Non-asbestiform elongate mineral particles and mesothelioma risk: Human and experimental evidence.

The presentations in this session of the Monticello II conference were aimed at summarizing what is known about asbestiform and non-asbestiform elongate mineral particles (EMPs) and mesothelioma risks based on evidence from experimental and epidemiology studies. Dr. Case discussed case reports of mesothelioma over the last several decades. Dr. Taioli indicated that the epidemiology evidence concerning non-asbestiform EMPs is weak or lacking, and that progress would be limited unless mesothelioma registries are established. One exception discussed is that of taconite miners, who are exposed to grunerite. Drs. Mandel and Odo noted that studies of taconite miners in Minnesota have revealed an excess rate of mesothelioma, but the role of non-asbestiform EMPs in this excess incidence of mesothelioma is unclear. Dr. Becich discussed the National Mesothelioma Virtual Bank (NMVB), a virtual mesothelioma patient registry that includes mesothelioma patients' lifetime work histories, exposure histories, biospecimens, proteogenomic information, and imaging data that can be used in epidemiology research on mesothelioma. Dr. Bernstein indicated that there is a strong consensus that long, highly durable respirable asbestiform EMPs have the potential to cause mesothelioma, but there is continued debate concerning the biodurability required, and the dimensions (both length and diameter), the shape, and the dose associated with mesothelioma risk. Finally, Dr. Nel discussed how experimental studies of High Aspect Ratio Engineered Nanomaterials have clarified dimensional and durability features that impact disease risk, the impact of inflammation and oxidative stress on the epigenetic regulation of tumor suppressor genes, and the generation of immune suppressive effects in the mesothelioma tumor microenvironment. The session ended with a discussion of future research needs.

Intimate Partner Violence and Barriers to Help-Seeking Among Black, Asian, Minority Ethnic and Immigrant Women: A Qualitative Metasynthesis of Global Research.

It is well known that victims of intimate partner violence experience numerous barriers to leaving abusive relationships. For ethnic minority and immigrant women these barriers are significantly exacerbated. This metasynthesis explored barriers to help-seeking as experienced by Black, Asian, minority ethnic and immigrant women with experience of intimate partner violence. A review of worldwide literature published in English in peer-reviewed journals on this topic from 2000 to July 2020 produced 2597 relevant articles. After removing duplicates and applying the exclusion criteria, a total of 47 articles were selected for inclusion in the review. The synthesis found that these women faced additional barriers as a result of institutional racism, immigration laws, culture and religion, and issues of cultural competence, and lack of diversity within frontline services. Such barriers, from a range of formal and informal resources, services and other mechanisms of support, served to exacerbate feelings of fear, threat, isolation and powerlessness. The barriers were also further weaponised by perpetrators in order to extend their reign of terror and control. As a result, women were caught in a double-bind - stay in an abusive relationship or face further threats and consequences if they attempted to leave. Whilst our search criteria focused on barriers to help-seeking, many of the papers included in our synthesis also explored facilitators to help-seeking, which are included in our findings and overwhelmingly relate to informal support from females.

Continuous Traumatic Stress: Examining the Experiences and Support Needs of Women After Separation From an Abusive Partner.

Intimate partner violence causes significant, long-lasting harm to almost one-third (27%) of the world's population of women. Even when women leave abusive relationships, some men continue to exercise control over their ex-partners through psychological control, threats, violence, stalking, and other forms of harassment. In this qualitative study, 52 purposively sampled women who self-identified as victims or survivors of intimate partner violence (IPV) from male partners were interviewed. Data were analyzed with a theoretically informed thematic analysis, supported by Nvivo® software. We found that leaving a violent relationship was a long-term process fraught with difficulty and ongoing risks of psychological harm. The concept of Continuous Traumatic Stress (CTS), first developed to understand the impact of state-sponsored violence and war, was found to be a particularly useful tool for the analysis of the impact of post-separation abuse. Additionally, CTS encourages researchers and practitioners to think anew about resilience-centered approaches to improving protection and access to justice for female victims.

Evaluation of a novel moving threshold gating strategy for assessment of reticulated platelets in dogs using the ADVIA 2120 analyzer.

BACKGROUND: A novel method using a moving threshold (r-PLTmt) to determine canine r-PLTs (reticulated platelets) has been introduced for ADVIA 2120 software v6.11.7. OBJECTIVES: We aimed to evaluate absolute (ar-PLTmt) and percent (%r-PLTmt) prior to and after visual inspection of scattergrams (ar-PLTmtv, %rPLTmtv) compared with flow cytometry (flow) and to determine reference intervals (RIs) in 120 dogs. METHODS: For method comparison, 42 blood samples of healthy and thrombocytopenic dogs were included. Calculation of Spearman's rho, Bland-Altman, and Passing-Bablok analysis was performed. Coefficients of variation (CVs) were determined for three concentration levels. RESULTS: Moderate correlations between %r-PLTmt and %r-PLTmtv (rs 0.75-0.76) were seen compared with flow cytometry. The CV for medium %r-PLTs counts assessed with flow cytometry was 12.9%. Comparable CVs were obtained for ar-PLTmt (14.4%) and %r-PLTmt (15.7%), and ar-PLTmtv and %r-PLTmtv (10.9% and 12.9%, respectively). At low and high concentration levels, CVs for % and absolute r-PLTmt/rPLTmtv ranged between 23%-30% and 15%-20%. In patients with microcytic hypochromic erythrocytes, CVs for ar-PLTmt and %r-PLTmt were 36%-66%. Visual inspection of scattergrams resulted in a marked decrease in CV ranging between 15% and 20%. A proportional bias of 10.8% between %r-PLTmt and flow cytometry became lower (9.7%) after visual validation of scattergrams. Passing-Bablok analysis showed proportional and constant error. RIs for r-PLTmt and r-PLTmtv were 0.2%-3.8% and 0.6-10.2 × 109 /L and 0.3%-4.5% and 1.1-10.3 × 109 /L, respectively. Median values for %r-PLTmtv were higher in young adults (≤2 years) than in older dogs (P = 0.03). CONCLUSIONS: r-PLTmt and r-PLTmtv were moderately correlated with flow cytometry. Visual inspection of scattergrams is recommended.

Well-being programmes in prisons in England and Wales: a mixed-methods study.

PURPOSE: In the past decade, there has been growing awareness of well-being and its importance and an increase in the development of activities or programmes aimed at improving well-being. The purpose of this study is to investigate what well-being programmes were being offered to prisoners in England and Wales and what benefits and other outcomes were experienced. DESIGN/METHODOLOGY/APPROACH: The study used a mixed-methods exploratory design in two phases. Phase 1 was a questionnaire survey of all adult prisons in England and Wales, completed by prison staff. In Phase 2, a sample of survey respondents took part in in-depth interviews. FINDINGS: The programmes identified in Phase 1 included physical activities, creative arts, mindfulness, horticulture, reading and animal-assisted activities. Prison staff reported a range of universally positive outcomes shared by all programmes, including enthusiasm from prisoners, enjoyment of the activities and being able to do something different from the usual prison routine. However, in Phase 2, interviewees rarely mentioned direct health and well-being benefits. The impetus for programmes was varied and there was little reference to national policy on health and well-being; this reflected the ad hoc way in which programmes are developed, with a key role being played by the Well-being Officer, where these were funded. ORIGINALITY/VALUE: The literature on well-being programmes in prisons is limited and tends to focus on specific types of initiatives, often in a single prison. This study contributes by highlighting the range of activities across prisons and elucidating the perspectives of those involved in running such programmes.

Nature-based interventions in institutional and organisational settings: a scoping review.

The objective of this review was to scope the literature on nature-based interventions that could be conducted in institutional settings where people reside full-time for care or rehabilitation purposes. Systematic searches were conducted across CINAHL, Medline, Criminal Justice Abstracts, PsycINFO, Scopus, Social Care Online and Cochrane CENTRAL. A total of 85 studies (reported in 86 articles) were included. Four intervention modalities were identified: Gardening/therapeutic horticulture; animal-assisted therapies; care farming and virtual reality-based simulations of natural environments. The interventions were conducted across a range of settings, including inpatient wards, care homes, prisons and women's shelters. Generally, favourable impacts were seen across intervention types, although the reported effects varied widely. There is a growing body of literature on nature-based interventions that could be applied to a variety of institutional settings. Within most intervention types, there is sufficient research data available to perform full systematic reviews. Recommendations for future systematic reviews are offered.

Mortality and cancer incidence in aluminum smelter workers: a 5-year update.

OBJECTIVE: To determine the mortality and cancer incidence of aluminum smelter workers. METHOD: The experience of 17,089 workers between 1950 and 2004 was studied. RESULTS: There were 25 deaths/47 female incident cancers and 6350 deaths/3984 male incident cancers. Mortality was significantly elevated for chronic obstructive pulmonary disease, Alzheimer disease (likely influenced by regional factors), all cancers, stomach, bladder, and lung cancers. Incidence was significantly elevated for bladder, lung, and laryngeal cancers. Digestive, lung, and bladder cancer mortality and lung, bladder, and buccal cancer incidence increased significantly with benzo(a)pyrene (B(a)P) exposure. Over time lung cancer risk has diminished but bladder cancer risk has not. CONCLUSIONS: Bladder cancer incidence was not increased at B(a)P exposures below 40 µg/m·yr. Occupational origins for other cancers occurring above expected rates but probably unrelated to B(a)P exposure cannot be excluded. In the prebake plant, nonsignificant increases of lung cancer were observed between 2000 and 2004.

Cancer risks in aluminum reduction plant workers: a review.

OBJECTIVE AND METHODS: This review examines epidemiological evidence relating to cancers in the primary aluminum industry where most of what is known relates to Söderberg operations or to mixed Söderberg/prebake operations. RESULTS AND CONCLUSIONS: Increased lung and bladder cancer risks have been reported in Söderberg workers from several countries, but not in all. After adjustment for smoking, these cancer risks still increase with cumulative exposure to benzo(a)pyrene, used as an index of coal tar pitch volatiles exposure. Limited evidence has been gathered in several cohorts for an increased risk of tumors at other sites, including stomach, pancreas, rectum/rectosigmoid junction, larynx, buccal cavity/pharynx, kidney, brain/nervous system, prostate, and lymphatic/hematopoietic tissues (in particular non-Hodgkin lymphoma, Hodgkin disease, and leukemia). Nevertheless, for most of these tumor sites, the relationship with specific exposures has not been demonstrated clearly and further follow-up of workers is warranted.

Flow cytometry in clinical pathology.

Flow cytometry has had an impact upon all areas of clinical pathology and now, in the 21st century, it is truly coming of age. This study reviews the application of flow cytometry within clinical pathology with an emphasis upon haematology and immunology. The basic principles of flow cytometry are discussed, including the principles and considerations of the flow-cell and hydrodynamic focusing, detector layout and function, use of fluorochromes and multicolour flow cytometry (spectral overlap and colour compensation), alongside the strategies available for sample preparation, data acquisition and analysis, reporting of results, internal quality control, external quality assessment and flow sorting. The practice of flow cytometry is discussed, including the principles and pitfalls associated with leukocyte immunophenotyping for leukaemia and lymphoma diagnosis, immune deficiency, predicting and monitoring response to monoclonal antibody therapy, rare event detection and screening for genetic disease. Each section is illustrated with a case study. Future directions are also discussed.

Silica exposure assessment in a mortality study of Vermont granite workers.

A study of past silica and respirable dust exposures in the Vermont granite industry was conducted to develop a job exposure matrix (JEM) that used 5204 industrial hygiene measurements made from 1924-2004. The construction of the JEM involved data entry from several original sources into an Excel database that was reviewed later to ensure accuracy. Exposure measurements by job or location were grouped in two broad categories of quarry or shed and then into 22 job classes. Missing exposure data by time period were computed, taking into account improvements in dust control and periods of significant reduction in dustiness. Percent free silica (α-quartz) in respirable dust was estimated to be 11.0% based on previous published studies in Vermont and on data in the current database. About 60% of all measurement data (primarily from years prior to 1972) were obtained using the impinger and expressed in millions of particles per cubic foot (mppcf), which were converted to equivalent respirable free silica concentrations using the conversion of 10 mppcf = 0.1 mg/m(3) of respirable silica. For impinger data, respirable dust was calculated by multiplying respirable silica by a factor of 9.091 to reflect that the respirable silica was 11.0% respirable dust. This JEM has been used in a recent epidemiologic study to assess mortality in Vermont granite workers and to examine the relationships among mortality from silicosis, lung cancer, and other nonmalignant respiratory diseases.

Mortality in Vermont granite workers and its association with silica exposure.

OBJECTIVES: To assess mortality in Vermont granite workers and examine relationships between silica exposure and mortality from lung cancer, kidney cancer, non-malignant kidney disease, silicosis and other non-malignant respiratory disease. Methods Workers employed between 1947 and 1998 were identified. Exposures were estimated using a job-exposure matrix. Mortality was assessed through 2004 and standardised mortality ratios (SMRs) were computed. Associations between mortality and exposure to silica were assessed by nested case-control analyses using conditional logistic regression. Results 7052 workers had sufficient data for statistical analysis. SMRs were significantly elevated for lung cancer (SMR 1.37, 95% CI 1.23 to 1.52), silicosis (SMR 59.13, 95% CI 44.55 to 76.97), tuberculosis (SMR 21.74, 95% CI 18.37 to 25.56) and other non-malignant respiratory disease (SMR 1.74, 95% CI 1.50 to 2.02) but not for kidney cancer or non-malignant kidney disease. In nested case-control analyses, significant associations with cumulative exposure to respirable free silica were observed for silicosis (OR 1.13, 95% CI 1.05 to 1.21 for each 1 mg/m(3)-year increase in cumulative exposure) and other non-malignant respiratory disease (OR 1.10, 95% CI 1.03 to 1.16) but not for lung cancer (OR 0.99, 95% CI 0.94 to 1.03), kidney cancer (OR 0.96, 95% CI 0.84 to 1.09) or non-malignant kidney disease (OR 0.95, 95% CI 0.84 to 1.08). Conclusions Exposure to crystalline silica in Vermont granite workers was associated with increased mortality from silicosis and other non-malignant respiratory disease, but there was no evidence that increased lung cancer mortality in the cohort was due to exposure. Mortality from malignant and non-malignant kidney disease was not significantly increased or associated with exposure.

Pseudobasophilia and the Advia 120.

Pseudobasophilia is an analyzer phenomenon whereby abnormal cells in the peripheral blood are counted as basophils. Previously described on the Technicon H-series hematology analyzers, pseudobasophilia is also a technical consideration on the Advia 120. Sometimes seen as a hindrance to inexperienced users, an understanding of the basophil (baso) method and baso cytogram produced by the Advia 120 can be utilized to alert the laboratory scientist and clinician to the possible presence of an abnormal cell population in the peripheral blood. Cytogram analysis should form part of routine laboratory practice and the present annotation aims to offer some assistance to users of the Advia 120 and Advia 2120.

Análise de dados qualitativos / Analyzing qualitative data

Este livro oferece uma base para analisar todos os tipos de dados qualitativos verbais, como entrevistas, grupos focais e biografias. Examina as várias abordagens e as questões práticas relacionadas ao entendimento dos dados qualitativos. Destaca o uso da informática na pesquisa qualitativa e auxilia na elaboração descritiva dos dados.

An evaluation of the risks of lung cancer and mesothelioma from exposure to amphibole cleavage fragments.

Amphiboles are hydrated mineral silicates five of which occur in asbestiform habits as asbestos grunerite (amosite) asbestos, riebeckite (crocidolite) asbestos, anthophyllite asbestos, tremolite asbestos and actinolite asbestos] and non-asbestiform habits (grunerite, riebeckite, anthophyllite, tremolite and actinolite). The asbestiform varieties are characterized by long, thin fibers while non-asbestiform varieties such as cleavage fragments form short fibers with larger widths. The U.S. regulatory method for counting asbestos fibers (aspect ratio > or = 3:1, length > or = 5 microm) does not distinguish between asbestos and cleavage fragments. The method biases toward increased counts of non-asbestiform cleavage fragments compared to long, thin asbestos fibers. One consequence of this regulatory approach is that workers can be erroneously classified as exposed to concentrations of asbestos (asbestiform amphiboles) above the U.S. 0.1 f/mL exposure standard when in fact they are not exposed to asbestos at all but non-asbestiform amphibole cleavage fragments. Another consequence is that the known carcinogenic effects of asbestos may be falsely attributed to non-asbestiform amphibole cleavage fragments of the same mineral. The purpose of this review is to assess whether amphibole cleavage fragments pose the same risk of lung cancer and mesothelioma characteristic of amphibole asbestos fibers. We identified three groups of workers exposed to non-asbestiform amphiboles: two groups exposed to grunerite (Homestake gold miners and taconite miners) and one group exposed to industrial talc containing non-asbestiform tremolite and anthophyllite in St. Lawrence County, NY. In addition to assessing strength of association and exposure-response trends in the non-asbestiform amphibole cohorts, comparisons were also made with cohorts exposed to the asbestiform counterpart (positive control) and cohorts exposed to the mineral (e.g. talc) that does not contain amphiboles (negative controls). The cohorts exposed to non-asbestiform amphiboles had no excesses of lung cancer or mesothelioma. Similar results were observed in the negative control groups, in stark contrast to the excess risks of asbestos-related disease found in the asbestos cohorts. The only possible exception is the twofold increased risk of lung cancer where exposure was to industrial talc containing cleavage fragments of tremolite and anthophyllite. However, this risk is not considered attributable to the talc or amphibole cleavage fragments for several reasons. A similar increased risk of lung cancer was found in Vermont talc workers, studied in the same time period. Their exposure was to relatively pure talc. There was no relationship between lung cancer mortality and exposure measured as mg/m(3)years and years worked. A case-control study reported that all the lung cancer cases were smokers (or former smokers) and attributed the excess to smoking. There were two mesothelioma cases among the NY State talc workers exposed to cleavage fragments of tremolite and anthophyllite, but talc is not a plausible cause because of too short latency and potential for previous asbestos exposure. The positive controls of tremolite asbestos and anthophyllite asbestos exposed workers showed excess risks of both lung cancer and mesothelioma and positive exposure-response trends. St. Lawrence, NY talc does not produce mesotheliomas in animals while amphibole asbestos does. In sum, the weight of evidence fully supports a conclusion that non-asbestiform amphiboles do not increase the risk of lung cancer or mesothelioma.