Nodular lymphocyte predominant Hodgkin lymphoma behaves as a distinct clinical entity with good outcome: evidence from 14-year followup in the West of Scotland Cancer Network

Clinically and biologically, nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) has much more in common with germinal-center derived B-cell non-Hodgkin lymphoma (NHL) than with classical Hodgkin lymphoma (cHL). Management of NLPHL remains controversial. In a 14-year multicenter series, 69 cases were analyzed, and the median follow-up was 53 months (range 11–165.) B-symptoms were present in only 4.3% of patients, and 81.1% of patients had stage I/II disease. Treatment was with radiotherapy (53.6%), chemotherapy (21.7%), combined modality (17.4%), and observation (7.2%). In all, 10.1% of patients relapsed and 2.9% of patients developed high-grade transformation to DLBCL. All relapses and transformations were salvageable. No patient died of their disease. The 5-year relapse-free survival was 92%, transformation-free survival 98.4%, and overall survival 100%. We conclude that NLPHL behaves as a distinct clinical entity, often presenting at an early stage without risk factors. It has an excellent outcome. It may be possible, in early-stage disease, to reduce the intensity of therapy in NLPHL, to single-modality radiotherapy, without affecting OS

Perceived discrimination and mental health disorders : the South African Stress and Health study (SASH)

The original publication is available at http://www.samj.org.zaObjectives. To describe the demographic correlates of perceived discrimination and explore the association between perceived discrimination and psychiatric disorders. Design. A national household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses of psychiatric disorders. Additional instruments provided data on perceived discrimination and related variables. Setting. A nationally representative sample of adults in South Africa. Subjects. 4 351 individuals aged 18 years and older. Outcomes. 12-month and lifetime mood, anxiety and substance use disorders. Results. In the multivariate analyses, acute and chronic racial discrimination were associated with an elevated risk of any 12-month DSM-IV disorder when adjusted for socio-demographic factors, but this association was no longer statistically significant when adjusted for other sources of social stress. In fully adjusted models, acute racial discrimination was associated with an elevated risk of lifetime substance use disorders. Acute and chronic non-racial discrimination were associated with an elevated risk of 12-month and lifetime rates of any disorder, even after adjustment for other stressors and potentially confounding psychological factors. The association of chronic non-racial discrimination and 12-month and lifetime disorder was evident across mood, anxiety, and substance use disorders in the fully adjusted models. Conclusion. The risk of psychiatric disorders is elevated among persons who report experiences of discrimination. These associations are more robust for chronic than for acute discrimination and for non-racial than for racial discrimination. Perceived discrimination constitutes an important stressor that should be taken into account in the aetiology of psychiatric disorders.Publishers' versio

Datification and the pursuit of meaningfulness in work

Proliferation of digital means of tracking worker activities has contributed to the rise of data-driven approaches to managing people, with employees often required to record their activities for accountability purposes. Increased requirement for such datification work occurs at a juncture where meaningfulness is one of the most sought-after work features. Datification work could both facilitate and hinder the pursuit of meaningfulness, yet literature provides little guidance into the nature of the connection and how it transpires. Our inductive study of academic professionals using an accountability system suggests that datification work characteristics link to meaningful work experiences in complex ways. We advance current theory on work meaningfulness by theorizing the role of a new work condition – datification – in meaningfulness experiences of professionals, outlining how system design and the institutional context become important elements influencing meaningful work experiences, and explaining how meaningfulness experiences are constructed through system appropriations

And now woman? An analysis of the career and family of university women from a Public University

The study investigated the main obstacles and/or opportunities that women students from a public university experience when reconciling career and family. For data analysis, inferential statistics were used. The population comprised women students from the last year of the Administration course at the State University of Paraná – UNESPAR/Campus Paranaguá. The sampling was of the simple random type. In order calculate the sample size, a tolerable sampling error of 10% was used. Most of the interviewees work outside the home, are aged between 18 and 29 years old, they are single, do not have children and their income is between one and three minimum Brazilian wage. The multiplicity of simultaneous roles often assumed by some women (mother, housewife, student, wife among others) requires an effort, sometimes undervalued, to reconcile and adapt the demands of the family, social, professional and academic environment. Despite the existence of a support network, the challenges as a woman in reconciling the various activities make us reflect on whether such support actually is materialized in practice

NGOs and the Promotion of the Sexual and Reproductive Rights of Girls and Young Women with Disabilities in Zimbabwe

This case study investigates strategies used by the NGO Leonard Cheshire Disability Zimbabwe (LCDZ) to promote the SRHRs of girls and young women with disabilities in Zimbabwe. The findings show that LCDZ employed a combination of six strategies. These are: (1) building practical knowledge on SRHRs; (2) increasing community awareness and sensitivity; (3) providing SRHRs-related education; (4) enhancing access to justice and related services for survivors of sexual violence; (5) delivering assistive devices; and (6) promoting the livelihoods and economic empowerment. LCDZ made use of multi-stakeholder partnerships to implement these strategies, leveraging complementary skills and experience in the promotion of SRHRs. In each of these strategies, girls and young women with disabilities are the target group, with other stakeholders brought together to support them

Life stress and mental disorders in the South African stress and health study

Background. Although stressful life events (SLEs) are associated with psychopathology, the contribution from distal and proximal events and the specificity of their association with common mental disorders require further exploration. We examined the association of recent life events and past adversities to mood, anxiety, substance use and impulse control disorders in South Africa. Methods. Data were analysed from the South African Stress and Health study, a population-based study of mental disorders in a nationally representative sample of 4 351 adults. Psychiatric disorders were assessed with the Composite International Diagnostic Interview (CIDI). This included questions covering early and later SLEs (negative life events, relationship stress, partner violence, social strain and adverse events during childhood) and various sociodemographic variables. Logistic regression models were constructed for 3 957 respondents (2 371 female, 1 586 male) with no missing covariate data, to assess life stress and sociodemographic predictors of 12-month and lifetime disorder. Results. Recent negative life events and relationship problems were significant predictors of any 12-month disorder and any lifetime disorder. Physical partner violence predicted any lifetime disorder. There was evidence of specificity for the prediction of mood versus anxiety disorders, with childhood adversity specifically associated with mood disorders but not anxiety disorders. Single marital status was the strongest socio-demographic predictor of any 12-month and any lifetime disorder. Conclusions. Stressful life events, distal and proximal, contribute significantly and independently to the prediction of major psychiatric disorders among South Africans, underscoring the importance of screening adversities in adults with common mental disorders, and of providing appropriate adjunctive interventions

Life stress and mental disorders in the South African stress and health study

Background. Although stressful life events (SLEs) are associated with psychopathology, the contribution from distal and proximal events and the specificity of their association with common mental disorders require further exploration. We examined the association of recent life events and past adversities to mood, anxiety, substance use and impulse control disorders in South Africa. Methods. Data were analysed from the South African Stress and Health study, a population-based study of mental disorders in a nationally representative sample of 4 351 adults. Psychiatric disorders were assessed with the Composite International Diagnostic Interview (CIDI). This included questions covering early and later SLEs (negative life events, relationship stress, partner violence, social strain and adverse events during childhood) and various sociodemographic variables. Logistic regression models were constructed for 3 957 respondents (2 371 female, 1 586 male) with no missing covariate data, to assess life stress and sociodemographic predictors of 12-month and lifetime disorder. Results. Recent negative life events and relationship problems were significant predictors of any 12-month disorder and any lifetime disorder. Physical partner violence predicted any lifetime disorder. There was evidence of specificity for the prediction of mood versus anxiety disorders, with childhood adversity specifically associated with mood disorders but not anxiety disorders. Single marital status was the strongest socio-demographic predictor of any 12-month and any lifetime disorder. Conclusions. Stressful life events, distal and proximal, contribute significantly and independently to the prediction of major psychiatric disorders among South Africans, underscoring the importance of screening adversities in adults with common mental disorders, and of providing appropriate adjunctive interventions

Impact of common mental disorders during childhood and adolescence on secondary school completion

There are few data from South Africa and other low- and middle-income countries on how mental disorders in childhood and adolescence may influence different aspects of socio-economic position, including educational attainment. We examined the association between early-onset disorders and subsequent educational achievement in a nationally representative sample of 4 351 South African adults. After adjusting for participant demographic characteristics and traumatic life events, post-traumatic stress disorder, major depressive disorder and substance-related disorders were each associated with increased odds of failing to complete secondary education (odds ratios and 95% confidence intervals 2.3, 1.0 - 5.1; 1.7, 1.2 - 2.5, and 1.7, 1.2 - 2.5, respectively). These data point to the role that early-life mental disorders may play in educational achievement and subsequent socio-economic position over the life course

Race and Psychological Distress: The South African Stress and Health Study

We analyze data from the South African Stress and Health Study, a nationally representative in-person psychiatric epidemiologic survey of 4,351 adults conducted as part of the World Mental Health Survey Initiative between January 2002 and June 2004. All blacks (Africans, Coloreds, and Indians) initially report higher levels of non-specific distress and anger/hostility than whites. Access to socioeconomic resources helps explain differences in non-specific distress between Coloreds and whites and Indians and whites. However, only when social stressors are considered do we find few differences in psychological distress (i.e., non-specific distress and anger/hostility) between Africans and whites. In addition, self-esteem and mastery have independent effects on non-specific distress and anger/hostility, but differences between Coloreds and whites in feelings of anger/hostility are not completely explained by self-esteem and mastery. The findings contribute to the international body of work on social stress theory, challenge underlying assumptions of the minority status perspective, and raise a series of questions regarding mental health disparities among South Africans