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To advance ongoing efforts to diversify the healthcare field and promote inclusion in physiology courses, the present study investigates the potential for an evidence-based intervention - Scientist Spotlight assignments - to highlight counter-stereotypical representations of scientists in the context of majors and non-majors physiology courses. Undergraduate students at an emerging Hispanic serving R1 institution completed six Scientist Spotlights assignments in their physiology courses. We conducted semi-structured interviews and disseminated an established pre-post survey protocol at the beginning and end of the courses. Our findings from interviews with 31 students from a range of marginalized backgrounds revealed that (1) the biographical information about counter-stereotypical scientists deeply resonated with students by humanizing science, (2) the instructor implementation of the assignments made a meaningful difference in their feelings of inclusion, and (3) the assignments supported students' beliefs about their content learning and understanding of physiological concepts. The results from the survey showed that regardless of being in a majors (n=159) or non-majors (n=117) course, students from a range of demographic groups can and do significantly shift in their relatability to and descriptions of scientists. We highlight implications for inclusive curriculum like Scientist Spotlights for addressing the issue of representation in physiology textbooks, curriculum, and healthcare fields at large.
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Recent improvements in the accessibility of mapping tools and an increased recognition of the importance of leveraging data to inform public health operations has led to enthusiasm among public health departments to rapidly evolve their ability to analyze and apply data to programs. As the COVID-19 pandemic made evident, many health department data systems have been neglected for decades and data literacy among staff low. Significant federal dollars have been allocated to local health departments to modernize health systems. This case study recounts the effort to equip the Pima County Health Department with a highly sophisticated "COVID-19 Vaccines Solutions Dashboard" in 2021-2022, quantifying community vulnerability in the midst of the COVID-19 pandemic and shares key successes and challenges in process and outcomes that can guide other such dashboard initiatives. The experience informed the development of Pima' County Health Department's Data & Informatics Team as well as efforts to cultivate a more robust data culture throughout the department. Many health departments around the United States are in a similar position, and these lessons learned are widely applicable.
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OBJECTIVES: To evaluate patterns of recurrence in 1988 FIGO stage IC endometrioid endometrial adenocarcinoma. METHODS: A prospectively maintained endometrial cancer database was utilized to identify all patients with stage IC endometrioid endometrial adenocarcinoma treated between 2/93 and 6/09. Patterns of recurrence and risk factors were analyzed. RESULTS: One hundred thirty-four patients with stage IC endometrial cancer were identified. Median age was 66 years (range, 31-91 years). All patients were initially treated surgically, and 79% underwent comprehensive surgical staging with lymphadenectomy. Median number of lymph nodes removed was 18 (range, 1-45). Fifty-one patients (38%) had FIGO grade 1 tumors, 55 (41%) had grade 2 tumors, and 28 (21%) had grade 3 tumors. The majority of patients (91%) received adjuvant radiation therapy. With a median follow-up of 36 months (range, 0.6-141.4 months), 10 patients recurred. Of these, 2 (20%) were grade 1, 2 (20%) were grade 2, and 6 (60%) were grade 3. Nine (90%) of these recurrences had a distant component and 7 (70%) were fatal. Overall, the 3 year cumulative incidence failure rate for grade 1/2 tumors was 5.4%; for grade 3 tumors it was 28.9% (P<0.001). Age, BMI, and lymphovascular invasion were not associated with an increased risk of recurrence. CONCLUSIONS: Patients with stage IC, grade 3 endometrial cancer had a significantly increased risk of recurrence (28.9%). All of these recurrences had a distant component and the majority were fatal. Further investigation into the addition of adjuvant systemic therapy in these high-risk patients is warranted.
Assuntos
Carcinoma Endometrioide/patologia , Neoplasias do Endométrio/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Endometrioide/mortalidade , Carcinoma Endometrioide/terapia , Terapia Combinada , Neoplasias do Endométrio/mortalidade , Neoplasias do Endométrio/terapia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Recidiva , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Resultado do TratamentoRESUMO
OBJECTIVE: To describe the incidence of isolated paraaortic nodal metastasis in surgically staged endometrial cancer patients with negative pelvic lymph nodes. METHODS: Using a prospectively maintained database we identified all cases of endometrial cancer that had both pelvic and aortic nodal dissection and determined the rate of isolated paraaortic nodal metastasis in the setting of negative pelvic nodes. For this report a satisfactory pelvic node dissection meant the identification of 8 or more pelvic nodes on final pathology. RESULTS: 1942 endometrial cancer patients were surgically treated at our institution from 1/93 to 1/08. 847 had both pelvic and paraaortic nodes removed during surgery and identified by pathology. 734 had negative pelvic nodes with at least one paraaortic node identified. Only 12 (1.6%) had positive paraaortic nodes with negative pelvic nodes. Seven (1%) of 640 cases with 8 or more negative pelvic nodes had positive paraaortic nodes. Final grade for these cases included: G1 (2), G2 (2), G3 (1), papillary serous (1), and undifferentiated (1). Of the 570 cases with a final diagnosis of grade 1 endometrial cancer, 187 had both pelvic and aortic node dissection during the same operation, and 2/187 (1%) had a positive paraaortic node with negative pelvic nodes. CONCLUSIONS: Isolated paraaortic nodal metastasis in the setting of negative pelvic nodes occurs in approximately 1% of surgically staged endometrial cancer cases. This low rate seems consistent for low- and high-grade lesions. Future studies looking at the incidence of isolated paraaortic nodal metastasis in the setting of negative sentinel pelvic nodes are warranted.
Assuntos
Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/cirurgia , Linfonodos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pelve , Adulto JovemRESUMO
En gestion se describe la actual infraestructura de riego, derechos de agua, distribucion, organizacion y mantenimiento. La agricultura es semiintensiva compuesta por frutales hortalizas y forrajeras; en periodo lluvioso se cultiva toda la superficie, mientras en estiaje solo el 5 por ciento. Hay un deficit hidrico desde marzo a noviembre con un caudal de promedio de 60 L/s. El diseño de infraestructura consiste en una galeria filtrante, construccion revestida de 4000 ml de HºCº, 3 sifones de PVC y 7 acueductos de HºAº. El diseño de la gestion implica una organizacion, distribucion del riego y su mantenimiento...