11 research outputs found
Migrating Possibilities: Jonathan Escoffery's "In Flux" and "Independent Living"
No full textThe first- and second-generation immigrant characters in Jonathan Escoffery’s short story collection If I Survive You (2022) struggle to belong as they navigate racism, a precarious existence in a foreign country, and familial conflicts. Both the precarity characteristic of the migrant condition and the histories of colonialism, with its enduring legacy in shaping contemporary migration flows from the so-termed Global South to the North, come to be highlighted by Escoffery through these works of short fiction. The eight stories, though they may be read as parts of a whole, are nonetheless separate, self-contained literary works. It is through his characters and their trajectories that Escoffery critiques institutionalized racism and the facile promises that the term “American dream” embodies. In this article two short stories from If I Survive You, “In Flux” and “Independent Living,” are analyzed with a view to opening up a larger academic discussion on how writers such as Escoffery, reflecting deterritorialization through the form of the short story and the English language, may be seen as opening up the borders of what may be referred to as American literary fiction. The article also explores how the character/narrator Trelawny may be seen as an attempt at autofiction by the author, whose life has followed a similar trajectory, and how that becomes an important aesthetic choice for Escoffery’s politics of literary representation of the transnational Jamaican-American community
The Pathology of Breast Cancer in Jamaica: The National Public Health Laboratory Study
No full textObjective: To document the pathologic features of breast cancer in Jamaica.
Methods: The pathology reports and slides of all patients diagnosed with breast cancer at the National Public Health Laboratory between January 1999 and December 2002 were reviewed. Patient age and gender, side involved, number of tumours identified, tumour size, histologic type, histologic grade, degree of lymph node involvement and parish of origin of the specimens were documented.
Results: There were 772 patients, 762 females and 10 males; age range 21 to 96 (mean 57.9 ± 15.9) years. There were 778 specimens (6 bilateral cases), the majority of whom originated from Kingston and St Andrew (34.7%). Manchester (22.9%), St Catherine (13.9%) and St Ann (7.3%) were the next most common sources. The left breast was involved in 50.5% of cases. Gross tumour was identified in 641 (82.4%) specimens, the number of tumours ranging from 1 – 6 (mean 1.1 ± 0.6). The maximum gross tumour dimension ranged from 0.3 to 15 cm (mean 4.1 ± 2.7 cm). Infiltrating duct carcinoma was the predominant histologic type (69.3 %); 13.3%, 49.5% and 37.2 % of all infiltrating tumours were
well, moderately and poorly differentiated respectively. In-situ lesions (7.1% of tumours) were all of the ductal phenotype. Axillary lymph nodes were submitted in 296 (38.1%) cases; metastatic disease was identified in 224 (75.7%) of these. The total number of nodes submitted ranged from 1 – 34 (mean 10.8 ± 6.7) with an average of 6.1 (± 5.8) being positive for metastases (range 1 – 29).
Conclusions: The pathologic features of breast cancer documented in this series including average tumour size, histologic types and grade and the degree of lymph node involvement are consistent with patient presentation at relatively advanced stages of disease and highlight the urgent need for public health intervention including a national screening programme.
Keywords: Breast cancer, screening programme
"La Patología del Cáncer de Mamas en Jamaica: Estudio del Laboratorio Nacional de Salud Pública"
RESUMEN
Objetivo: Documentar los aspectos patológicos del cáncer de mamas en Jamaica.
Métodos: Se revisaron los reportes y diapositivas de patología de todas las pacientes diagnosticadas con cáncer de mamas en el Laboratorio Nacional de Salud Pública entre enero de 1999 y diciembre de 2002. Se documentaron la edad y el género de los pacientes, el lado afectado, el número de tumores identificados, el tamaño del tumor, el tipo histológico, el grado histológico, el nivel del nódulo linfático,
y el distrito de origen de los especimenes.
Resultados: Hubo 772 pacientes (762 hembras y 10 varones); el rango de edad 21 a 96 (media 57.9 ± 15.9) años. Hubo 778 especimenes (6 casos bilaterales), la mayor parte de los cuales provenían de Kingston y St Andrew (34.7%). Manchester (22.9%), St Catherine (13.9%), y St Ann (7.3%) fueron las siguientes fuentes más comunes. La mama izquierda estaba afectada en el 50.5% de los casos. El tumor macroscópico se identificó en 641 (82.4%)especimenes, fluctuando el número de tumores de 1– 6 (media 1.1 ± 0.6). La dimensión máxima del tumor macroscópico osciló de 0.3 a 15 cm. (media 4.1 ± 2.7 cm). El carcinoma ductal infiltrante fue el tipo histológico predominante (69.3%). El 13.3%,
49.5% y 37.2% de todos los tumores infiltrantes estaban bien, moderadamente y pobremente diferenciados respectivamente. Las lesiones in situ (7.1% de los tumores) fueron todas del fenotipo ductal. Nódulos linfáticos axilares fueron sometidos en 296 (38.1%) de los casos; la enfermedad
metastática se identificó en 224 (75.7%) de éstos. El número total de nódulos sometidos fluctuó de 1 – 34 (media 10.8 ± 6.7) con un promedio de 6.1 (± 5.8) positivo a las metástasis (rango 1 – 29).
Conclusiones: Los aspectos patológicos del cáncer de mamas documentados en esta serie incluyendo el tamaño del tumor, el tipo histológico, y el grado y nivel de afectación del nódulo linfático, concuerdan con la presentación del paciente en etapas relativamente avanzadas de la enfermedad y subrayan la necesidad urgente de la intervención de la salud pública, incluyendo un programa nacional de pesquisaje.
Palabras claves: Cancer de mamas, programa de pesquisaj
Utility of Rapid Staining of Fine Needle Aspiration Smears at the University Hospital of the West Indies
No full textIn a prospective study at the University Hospital of the West Indies, 187 fine needle aspiration cytology (FNAC) specimens, comprising 100 breast, 75 head and neck, and 12 miscellaneous specimens, were subjected to rapid Papanicolaou staining and immediate assessment. Inadequate aspirates were repeated, and all cases were also evaluated after routine Papanicolaou staining. Histologic and clinical follow-up data were obtained. The overall concordance between rapid and routine cytologic diagnoses ranged from 79% to 87% for the three specimen cohorts. Sensitivity and specificity values were similar for rapid and routine-stained slides and ranged from 80% to 100%. There were no false positive or false negative diagnoses in the cases for which the outcome was known. Rapid staining of cytologic smears is a useful adjunct to the evaluation of aspirated material, improving adequacy rates and overall performance of the FNAC service, and should also result in significant savings in time and cost to patients
Clinicopathologic Features of Breast Disease in Jamaica: Findings of The Jamaican Breast Disease Study, 2000–2002
No full textHistopathological Findings in Women with Postmenopausal Bleeding in Jamaica
No full textWe investigated the histopathological findings in women presenting with postmenopausal bleeding in a population predominantly of African descent by conducting a six-year retrospective study of 716 gynaecological surgical specimens from 629 women accessed in the Department of Pathology, The University of the West Indies, Jamaica. Histopathological diagnoses were correlated with patient age, specimen volume, duration of bleeding and length of postmenopausal interval at presentation using ttests and linear regression models. The mean (SD) age was 63.6 (9.3) years.
The frequency of the main causes of postmenopausal bleeding was: endometrial hyperplasia (22.3%); endometrial atrophy (21.3%); non-diagnostic (19.9%); endometrial carcinoma (9.5%); cervical carcinoma (6.8%); cervical polyps (4.5%); endometrial sarcoma (3.5%); proliferative endometrium (3.2%). Mean (SD) duration of bleeding was 6.9 (12.7) months. The percentage of women with malignant lesions was two to three times greater than those reported in the United States of America and Europe subsequent to 1980. The delay between the onset of bleeding and presentation is worrisome and suggests the need for public education
Angiomatosis of the Breast in a Male Child
No full textAngiomatosis is a benign vascular lesion that has been described rarely in the breast. We describe a case in a seven-year-old boy of African descent who presented with progressively increasing, unilateral breast enlargement, the first such report in a male child. The patient underwent excisional biopsy of the breast mass followed by mastectomy. Pathologic examination revealed a diffuse proliferation of variably-sized, thin-walled vascular channels lined by flattened endothelium that showed negative immunohistochemical staining for von Willebrand factor, factor VIII-related antigen, CD34 and S-100 protein. There is no evidence of recurrence after 24 months of follow-up
Developing Theory to Guide Building Practitioners’ Capacity to Implement Evidence-Based Interventions
Full text linkPublic health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners’ capacity to adopt and implement a variety of EBIs across diverse practice contexts
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What strategies are used to build practitioners' capacity to implement community-based interventions and are they effective?: A systematic review
No full text© 2015 Leeman et al.; licensee BioMed Central. Background: Numerous agencies are providing training, technical assistance, and other support to build community-based practitioners' capacity to adopt and implement evidence-based prevention interventions. Yet, little is known about how best to design capacity-building interventions to optimize their effectiveness. Wandersman et al. (Am J Community Psychol.50:445-59, 2102) proposed the Evidence-Based System of Innovation Support (EBSIS) as a framework to guide research and thereby strengthen the evidence base for building practitioners' capacity. The purpose of this review was to contribute to further development of the EBSIS by systematically reviewing empirical studies of capacity-building interventions to identify (1) the range of strategies used, (2) variations in the way they were structured, and (3) evidence for their effectiveness at increasing practitioners' capacity to use evidence-based prevention interventions. Methods: PubMed, EMBASE, and CINAHL were searched for English-language articles reporting findings of empirical studies of capacity-building interventions that were published between January 2000 and January 2014 and were intended to increase use of evidence-based prevention interventions in non-clinical settings. To maximize review data, studies were not excluded a priori based on design or methodological quality. Using the EBSIS as a guide, two researchers independently extracted data from included studies. Vote counting and meta-summary methods were used to summarize findings. Results: The review included 42 publications reporting findings from 29 studies. In addition to confirming the strategies and structures described in the EBSIS, the review identified two new strategies and two variations in structure. Capacity-building interventions were found to be effective at increasing practitioners' adoption (n = 10 of 12 studies) and implementation (n = 9 of 10 studies) of evidence-based interventions. Findings were mixed for interventions' effects on practitioners' capacity or intervention planning behaviors. Both the type and structure of capacity-building strategies may hav e influenced effectiveness. The review also identified contextual factors that may require variations in the ways capacity-building interventions are designed. Conclusions: Based on review findings, refinements are suggested to the EBSIS. The refined framework moves the field towards a more comprehensive and standardized approach to conceptualizing the types and structures of capacity-building strategies. This standardization will assist with synthesizing findings across studies and guide capacity-building practice and research
La jurisdicción penal electoral de corte acusatorio, su procedimiento y los delitos electorales en Panamá
No full textEl autor nos brinda una excelente reflexión acerca del origen de las faltas y delitos electorales en Panamá, desde una perspectiva evolutiva del Tribunal Electoral. En el mismo sentido, nos brinda una serie de interrogantes sobre los procedimientos aplicables en la jurisdicción penal electoral, destacando el análisis de la estructura penal electoral establecida en el Código Electoral. Por otra parte, nos refiere a los tipos de delitos electorales.The author offers an excellent reflection on the origin of electoral offenses and crimes in Panama, from an evolutionary perspective of the Electoral Tribunal. In the same sense, it offers us a series of questions about the applicable procedures in the electoral criminal jurisdiction, highlighting the analysis of the electoral criminal structure established in the Electoral Code.4th. ed
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Mixed methods evaluation of the inaugural year of the Cancer Prevention and Control Research Network’s (CPCRN) scholars program
No full textPurpose: A diverse workforce trained in dissemination & implementation (D&I) science is critical for improving cancer outcomes and reducing cancer-related health disparities. This study aims to describe and evaluate impact of the Cancer Prevention and Control Research Network (CPCRN) Scholars Program in preparing scholars for collaborative careers in cancer control and implementation research and practice, and offers evaluation-driven recommendations for program improvements. Methods: The CPCRN Scholars Workgroup conducted a sequential, mixed methods evaluation. We collected baseline and follow-up surveys and invited all 20 scholars and ten mentors to participate in an exit interview. We assessed the experience with the Scholar’s program, ratings of D&I competences, progress on their project, feedback about the curriculum, and understanding of implementation science. Results: Over 86% partially or fully completed their project within 9 months; 78% of scholars engaged with a CPCRN workgroup. Scholars rated the following program components as valuable: the Putting Public Health Evidence in Action (PPHEIA) training (88.9%), D&I training modules (83.3%), and webinars (kickoff webinar-88.9% and selecting theories/models-88.9%). There was an increase in D&I competencies from baseline to posttest, with the greatest in community engagement topics. About 78% reported that they were satisfied with format of the activities and increased confidence in ability to discuss D&I concepts. From the qualitative interviews, the benefit of the program was becoming more knowledgeable about D&I research and networking. Conclusion: The inaugural year of the program yielded positive results, particularly related to increasing knowledge about D&I science and cancer control. This program builds the capacity of students, researchers and practitioners in D&I science. © 2023, The Author(s).Open access articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]
