Incidence of bladder cancer in Sri Lanka : analysis of the cancer registry data and review of the incidence of bladder cancer in the South Asian population

PurposeTo investigate the incidence of bladder cancer (BC) in Sri Lanka and to compare risk factors and outcomes with those of other South Asian nations and South Asian migrants to the United Kingdom (UK) and the United States (US).Materials and MethodsThe incidence of BC in Sri Lanka was examined by using two separate cancer registry databases over a 5-year period. Smoking rates were compiled by using a population-based survey from 2001 to 2009 and the relative risk was calculated by using published data.ResultsA total of 637 new cases of BC were diagnosed over the 5-year period. Sri Lankan BC incidence increased from 1985 but remained low (1.36 and 0.3 per 100,000 in males and females) and was similar to the incidence in other South Asian countries. The incidence was lower, however, than in migrant populations in the US and the UK. In densely populated districts of Sri Lanka, these rates almost doubled. Urothelial carcinoma accounted for 72%. The prevalence of male smokers in Sri Lanka was 39%, whereas Pakistan had higher smoking rates with a 6-fold increase in BC.ConclusionsSri Lankan BC incidence was low, similar to other South Asian countries (apart from Pakistan), but the actual incidence is likely higher than the cancer registry rates. Smoking is likely to be the main risk factor for BC. Possible under-reporting in rural areas could account for the low rates of BC in Sri Lanka. Any genetic or environmental protective effects of BC in South Asians seem to be lost on migration to the UK or the US and with higher levels of smoking, as seen in Pakistan.

Problem sexual behaviour in children: a review of the literature

   Although there is an under-acknowledgement of the issue in Australia there is a large body of international scholarship on juveniles who exhibit sexually violent or coercive behaviours toward other juveniles. Research undertaken in the United States and the United Kingdom emphasises options for clinical treatment, the logistics of coordinating multi agency response, and the causes and correlatives for coercive sexual behaviours in adolescents. Much of this literature has tended to focus on adolescents and there is an urgent need for increased studies on young children engaging in problem sexual behaviour.

   The smaller body of work published in Australia also favours adolescents rather than children with much of this work heavily influenced by international clinical studies. There are, however, a handful of reports based on Australian practitioner data that do focus on young children who engage in problem sexual behaviour. This literature surveys and evaluates the very limited number of existing therapeutic programs in Australia, and provides interview data with practitioners working with children exhibiting problem sexual behaviour. In the main, this research reinforces the findings of the internationa scholarship, both in terms of the contributing factors to problem sexual activity in children, but also in terms of the need for multi-faceted and contextually based cognitive behavioural therapeutic programs in response. More importantly, this burgeoning field of study indicates how far we have to go both in understanding the extent of the problem in Australia and in fashioning appropriate programs for prevention and intervention. Dr Joe Tucci is Chief Executive Officer of the Australian Childhood Foundation (ACF), an organisation that has taken a lead in responding to childhood problem sexual behaviour. Tucci et al., (2006) claim an urgent need for investment in a dedicated research and response agenda (Staiger et al., 2005b). To effectively address this issue researchers and practitioners require comprehensive empirical data on problem sexual behaviour in children across all sectors of Australian society, including Indigenous communities.

A systematic review of the management and outcome of toxic epidermal necrolysis treated in burns centres

Introduction
Toxic epidermal necrolysis (TEN) is a rare condition characterised by mucocutaneous exfoliation of greater than 30% total body surface area (%TBSA), increasingly being treated in burns centres. The rate of mortality varies significantly in the literature, with recent prospective studies in non-burns centres reporting percentage mortality of approximately 45%. We undertook a systematic review of published studies that included TEN patients treated specifically in burns centres to determine a cumulative mortality rate.

Methods
Electronic searches of MEDLINE, EMBASE and The Cochrane Library (Issue 4, 2010) databases from 1966 onwards were used to identify English articles related to the treatment of TEN in burns centres.

Results
The systematic literature search identified 20 studies which specifically described patients with TEN grater than 30% %TBSA. Treatment regimens varied amongst studies, as did mortality. The overall percentage mortality of the combined populations was 30%. Risk factors commonly described as associated with mortality included age, %TBSA and delay to definitive treatment.

Conclusion
The review highlights the variation between principles of treatment and mortality amongst burns centres. It offers a standard that burns centre can use to internationally compare their mortality rates. The review supports the ongoing reporting of outcomes in TEN patients with epidermal detachment greater than 30%.

Qualitative and historiometric methods in leadership research: a review of the first 25 years of the leadership quarterly

In the spirit of the 25th anniversary edition of The Leadership Quarterly, as the world's premier outlet for leadership research, we have reviewed qualitative and historiometric research across those 25. years. Qualitative research is a complex and cluttered area of scholarship. This is not because there is an inherent confusion about it. Rather, it is because 'qualitative' research is a cover-all term for a wide range of research strategies, paradigms, parent disciplines, sources of data, and methods of analysis for them. More so than in previous journal review articles, we explored variation in qualitative analysis as well as variety in qualitative data. In terms of methodologies, our efforts concentrated on case study, content analysis, grounded theory and historiometrics. We also examined trends toward post-positivism, post-modernity and liquid modernity, and their resultant benefits for researching leadership. Future directions for leadership research are posited. © 2013 Elsevier Inc.

Effectiveness of interventions for convicted DUI offenders in reducing recidivism: a systematic review of the peer-reviewed scientific literature

Abstract Background: Driving under the influence (DUI) is a major cause of death and disability. Although a broad array of programs designed to curb DUI incidents are currently offered to both first-time and recidivist DUI offenders, existing evaluations of the effectiveness of these programs have reported mixed results. Objective: To synthesize the results of DUI program evaluations and determine the strength of the available evidence for reducing recidivism for different types of programs. Methods: A systematic review of all EBSCO databases, EMBASE, PubMed, ProQuest, Sociological Abstracts and TRIS was conducted to identify evaluations of treatments/interventions to prevent DUI offenses. Additional articles were identified from reference lists of relevant articles. Results: A total of 42 relevant studies were identified by the search strategy. Of these, 33 utilized non-experimental evaluation designs or reported insufficient data to allow effect sizes to be calculated, making meta-analysis unfeasible. Evaluations of several different program types reported evidence of some level of effectiveness. Conclusion: Because of the general lack of high quality evidence assessing the effectiveness of DUI prevention programs, it is not possible to make conclusive statements about the types of programs that are likely to be most effective. Nonetheless, there was some evidence to support the effectiveness of programs that utilize intensive supervision and education. There is a need for future evaluations to adopt more scientifically rigorous research designs to establish the effects of these programs.