Descriptive characteristics of colon and rectal cancer recurrence in a Danish population-based study.

BACKGROUND: Recurrence is a common outcome among patients that have undergone an intended curative resection for colorectal cancer. However, data on factors that influence colorectal cancer recurrence are sparse. We report descriptive characteristics of both colon and rectal cancer recurrence in an unselected population. MATERIAL AND METHODS: We identified 21,152 patients with colorectal cancer diagnosed between May 2001 and December 2011 and registered with the Danish Colorectal Cancer Group. Recurrences were identified in 3198 colon and 1838 rectal cancer patients during follow-up. We calculated the frequency, proportion, and incidence rates of colon and rectal cancer recurrence within descriptive categories, and the cumulative five- and ten-year incidences of recurrence, treating death as a competing risk. We used a Cox proportional hazard model to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: Recurrence risk was highest in the first three years of follow-up. Patients <55 years old at initial diagnosis (incidence rate for colon: 7.2 per 100 person-years; 95% CI: 6.5-7.9; rectum: 8.1 per 100 person-years; 95% CI: 7.2-9.0) and patients diagnosed with stage III cancer (colon HR: 5.70; 95% CI: 4.61-7.06; rectal HR: 7.02; 95% CI: 5.58-8.82) had increased risk of recurrence. Patients diagnosed with stage III cancer from 2009 to 2011 had a lower incidence of recurrence than those diagnosed with stage III cancer in the years before. Cumulative incidences of colon and rectal cancer recurrence were similar for both cancer types among each descriptive category. CONCLUSIONS: In this population, increases in colorectal cancer recurrence risk were associated with younger age and increasing stage at diagnosis. Cumulative incidence of recurrence did not differ by cancer type. Descriptive characteristics of colon and rectal cancer recurrence may help to inform patient-physician decision-making, and could be used to determine adjuvant therapies or tailor surveillance strategies so that recurrence may be identified early, particularly within the first 3 years of follow-up.

Key correlates of exclusive breastfeeding at three timepoints: Evidence from Ethiopia.

Aim: To compare factors associated with exclusive breastfeeding (EBF) within 1 h of birth, within 3 days, and within the first 6 months post-birth. Methods: We used multivariate logistic regression models and data from "The Alive and Thrive Phase 2 Amhara Baseline Survey 2015" from Ethiopia (N = 3113). Results: Giving colostrum was strongly associated with EBF at all three time points, controlling for multiple confounders. Putting the baby to the breast before cleaning the baby and before cleaning the mother was significantly associated with EBF within 1 h and for the first 3 days. EBF within an hour of birth was more likely for girl babies than boy babies. Having a healthcare professional check whether the baby was sucking well was significantly associated with EBF 3 days post-birth. Conclusions: The World Health Organization recommends breastfeeding within 1 h of birth and exclusively thereafter for 6 months, which can improve health outcomes for infants and children. In Ethiopia, many factors influence breastfeeding practices, but little is known about how these factors differ at various key timepoints in the 6 months after birth. Our study provides important information on correlates of EBF at three timepoints and shows that factors that are significantly correlated with EBF vary over time. Future research should assess the potential causal links among statistically significant associations between EBF and risk factors at various times between birth and 6 months of age. Ultimately, these findings have the potential to inform areas of intervention related to promoting EBF.

"Collaboration Toward One Collective Goal": A Mixed-Methods Study of Short-Term Learning Outcomes and Long-Term Impacts Among Students Participating in an Undergraduate Community-Based Participatory Research (CBPR) Course.

Background: Research shows positive learning outcomes for students participating in service learning. However, the impacts of undergraduate student participation in Community-Based Participatory Research (CBPR) courses are minimally studied. Methods: We used a triangulation mixed-methods design approach to analyze short- and long-term (1-5 years post-course) data collected from 59 undergraduate students across 5 cohorts of a CBPR course (2014-19). Thematic analysis was used to analyze the qualitative data and descriptive statistics and frequencies were generated to analyze the quantitative data. Results: We developed five key themes based on short-term qualitative data: integration of CBPR and traditional research skills; importance of community engagement in research; identity; accountability; and collaboration. Themes from qualitative course evaluations aligned with these findings. Long-term qualitative data revealed that former students gained research knowledge, research skills, and professional skills and then applied these in other settings. This aligns with quantitative findings, where >79% of respondents reported that course participation "extensively" improved their research skills. Post-course, students still reflected on the importance of community engagement in research and reported a substantially enhanced likelihood of civic engagement. Discussion/Conclusions: Students gained critical knowledge and skills that positively impact their ability to engage in community-based work well after the end of course participation. Some students reported considering research-oriented careers and graduate programs for the first time after course participation. Collaborative learning experiences with community partners and members encouraged students to reflect on research designs that center community voices. We stress here that community partnerships require extensive cultivation, but they can create opportunities to translate findings directly back to communities and provide numerous benefits to undergraduate students. We hope that our findings provide the information needed to consider pilot testing practice-based CBPR courses in a variety of public health training contexts.