Long-term survival following laparoscopic and open colectomy for colon cancer: a meta-analysis of randomized controlled trials

Aim: Large randomized clinical trials comparing long-term survival after laparoscopic and open colectomy for large bowel cancer show equivalence, but meaningful analysis of data by stage has not been possible due to the small numbers of patients in individual trials. The aim of this meta-analysis was to improve statistical power by combining data to enable assessment of survival for individual stages. Method: A systematic review and meta-analysis was conducted through a computerized search of all randomized controlled trials comparing open and laparoscopic surgery for large bowel cancer. Overall survival data were analysed and subgroup analysis was performed for cancer of Stages I–III. Results: Five trials (3152 patients) were included. Overall survival was equivalent (hazard ration 0.93; 95% confidence interval 0.80–1.07). With each of the cancer stages, I–III, there was no difference in 5-year survival. There was, however, a nonsignificant trend in favour of open surgery in the subgroup analysis of Stage II patients. Conclusion: Laparoscopic-assisted surgery for colon cancer is equivalent to open surgery with respect to long-term survival although there may be a difference for Stage II cancer

Female Engineering Education in the University of Mines and Technology, Tarkwa – Ghana

The study investigated the female engineering education in the University of Mines and Technology, Tarkwa. Numerous studies have examined the participation of women in engineering education, and the reasons for the low number of female engineers are complex. The University of Mines and Technology established a gender mainstreaming policy in 2005 with the goal of raising female enrollment to 25% by 2014. Data on admission and completion rates were gathered for the study from the 2004/2005 through 2015/2016 academic years. The study found that female admission rates gradually rose from a low of 4.6 percent in 2005 to a maximum of 22.1 percent in the academic year 2010–2011. The next year, there was a dramatic decline to 12.8%, and by 2015, it had averaged out at 14%. Analysis of department-by-department admission data shows that though engineering is generally regarded as a “men’s sphere,” within the engineering programmes some are more preferred by females to others. For the period under consideration, the preferences at UMaT are in the order; ES > CE > GL > PE > GM > EL > MR > MN > MA > MC. The study concluded that there has been a steady increase in the enrollment and completion rate for females in engineering programmes. It was recommended that UMaT and other engineering institutions in Ghana should vigorously pursue female enrollment drive to ensure higher enrolment and completion rate for female students in engineering programmes. Keywords: UMaT, Female admission, Gender mainstreaming, engineering. DOI: 10.7176/JEP/13-21-04 Publication date:June 30th 202

Assessing the efficacy of TNF-alpha inhibitors in preventing emergency and emergent colectomies

Background and Aim: Severe ulcerative colitis (UC) is potentially life threatening and is associated with significant morbidity. TNF-∝ inhibitors (Infliximab) were introduced in Australia for the management of medically resistant, acute, severe flares of UC in 2008. The aim of this study is to assess the efficacy of Infliximab in preventing emergent and emergency colectomies for patients with moderate to severe UC by comparing colectomy rates before and after its introduction at our institution. Methods: This was a retrospective cohort study of all patients who were admitted to the Royal Perth Hospital with a flare of UC between 2002 and 2017. Patients were divided into two cohorts: those admitted prior to the introduction of Infliximab (pre-2008) and those admitted after. We compared data between these two groups, including age, gender, length of admission, use of Infliximab, colectomy, and complications of surgery. We defined emergency surgery as requiring surgery during the index admission and emergent surgery as an operation within 54 weeks. Results: A total of 313 UC cases from 2002 to 2017 were analyzed. There was a decrease in emergency and emergent colectomies from 19.4 to 8% in the post-2008 cohort (P = 0.008). Furthermore, there was a decrease in the proportion of operations performed as emergencies, from 36 to 20%. This resulted in a significantly reduced length of stay (13.4–9.7 days, P \u3c 0.05) and complication rate (36 to 20%, P \u3c 0.05). Conclusion: Overall, the need for emergency and emergent operations has drastically reduced at our institution with the introduction of Infliximab. This study has confirmed the efficacy of Infliximab in reducing colectomy rates at our institution. © 2019 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd

Experiences and perceptions of men following breast cancer diagnosis : A Mixed Method Systematic Review

Men with breast cancer experience unique physical and emotional challenges. However, a thorough understanding of these experiences including the psychosocial effects and supportive care needs have received less attention. In some settings, men with breast cancer experience stigma within the healthcare system and their care needs are not prioritised. This influences the level of professional support offered, consequently worsening their health and well-being outcomes. This review explored the variabilities in the experiences and treatment modalities of male breast cancer (MBC) across different contexts. All primary study designs including qualitative, quantitative, and mixed methods studies that reported on the experiences, treatment approaches and outcomes of MBC were included in this systematic review. Six databases (Embase, Medline, PsycINFO, Global Health, CINAHL and Web of Science) were searched for articles from January 2000 to September 2023. A results-based convergence synthesis was used for data analysis and reported using PRISMA guidelines. Of the studies screened (n = 29,687), forty-four fulfilled the predetermined criteria and were included. Our findings relating to the experiences and treatment approaches of MBC are broadly themed into three parts. Theme 1-Navigating through a threat to masculinity: describes how males experienced the illness reflecting on detection, diagnosis, coming to terms with breast cancer, and disclosure. Theme 2- Navigating through treatment: captures the experiences of undergoing breast cancer treatment/ management following their diagnosis. Theme 3-Coping and support systems: describes how MBC patients coped with the disease, treatment process, aftercare/rehabilitative care, and the available support structures. Men experience a myriad of issues following a breast cancer diagnosis, especially with their masculinity. Awareness creation efforts of MBC among the public and healthcare practitioners are urgently required, which could change the perception of men in promoting early diagnosis, adherence to treatments, post-treatment monitoring, oncological results and a better quality of life. Considerations for training, education and development of specialised guidelines for healthcare practitioners on MBC would provide the necessary knowledge and skills to enhance their practice through the adoption of person-centred and male-specific care strategies. Professional care intervention and support for MBC should not end after the diagnosis phase but should extend to the entire treatment continuum and aftercare including future research focusing on MBC specific clinical trials. PROSPERO Registration No. CRD42021228778. [Abstract copyright: © 2024. The Author(s).

Experiences and perceptions of men following breast cancer diagnosis: a mixed method systematic review

Background Men with breast cancer experience unique physical and emotional challenges. However, a thorough understanding of these experiences including the psychosocial effects and supportive care needs have received less attention. In some settings, men with breast cancer experience stigma within the healthcare system and their care needs are not prioritised. This influences the level of professional support offered, consequently worsening their health and well-being outcomes. This review explored the variabilities in the experiences and treatment modalities of male breast cancer (MBC) across different contexts. Methods All primary study designs including qualitative, quantitative, and mixed methods studies that reported on the experiences, treatment approaches and outcomes of MBC were included in this systematic review. Six databases (Embase, Medline, PsycINFO, Global Health, CINAHL and Web of Science) were searched for articles from Janu-ary 2000 to September 2023. A results-based convergence synthesis was used for data analysis and reported using PRISMA guidelines. Results Of the studies screened (n = 29,687), forty-four fulfilled the predetermined criteria and were included. Our findings relating to the experiences and treatment approaches of MBC are broadly themed into three parts. Theme 1-Navigating through a threat to masculinity: describes how males experienced the illness reflecting on detection, diagnosis, coming to terms with breast cancer, and disclosure. Theme 2-Navigating through treatment: captures the experiences of undergoing breast cancer treatment/ management following their diagnosis. Theme 3-Coping and support systems: describes how MBC patients coped with the disease, treatment process, aftercare/rehabilitative care, and the available support structures. Conclusions Men experience a myriad of issues following a breast cancer diagnosis, especially with their masculinity. Awareness creation efforts of MBC among the public and healthcare practitioners are urgently required, which could change the perception of men in promoting early diagnosis, adherence to treatments, post-treatment monitoring, oncological results and a better quality of life. Considerations for training, education and development of specialised guidelines for healthcare practitioners on MBC would provide the necessary knowledge and skills to enhance their practice through the adoption of person-centred and male-specific care strategies. Professional care intervention and support for MBC should not end after the diagnosis phase but should extend to the entire treatment continuum and aftercare including future research focusing on MBC specific clinical trials

E-learning in Higher Education of Nurse and Midwife Educators in Developing Countries: The Case of Liberia

This case study describes the use of e-learning in a new graduate program in nursing and midwifery education in Liberia, a developing country recovering from a decades long internal conflict and more recently an Ebola epidemic. The program was established to prepare the educator workforce with current educational concepts and practices as well as health information. Issues involved in making the hardware and internet access are addressed. Through the voices of eleven graduate students who were also nurse and midwife instructors in education facilities throughout the country, perceptions of using e-learning for course work as well as the experience of beginning to use technology in teaching pre-service students are identified. Sustainment and expansion of e-learning challenges are addressed. To further global health security and equity in access to education the Liberian government, administrators, educators and bi- or multi-national partnerships need to prioritize investments technology and e-learning in developing countries

a review of methodological design choices

Publisher Copyright: © 2023 Cambridge University Press. All rights reserved.This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the Disability-Adjusted Life Years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3,053 studies of which 2,948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.publishersversionepub_ahead_of_prin