Search

We conducted a randomized, triple-blinded home drinking water intervention trial to determine if a large study could be undertaken while successfully blinding participants. Households were randomized 50:50 to use externally identical active or sham treatment devices. We measured the effectiveness of blinding of participants by using a published blinding index in which values >0.5 indicate successful blinding. The principal health outcome measured was "highly credible gastrointestinal illness" (HCGI). Participants (n=236) from 77 households were successfully blinded to their treatment assignment. At the end of the study, the blinding index was 0.64 (95% confidence interval 0.51-0.78). There were 103 episodes of HCGI during 10,790 person-days at risk in the sham group and 82 episodes during 11,380 person-days at risk in the active treatment group. The incidence rate ratio of disease (adjusted for the clustered sampling) was 1.32 (95% CI 0.75, 2.33) and the attributable risk was 0.24 (95% CI -0.33, 0.57). These data confirm that participants can be successfully blinded to treatment group assignment during a randomized trial of an in-home drinking water intervention.

Neighbourhood design can have substantial impacts on children's physical and psychological well-being. COVID-19 lockdowns produced striking and unprecedented changes in how neighbourhoods functioned for children. The aim of this research was to explore what worked well for children during Alert Levels 3 and 4 (lockdown) in Aotearoa New Zealand (NZ), focusing in particular on the neighbourhood environment. Children (n = 192) aged between 5 and 13 years completed an online survey that collected information on neighbourhood walking and wheeling and what they liked about their neighbourhood during lockdown in NZ. Car-less neighbourhoods were important for supporting children's well-being. Community activities such as the NZ Bear Hunt were appreciated by children. Natural environments, being home, spending time with family, and simple activities were all liked by participants. Social connections were important but often required technology. Findings can help inform initiatives to support child well-being in the face of potential future lockdowns or new pandemics. [ABSTRACT FROM AUTHOR]

As a Chinese immigrant, motherhood involves unlearning patterns of thinking and behaving from one's upbringing and learning healthier ways to mother. Many view Chinese mothers as tiger moms, a harmful stereotype that does little to embrace the diversity of Chinese motherhood. This article draws on my lived experiences as an immigrant mother to my three American-born Chinese children. For me, the act of immigrant mothering entails a delicate balancing act where Chinese and American values often conflict. These conflicts highlight the racial inequities in how mothers are allowed to mother and experience motherhood. There is no one way to mother, but the heteronormative white, middle-class mothering style is dominant in how society defines good mothers. Little has been written about racial equity among mothers and how motherhood often details negotiating between culture-specific and American norms. My article seeks to explore racial equity and widen the boundaries of motherhood by exploring the impact of immigrant mothering practices, navigating Chinese and American cultures as an immigrant mother, reflecting on how my immigrant mothering has affected my American-born children, and lastly, understanding my cultural history and its influence on my Chinese identity. To widen the rhetoric on mothering, we must engage the narratives of racially diverse mothers to understand motherhood's multiplicities and complexities. Only then will we have a more inclusive view of motherhood that will build racial equity to benefit women and children. [ABSTRACT FROM AUTHOR]

The study of the Hong Kong watch industry examines the relationship between the nature of the Chinese Family Business (CFB) and the business strategies adopted. CFB's nature is positively associated with traditional business strategies but is not very supportive of the upgrading strategies.

Each of us has been negatively affected by this pandemic, but mothers have had to shoulder the brunt of it, as they have been forced to work from home, provide child/elder care, and ensure that their family survives. Sadly, academic mothers have been burdened not only with an increased workload at home but also with trying to juggle their academic careers, which have been gravely affected by this pandemic. As a Chinese academic mother, I have struggled with managing my publishing requirements, my service to my department, and my online teaching responsibilities. I have had to care for elderly family members, who are more susceptible to COVID-19, and for my children, who have been exposed to COVID-19. I have also had to work through filial piety failures as a daughter and daughter-in-law. Sharing the struggles of academic mothers aims to expose how the exorbitant workload that falls upon academic mothers is not sustainable and to address systemic problems that have been long plagued both the academic and home environment. All mothers cannot continue to support a system or a government that lacks leadership during global crises that do not value the visible and invisible labor of mothers because women have far too long been viewed as disposable. In sharing my experiences during this pandemic as a Chinese mother and academic navigating through this uncharted territory of pandemic survival, I hope my journey can provide support to other academic mothers as we advocate for structural change in how mothers should be supported as essential workers. [ABSTRACT FROM AUTHOR]

Macromastia is a common condition that can lead to physical pain, emotional burden, and behavioral impairment, with significant decrements in quality of life. Reduction mammaplasty offers the only effective treatment of symptomatic macromastia, and patients experience significant improvements in their physical and psychosocial health through surgical correction. Although symptoms typically arise during adolescence, most women seeking surgical intervention do not undergo reduction mammaplasty until their fifth decade of life. Providers often delay surgery due to speculative concerns about emotional immaturity, postoperative breast regrowth, and future lactation performance. The strict guidelines related to age and body mass index imposed by insurance companies further restrict the options available to younger patients with macromastia. This review offers an evidence-based approach to treating macromastia in younger patients. After more than 15 years of treatment and research centered on adolescents and young adults with macromastia led by the senior author (B.I.L.), a pediatric plastic surgeon, we have found that reduction mammaplasty is a safe and effective treatment option for this patient population. It is our hope that our work will enable care providers to make data-supported decisions when treating younger patients with symptomatic macromastia., Competing Interests: Conflict of Interest: None declared., (Copyright © 2023 International Society of Plastic and Aesthetic Nurses. All rights reserved.)

Purpose Studies suggest that a subset of patients with triple-negative breast cancer (TNBC) have tumors that express the androgen receptor (AR) and may benefit from an AR inhibitor. This phase II study evaluated the antitumor activity and safety of enzalutamide in patients with locally advanced or metastatic AR-positive TNBC. Patients and Methods Tumors were tested for AR with an immunohistochemistry assay optimized for breast cancer; nuclear AR staining > 0% was considered positive. Patients received enzalutamide 160 mg once per day until disease progression. The primary end point was clinical benefit rate (CBR) at 16 weeks. Secondary end points included CBR at 24 weeks, progression-free survival, and safety. End points were analyzed in all enrolled patients (the intent-to-treat [ITT] population) and in patients with one or more postbaseline assessment whose tumor expressed ≥ 10% nuclear AR (the evaluable subgroup). Results Of 118 patients enrolled, 78 were evaluable. CBR at 16 weeks was 25% (95% CI, 17% to 33%) in the ITT population and 33% (95% CI, 23% to 45%) in the evaluable subgroup. Median progression-free survival was 2.9 months (95% CI, 1.9 to 3.7 months) in the ITT population and 3.3 months (95% CI, 1.9 to 4.1 months) in the evaluable subgroup. Median overall survival was 12.7 months (95% CI, 8.5 months to not yet reached) in the ITT population and 17.6 months (95% CI, 11.6 months to not yet reached) in the evaluable subgroup. Fatigue was the only treatment-related grade 3 or higher adverse event with an incidence of > 2%. Conclusion Enzalutamide demonstrated clinical activity and was well tolerated in patients with advanced AR-positive TNBC. Adverse events related to enzalutamide were consistent with its known safety profile. This study supports additional development of enzalutamide in advanced TNBC.

Observational evidence has established a relationship between obesity and cancer risk and outcomes. Interventional studies have demonstrated the feasibility and benefits of lifestyle change after cancer diagnosis, and guidelines recommend weight management and regular physical activity in cancer survivors; however, lifestyle interventions are not a routine part of cancer care. The ASCO Research Summit on Advancing Obesity Clinical Trials in Cancer Survivors sought to identify the knowledge gaps that clinical trials addressing energy balance factors in cancer survivors have not answered and to develop a roadmap for the design and implementation of studies with the potential to generate data that could lead to the evidence-based incorporation of weight management and physical activity programs into standard oncology practice. Recommendations highlight the need for large-scale trials evaluating the impact of energy balance interventions on cancer outcomes, as well as the concurrent conduct of studies focused on dissemination and implementation of interventions in diverse populations of cancer survivors, including answering critical questions about the degree of benefit in key subgroups of survivors. Other considerations include the importance of incorporating economic metrics into energy balance intervention trials, the need to establish intermediate biomarkers, and the importance of integrating traditional and nontraditional funding sources. Establishing lifestyle change after cancer diagnosis as a routine part of cancer care will require a multipronged effort to overcome barriers related to study development, funding, and stakeholder engagement. Given the prevalence of obesity and inactivity in cancer survivors in the United States and elsewhere, energy balance interventions hold the potential to reduce cancer morbidity and mortality in millions of patients, and it is essential that we move forward in determining their role in cancer care with the same care and precision used to test pharmacologic and other interventions.

Rates of obesity have increased significantly over the last three decades in the United States and globally. In addition to contributing to heart disease and diabetes, obesity is a major unrecognized risk factor for cancer. Obesity is associated with worsened prognosis after cancer diagnosis and also negatively affects the delivery of systemic therapy, contributes to morbidity of cancer treatment, and may raise the risk of second malignancies and comorbidities. Research shows that the time after a cancer diagnosis can serve as a teachable moment to motivate individuals to adopt risk-reducing behaviors. For this reason, the oncology care team--the providers with whom a patient has the closest relationships in the critical period after a cancer diagnosis--is in a unique position to help patients lose weight and make other healthy lifestyle changes. The American Society of Clinical Oncology is committed to reducing the impact of obesity on cancer and has established a multipronged initiative to accomplish this goal by 1) increasing education and awareness of the evidence linking obesity and cancer; 2) providing tools and resources to help oncology providers address obesity with their patients; 3) building and fostering a robust research agenda to better understand the pathophysiology of energy balance alterations, evaluate the impact of behavior change on cancer outcomes, and determine the best methods to help cancer survivors make effective and useful changes in lifestyle behaviors; and 4) advocating for policy and systems change to address societal factors contributing to obesity and improve access to weight management services for patients with cancer., (© 2014 by American Society of Clinical Oncology.)