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Gastric diverticula rarely occur in adolescence. In adults, they are predominantly congenital, asymptomatic, and are located adjacent to the gastroesophageal junction on the posterior aspect of the stomach wall. In this report we present a 14-year-old female who underwent laparoscopic gastric diverticulectomy after incidental discovery on magnetic resonance urography.

The 2015 election of the New Democratic Party (NDP) in Alberta and the NDP government’s commitment to implementing the United Nations Declaration on the Rights of Indigenous Peoples has opened up new possibilities for reforming the province’s relationship with First Nations and Métis communities. Alberta’s tar sands regulatory process and consultation policy with Indigenous peoples, however, has so far remained the same, and the provincial government continues to support expanding the industry. This article argues that the 2014 Consultation Guidelines imposed by the previous Progressive Conservative government severely limit the participation rights of Indigenous peoples and violate treaty rights by not adequately addressing cumulative impacts. Despite sustained critique by legal scholars and Indigenous communities, previous reforms to the consultation system have not substantively addressed their concerns. In response, several First Nations in Alberta have launched legal actions challenging both the consultation regime and specific project approvals. Following a discussion of consultation and consent in Canada, the article uses recent legal cases to illustrate how Indigenous peoples in Alberta have been excluded from key decision-making around the oil industry. Finally, it considers how the regulatory process must change to respect Indigenous rights and self-determination.

Introduction: B cell lymphoma/leukemias (BCL) are a diverse set of malignancies. The genomic landscape of many BCL subtypes have been described. However, genomic ancestry has rarely been investigated. We applied SNP-based genomic ancestry prediction to comprehensive genomic profiling (CGP) data to identify significant enrichment of ancestry by subtype. We also explored enrichment of genomic alterations (GAs) by ancestry. Methods: During routine clinical care, 2834 unique patient (pt) samples of BCLs underwent CGP for 406 DNA genes and 265 RNA genes to detect all classes of GAs on the FoundationOne® Heme platform. This dataset was enriched for relapsed/refractory pts as they are more likely to have genomic testing as part of clinical care (referral bias). Each pt was assigned an ancestry of American (AMR), African (AFR), East Asian (EAS), European (EUR), or South Asian (SAS) using a SNP-based machine learning methodology (J. Newberg et al., AACR 2019). AMR was defined using a mix of Hispanic and Latin American populations. Enrichment analyses were performed using Fisher's exact test with FDR correction. Results: We compared the ancestry composition of each BCL subtype to the overall ancestry composition of the rest of the sample set (Fig 1A). Pts of AFR ancestry were overrepresented in plasmablastic lymphoma (PBL) (OR=7.2, P In diffuse large B cell lymphoma (DLBCL), we found pts to be primarily of EUR ancestry, however we identified ancestry bias in GAs (Fig 1C). CD79B alterations were enriched in DLBCL pts of SAS ancestry, although not significant after FDR correction, consistent with previous reports of increased Activate B-Cell (ABC) cell of origin (COO) subtype and BTK signaling in pts from South East Asia (PMID: 31189540). CDKN2A, also frequently altered in ABC COO subtype, trended towards enrichment in EAS ancestry. CUX1, a tumor suppressor involved in PI3K signaling, was strongly enriched in AFR pts in both DLBCL and B-ALL. One CUX1 insertion variant (G870_G871insSGG) was particularly common in AFR pts with BCL (7/9 AFR, 2/9 AMR), which has been reported previously in Myelodysplastic syndromes (PMID: 24030381). CUX1 alterations have been reported to be associated with increased PI3K signaling suggesting in part PI3K inhibitor trials should proactively include pts of AFR ancestry (PMID: 24316979). Finally, EZH2 alterations were slightly enriched in AMR DLBCL pts, but showed no ancestry bias in follicular lymphoma (FL) pts, of interest given the recent EZH2 inhibitor approval in FL. Conclusions: This study described multiple important genomic differences in BCL using genomic ancestry rather than patient-reported descriptive variables. Enrichment of AMR ancestry was observed in B-ALL overall, and in Ph-like B-ALL. In addition, enrichment of CUX1 alterations was observed in both DLBCL and B-ALL of AFR ancestry. While precision medicine holds the promise to advance cancer care, many acknowledge the potential to unintentionally deepen existing health disparities (PMID: 31112478). Further analysis of ancestry informative markers in BCL, including enrichment of ancestry markers in specific cancer subtypes and ancestry-associated enrichment of specific GAs, may lead to insights into cancer biology and contribute to ongoing cancer health disparities research. Disclosures Moore: Foundation Medicine, Inc: Current Employment; Roche Holdings: Current equity holder in publicly-traded company. Evens:Abbvie: Consultancy, Honoraria; Mylteni: Consultancy, Honoraria; Research To Practice: Honoraria, Speakers Bureau; MorphoSys: Consultancy, Honoraria; Novartis: Consultancy, Honoraria; Pharmacyclics: Consultancy, Honoraria; Merck: Consultancy, Honoraria, Research Funding; Epizyme: Consultancy, Honoraria, Research Funding; Seattle Genetics: Consultancy, Honoraria, Research Funding. Newberg:Roche Holdings: Current equity holder in publicly-traded company; Foundation Medicine, Inc: Current Employment. Severson:Foundation Medicine, Inc: Current Employment; Roche Holdings: Current equity holder in publicly-traded company. Mills:Foundation Medicine, Inc: Current Employment; Abbvie: Current equity holder in publicly-traded company; Roche Holdings: Current equity holder in publicly-traded company; Abbott: Current equity holder in publicly-traded company; Merck: Current equity holder in publicly-traded company. Vergilio:Roche Holdings: Current equity holder in publicly-traded company; Foundation Medicine, Inc: Current Employment. Trabucco:F. Hoffmann-La Roche, Bristol-Myers Squibb Co., BioNTech: Current equity holder in publicly-traded company; Patent pending with Foundation Medicine and Genentech: Patents & Royalties: Patent pending; Foundation Medicine, Inc.: Current Employment; Bristol-Myers Squibb Co: Current equity holder in publicly-traded company; BioNTech: Current equity holder in publicly-traded company; Loxo Oncology: Divested equity in a private or publicly-traded company in the past 24 months. Ganesan:M2GEN: Research Funding; Foundation Medicine, Inc: Consultancy; Inspirata: Consultancy; Merck: Consultancy, Current Employment, Current equity holder in publicly-traded company; Silagene: Consultancy; Foghorn Therapeutics: Consultancy; Roche: Consultancy; Novartis: Consultancy.

Calcium carbonate nucleation is often a complex and multistep process that is difficult to follow in situ. The time-resolved electrochemical and electrophoretic methods can provide a new insight into the nucleation pathway.Here, we used a combination of speciation calculations with time-resolved electrophoretic and potentiometric methods to monitor calcium carbonate precipitation from a slightly supersaturated solution.After an initial mixing period of three minutes in which metastable CaCO

5003 Background: Prostate cancer (PCa) incidence, mortality, and outcomes vary widely across race/ethnicity. The underlying drivers of these differences are multifactorial, including systemic barriers that lead to wide variation in access to care including genomic and precision medicine. Men of African ancestry (AFR) are particularly underrepresented in genomic and precision medicine studies. Therefore, we sought to comprehensively assess patterns of gene alterations, comprehensive genomic profiling (CGP) utilization, and treatment patterns in a large, diverse advanced PCa cohort. Methods: 11,741 PCa patients with CGP, as part of routine clinical care (Foundation Medicine Inc., FMI) were evaluated for their genomic landscape. Predominant ancestry was inferred using a SNP-based approach (Connelly et al, AACR 2018). Independently, the US-based de-identified Flatiron Health (FH)-FMI clinico-genomic database (CGDB) of 897 evaluable PCa patients was also queried. Clinical characteristics and treatment selections were described for patients who received metastatic or castrate-resistant diagnosis between 1/2011 and 6/2020. Results: The FMI cohort included 1,422 (12%) men of AFR and 9,244 (79%) men of European ancestry (EUR). Median age was lower in AFR compared with EUR men (64 vs. 67, p < 0.001). TP53 and PTEN alterations and TMPRSS2-ERG rearrangements occurred less frequently in AFR than EUR men (35% vs. 43%, 21% vs. 33%, 15% vs. 33% respectively, p < 0.05). In contrast, alterations in SPOP (11.9% vs. 7.3%), CDK12 (10.0% vs. 5.2%), CCND1 (6.0% vs. 3.8%), KMT2D (7.7% vs. 5.1%), HGF (4.1% vs. 2.5%), and MYC (13.4% vs. 10.6%) were enriched in the AFR cohort (p < 0.05). Alteration frequency in BRCA1/2, AR, DNA damage response pathway genes, and actionable genes with therapy implications, were similar across ancestry. Of note, BRAF alterations were slightly enriched in AFR (5.0% vs. 3.2%, p < 0.05). In the CGDB cohort (79 AFR, 762 EUR), AFR men received a median of 2 lines of therapy prior to CGP, compared to 1 line for EUR men. Notably, the proportion of patients receiving immunotherapy and PARPi was similar across ancestry, however AFR men were less likely to receive clinical study drug compared with EUR men (11% vs 30%, p < 0.001), even among men with actionable alterations (1% vs 6%, p < 0.001). Conclusions: To our knowledge, this study encompasses the largest cohort, particularly of AFR men in a genomic study, that defines CGP utilization, the genomic landscape and therapeutic implications of CGP in PCa across ancestry. Overall, there were largely similar rates of actionable gene alterations across ancestry. Notably, AFR men were less likely to receive CGP earlier in their treatment course, and less likely to be treated on clinical trials, which could impact the genomic landscape, outcomes, and ultimately disparities.

High rates of sex and drug risk behaviors have been documented among Latino migrant men in the US. Whether these behaviors were established in the migrants’ home countries or were adopted in the US has not been described and has implications for prevention strategies. Quarterly surveys were conducted to gather information on selected sex and drug risk practices of Latino migrant men who arrived in New Orleans after Hurricane Katrina seeking work. Both kappa scores and McNemar’s tests were performed to determine if practice of these behaviors in home country was similar to practice post-emigration to the US. Female sex worker (FSW) patronage, same sex encounters (MSM), and crack cocaine use was more likely to occur post- rather than pre-emigration. Of those who ever engaged in these selected behaviors, most adopted the behavior in the US (i.e., 75.8 % of FSW patrons, 72.7 % of MSM participants, and 85.7 % of crack cocaine users), with the exception of binge drinking (26.8 %). Men who were living with a family member were less likely to adopt FSW patronage OR = 0.27, CI = 0.10–0.76, whereas men who earned >$465 per week were more likely to adopt crack cocaine use OR = 6.29 CI = 1.29, 30.57. Interventions that facilitate the maintenance of family cohesion and provide strategies for financial management may be useful for reducing sex and drug risk among newly arrived migrants.

Societal perceptions may factor into the high rates of nontreatment in patients with lung cancer. To determine whether bias exists toward lung cancer, a study using the Implicit Association Test method of inferring subconscious attitudes and stereotypes from participant reaction times to visual cues was initiated. Participants were primarily recruited from an online survey panel based on US census data. Explicit attitudes regarding lung and breast cancer were derived from participants’ ratings (n = 1778) regarding what they thought patients experienced in terms of guilt, shame, and hope (descriptive statements) and from participants’ opinions regarding whether patients ought to experience such feelings (normative statements). Participants’ responses to descriptive and normative statements about lung cancer were compared with responses to statements about breast cancer. Analyses of responses revealed that the participants were more likely to agree with negative descriptive and normative statements about lung cancer than breast cancer (P

A sizable body of literature exists for young adult survivors of childhood cancer but relatively little is known about the health and supportive care needs of older adolescent and young adult cancer survivors. This project assessed priority health and supportive care needs for young adult patients and off-treatment survivors.1,088 cancer patients and off-treatment survivors (age 18-39, diagnosed between the ages of 15-35) rank ordered a series of health and supportive care needs. Item rank scores were calculated to prioritize lists of needs for patients receiving treatment and off-treatment survivors, respectively. Differences in rankings based on respondent age, age at diagnosis, years since diagnosis, gender and treatment status (currently receiving treatment or off-treatment) were examined.Availability of state-of-the-art treatment specific to this age-group and having adequate health insurance were the most highly-ranked health care needs. Support from family and friends were the most highly ranked supportive care needs, although younger respondents attributed greater importance to support from family and friends. Older respondents attributed greater importance to availability of age-appropriate information, psychological counseling, and being responsible for one's own health care and decision-making. Younger respondents reported significantly higher needs for fertility information and services and for scheduling treatments to fit their lifestyles.Needs of adolescents and young adults with cancer vary along a continuum of care, from diagnosis and treatment through survivorship. Findings emphasize the value of age-appropriate resources and peer support. The study offers direction for delivering services to what previously has been an underserved population.

This chapter focuses on how extractivism increasingly dominates the direction of Canada’s domestic development as well as its hemispheric relations. We describe the instrumental role that Canada’s policies are playing in accentuating an extractivist paradigm that is shared by both neoliberal and progressive Latin American governments, and how such policies are shaping north–south relations. Whereas a large majority of Canadians believe that Canada’s foreign policy should be based on peacekeeping, mediation, and being a global leader on the environment (Broadbent Institute 2013), the reality of Canada’s presence in many Latin American nations is discordant with those values. Canadian foreign policy in the region is increasingly being driven by the interests of Canadian and global extractive capital (Veltmeyer 2013).

The paper presents the results of a questionnaire survey from Ghana that investigates how perceived environmental uncertainty (environmental level factor) and organizational culture (organizational level factor) influence budget participation, and how budget participation in turn influences managerial performance. Data is gathered using a survey questionnaire responded to by 89 line managers with budget responsibilities. Results presented illustrate support for organizational culture influencing budget participation, but not for the possible influence of perceived environmental uncertainty on budget participation. Consistent with prior studies, budget participation was found to influence managerial performance. The study contributes to the emerging literature on management accounting practices in the developing world.

Previous studies have investigated the accounting/marketing interface in industry and found the existence of cultural differences and a knowledge gap between the two groups of professionals. This paper contributes to this ongoing debate by focusing on the two groups at a broad professional level, an approach ignored in prior studies. Consistent with previous research, this paper relies on a survey methodology to investigate the existence/non-existence of cultural differences and a knowledge gap between accounting and marketing professionals working in industry. Responses from the members of the Australian Society of Certified Public Accountants and the Australian Marketing Institute support our hypotheses of the existence of cultural differences and a knowledge gap at the accounting/marketing interface in industry. Our interpretation of the results using Habermas's Theory of Communicative Action raises several issues concerning the need for accounting and marketing personnel to develop an understanding, c...

During the past 15 years, occupational therapists in Canada, through the Canadian Association of Occupational Therapists, have worked to develop and implement guidelines for practice of a client-centred approach to occupational therapy. One of the difficulties with the current Guidelines for the Client-Centred Practice of Occupational Therapy is the lack of a definition and discussion of the concepts and issues fundamental to client-centred practice. In this paper, key concepts of client-centred practice: individual autonomy and choice, partnership, therapist and client responsibility, enablement, contextual congruence, accessibility and respect for diversity are discussed. Two practice examples are used to illustrate these ideas and raise issues about obstacles to the practice of client-centred occupational therapy. Research evidence about the effectiveness of client-centred concepts in enhancing client satisfaction, functional outcomes and adherence to health service programmes is reviewed.

Until recently, business ethics in the United States has been conducted largely in isolation from work by scholars and practitioners in other coun? tries. Even "multinational" issues, which have long been a concern of busi? ness ethics in the U.S., have been approached from a distinctly American perspective.1 This academic isolationism has begun to change, however. The past five years have seen increasing give-and-take between American busi? ness ethicists and scholars from other countries, particularly those of West? ern Europe.2 Recent developments in Eastern Europe and the imminent European Community have intensified the interest in Europe. For Ameri? cans interested in European thinking about business ethics, the activities and publications of the European Business Ethics Network (EBEN) are likely to prove a most valuable resource. People in Corporations: Ethical Responsi? bilities and Corporate Effectiveness, edited by Georges Enderle, Brenda Almond, and Antonio Argandona, is one such EBEN publication. It contains a selection of papers presented at the Second European Business Ethics Conference in 1989 in Barcelona, Spain. The initiative for EBEN began at a small meeting of European business ethicists in Brussels in 1985. The participants agreed on the need for a forum for the exchange of national perspectives on business ethics, and for a "practical" business ethics that bridged the gap between academics and practitioners. They were also eager to include representatives from a wide range of academic disciplines. In 1987, at the First European Conference on Business Ethics ("Business Ethics: Crucial Issues in a Successful European Business"), EBEN was officially formed. Since then, the Network has held

The nucleus basalis magnocellularis (nBM) provides the primary source of cholinergic input to the cortex. Neonatal lesions of the nBM produce transient reductions in cholinergic markers, persistent abnormalities in cortical morphology, and spatial navigation impairments in adult mice. The present study examined sex differences in the effects of an electrolytic nBM lesion on postnatal day 1 (PND 1) in mice on behavior and neurochemistry in adulthood. Mice were lesioned on PND 1 and tested at 8 weeks of age on a battery of behavioral tests including passive avoidance, cued and spatial tasks in the Morris water maze, simple and delayed nonmatch to sample versions of an odor discrimination task, and locomotor activity measurements. Following behavioral testing, mice were sacrificed for either morphological assessment or neurochemical analysis of a cholinergic marker or catecholamines. There were no lesion or sex differences in acquisition or retention of passive avoidance, performance of the odor discrimination tasks, or activity levels. Control mice showed a robust sex difference in performance of the spatial water maze task. The lesion produced a slight cued but more dramatic spatial navigation deficit in the water maze which affected only the male mice. Neurochemical analyses revealed no lesion-induced changes in either choline acetyltransferase activity or levels of norepinephrine or serotonin at the time of testing. The subsequent report shows a sex difference in lesion-induced changes in cortical morphology which suggests that sexually dimorphic cholinergic influences on cortical development are responsible for the behavioral deficits seen in this study.

8017 Background: Emerging research suggests that LC may be associated with greater levels of stigma, shame and hopelessness compared to other cancers. This study measured explicit, conscious attitudes (EAs) and used the Implicit Association Test (IAT) to assess implicit, unconscious attitudes (IAs) of LC relative to BC. Methods: To assess EAs, participants (Ps), [people with cancer (n=243), caregivers (n=677), healthcare providers (HCPs, n=142), and the general public (n=864)] were asked to rate their agreement, on a six-point scale, with statements about how people with LC and BC “do feel” (descriptive attitudes) or “ought to feel” (normative attitudes) about their disease. IAs were measured with three IATs that used LC or BC images with words representing good/bad; hope/despair; or suitable/shameful. An IAT D score indicated the strength of bias against LC relative to BC: >0.65 = strong bias; 0.35-0.65 = moderate bias; 0.15-0.35 = slight bias; -0.15 -+0.15 = no bias, and < -0.15 indicated bias against BC. Results: EAs and IAs were substantially more negative towards LC. Most Ps provided more negative ratings for LC than BC for both descriptive (70%vs.8%) and normative statements (56% vs. 3%). Ps had strong negative IAs towards LC compared to BC (bad: 74% vs. 10%; despair: 75% vs. 9%; shame: 67% vs. 17%). These trends were consistent across caregivers, patients, HCPs, and the public. EAs and IAs were uncorrelated. Conclusions: Ps had greater explicit and implicit negative bias against LC compared to BC. [Table: see text]

The results of a national survey which examined current computer usage and occupational therapist direct entry of Workload Measurement Data is presented. Results indicated an almost equal distribution of departments using computers versus not using computers. A variety of software packages are used for the purposes of collecting workload measurement data, but the majority of departments use customized in-house programmes. The most common method of data entry was a clerk in a central location, however, a number of departments are considering a switch to therapist direct entry. Advantages and disadvantages of both methods were described by survey respondents.

In his ‘What is “Business Ethics”?’ Peter Drucker accuses business ethics of singling out business unfairly for special ethical treatment, of subordinating ethical to political concerns, and of being, not ‘ethics’ at all, but ‘ethical chic’. We contend that Drucker's denunciation of business ethics rests upon a fundamental misunderstanding of the field. This article is a response to his charges and an effort to clarify the nature, scope and purpose of business ethics.

Out of 655 schools that responded, 317 offered a business ethics course. 386 courses were listed by these 317 schools. Of these 386, 279 were taught at the undergraduate level, 53 at the graduate level and 54 at both levels. 271 were elective, 101 were required and 14 were both depending on specific programs. Annual enrollment in the 386 courses was estimated between 35,000 to 40,000. Of the 338 schools which do not offer such a course, 48 are planning to offer and 144 would like to. 151 of these courses were titled ‘Business Ethics’ and 44 were titled ‘Business and Society’. 186 (out of the 386 courses) were offered by Philosophy Departments. 147 were offered by Business departments. 19 were interdisciplinary. 322 of the 386 courses have entered the curriculum since 1973, with a gradual increase each year.