Exploring the Unique Characteristics of Cancer in Adolescents and Young Adults in Tennessee

Adolescents and Young Adults (AYAs) ages 15-39 years with cancer have received little attention in the medical and health fields, resulting in a lack of progress for this age group. Little is known about the unique biologic, epidemiologic, and psychosocial issues that play an integral role in the AYA cancer journey. The purposes of this study were to use the Tennessee Cancer Registry for all new cancer cases from 2004-2008 to determine 1) the main types of cancer that affect AYAs in TN, 2) the predictors of late-stage diagnosis of melanoma, and 3) the factors that predict a total thyroidectomy for cancer treatment. A total of 8,097 cancer cases were diagnosed in AYAs in Tennessee from 2004-2008. The five main cancer types were breast cancers, melanomas, thyroid cancers, lymphomas, and testicular cancers and accounted for over 50% (N=4,269) of cancers in AYAs in Tennessee during the study period. Females were significantly more likely to be diagnosed with melanomas (age adjusted incidence rate (AIR) 14.01, 95% CI 12.96-15.06) and thyroid cancers (AIR 13.39, CI 12.37-14.42) compared to males (AIR 8.08, CI 7.28-8.88 and AIR 3.50, CI 2.98-4.03, respectively). All cancer types increased with age. Individuals with government insurance (OR 8.41, CI 3.04-23.27) and those 15-19 years of age (OR 6.30, CI 1.74-22.86) had the highest risk of late-stage melanoma. Significant predictors of a using total thyroidectomy for thyroid cancer treatment included regional/distant stage cancer at diagnosis (OR 2.80, CI 1.34-5.85) compared to localized stage, papillary carcinoma (OR 2.64, CI 1.02-6.83) and papillary adenocarcinoma (OR 3.56, CI1.37-9.19) histology types compared to follicular adenocarcinoma, and residence in non-Appalachian Tennessee (OR 2.07, CI 1.26-3.42) compared to Appalachian TN. An increased awareness of cancer types that affect AYAs in Tennessee will provide a basis for developing public health campaigns for cancer prevention and control in this population. This research serves as a first step in using state-based cancer registries to identify the unique characteristics of cancer in AYAs and will set the stage for future state-based research in this underserved population

An Exploration of Pattern: British Wildflowers

For this creative project I decided to focus on illustration and design, displaying the skills I have picked up over my academic journey. The natural world is all around us and throughout history, in both written and visual methods of communication, organic patterns based in nature have played a large part in how we as individuals interpret and interact with the world. Organic material is at the forefront of our minds as we navigate through the challenges that life throws at us, and for me, I wanted to celebrate this through my own artistic journey. The natural world for me is a large part of my own work, academically, personally, and professionally, and over the years my artistic style has grown because of it

INNOVATIVE MEDICINE FOR ACL REPAIRS IN DOGS

The acronym ACL, more commonly CCL, stands for the Anterior (Cranial) Cruciate Ligament; the word cruciate means to cross over or form a cross . There are two cruciate ligaments in the knee: the anterior cruciate ligament and the caudal cruciate ligament. These fibrous ligaments located within the knee join the femur and the tibia together allowing the knee to function as a hinged joint. The most common orthopedic injury in dogs is a rupture of the anterior cruciate ligament. This ligament typically ruptures during daily activities due to non-traumatic degeneration of the cranial cruciate ligament over time. Cranial cruciate disease has turned the veterinary orthopedic medicine into a billion-dollar business. With a specialty being so profitable and in such high demand, one wonders why is there such a shortage of orthopedic veterinarians

Diminished Quality of Life among Women affected by Ebola

This article analyzes data collected from Liberian women afflicted by the Ebola virus disease, survivors of the virus and noninfected persons living in Ebola-affected homes. This research is one of the first statistical analyses examining factors diminishing quality of life: negative experiences, stigma, and psychosocial symptoms among females affected by the virus after the outbreak. The research presents a thorough literature review, including research related to other infectious diseases like HIV/AIDS, to inform the gap in studies on Ebola’s effects on quality of life. Women who are Ebola virus disease survivors demonstrate significant differences in stigma and psychosocial stress when compared to their female peers. This article attempts to broaden understanding of the conditions and mental health of women affected by Ebola

Impact of Adverse Childhood Experiences on HIV Risk Behaviors using a Nationally Representative Sample from 2011 and 2012

Introduction: Adverse childhood experiences (ACEs) have been linked with negative physical and mental health outcomes in adulthood. A limited amount of literature has discussed the impact of individual ACEs on HIV risk behaviors using nationally representative data. Objective: This study investigated how ACEs impact HIV risk behaviors using cross-sectional data from the 2011 and 2012 Behavioral Risk Factor Surveillance System (BRFSS). Methods: Data were obtained from BRFSS for 2011 and 2012. Only states that answered the optional ACE questionnaire were included in the study. All ten ACEs were categorized into abuse (parents physically hurt you in any way or parents swore, insulted or put you down), household dysfunction (lived with anyone mentally ill, lived with parental alcoholic, lived with parental drug abuser, had a parent incarcerated, parents beat each other, or parents were divorced or separated) and childhood sexual abuse (forced to have sex, forced to touch sexually, or forced to be touched sexually). The number of individuals in each category were then categorized based on if they said yes to HIV risk behaviors: used intravenous drugs in the past year, been treated for a sexually transmitted or venereal disease in the past year, and/or given or received anal sex without a condom in the past year. Sociodemographic factors were assessed including race (White, Black, Hispanic, or Other), sex, income (\u3c$15,000,$15,000-\u3c$25,000,$25,000-\u3c$35,000,$35,000-\u3c$50,000, and \u3e$50,000), education (high school education or less and some college or more), age (18-34, 35-54, and 55+) and marital status (currently married or widowed and never married, divorced or separated). Weighted multiple logistic regression analyses were used to examine the association between ACEs and HIV risk behaviors controlling for sociodemographic characteristics. Results: The unweighted sample size was 151,289. The final adjusted sample size was 58,622. Majority of those who said yes to HIV risk behaviors were among the ages of 18-34 (7.92%) compared to other age categories. Adults with an income of \u3c$15,000 had a higher prevalence of saying yes to HIV risk behaviors compared to all other income categories (6.30% vs. 4.85% vs. 3.87% vs. 3.12% vs 2.33%). Adults who experienced growing up with a parent in jail or had a parent who abused drugs had a higher prevalence of saying yes to HIV risk behaviors (11.18% and 11.14% respectively). Of the 4.34% of adults who were forced to have sex as a child, 12.17% said yes to HIV risk behaviors. All ACEs were significantly associated with HIV risk behaviors (P\u3c0.0001). Multiple logistic regression analysis show that adults who grew up with parents who abused drugs (Odds Ratio (OR)= 1.74, 95% Confidence Interval (CI)= 1.72-1.74) or were forced to have sex as a child (OR=1.70, 95% CI=1.68-1.72) were more likely to have HIV risk behaviors. Not being currently married or widowed increased the odds of HIV risk behaviors by 2.31 times (OR= 2.31, 95% CI= 2.30-2.33). Conclusions: ACEs were positively associated with HIV risk behaviors. Longitudinal studies are warranted to confirm the causal relationship. Educational and prevention measures may be considered to address this public health problem

The Role of Transport and Telecommunications Technology in the Development of the Scottish Highlands and Islands Medical Service : A Historical Perspective

Peer reviewedPublisher PD

Arrest or Hospitalization? An Examination of the Relationship Between Psychiatric Symptoms, Traumatic Childhood Experiences, and Socio-Ecological Factors in Forensic Mental Health System Responses to Offender Behavior

It has been well documented that Adverse Childhood Experiences (ACEs) lead to unfavorable outcomes in later life, especially with regard to health and psychological outcomes. Recent research has demonstrated the impact of early childhood adversity on the onset of aggression and illegal behavior. However, often those with mental illness diagnoses with comorbid behavioral problems exhibit trajectories that include both arrest and hospitalization. While some are arrested for their criminal behavior, others are hospitalized. This begs the question: are those with mental illness and behavioral problems more likely to be arrested, or hospitalized, for their early behavioral problems? In the current study, it was hypothesized that arrest precedes hospitalization for the majority of these offenders, and that specific diagnoses of a mental illness are related to outcome. It was also hypothesized that early exposure to environmental adversity, as measured by the age of earliest ACE and total ACE score, would significantly predict whether offenders were arrested or hospitalized first. Other socio-ecological factors were also studied. The data for this study were gathered from a sample of 182 adult psychiatric inpatients in a secure forensic facility. Data were archival and retrospective in nature. All participants had been hospitalized following acts of violence or aggression, exhibiting a history of both behavioral problems as well as mental illness. A series of logistic and linear regressions were used to examine the relationship between reason for first admission to a psychiatric facility, diagnosis of a mental disorder, and early childhood adversity to clarify whether early problematic behaviors resulted in initial arrest or psychiatric hospitalization. Results indicate that subjects were much more likely to be hospitalized initially than arrested (33.5% arrested first, 66.5% hospitalized first). A diagnosis of impulse control disorder was significantly related to whether initial incident led to arrest or hospitalization (p=0.030), while the diagnosis of ADHD neared significance (p=0.056). No significant relationship was found between incidence of initial arrest or hospitalization and age that drug/alcohol abuse began. Other findings and implications for future research will be discussed

Alcohol Consumption, Depression, Insomnia and Colorectal Cancer Screening: Racial Differences

Background: Mortality from colorectal cancer (CRC) can be reduced drastically by early detection and early treatment. However, uptake of CRC screening is relatively low, about 50% for those whom the test is highly recommended. Objectives: We examined the influence of and racial differences in depression, insomnia, alcohol use, and tobacco use on CRC screening uptake in the US. Patients and Methods: Analysis of the 2012 National Health Information Survey data was conducted. Both weighted univariate and multiple logistic regression analyses were performed in SAS to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs). A total of 21511 participants were included in the analysis. Results: Prevalence of CRC screening in the participants was 19%. Adjusting for all factors, insomnia (OR = 1.18, 95%CI = 1.06 - 1.32), moderate alcohol drinking (OR = 1.16, 95%CI = 1.01 - 1.30), past smoking (OR = 1.17, 95%CI = 1.04 - 1.32), depression (OR = 1.37, 95%CI = 1.18 - 1.58), African American (AA) race, and cancer history were positively associated with CRC screening. Females and Single were inversely associated with CRC screening prevalence. In stratified analysis by races (White and AA), depression was associated with CRC screening in both races. Marital status, smoking, cancer history and insomnia were associated with CRC screening in Whites only; while alcohol use was associated with CRC screening in AAs only. Conclusions: We have found significant associations between lifestyle factors (alcohol consumption and smoking) and mental health problems (depression and insomnia) and CRC screening uptake. To improve overall CRC screening uptake in the US, it is important to consider racial differences in predictors and tailor appropriate interventions to each racial/ethnic group

Analysis of the Liberian Ebola Survivors Support System (ESSS)

A systems theoretical analysis to capture the evolution and transition of the network systems supporting Ebola survivors and their affected communities, during the 2014-15 Ebola outbreak and recovery phases. The qualitative analysis includes a literature review, archival review, and interviews with representatives of key actors operating in strategic action fields. This paper uses a series of Diagrams that visually illustrate the various complex phases and their network changes that occurred and were established during the outbreak. This case analysis provides crucial phase information that both captures the historical events that informed the systems changes, including the development of the Ebola Survivors’ Support System (ESSS). Secondly, this analysis acts as, a model of understanding how disease support networks first emerge and can be better supported in other outbreaks