Determinants of quality of advanced cancer care in Latin America. A look at five countries: Argentina, Brazil, Cuba, Mexico and Peru

The World Health Organization reports that nearly half a million people died of cancer in Latin America in 2001. As a growing public health problem, cancer is now either the first or second leading cause of death among adults in most Latin American nations. Despite these trends, information on the quality of care people with advanced cancer in Latin America receive has been limited. This study assessed the quality of advanced cancer care in diverse Latin American countries and institutions by surveying cancer care providers from: Argentina; Brazil; Cuba; Mexico; and Peru. This study also identified the most salient factors that influence the quality of this care at the national and institutional levels and compared these factors across countries. This study was based on the secondary analyses of data collected by the University of Texas M. D. Anderson's WHO/PAHO Collaborating Center in Supportive Cancer Care from March 2000 to November 2002. The sample for this survey was a convenience sample of physicians and nurses who treat cancer patients in these regions. Strategies for the dissemination of this survey included: mass mailings; distribution at professional meetings/conferences; collaboration with regional institutions, professional organizations and PAHO; and the posting of online surveys. The strongest predictor of providers' assessments of the quality of advanced cancer care was their ratings of access to care. This major finding reflects a shared equitable notion of quality care among providers from diverse countries and medical institutions that is highly interrelated with providing accessible care to those with advanced cancer. Higher ratings of the affordability of care, an increased reported availability of end-of-life services and opioid analgesics, practicing in either a private hospital or specialized cancer center, and practicing in Cuba were also associated with higher provider ratings of the quality of advanced cancer care. The findings of this study contribute towards the much needed body of knowledge that may guide the formulation of policies and interventions aimed at improving the care for people with advanced cancer in Latin America. ^

Impact of a modified dietary plan on the health related quality of life of minority participants in the Women's Healthy Eating and Living (WHEL) Study

Advances in medical technology, in genetics, and in clinical research have led to early detection of cancer, precise diagnosis, and effective treatment modalities. Decline in cancer incidence and mortality due to cancer has led to increased number of long-term survivors. However, the ethnic minority population has not experienced this decline and still continues to carry a disparate proportion of the cancer burden. Majority of the clinical research including survivorship studies have recruited and continue to recruit a convenient sample of middle- to upper-class Caucasian survivors. Thus, minorities are underrepresented in cancer research in terms of both clinical studies and in health related quality of life (HRQOL) studies. ^ Life style and diet have been associated with increased risk of breast cancer. High vegetable low fat diet has been shown to reduce recurrence of breast cancer and early death. The Women's Healthy Eating and Living Study is an ongoing multi-site randomized controlled trial that is evaluating the high-vegetable low fat diet in reducing the recurrence of breast cancer and early death. The purpose of this dissertation was to (1) compare the impact of the modified diet on the HRQOL during the first 12-month period on specific Minorities and matched Caucasians; (2) identify predictors that significantly impact the HRQOL of the study participants; and (3) using the structural equation modeling assess the impact of nutrition on the HRQOL of the intervention group participants. Findings suggest that there are no significant differences in change in HRQOL between Minorities and Caucasians; between Minorities in the intervention group and those in the comparison group; and between women in the intervention group and those in the comparison group. Minority indicator variable and Intervention/Comparison group indicator variable were not found to be good predictors of HRQOL. Although the structural equation models suggested viable representation of the relationship between the antecedent variables, the mediating variables and the two outcome variables, the impact of nutrition was not statistically significant to be included in the model. This dissertation, by analyzing the HRQOL of minorities in the WHEL Study, attempted to add to the knowledge base specific to minority cancer survivors. ^

Effects of soil management in vineyard on soil physical and chemical characteristics

Cover crops in Mediterranean vineyards are scarcely used due to water competition between the cover crop and the grapevine; however, bare soil management through tillage or herbicides tends to have negative effects on the soil over time (organic matter decrease, soil structure and soil fertility degradation, compaction, etc). The objective of this study was to understand how soil management affects soil fertility, compaction and infiltration over time. To this end, two bare soil techniques were compared, tillage (TT) and total herbicide (HT) with two cover crops; annual cereal (CT) and annual grass (AGT), established for 8 years. CT treatment showed the highest organic matter content, having the biggest amount of biomass incorporated into the soil. The annual adventitious vegetation in TT treatment (568 kg dry matter ha-1) that was incorporated into the soil, kept the organic matter content higher than HT levels and close to AGT level, in spite of the greater aboveground annual biomass production of this treatment (3632 kg dry matter ha-1) whereas only its roots were incorporated into the soil. TT presented the highest bulk density under the tractor track lines and a greatest resistance to penetration (at 0.2 m depth). AGT presented bulk density values (upper 0.4 m) lower than TT and penetration resistance in CT lower (at 0.20 m depth) than TT too. Effects of soil management in vineyard on soil physical and chemical characteristics - ResearchGate. Available from: http://www.researchgate.net/publication/268520480_Effects_of_soil_management_in_vineyard_on_soil_physical_and_chemical_characteristics [accessed May 20, 2015].

Comparative Evaluation of Groundwater Management Practices of the Ogallala Aquifer

Mining of groundwater, or extracting a larger quantity of water than what is naturally returned to the aquifer through recharge, has been occurring for more than fifty years. The minimal natural recharge to the Ogallala Aquifer makes sustainable use of this resource a daunting task for states across the High Plains that rely on it to support their well-established ways of life. This task is compounded when considering the different combinations of federal, state and local governance, as well as regional economic and social frameworks that each state overlaying the aquifer experiences. This project critically examines factors contributing to groundwater management successes and failures of three states that overlay the majority (87%) of this resource: Nebraska, Kansas and Texas.

Guide to Writing a Programmatic Resource Management Plan/ Environmental Impact Statement for the Bureau of Land Management

This guide is written for Booz Allen Hamilton (BAH) employees assigned to the Public Lands team who may have some National Environmental Policy Act (NEPA) knowledge, possibly have experience with writing Environmental Impact Statements (EIS), and with little or no experience writing programmatic EIS documents. The guide contains information encompassing the preparation of a complete Resource Management Plan/Environmental Impact Statement (RMP/EIS) for the Bureau of Land Management. The RMP/EIS is a programmatic NEPA document which has many differences and nuances distinct from a typical project type EIS. This guide provides the information necessary for a BAH Public Lands team member to understand the project process and the RMP/EIS document to successfully maneuver through the entire project from beginning to end.

Study of the emissions from pyrolytic and oxidative thermal decomposition of PVC

Polyvinyl chloride (PVC) is one of the plastics most extensively used due to its versatility. The demand of PVC resin in Europe during 2012 reached 5000 ktonnes1. PVC waste management is a big problem because of the high volume generated all over the world and its chlorine content. End-of-life PVC is mainly mixed with municipal solid waste (MSW) and one common disposal option for this is waste-to-energy incineration (WtE). The presence of plastics such as PVC in the fuel mix increases the heating value of the fuel. PVC has two times higher energy content than MSW ‒around 20 MJ/kg vs 10 MJ/kg, respectively. However, the high chlorine content in PVC resin, 57 wt.%, may be a source for the formation of hazardous chlorinated organic pollutants in thermal processes. Chlorine present in the feedstock of WtE plants plays an important role in the formation of (i) chlorine (Cl2) and (ii) hydrochloric gas (HCl), both of them responsible for corrosion, and (iii) chlorinated organic pollutants2. In this work, pyrolytic and oxidative thermal degradation of PVC resin were carried out in a laboratory scale reactor at 500 ºC in order to analyze the influence of the reaction atmosphere on the emissions evolved. Special emphasis was put on the analysis of chlorinated organic pollutants such as polychlorodibenzo-p-dioxins (PCDDs), polychlorodibenzofurans (PCDFs) and other related compounds like polychlorobenzenes (PCBzs), polychlorophenols (PCPhs) and polycyclic aromatic hydrocarbons (PAHs). Another objective of this work was to compare the results with those of a previous work3 in which emissions at different temperatures in both pyrolysis and combustion of another PVC resin had been studied; in that case, experiments for PCDD/Fs emissions had been performed only at 850 ºC.

Analysis of pollutants evolved from combustion and pyrolysis of flexible polyurethane foam in a laboratory furnace

Resumen del póster presentado en PIC2015 – the 14th International Congress on Combustion By-Products and Their Health Effects, Umeå, Sweden, 14-17 June 2015.

Use of an Inverse Method for Time Series to Estimate the Dynamics of and Management Strategies for the Box Jellyfish Carybdea marsupialis

Frequently, population ecology of marine organisms uses a descriptive approach in which their sizes and densities are plotted over time. This approach has limited usefulness for design strategies in management or modelling different scenarios. Population projection matrix models are among the most widely used tools in ecology. Unfortunately, for the majority of pelagic marine organisms, it is difficult to mark individuals and follow them over time to determine their vital rates and built a population projection matrix model. Nevertheless, it is possible to get time-series data to calculate size structure and densities of each size, in order to determine the matrix parameters. This approach is known as a “demographic inverse problem” and it is based on quadratic programming methods, but it has rarely been used on aquatic organisms. We used unpublished field data of a population of cubomedusae Carybdea marsupialis to construct a population projection matrix model and compare two different management strategies to lower population to values before year 2008 when there was no significant interaction with bathers. Those strategies were by direct removal of medusae and by reducing prey. Our results showed that removal of jellyfish from all size classes was more effective than removing only juveniles or adults. When reducing prey, the highest efficiency to lower the C. marsupialis population occurred when prey depletion affected prey of all medusae sizes. Our model fit well with the field data and may serve to design an efficient management strategy or build hypothetical scenarios such as removal of individuals or reducing prey. TThis This sdfsdshis method is applicable to other marine or terrestrial species, for which density and population structure over time are available.

Length of life; a study of the life table,

Bibliography: p. 379-385; "References" at end of chapter 9.

Principles of newspaper management,

"Suggested periodical references" at end of each chapter; Bibliography: p. 437-439.

Pages from an old volume of life ; a collection of essays, 1857-1881,

Bread and the newspaper.--My hunt after "the captain."--The inevitable trail.--The physiology of walking.--The seasons.--The human body and it's management.--Cinders from the ashes.--Mechanism in thought and morals.--The physiology of versification.--Crime and automatism.--Jonathan Edwards.--The pulpit and the pew.

Workmen's compensation act Chapter 751, acts of 1911, and amendments to end of the legislative year of 1915 with introductory statement, rules, forms, annotations and index. Industrial accident board...

At head of title : The Commonwealth of Massachusetts.

Pages from an old volume of life ; a collection of essays, 1857-1881,

Bread and the newspaper.--My hunt after "the captain."--The inevitable trail.--The physiology of walking.--The seasons.--The human body and it's management.--Cinders from the ashes.--Mechanism on thought and morals.--The physiology of versification.--Crime and automatism.--Jonatahan Edwards.--The pulpit and the pew.

The history of the Church of Scotland, : beginning the year of our Lord 203, and continued to the end of the reign of King James VI. ... /

Head-pieces; initials.

The conduct of life /

Fate -- Power -- Wealth -- Culture -- Behavior -- Worship -- Considerations by the way -- Beauty -- Illusions.