Perceptions of Cancer in Parents of Adolescent Daughters in Northwest Cameroon.

BACKGROUND: Cancer is a rapidly rising cause of morbidity and mortality in sub-Saharan Africa. Cervical cancer, in particular, is still one of the leading causes of mortality for women in this setting. The uptake of healthcare services is in part influenced by patients' belief systems. We sought to better understand the perception of cancer in the Kom tribe of Northwest Cameroon. METHODS: A qualitative research study was completed using a semi-structured interview guide and one-on-one interviews with 45 parents of girls aged 9-14 years. These girls were candidates for free HPV vaccination to prevent cervical cancer. The interviews were recorded, transcribed, and analyzed using ATLAS.ti 9. RESULTS: Thirty-five mothers and ten fathers with a median age of 42 yo were interviewed from Mbingo, Belo, Njinikom, and Fundong. Half of the parents were farmers, with three being herbalists or traditional medicine doctors. Seventy-seven percent had either no or only primary school education. None had had cancer. All knew at least one person with cancer. The most common word for cancer in the Kom language is "ngoissu". It can refer to a bad infection or cancer. The occurrence of ngoissu is the result of either a curse placed on you, ancestral retribution, or transgressing the ngoulatta (snail shell spoken over and usually placed in a garden). The implications are that treatment of ngoissu must involve the traditional doctor who determines the spiritual issue and prescribes a remedy (like a herb or tea) and/or an incantation. Within the context of cancer, this can lead to a delay in diagnosis until the disease is no longer curable by conventional therapies. CONCLUSION: Ways to bridge biomedical healthcare services and traditional medicine are needed, especially in tribal contexts where the latter is an integral part of daily life.

Parental occupational exposure to solvents and risk of developing testicular germ cell tumors among sons: a French nationwide case-control study (TESTIS study).

OBJECTIVES: The etiology of testicular germ cell tumors (TGCT) is suspected to be related to prenatal environmental risk factors. Some solvents have potential endocrine disrupting or carcinogenic properties and may disrupt male genital development in utero. The aim of this study was to examine the association between parental occupational exposure to solvents and TGCT risk among their offspring. METHODS: A French nationwide case-control study, TESTIS included 454 TGCT cases and 670 controls frequency-matched on region and 5-year age strata. Participants were interviewed via telephone and provided information on parental occupations at birth. Job-exposure matrices (JEM) developed in the French Matgéné program were used to assign exposure to five petroleum-based solvents, five solvents or groups of oxygenated solvents, and five chlorinated solvents. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors. RESULTS: Occupational exposure to at least one solvent during the year of their son's birth was 41% among fathers and 21% among mothers. Paternal exposure to at least one solvent showed OR 0.89 (95% CI 0.68-1.15). Exposure to perchloroethylene (OR 1.41, 95% CI 0.55-3.61), methylene chloride (OR 1.13, 95% CI 0.54-2.34) and diesel/kerosene/fuel oil (OR 1.17, 95% CI 0.80-1.73) disclosed OR >1 but with low precision. Our results suggest a possible modest increase in non-seminoma risk for sons whose fathers were highly exposed to trichloroethylene (OR 1.44, 95% CI 0.79-2.63). Maternal exposure to at least one solvent showed OR 0.90 (95% CI 0.65-1.24). When stratifying by birth year, men born in the 1970s experienced an increased TGCT risk following maternal exposure to fuels and petroleum-based solvents (OR 2.74, 95% CI 1.11-6.76). CONCLUSION: Overall, no solid association was found between parental occupational exposure to solvents and TGCT risk. The association found with maternal occupational exposure to fuels and petroleum solvents among older men needs further investigation.

"Give My Daughter the Shot!": A Content Analysis of the Depiction of Patients with Cancer Pain and Their Management in Hollywood Films.

INTRODUCTION: Cinemeducation, the pedagogical use of films, has been used in a variety of clinical disciplines. To date, no studies have looked at the use of film depictions of cancer pain and its management in clinical education. We investigated how patients with cancer pain and their management are depicted in Hollywood films to determine whether there is content that would be amenable to use for cancer pain assessment and management education. METHODS: A qualitative content analysis was performed. Films that contained characters with or references to cancer pain were searched for using the International Movie Database, the Literature Arts Medicine Database, the History of Medicine and Medical Humanities Database, and Medicine on Screen. After review, 4 films were identified for review and analysis. RESULTS: Themes that emerged from the analysis concerned the films' depictions of characters with pain, their healthcare providers, the therapies used for pain management, and the setting in which pain management was provided. CONCLUSIONS: This study demonstrates that patients with cancer pain are depicted in a compassionate manner. Pain management focused on the use of opioids. The settings in which patients received pain management was depicted as not being amenable to providing holistic care. This variety of topics related to pain management covered in the films make them amenable to use in cinemeducation. This study therefore forms the basis for future work developing film-based cancer education modules.

Foliar Silicon Spray before Summer Cutting Propagation Enhances Resistance to Powdery Mildew of Daughter Plants.

Silicon (Si) has beneficial effects on not only plant growth but also against biotic and abiotic stresses. However, a few studies focus on how Si application helps strawberry (Fragaria × ananassa Duch.) resist powdery mildew. The aim of this work was to find out the optimal Si application method before cutting propagation to enhance the resistance to powdery mildew in strawberry "daughter" plants. Naturally infected "mother" plants of 'Sulhyang', 'Maehyang', and 'Kuemsil' strawberries were supplied with Si. Potassium silicate (K2SiO3) at a final concentration of 75 mg·L-1 Si was either added to the medium for drenching or sprayed to the leaves of the "mother" or "daughter" plant, or soluble Si fertilizer was used to dress the "mother" plant. The Si application significantly increased the shoot fresh weight of the "daughter" plants. Supplemental Si also increased the contents of phosphorus (P), potassium (K), and magnesium (Mg). In addition, the Si treatment decreased the damage of powdery mildew by increased level of proline content and suppressive reactive oxygen species. After applying Si, the length and density of hyphae on the leaf surface decreased. In addition, the infected area of "daughter" plant leaves covered with powdery mildew decreased. This study also demonstrated that Si increased the expression of resistance-gene and decreased the expression of susceptibility-gene of strawberry. Overall, Si application promoted the growth of the "daughter" plants regardless of the application method. Direct foliar Si spray to the "daughter" plants before cutting propagation is recommended to increase their resistance to powdery mildew.

Diné (Navajo) Female Perspectives on Mother-Daughter Cultural Assets Around the Transition to Womanhood: A Qualitative Study.

INTRODUCTION: American Indian (AI) people have protective factors embedded in cultural teachings that buffer against high-risk behaviors. This study applies a qualitative, grounded theory approach to identify cultural assets for a Diné (Navajo) mother-daughter intervention aimed at preventing substance abuse and teen pregnancy. METHOD: Focus groups and in-depth interviews were conducted with 28 AI females' ages 8 years and older from the Navajo Nation. RESULTS: Key themes were (a) preserving the Diné way of life, (b) cultural assets related to being a healthy Diné woman, (c) matrilineal networks as a source of strength/pride, (d) historical trauma as a source of resilience, (e) male influences as protective health factors, (f) Western education as a measure of success, and (g) integrating different belief systems. DISCUSSION: Study findings may be applied as foundational elements for culturally grounded AI substance abuse and teen pregnancy prevention strategies, as well as culturally safe nursing practice.

Late gestation hyperthermia: epigenetic programming of daughter's mammary development and function.

Exposure to stressors during early developmental windows, such as prenatally (i.e., in utero), can have life-long implications for an animal's health and productivity. The mammary gland starts developing in utero and, like other developing tissues and organs, may undergo fetal programming. Previous research has implicated factors, such as prenatal exposure to endocrine disruptors or alterations in maternal diet (e.g., maternal over or undernutrition), that can influence the developmental trajectory of the offspring mammary gland in postnatal life. However, the direct links between prenatal insults and future productive outcomes are less documented in livestock species. Research on in utero hyperthermia effects on early-life mammary development is scarce. This review will provide an overview of key developmental milestones taking place in the bovine mammary gland during the pre- and postnatal stages. We will showcase how intrauterine hyperthermia, experienced by the developing fetus during the last trimester of gestation, derails postnatal mammary gland development and impairs its synthetic capacity later in life. We will provide insights into the underlying histological, cellular, and molecular mechanisms taking place at key postnatal developmental life stages, including birth, weaning and the first lactation, that might explain permanent detriments in productivity long after the initial exposure to hyperthermia. Collectively, our studies indicate that prenatal hyperthermia jeopardizes the normal developmental trajectory of the mammary gland from fetal development to lactation. Further, in utero hyperthermia epigenetically programs the udder, and possibly other organs critical to lactation, yielding a less resilient and less productive cow for multiple lactations.

Implicações para homens do afastamento do(a) filho(a) devido medida protetiva de urgência / Impacto en los hombres del distanciamiento del(la) hijo(a) debido a medida protectora de urgencia / Implications for men of separation from their children due to emergency protective measure

Resumo Objetivo Desvelar as implicações para os homens do afastamento pai-filho(a) em decorrência de medida protetiva por violência conjugal. Métodos Estudo descritivo exploratório, abordagem qualitativa, desenvolvido com nove homens que respondiam a processo judicial por violência conjugal junto às 1ª e 2ª Varas de Justiça pela Paz em Casa de Salvador, Bahia, Brasil. A pesquisa ocorreu por meio da entrevista semiestruturada, tendo seu conteúdo gravado, transcrito e, em seguida, submetido à validação pelos homens. Os dados foram sistematizados com base nos passos preconizados pela análise de conteúdo temática categorial. Resultados O estudo revela que o afastamento pai-filho em decorrência da medida protetiva de urgência suscita no rompimento do vínculo paterno, fomentando o desenvolvimento de problemas psicoemocionais, como ansiedade, depressão e ideação suicida, muitas vezes somatizados e expressos desde cefaleia até condições que necessitam de cuidados hospitalares. Conclusão O comprometimento do exercício da paternidade viola também o direito de crianças e adolescentes ao convívio com a figura paterna. Deste modo, há grande necessidade de que a Política Nacional de Atenção Integral à Saúde dos Homens contemple uma gestão que priorize ações preventivas para a violência, assim como desempenhe acompanhamento psicossocial aos homens.

Resumen Objetivo Revelar el impacto en los hombres del distanciamiento padre-hijo(a) como consecuencia de medidas protectoras por violencia conyugal. Métodos Estudio descriptivo exploratorio, enfoque cualitativo, llevado a cabo con nueve hombres que respondían a juicio por violencia conyugal en el 1º y 2º Juzgado de Justicia por la Paz en Casa de Salvador, estado de Bahia, Brasil. La investigación se realizó a través de encuesta semiestructurada, con grabación y transcripción del contenido, y luego sometido a su validación por los hombres. Los datos fueron sistematizados con base en los pasos preconizados por el análisis de contenido temático de la categoría. Resultados El estudio revela que el distanciamiento padre-hijo como consecuencia de medidas protectoras de urgencia provoca la ruptura del vínculo paterno y fomenta el desarrollo de problemas psicoemocionales, como ansiedad, depresión e ideación suicida, muchas veces somatizados y expresados desde una cefalea hasta condiciones que necesitan cuidados hospitalarios. Conclusión El comprometimiento del ejercicio de la paternidad también viola el derecho de niños y adolescentes a convivir con la figura paterna. De este modo, hay una gran necesidad de que la Política Nacional de Atención Integral a la Salud de los Hombres contemple una gestión que establezca prioridades en acciones preventivas contra la violencia, así como también realice un seguimiento psicosocial de los hombres.

Abstract Objective To unveil the implications for men of father-son estrangement as a result of a protective measure for conjugal violence. Methods This is an exploratory descriptive study, with a qualitative approach, developed with nine men who were responding to a lawsuit for conjugal violence at the 1st and 2nd Courts of Justice of the Peace in Casa de Salvador, Bahia, Brazil. The research took place through a semi-structured interview, with its content recorded, transcribed and then submitted for validation by the men. Data were systematized based on the steps recommended by the categorical thematic content analysis. Results The study reveals that the father-son estrangement as a result of an emergency protective measure causes paternal bond rupture, promoting the development of psycho-emotional problems, such as anxiety, depression and suicidal ideation, often somatized and expressed from headache to conditions that require hospital care. Conclusion The commitment to the exercise of paternity also violates the right of children and adolescents to live with their father figure. Thus, there is a great need for the Brazilian National Policy for Comprehensive Care for Men's Health to include a management that prioritizes preventive actions against violence as well as providing psychosocial support to men.

Sporotrichosis caused by Sporothrix brasiliensis in Argentina: Case report, molecular identification and in vitro susceptibility pattern to antifungal drugs.

Sporotrichosis is considered a neglected disease of humans and animals in many regions of the world and is the most frequent implantation mycosis in Latin America. OBJECTIVES: To illustrate the zoonotic importance of the disease, describing a case involving a veterinarian and an infant that acquired the disease from a domestic cat and to describe, genotype and characterize these new isolates. METHODS: Direct examination of tissue samples from the two patients and feline lesions revealed the presence of Sporothrix yeast-like organisms. Fungal cultures and molecular identification of the strains were performed. Since antifungal susceptibility data of animal-borne isolates are scarce, the in vitro susceptibility testing by a microdilution reference method was determined against azoles, amphotericin B and terbinafine. RESULTS: Fungal culture and sequence analysis of the ITS region of rDNA and calmodulin and ß-tubulin genes confirmed the diagnosis and the causative agent as Sporothrix brasiliensis. In all cases, terbinafine was the most active drug, followed by posaconazole, itraconazole and voriconazole; the least active drugs were amphotericine B and fluconazole. Lack of clinical response in the veterinarian and in the infant to itraconazole and potassium iodide, respectively was observed. CONCLUSIONS: This study contributed to the molecular epidemiology of Sporothrix species in Argentina and the characterization of the in vitro susceptibility pattern of S. brasiliensis isolates recovered from a cat and two humans involved in this case of zoonotic sporotrichosis. Bearing in mind the "One Health" concept, the experience described in the present study highlights the need for future strategies for sporotrichosis treatment, control and prevention.

Funcionamiento familiar y estilos de vida saludable en pacientes con cáncer colorrectal, según características sociodemográficas / Functioning and healthy lifestyles in patients with colorectal canceraccording to sociodemographic characteristics

INTRODUCCIÓN: Las familias funcionales se caracterizan por la efectividad al manejar situaciones estresantes como grupo. Los estilos de vida saludable son las maneras de vivir, en sintonía con la protección de la salud integral. OBJETIVO: Analizar la relación entre el funcionamiento familiar y los estilos de vida saludable, con las variables sociodemográficas en familias de pacientes con cáncer colorrectal. MÉTODOS: Estudio descriptivo transversal. Se determinaron las características sociodemográficas mediante encuestas autoadministradas a 78 pacientes en tratamiento o post-tratamiento, que cumplieron los criterios de inclusión. Los instrumentos fueron la Escala de Funcionamiento Familiar (ASF-E)y de Health Promoting Lifestyle Profile II (HPLP II) en español. El análisis estadístico fue univariado y bivariado. Corresponde a un estudio con riesgo mínimo. RESULTADOS: La mayor parte de los participantes percibieron funcionamiento familiar medio/alto y se asoció con un alto nivel de estudios, recibir apoyo familiar permanente y pertenecer a una familia nuclear. Las conductas promotoras de salud más practicadas fueron crecimiento espiritual, responsabilidad en salud y relaciones interpersonales, la menos practicada fue la actividad física. Se asociaron positivamente con ser mujer, tener más de 62 años, ocuparse de las labores del hogar y recibir todo tipo de apoyo. CONCLUSIONES: Es vital valorar el funcionamiento familiar y los estilos de vida saludable durante la atención integral al paciente con cáncer colorrectal e involucrar a las familias en el cuidado, a partir del apoyo en todas sus formas, la práctica de actividad física, el cambio de hábitos de vida y relaciones familiares.

INTRODUCTION: Functional families are characterized by effectiveness in handling stressful situations as a group. Healthy lifestyles are ways of living, in tune with the protection of integral health. OBJECTIVE: To analyze the relationship between family functioning and healthy lifestyles, with sociodemographic variables in families of patients with colorectal cancer. METHODS: Cross-sectional descriptive study. Sociodemographic characteristics were determined through self-administered surveys of 78 patients in treatment or post-treatment, who met the inclusion criteria. The instruments were the Family Functioning Scale (ASF-E) and the Health Promoting Lifestyle Profile II (HPLP II) in Spanish. Statistical analysis was univariate and bivariate. It corresponds to a minimal risk study. RESULTS: Most of the participants perceived medium / high family functioning and associated with a high level of education, receiving permanent family support and belonging to a nuclear family. The most practiced health promoting behaviors were spiritual growth, responsibility in health and interpersonal relationships, the least practiced was physical activity. They were positively associated with being a woman, being over 62 years old, taking care of household chores and receiving all kinds of support. CONCLUSIONS: It is vital to assess family functioning and healthy lifestyles during comprehensive care for patients with colorectal cancer and to involve families in care, based on support in all its forms, the practice of physical activity, the change of life habitsand family relationships.

Characteristics of caregivers submitted to music therapy after the death of loved ones / Características de cuidadores sometidos a la musicoterapia después de la muerte de sus seres queridos / Características de cuidadores submetidos à musicoterapia após a morte de seus entes queridos

ABSTRACT Objective: To describe the characteristics of bereaved caregivers submitted to post-loss music therapy. Method: This is a cross-sectional database from a randomized clinical trial that performed music therapy for caregivers who lost their loved ones to cancer. The following variables were used for this analysis: sociodemographic, religious beliefs, previous sound-musical experiences, and experiences related to care, loss and repair processes. Descriptive statistical analyzes were performed. Results: Of the 69 participants, 85.5% had a strong bond/secure attachment with their loved ones; 68.1% followed a long death and dying process (> 6 months), which was related to a chronic disease; 88.4% did not participate in conspiracy of silence, suggesting a satisfactory communication; 60.9% reported receiving spiritual/religious support, suggesting healthy and continent support; and all participated in funeral rites. Conclusion: The process of elaborating the bereavement of caregivers indicated the presence of protective factors.

RESUMEN Objetivo: Describir las características de los cuidadores sometidos a la musicoterapia durante el luto. Método: Se trata de un corte transversal del banco de datos de un ensayo clínico aleatorizado, en el cual utilizó la musicoterapia en cuidadores que perdieron a sus seres queridos por cáncer. Para este análisis, se utilizaron las siguientes variables: sociodemográficas, creencias religiosas, experiencias sonoras y musicales previas, y vivencias relacionadas a los procesos de cuidado, pérdida y reparación. Se realizó un análisis estadístico descriptivo. Resultados: De los 69 participantes, el 85,5% tenían un vínculo fuerte/apego seguro con sus seres queridos; el 68,1% acompañaron un proceso de muerte y morir largo (> 6 meses), cuya muerte estuvo relacionada a una enfermedad crónica; el 88,4% no participaron en la conspiración de silencio, lo que sugiere una comunicación satisfactoria; el 60,9% estaban recibiendo apoyo espiritual/religioso, lo que sugiere un apoyo sano y contenido; y todos participaron en rituales fúnebres. Conclusión: El proceso de elaboración del luto de los cuidadores indicó la presencia de factores de protección.

RESUMO Objetivo: Descrever as características de cuidadores enlutados submetidos à musicoterapia pós-perda. Método: Trata-se de um corte transversal do banco de dados de um ensaio clínico randomizado que realizou musicoterapia para cuidadores que perderam seus entes queridos por câncer. Para esta análise utilizaram-se as seguintes variáveis: sociodemográficas, crenças religiosas, experiências sonoro-musicais pregressas e vivências relacionadas aos processos de cuidado, perda e reparação. Foram realizadas análises estatísticas descritivas. Resultados: Dos 69 participantes, 85,5% tinham um vínculo forte/apego seguro com os seus entes queridos; 68,1% acompanharam um processo de morte e morrer longo (> 6 meses), cuja morte está relacionada a uma doença crônica; 88,4% não participaram de conspiração de silêncio, sugerindo uma comunicação satisfatória; 60,9% referiram estar recebendo apoio espiritual/religioso, sugerindo apoio saudável e continente; e todos participaram de rituais fúnebres. Conclusão: O processo de elaboração do luto dos cuidadores indicou a presença de fatores de proteção.

Characteristics of caregivers submitted to music therapy after the death of loved ones.

OBJECTIVE: To describe the characteristics of bereaved caregivers submitted to post-loss music therapy. METHOD: This is a cross-sectional database from a randomized clinical trial that performed music therapy for caregivers who lost their loved ones to cancer. The following variables were used for this analysis: sociodemographic, religious beliefs, previous sound-musical experiences, and experiences related to care, loss and repair processes. Descriptive statistical analyzes were performed. RESULTS: Of the 69 participants, 85.5% had a strong bond/secure attachment with their loved ones; 68.1% followed a long death and dying process (> 6 months), which was related to a chronic disease; 88.4% did not participate in conspiracy of silence, suggesting a satisfactory communication; 60.9% reported receiving spiritual/religious support, suggesting healthy and continent support; and all participated in funeral rites. CONCLUSION: The process of elaborating the bereavement of caregivers indicated the presence of protective factors.

Parental occupational exposure to solvents and heavy metals and risk of developing testicular germ cell tumors in sons (NORD-TEST Denmark).

Objective The present study aims to assess if parental occupational exposure to solvents or heavy metals is associated with risk of testicular germ cell tumors (TGCT) in sons in Denmark. Methods The NORD-TEST Denmark included 3421 cases diagnosed with TGCT at ages 14-49 years in Denmark between 1981 and 2014. Controls (N=14 024) selected from the central population registry were matched to cases on birth year. The Danish Supplementary Pension Fund provided parental occupational information. A job-exposure matrix was used to assign exposures, and conditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI). Results The overall analyses showed no significant associations except for paternal exposure to a sub-group of "heavy metal(s) and solvent(s)" (OR 1.50, 95% CI 1.01-2.24). Most fathers in this category had worked in wood related jobs and were assigned exposure to chromium VI and toluene. Other sub-group analyses suggested that maternal exposure to aromatic hydrocarbon were associated with TGCT risk, in sons born in 1970-1979, and to heavy metals (chromium, iron and nickel) in sons born in 1980-1998. Conclusion NORD-TEST Denmark provides no strong support for an association between parental exposures to solvents or heavy metals and TGCT in sons, and only weak support for an association between paternal exposure to chromium and toluene and TGCT risk in sons.

Do the Constructs of the FACES IV Change Based on Definitions of "Family?" A Measurement Invariance Test.

The Family Adaptability and Cohesion Scale (FACES) IV does not provide instructions about which family members respondents should think about while answering questions. This study examined which family members respondents thought about while completing the FACES IV, and if this changed measurement invariance and population heterogeneity of the measure. Using a sample of n = 511 individuals, a latent class analysis showed three distinct classes: Nuclear Family, Family of Origin, and All of the Above. The FACES IV demonstrated measurement invariance across classes on the majority of subscales; however, population heterogeneity tests suggested that the means and variances of the subscales varied across classes. The findings suggest further examination of how the measure functions with unique family constellations is warranted.

The (Re) Production of the Genetically Related Body in Law, Technology and Culture: Mitochondria Replacement Therapy.

Advances in medicine in the latter half of the twentieth century have dramatically altered human bodies, expanding choices around what we do with them and how they connect to other bodies. Nowhere is this more so than in the area of reproductive technologies (RTs). Reproductive medicine and the laws surrounding it in the UK have reconfigured traditional boundaries surrounding parenthood and the family. Yet culture and regulation surrounding RTs have combined to try to ensure that while traditional boundaries may be pushed, they are reconstructed in similar ways. This paper looks at the most recent RT to be permitted in the UK, mitochondria (mtDNA) replacement therapy (MRT). Despite controversial media headlines surrounding the technique, MRT is in fact an example of how science and regulation seek to expand models of traditional relatedness in a way that doesn't challenge the existing order. Yet, like other RTs, while attempts are made to ensure it doesn't push traditional boundaries too far, fissures and inconsistencies appear in law and culture, which give interesting insights into how genetics, parentage and identity are being mediated in new but familiar ways.

A qualitative study to assess the potential of the human papillomavirus vaccination programme to encourage under-screened mothers to attend for cervical screening.

BACKGROUND: Coverage of the UK National Health Service Cervical Screening Programme is declining. Under-screened women whose daughters participate in the human papillomavirus (HPV) vaccination programme could be stimulated to attend. We investigated whether factors associated with the vaccination programme changed mothers' intentions for future screening. METHODS: Questionnaires were sent to mothers of girls aged 12-13 years across two North West primary care trusts (n=2387) to assess the effect of the HPV vaccination programme on screening intentions. This identified mothers whose intentions had changed. Consent was sought to contact them for a semi-structured interview to discuss their screening intentions. Key themes were identified using framework analysis. RESULTS: 97/606 women responding to the questionnaire had changed their views about cervical screening. 23 women were interviewed, 10 of whom expressed a positive change and 13 no change. Most had discussed the vaccine information, including cervical screening, with their daughters. Mothers who made a positive change decision recognised their daughters' risk of cervical cancer, the need for future screening, and the importance of their own example. In this way daughters became 'significant others' in reinforcing their mothers' cervical screening motivation. CONCLUSIONS: A daughter's invitation for HPV vaccination instigates a reassessment of cervical screening intention in some under-screened mothers.

When Opportunity Knocks Twice: Dual Living Kidney Donation, Autonomy and the Public Interest.

Living kidney transplantation offers the best treatment in terms of life-expectancy and quality of life for those with end-stage renal disease. The long-term risks of living donor nephrectomy, although real, are very small, with evidence of good medium-term outcomes. Who should be entitled to donate, and in which circumstances, is nevertheless a live question. We explore the ethical dimensions of a request by an individual to donate both of their kidneys during life: 'dual living kidney donation'. Our ethical analysis is tethered to a hypothetical case study in which a father asks to donate a kidney to each of his twin boys. We explore the autonomy of the protagonists, alongside different dimensions of the public interest, such as the need to protect not only the recipients, but also the donor and even the wider community. Whilst acknowledging objections to 'dual-donation', not least by reference to the harms that the donor might be expected to endure, we suggest there is a prima facie case for permitting this, provided that both donor and recipients are willing and that due attention is paid to such considerations as the autonomy and welfare of all parties, as well as to the wider ramifications of acting on such a request. We argue for broader interpretations of the concepts of autonomy and welfare, recognizing the importance of relationships and the relevance of more than merely physical well-being. Equipped with such a holistic assessment, we suggest there is a prima facie case for allowing 'dual living kidney donation'.

Tumoral Calcinosis as an Initial Complaint of Juvenile-Onset Amyopathic Dermatomyositis

Calcinosis is rarely observed in juvenile-onset amyopathic dermatomyositis in contrast to juvenile-onset dermatomyositis. A 6-year-old female presented with several 0.5 to 2 cm-sized painless grouped masses on both knees for 3 years. The patient also presented with multiple erythematous scaly patches and plaques on both elbows, knuckles, buttock, ankles and cheeks. Her mother had similar skin lesions which were erythematous scaly patches on the knuckles and elbows, since her childhood. When skin biopsy was performed from a left knee nodule, liquid chalky discharge was observed. The biopsy results were consistent with calcinosis cutis. Other biopsies from erythematous patch of the patient and erythematous patch of her mother showed vacuolization of basal cell layer with inflammatory cell infiltrations. Laboratory findings showed normal range of serum phosphorus (4.5 mg/dl), calcium (9.3 mg/dl), 1,25-dihydroxy-vitamin D (10.8 ng/ml) and parathyroid hormone levels (11 pg/ml). Both patient and her mother had no history of muscle weakness and showed normal levels of muscle-specific enzyme. Both patients were diagnosed with juvenile-onset amyopathic dermatomyositis based on histopathology and cutaneous manifestations with no evidence of muscle weakness and no serum muscle enzyme abnormalities. Tumoral calcium deposits observed in daughter was diagnosed as dystrophic calcinosis which can be rarely seen in juvenile-onset amyopathic dermatomyositis. The patient is being treated with oral acetazolamide (40 mg/kg/d) for calcinosis.

Diet and Health Status of Elderly Women According to the Family Type / 대한지역사회영양학회지

OBJECTIVES: This study aimed to evaluate the diet and health status of elderly women according to the family type. METHODS: A total of 307 elderly women participated in this study were divided into one of three groups according to their family type: residing with spouse (RSP; n=88), residing with son or daughter (RSD; n=119), and residing alone (RAL; n=100). Chi-square test was used to assess dietary habits and health status of the subjects by the family types. RESULTS: Results demonstrated significant associations between eating regular meals, person preparing meals, coffee intake, and bone fracture experience and family type. Among the three groups, the RSP and RAL groups had a higher percentage for preparing meals by themselves (p<0.001) than the RSD group. The RAL group had a lower percentage for eating regular meals (p<0.01) but a higher percentage for bone fracture experience (p<0.05) than the other groups. There were no significant differences in monthly allowance, self-estimated health status, physical activity, exercise, drinking, and dietary habits such as frequency of consumption of dairy, beans, eggs, fish, meat, fruits, and vegetables among the three groups. CONCLUSIONS: The results showed that elderly women residing alone without a son, daughter, or spouse had more diet-related and health problems such as irregular meals and high bone fracture experience. These findings suggested that elderly women residing alone need more attention and support.