Parental occupation and Ewing's sarcoma: Pooled and meta-analysis

Etiologic data on Ewing's sarcoma family of tumors (ESFT) are limited, with only 5 case-control studies reported. Interesting associations, particularly related to parental occupation, have been noted, but results are somewhat inconsistent. We conducted a pooled analysis of 3 case-control studies to assess the overall associations between parental occupation and ESFT. The pooled analysis provided data on parental occupational exposure on 199 cases of ESFT and 1,451 controls. The pooled odds ratio for the periconception and gestation periods were 2.3 (95% CI = 1.3-4.1) for children whose fathers had worked on farms and 3.9 (95% CI 1.6-9.9) for those whose mothers had farmed. For the periconception and gestation periods, there was a 3.5-fold increased risk for those with both parents having farmed and a doubling of risk for those with at least one parent having farmed; pattern of increasing risk with increasing number of years of postnatal parental exposure to farms was seen. No other occupational group (or more narrowly defined occupations) had other than minor inconsistent associations with the occurrence of ESFT. In addition, we conducted a meta-analysis of farm occupation (a main risk factor) including all 4 case-control studies that collected required information to consider parental occupation. Results of the meta-analysis were consistent with those from the pooled analysis. This collaborative analysis of available individual data on parental occupation and ESFT in the offspring provides evidence supporting the hypothesis of an association between ESFT and parental occupation in farming. © 2005 Wiley-Liss, Inc.

The tiered model of psychosocial intervention in cancer: A community based approach

Clinical practice guidelines for the management of psychosocial distress in people with cancer have been produced ill Australia and North America and these provide direction for the provision of psychosocial care for patients with cancer and their families. This report describes a tiered intervention model to operationalise psychosocial care ill oncology in the community and Outlines a framework for integrating services across sectors. Copyright (c) 2005 John Wiley & Soils, Ltd.

Using circular statistics to analyse time patterns in crime incidence

A set of techniques referred to as circular statistics has been developed for the analysis of directional and orientational data. The unit of measure for such data is angular (usually in either degrees or radians), and the statistical distributions underlying the techniques are characterised by their cyclic nature-for example, angles of 359.9 degrees are considered close to angles of 0 degrees. In this paper, we assert that such approaches can be easily adapted to analyse time-of-day and time-of-week data, and in particular daily cycles in the numbers of incidents reported to the police. We begin the paper by describing circular statistics. We then discuss how these may be modified, and demonstrate the approach with some examples for reported incidents in the Cardiff area of Wales. (c) 2005 Elsevier Ltd. All rights reserved.

Teamwork in Health and Rehabilitation Sciences: Evaluation of a multiprofessional workshop

This paper outlines a multiprofessional education workshop piloted and subsequently conducted with a cohort of 81 graduate entry students of occupational therapy, physiotherapy, speech pathology and audiology. The rationale for, and format of, the workshop is outlined, followed by comparisons between students' knowledge about teamwork prior to and after the four-hour workshop. The workshop was based on a real case scenario of a child with Developmental Coordination Disorder (DCD). Students completed pre- and post-workshop questionnaires about their knowledge of DCD, teamwork and the roles of various professionals and parents; and a post-workshop questionnaire about their views regarding the utility of the workshop, its strengths, and learning outcomes. The evaluation indicated that the workshop was overwhelmingly successful from the students' perspective in: (1) enhancing their understanding about DCD and its multifaceted impact on school age children; (2) developing a deeper appreciation of the importance of teamwork itself; (3) refining their understanding of their own profession's role and (4) developing an appreciation of the role of other professions and parents in working with children with complex needs, and their families. Limitations of this study and directions for future research are discussed.

Does pharmacogenomics provide an ethical challenge to the utilisation of cost-effectiveness analysis by public health systems?

Pharmacogenomics promotes an understanding of the genetic basis for differences in efficacy or toxicity of drugs in different individuals. Implementation of the outcomes of pharmacogenomic research into clinical practice presents a number of difficulties for healthcare. This paper aims to highlight one of the Unique ethical challenges which pharmacogenomics presents for the utilisation of cost-effectiveness analysis by public health systems. This paper contends that pharmacogenomics provides a challenge to fundamental principles which underlie most systems for deciding which drugs should be publicly subsidised. Pharmacogenomics brings into focus the conflict between equality and utility in the context of using cost-effectiveness analysis to aid distribution of a limited national drug budget.