An interactive and contextual model of community-university collaborations for research and action.

Community-university partnerships for research and action are at the heart of many fields in the social sciences including public health, urban planning, education, and community psychology. These partnerships involve individuals from different backgrounds and disciplines working together to address social issues of importance to the community. This article proposes an interactive and contextual model for developing and sustaining community-university partnerships. The phases in the model include gaining entry into the community, developing and sustaining a mutual collaboration (developing trust and mutual respect, establishing adequate communication, respecting human diversity, establishing a culture of learning, respecting the culture of the setting and the community, and developing an action agenda), and recognizing the benefits and outcomes of partnership work. The model also includes the potential challenges that might threaten the partnership, such as resource inequality and time commitment.     

Gemcitabine plus carboplatin versus mitomycin, ifosfamide, and cisplatin in patients with stage IIIB or IV non-small-cell lung cancer: a phase III randomized study of the London Lung Cancer Group.

PURPOSE: This phase III randomized trial compared two chemotherapy regimens, gemcitabine plus carboplatin and mitomycin, ifosfamide, and cisplatin, in chemotherapy-naive patients with advanced non-small-cell lung cancer (NSCLC). The regimens were compared with regard to effects on survival, response rates, toxicity, and quality of life. PATIENTS AND METHODS: Eligible patients had previously untreated stage IIIB or IV NSCLC suitable for cisplatin-based chemotherapy. Randomly assigned patients were to receive four cycles, each at 3-week intervals, of carboplatin area under the curve of 5 on day 1 plus gemcitabine 1,200 mg/m(2) on days 1 and 8 (GCa) or mitomycin 6 mg/m(2), ifosfamide 3g/m(2), and cisplatin 50 mg/m(2) on day 1 (MIC). RESULTS: Between February 1999 and August 2001, 422 patients (GCa, n = 212; MIC, n = 210) were randomly assigned in the United Kingdom. The majority of patients received the intended four cycles (GCa, 64%; MIC, 61%). There was a significant survival advantage for GCa compared with MIC (hazard ratio, 0.76; 95% CI, 0.61 to 0. 93; P = .008). Median survival was 10 months with GCa and 7.6 months with MIC (difference, 2.4 months; 95% CI, 1.0 to 4.0), and 1-year survival was 40% with GCa and 30% with MIC (difference, 10%; 95% CI, 3% to 18%). Overall response rates were similar (42% for GCa v 41% for MIC; P = .84). More thrombocytopenia occurred with GCa (P = .03), but this was not associated with increased hospital admission or fatality. GCa caused less nausea, vomiting, constipation, and alopecia and was associated with fewer admissions for administration and better quality of life. CONCLUSION: In patients with advanced NSCLC, GCa chemotherapy was shown to be a better-tolerated treatment that conferred a survival advantage over MIC.     

Recurrent intraneural ganglion cyst of the tibial nerve. Case report

Different theories have evolved to explain the pathogenesis and the cell of origin of intraneural ganglion cysts. Reportedly only three cases of intraneural ganglion of the tibial nerve have been located within the popliteal fossa, and all of these were thought to arise within the nerve. The authors report a case of a recurrent tibial intraneural ganglion in which a connection to the proximal tibiofibular joint was demonstrated on magnetic resonance (MR) images and at surgery. Surgical ligation of the articular branch and evacuation of the cyst led to symptomatic relief, and an MR image obtained 1 year after surgery documented no recurrence. This case reinforces the fact that surgeons need to consider and search for an articular connection in all cases of intraneural ganglia, especially in those that have recurred.     

Apophyseal injuries of the lesser tuberosity in adolescents: a series of five cases

An isolated avulsion fracture of the lesser tuberosity is an uncommon injury. We present five cases in adolescent athletes which demonstrate the radiographic, ultrasound, and MR appearances of this injury. Clinically and radiologically, the diagnosis can be difficult. In a setting of trauma, careful review of the imaging studies can lead to early diagnosis and appropriate treatment.     

Assessment of Respirable Crystalline Silica Analysis Using Proficiency Analytical Testing Results from 2003–2013

Analysis of Proficiency Analytical Testing (PAT) results between 2003 and 2013 suggest that the variation in respirable crystalline silica analysis is much smaller today than it was in the period 1990–1998, partly because of a change in sample production procedure and because the colorimetric method has been phased out, although quality improvements in the x-ray diffraction (XRD) or infrared (IR) methods may have also played a role. There is no practical difference between laboratories using XRD or IR methods or between laboratories which are accredited or those which are not. Reference laboratory means (assigned values) are not different from the means of all participants across the current range of mass loading, although there is a small difference in variance in the ratios of all participants to reference laboratory means based on method because the reference laboratories are much more likely to use XRD than are the others. Matrix interference does not lead to biases or substantially larger variances for either XRD or IR methods. Data from proficiency test sample analyses that include results from poorly performing laboratories should not be used to determine the validity of a method. PAT samples are not produced below 40 μg and variance may increase with lower masses, although this is not particularly predictable. PAT data from lower mass loadings will be required to evaluate analytical performance if exposure limits are lowered without change in sampling method. Task-specific exposure measurements for periods shorter than a full shift typically result in lower mass loadings and the quality of these analyses would also be better assured from being within the range of PAT mass loadings. High flow rate cyclones, whose performance has been validated, can be used to obtain higher mass loadings in environments of lower concentrations or where shorter sampling times are desired.     

Psychological distress among Ugandan adolescents living with HIV: Examining stressors and the buffering role of general and religious coping strategies

HIV infection increases the risk of psychological distress among adolescents living with HIV (ALHIV), which, in turn, increases risky behaviours such as medication non-adherence, substance use, and sexual risk-taking. The majority of studies on psychological distress among ALHIV have been conducted in high-income countries; data on the prevalence and correlates of psychological distress among ALHIV in sub-Saharan Africa (SSA) are scarce, yet over two-thirds of the global population of ALHIV resides in SSA. The purpose of this study was to identify the contextually relevant correlates of psychological distress among Ugandan ALHIV. Utilizing the stress and coping framework, we explored the risk and protective factors for psychological distress in cross-sectional sample of 464 ALHIV (aged 12–19; 53% female) at a large HIV treatment centre in Kampala, Uganda. The stressors associated with psychological distress included daily hassles, major negative life events, HIV-related quality of life, and stigma. Protective factors included psychosocial resources such as religious coping, satisfaction with social support, and general coping style and behaviours. Social support and optimism were significantly associated with psychological distress. Findings underscore the need for mental health services for ALHIV in Uganda and other resource-limited settings.     

Erythropoietic protoporphyria in Sweden: demographic,clinical, biochemical and genetic characteristics

Abstract. Wahlin S, Floderus Y, Stål P, Harper P (Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden). Erythropoietic protoporphyria in Sweden: demographic, clinical, biochemical and genetic characteristics. J Intern Med 2010; 269 : 278–288. Objective. To investigate the demographic, clinical, biochemical and genotypic features of patients with erythropoietic protoporphyria (EPP) in a Swedish cohort. Design. Cross‐sectional questionnaire, biochemical and genetic study. Setting. Sweden. Subjects. Fifty‐one Swedish individuals known in 2008 to have EPP confirmed by molecular diagnosis. There were no exclusion criteria; all patients were included in the demographic and genetic study. A total of 92% participants completed the questionnaire study and 82% the biochemical study. Results. The prevalence of EPP was 1 : 180 000. Nine novel ferrochelatase gene mutations were found. The most commonly reported age at onset of symptoms was the first year of life and the mean age at diagnosis was 22 years. Painful photosensitivity was the main symptom. Exogenous factors other than sunlight were frequently reported to cause cutaneous symptoms. One in five patients reported a positive effect of beta‐carotene therapy. A marked impact of EPP on quality of life was reported. Women had a significantly lower mean erythrocyte protoporphyrin concentration than men. Of all participants, 84% had insufficient vitamin D concentrations, 44% had below normal serum ferritin or transferrin saturation levels and red cell abnormalities were common. Conclusions. The notably delayed diagnosis suggests the need for an increased awareness of EPP. Disturbed erythropoiesis, biochemical signs of iron deficiency and low vitamin D levels are frequent findings in this disease. New and better treatments are needed as current treatment options for symptom amelioration are limited. Vitamin D supplementation should be considered.