Future patterns in burden and incidence of squamous cell carcinoma of the anus in the United States, 2001-2035.

Squamous cell carcinoma of the anus (SCCA) incidence has been rising in the United States, particularly among older adults (≥65 years). We estimated the impact of this rise on future burden (through 2035) using age-period-cohort modeling. The SCCA burden (cases/year) is expected to rise, reaching ∼2700 among men and ∼7000 among women in 2031-2035 (burden during 2016-2020 among men and women was ∼2150 and ∼4600), with most cases aged ≥65 years (61% in men and 70% in women in 2031-2035; from 40% and 46% in 2016-2020). SCCA incidence (per 100,000) is projected to rise among older men aged 65-74, 75-84, and ≥85 years (5.0, 4.9, and 4.3, in 2031-2035 vs 3.7, 3.8, 3.4 in 2016-2020) and women (11.2, 12.6, 8.0 in 2031-2035 vs 8.2, 6.8, 5.2 in 2016-2020). The projected rise in SCCA burden among older adults is troubling and highlights the importance of improving early detection and clinical care.

Extended Pharmacologic Prophylaxis for Venous Thromboembolism after Colon Cancer Surgery is Associated with Improved Long-term Survival: A Natural Experiment in the Chemotherapeutic Benefit of Heparin Derivatives.

OBJECTIVE: This large database study assessed whether extended pharmacologic prophylaxis for venous thromboembolism after colon cancer resection was associated with improved oncologic survival. BACKGROUND: Heparin-derivatives may confer an anti-neoplastic effect via a variety of mechanisms (e.g. inhibiting angiogenesis in the tumor microenvironment). Studies evaluating the oncologic benefit of heparin and its derivatives have been limited in post-surgical patients. Multiple society guidelines recommend consideration of 30-day treatment with low molecular weight heparin to reduce venous thromboembolism risk after abdominopelvic cancer surgery. However, utilization of extended prophylaxis remains low. METHODS: Surveillance, Epidemiology, and End Results-Medicare data were used to identify patients (age 65+) undergoing resection for non-metastatic colon cancer from 2016-2017. The primary outcomes were overall and cancer-specific survival. Log-rank testing and multivariable Cox regression compared survival in patients who received extended prophylaxis versus those that did not in an inverse propensity treatment weighted cohort. RESULTS: 20,102 patients were included in propensity-weighting and analyzed. 800 (3.98%) received extended pharmacologic prophylaxis. Overall and cancer-specific survival were significantly higher in patients receiving prophylaxis on log-rank tests (P=0.0017 overall, P=0.0200 cancer-specific). Multivariable Cox regression showed improved overall survival [aHR 0.66 (0.56-0.78)] and cancer-specific survival [aHR 0.56 (0.39-0.81)] with prophylaxis after controlling for patient, treatment, and hospital factors. CONCLUSIONS: Extended pharmacologic prophylaxis after colon cancer resection was independently associated with improved overall and cancer-specific survival. These results suggest a potential anti-neoplastic effect from heparin derivatives when used in the context of preventing post-surgical venous thromboembolism.

Predicting Accelerometer-Assessed Estimates of Adolescents' Multidimensional Physical Activity: A Self-Determination Theory Approach.

Based on the tenets in self-determination theory, a dual-process model of motivational processes was tested to predict accelerometer-assessed estimates of adolescents' light physical activity (LPA), moderate to vigorous physical activity (MVPA), and sedentary time. Here, we hypothesized that (a) perceptions of psychological need support for exercise would be positively associated with LPA and MVPA and negatively associated with sedentary time via exercise-related psychological need satisfaction and autonomous exercise motivation and (b) perceptions of psychological need thwarting for exercise would be negatively associated with LPA and MVPA and positively associated with sedentary time via exercise-related psychological need frustration and controlled exercise motivation. Adolescents (N = 338; 234 female) age 11-15 years (M = 12.75, SD = .90) wore an ActiGraph accelerometer for 8 days and completed questionnaires pertaining to the self-determination-theory variables. Results showed psychological need support to indirectly and positively predict LPA and MVPA via psychological need satisfaction and autonomous exercise motivation. Although directly predictive of need frustration and indirectly predictive of controlled motivation and amotivation, the hypothesized effects from psychological need thwarting to the behavioral outcomes were nonsignificant. The current findings highlight the important role that need-supportive environments play in facilitating autonomous exercise motivation and behavior by being conducive to exercise-related psychological need satisfaction.

"It's a bit exasperating to be locked up"- an exploration of Mexican adolescents' perceived barriers and facilitators for physical activity and healthy eating / "É um pouco irritante estar preso" - uma exploração das barreiras e facilitadores percebidos pelos adolescentes mexicanos para a prática de atividade física e alimentação saudável

Mexican adolescents' diet and physical activity levels fall short of recommendations for health. The aim of this study was to explore Mexican adolescents' perceived barriers and facilitators of physical activity and healthy eating. Twelve single-sex focus groups were conducted in six secondary schools in Mexico City during three months from October 2016. Data were analysed via inductive thematic analysis. Three themes were identified, namely: understanding the health-behaviour link, the impact of a restricted life, and social support. Participants understood how physical activity contributes to multiple dimensions of health, and how diet contributes to physical health. They also identified so-cialising, having fun, and stress relief as facilitators of PA, and knowledge and the desire for healthy food as facilitators for healthy eating. Barriers included inadequate facilities, insufficient time within current school structures, and inadequate social support from teachers. Context-specific physical activity barriers of neighbourhood safety concerns, and limited family support were also reported. Participants had a basic knowledge of healthy eating but showed little motivation to improve their diet. In conclusion, the findings of this study suggest that improvement of opportunities for safe outdoor time, social support, and availability of healthy food would be useful to explore to promote the health behaviours of Mexican adolescents.

A dieta e os níveis de atividade física dos adolescentes mexicanos estão aquém das recomendações para a saú-de. O objetivo deste estudo foi explorar as barreiras percebidas por adolescentes mexicanos e facilitadores da atividade física e da alimentação saudável. Doze grupos focais unissexuais foram realizados em seis escolas secundárias na Cidade do México durante três meses a partir de outubro de 2016. Os dados foram analisados por meio da Análise Temática Indutiva. Foram identificados três temas: compreensão do nexo saúde-comportamento, impacto da restrição de vida e apoio social. Os participantes compreenderam como a atividade física contribui para múltiplas dimensões da saúde e como a dieta contribui para a saúde física. Identificaram a socialização, a diversão e o alívio do estresse como facilitadores da atividade física, e o conhecimento e o desejo por alimentos saudáveis como facilitadores para uma alimentação saudável. As barreiras incluíram instalações inadequadas, tempo insuficiente dentro das estruturas escolares atuais e apoio social inadequado dos professores. Barreiras de atividade física específicas do contexto de preocupações com a segurança da vizinhança e suporte familiar limitado também foram relatados. Os participantes tinham um conhecimento básico sobre alimentação saudável, mas mostraram pouca motivação para melhorar sua dieta. Em conclusão, os resultados deste estudo sugerem que a melhoria das oportunidades de tempo seguro ao ar livre, apoio social e disponibilidade de alimentos saudáveis seria útil para explorar para promover os comportamentos de saúde de adolescentes mexicanos.