different vegetable extracts: artichoke (Cynara scolymus L.) edible (ED) and not edible (NED) part, strawberry-tree (Arbutus unedo L.) fruits at two different stages of ripening, ripe (red) and unripe (yellow) fruits, cherries (Prunus avium L.), compared to commercial yogurts supplemented with vegetable extracts or with antioxidant factors