Epithelial ovarian cancer risk: A review of the current genetic landscape

Ovarian cancer is the fourth most common cause of cancer-related death in women in the developed world, and one of the most heritable cancers. One of the most significant risk factors for epithelial ovarian cancer (EOC) is a family history of breast and/or ovarian cancer. Combined risk factors can be used in models to stratify risk of EOC, and aid in decisions regarding risk-reduction strategies. Germline pathogenic variants in EOC susceptibility genes including those involved in homologous recombination and mismatch repair pathways are present in approximately 22% to 25% of EOC. These genes are associated with an estimated lifetime risk of EOC of 13% to 60% for BRCA1 variants and 10% to 25% for BRCA2 variants, with lower risks associated with remaining genes. Genome-wide association studies have identified single nucleotide polymorphisms (SNPs) thought to explain an additional 6.4% of the familial risk of ovarian cancer, with 34 susceptibility loci identified to date. However, an unknown proportion of the genetic component of EOC risk remains unexplained. This review comprises an overview of individual genes and SNPs suspected to contribute to risk of EOC, and discusses use of a polygenic risk score to predict individual cancer risk more accurately.     

Gray platelet syndrome: Management of perioperative bleeding in redo cardiac surgery

Gray platelet syndrome (GPS) is a rare (<1/1 000 000) and inherited platelet function disorder characterized by macrothrombocytopenia, α-granule deficiency, and hemorrhages. Bleeding intensity does not correlate with platelet count nor with functional test results. We hereby describe the perioperative bleeding prevention and management of a patient with GPS requiring multiple redo cardiac surgeries.     

Living ‘good lives’: using mentoring to support desistance and recovery

Abstract

In recent years, a proliferation of mentoring projects have been established in England and Wales, targeted at both offenders and drug users. This is, in part, a consequence of high-level encouragement to establish such schemes. Mentoring features throughout the Ministry of Justice’s Transforming Rehabilitation strategy as a tool to support offenders to ‘get their lives back on track’, and the 2017 drug strategy highlights the importance of peer mentoring for those engaged in treatment services. Using Kingdon’s multiple streams approach, the article accounts for the popularity of mentoring within criminal justice and drug policy despite a less than convincing evidence-base. His model is based upon an appreciation of three streams (problem, policies and politics) which coincide when a compelling problem is linked to a plausible solution that meets the test of political feasibility. It is argued that mentoring has come to be viewed as a cost-effective solution to reduce reoffending and improve drug treatment outcomes despite a lack of conclusive evidence. It has garnered support because of its fit with dominant political discourses around citizenship and civil society. Mentoring has received support from within and without government but its inherent appeal overshadows a lack of clarity of what mentoring is and insufficient theoretical understanding of why it might be effective. Consequently, it is proposed that the Good Lives Model, a strengths-based rehabilitation theory, might provide an appropriate theoretical base and inform discussions about the role of mentoring within desistance and recovery journeys.     

South African abortion attitudes from 2007-2016: the roles of religiosity and attitudes toward sexuality and gender equality

ABSTRACT

Abortion is legal in South Africa, but negative abortion attitudes remain common and are poorly understood. We used nationally representative South African Social Attitudes Survey data to analyze abortion attitudes in the case of fetal anomaly and in the case of poverty from 2007 to 2016 (n = 20,711; ages = 16+). We measured correlations between abortion attitudes and these important predictors: religiosity, attitudes about premarital sex, attitudes about preferential hiring and promotion of women, and attitudes toward family gender roles. Abortion acceptability for poverty increased over time (b = 0.05, p < .001), but not for fetal anomaly (b = ?0.008, p = .284). Highly religious South Africans reported lower abortion acceptability in both cases (Odds Ratio (OR)_anomaly = 0.85, p = .015; OR_poverty = 0.84, p = .02). Premarital sex acceptability strongly and positively predicted abortion acceptability (OR_anomaly = 2.63, p < .001; OR_poverty = 2.46, p < .001). Attitudes about preferential hiring and promotion of women were not associated with abortion attitudes, but favorable attitudes about working mothers were positively associated with abortion acceptability for fetal anomaly ((OR_anomaly = 1.09, p = .01; OR_poverty = 1.02, p = .641)). Results suggest negative abortion attitudes remain common in South Africa and are closely tied to religiosity, traditional ideologies about sexuality, and gender role expectations about motherhood.