How well does the index of receptivity to tobacco industry promotion discriminate between smoking and never smoking adolescents.

Tobacco advertising is often named as the culprit that causes children to start smoking (Lancaster & Lancaster, 2003). This belief can partly be attributed to the Index of Receptivity to Tobacco Industry Promotion (IRTIP) developed by Evans, Farkas, Gilpin, Berry, & Pierce (1995). IRTIP was later modified and used by Pierce, Choi, Gilpin, Farkas, & Berry (1998) in a longitudinal study that claimed to have found a causal link between advertising and adolescent cigarette trial. The model is advertised by the American National Cancer Institute (2004) as being able to measure the likelihood of an adolescent starting smoking. Because of Pierce’s causality claim and this endorsement, IRTIP has been widely adopted by tobacco-control researchers. Consequently, the results from IRTIP based surveys have played a central role in influencing tobacco control policy. Based on the logic that a model used to predict the chances of a non-smoker becoming a smoker should be able to distinguish between these two groups, discriminant analysis with dummy coded variables was used to validate IRTIP. The results show that while IRTIP classifies never-smokers well, it grossly misclassifies smokers. This leads to questions about the validity of the model and of studies using IRTIP.

The metabolic syndrome and cancer: is the metabolic syndrome useful for predicting cancer risk above and beyond its individual components?

AIMS: The metabolic syndrome (MetS) is a risk factor for cancer. However, it is not known if the MetS confers a greater cancer risk than the sum of its individual components, which components drive the association, or if the MetS predicts future cancer risk. MATERIALS AND METHODS: We linked 20,648 participants from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on the MetS to national cancer registries and used Cox proportional hazards models to estimate associations of the MetS, the number of positive MetS components, and each of the five MetS components separately with the risk for overall, colorectal, prostate and breast cancer. Hazard ratios (HR) and 95% confidence intervals (95%CI) are reported. We assessed predictive ability of the MetS using Harrell's c-statistic. RESULTS: The MetS was inversely associated with prostate cancer (HR 0.85; 95% CI 0.72-0.99). We found no evidence of an association between the MetS overall, colorectal and breast cancers. For those with five positive MetS components the HR was 1.12 (1.02-1.48) and 2.07 (1.26-3.39) for overall, and colorectal cancer, respectively, compared with those with zero positive MetS components. Greater waist circumference (WC) (1.38; 1.13-1.70) and elevated blood pressure (1.29; 1.01-1.64) were associated with colorectal cancer. Elevated WC and triglycerides were (inversely) associated with prostate cancer. MetS models were only poor to moderate discriminators for all cancer outcomes. CONCLUSIONS: We show that the MetS is (inversely) associated with prostate cancer, but is not associated with overall, colorectal or breast cancer. Although, persons with five positive components of the MetS are at a 1.2 and 2.1 increased risk for overall and colorectal cancer, respectively, and these associations appear to be driven, largely, by elevated WC and BP. We also demonstrate that the MetS is only a moderate discriminator of cancer risk.

Global cancer surgery : delivering safe, affordable, and timely cancer surgery

Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

Monitoring athletes through self-report: factors influencing implementation

Monitoring athletic preparation facilitates the evaluation and adjustment of practices to optimize performance outcomes. Self-report measures such as questionnaires and diaries are suggested to be a simple and cost-effective approach to monitoring an athlete’s response to training, however their efficacy is dependent on how they are implemented and used. This study sought to identify the perceived factors influencing the implementation of athlete self-report measures (ASRM) in elite sport settings. Semi-structured interviews were conducted with athletes, coaches and sports science and medicine staff at a national sporting institute (n = 30). Interviewees represented 20 different sports programs and had varying experience with ASRM. Purported factors influencing the implementation of ASRM related to the measure itself (e.g., accessibility, timing of completion), and the social environment (e.g., buy-in, reinforcement). Social environmental factors included individual, inter-personal and organizational levels which is consistent with a social ecological framework. An adaptation of this framework was combined with the factors associated with the measure to illustrate the inter-relations and influence upon compliance, data accuracy and athletic outcomes. To improve implementation of ASRM and ultimately athletic outcomes, a multi-factorial and multi-level approach is needed.

The role of a self-report measure in athlete preparation

Athlete self-report measures (ASRM) are a common and cost-effective method of athlete monitoring. It is purported that ASRM be used to detect athletes at risk of overtraining, injury or illness, allowing intervention through training modification. However it is not known whether ASRM are actually being used for or are achieving these objectives in the applied sport setting. Therefore the aim of this study was to better understand how ASRM are being used in elite sports and their role in athletic preparation. Semi-structured interviews were conducted one-on-one with athletes, coaches and sports science and medicine staff (n=30) at a national sporting institute. Interview recordings were transcribed and analysed for emergent themes. Twelve day-to-day and seven longer-term practices were identified which contributed to a four-step process of ASRM use (record data, review data, contextualize, act). In addition to the purported uses, ASRM facilitated information disclosure and communication amongst athletes and staff and between staff, and improved the understanding and management of athlete preparation. These roles of ASRM are best achieved through engagement of athletes, coaches and support staff in the systematic, cyclic process.

Interview with Dr Ray Anere (d. 2015)

The late Dr Ray Anere was a Papua New Guinean who studied in Australia at the Australian National University in 1982 - 1985. He was awarded an Australian International Development Assistance Bureau (AIDAB) scholarship and completed a Master degree in Arts. He later completed a PhD at Claremont University in California, USA under a Fulbright Scholarship. Dr Anere was a Senior Research Fellow at the National Research Institute in PNG and maintained strong connections with Australia and with the USA. Dr Anere was a member of the PNG USA Alumni Association and the PNG Australia Alumni Association. Dr Anere passed away in April 2015. The interview was conducted in English on 17 December 2014 by Dr Musawe Sinebare and Mr Gande James, both of Pacific Adventist University. This set comprises: an interview recording, a timed summary and a photograph.

Brutalism, metabolism and its American parallel : encounters in Skopje and in the architecture of Georgi Konstantinovski

Abstract Massive, raw concrete structures – the likes of the Telecommunications Building (1972–81) by Janko Konstantinov; the campus of Ss. Cyril and Methodius University (1974) by Marko Musˇicˇ; the National Hydraulic Institute (1972) by Krsto Todorovski; and the Bank Complex (1970) by R. Lalovik and O. Papesˇ – have led to the production of an enduring monumental presence and helped inspire Skopje’s title as the “Brutalist capital of the world”. These works followed Kenzo Tange’s introduction of Japanese Metabolism to Skopje through his role in the 1965 United Nations sponsored reconstruction competition. The unique position of a Non-Aligned Yugoslavia staged and facilitated architectural and professional exchange during the Cold War. Each trajectory and manifestation illustrates the complex picture of international architectural exchange and local production. Skopje and its numerous Brutalist edifices is an elucidative story, because it represents a meeting point between Brutalism, Metabolism and its American parallel. This article discusses, in particular, the Skopje Archive Building (1966) and the “Goce Delcˇev” Student Dormitory (1969) – two buildings designed by the architect Georgi Konstantinovski, realised on his return from a Masters program at Yale University and employment within I. M. Pei’s New York office. Their architecture illustrates the simultaneous preoccupations of leading architects at the time in regaining a conceptual ground made explicit through a complete and apprehensible image. From this particular position, the article explores the question of ethics and aesthetics central to Banham’s outline of the “New Brutalism”.