 Terrorism preparedness training for occupational health professionals. / Occup Environ Med 2004;46(12):1204-1209.Really great cover, you are super talented. Plus special kudos on the song selection. Without a doubt one of the best Malayalam songs ever. The composition and melody alone are fantastic but the lyrics elevate this song to another level. One of those rare songs where simple language is used to create such beautiful poetry. There is such a sadness to the words. Plus in the context of the movie it is so much more powerful as you imagine Ganga pining for her parents. It makes so much sense that this poem would ignite the embers that later becomes the fire that is Nagavalli. What absolute brilliance!!! Thanks so much for reminding me about this song.Women with less education, with lower income, or from racial and ethnic minority groups have less access to 3D mammography and the potential benefits it provides.
3D mammography is not equally accessible to all women. Women who come from racial or ethnic minority groups, women who are less educated, and women who have lower incomes are less likely to undergo the exam that is most likely to detect an existing breast cancer without raising a false red flag.
In a five-state study, including nearly 100 facilities, a multi-institutional team showed that less than half of women in these groups have access to this type of breast cancer screening.
Lee’s team published their findings on Feb. 19 in JAMA Network Open.
Digital breast tomosynthesis (DBT) has been a viable alternative to digital mammography since it received approval from the U.S. Food & Drug Administration in February 2011. In the intervening years, a plethora of studies have shown that DBT is actually more accurate than digital mammography and does a better job at detecting breast cancer with fewer false positives.
For this study, the team examined 2.3 billion breast screening exams that were pulled from the Breast Cancer Surveillance Consortium. Patients, who were screened between January 2011 and December 2017, came from 92 imaging facilities across five states. With this volume, the team said, it is the largest study, to date, to analyze the access women have to DBT throughout the United States. In addition to looking at whether access was equitable among all women, the team also assessed whether facilities offered DBT at the time a patient was screened and compared DBT and mammography use at each facility across patient populations.
Their findings showed that DBT use and access did change over time. At the start of the study in 2011, only 3 percent of women included had access to DBT. By 2017, more facilities were using the technology, and 82 percent of women had access – but, it was not equal across all groups.
According to their analysis – when both 2D and 3D mammograms were available – DBT was utilized by fewer than 50 percent of women who were in racial and ethnic minority groups, as well as those who were less educated and those who were of lower income.
These results are critical, Lee said, because women with less access to 3D screening are already traditionally underserved, putting them at a greater risk of breast cancer morbidity and mortality.
Although addressing whether the institutional barriers to care, such as structural racism or cost, contributed to decreased access to newer technologies was outside the scope of the study, the team acknowledged that these obstacles are real and likely played into the inequity.
For example, Lee said, because DBT generates digital slices of breast tissue, acquisition and interpretation time are longer, and the cost is higher. While some states, including Washington, have laws in place that prevent charging patients more for DBT, most states do not. Consequently, depending on the type of insurance a patient has, she may have to pay high out-of-pocket costs for a 3D mammogram.
Additionally, a woman’s education could impact how much she knows about DBT mammography and the benefits it can provide. Women who have higher education levels could be more likely to explore healthcare options, to research the possible benefits of 3D mammography, or to search for a facility that offers the technology. They could also be more likely to directly ask for the service.
The physical availability of the technology also played a role. While approximately 40 percent of all certified mammography units actually have DBT capability, more than two-thirds of breast imaging facilities offer DBT in at least one of their units, according to FDA data. In addition, urban or rural location was less important than anticipated, Lee said.
In such situations, he said, a rural site could have one digital mammography machine that would provide access to all patients once switched to DBT. However, urban facilities might have more money to purchase machines, but if it can only afford one 3D-capable unit – at a cost of approximately $750,000 a pop – they will still have to direct some patients to 2D machines. Consequently, some sub-groups of women are not being screened with 3D mammography even when the option technically exists at their imaging facility.
Rwanda: Solutions to DR Congo Problems Cannot Be Outsourced - Rwandan Diplomat at UN
Rwanda's Deputy Permanent Representative to the UN, Robert Kayinamura, has said that whenever DR Congo is headed for presidential elections, a pile of accusations against Rwanda crop up and later disappear after polls.
Kayinamura was speaking at the 11th Emergency Special Session of the UN General Assembly, as he responded to DR Congo's Permanent Representative, Georges Nzongola-Ntalaja, who accused Rwanda of'stealing gorillas and chimpanzees' from his country.
Although the session was organised for member countries to debate and vote on a resolution on the referendum and annexation of four regions of Ukraine by Russia, Nzongola-Ntalaja took the floor and instead accused Rwanda of'stealing minerals, gorillas, and chimpanzees from DR Congo'.
This compelled Kayinamura to respond to Nzongola-Ntalaja, urguing that Congolese officials should stop outsourcing solutions to their internal challenges.
"DR Congo has had a difficult past, right from colonial times. Rwanda is just 28 years old. Every time there is no water, electricity, or roads, it's Rwanda to blame.
"We need to move from that mentality and address the problems in your country. You cannot outsource a solution. You have to deal with the issues you are dealing with locally and find sustainable solutions," said Kayinamura.
The Congolese diplomat had made reference to a certain report which he said was published "about 10 years ago" but could not recall what the report was called.
In his submission, Kayinamura said, "every time there are elections in DR Congo, Rwanda is going to be named. I know probably after 2023 when the elections are done, you may not hear Rwanda being mentioned again and that's why the report he was referring to could not come to mind because these are just allegations."
Rwanda is renowned globally for her efforts to preserve Mountain Gorillas, whose habitat cuts across three neighbouring countries; Rwanda Uganda and DR Congo.
In 2005, Rwanda began officially naming gorillas, an internationally renowned ceremony dubbed Kwita Izina where baby gorillas born in families on the Rwandan side are named anually. Since then, more than 350 mountain gorillas have been named.
Meanwhile, Kayinamura pointed out that DR Congo's continued misuse of various platforms to engage in baseless and malicious propaganda" against neghbouring countries, including Rwanda, is not new.
Top Headlines Rwanda Congo-Kinshasa Peacekeeping
During the 77th UN General Assembly, DR Congo President, Felix Tshisekedi, accused Rwanda of supporting the M23 rebel group claiming that his efforts to reunite the country and pursue peaceful settlements have been dragged by continual external interference.
Rwanda has denied the accusation and insisted that DR Congo should stop collaborating with anti-Rwanda groups, a fact that had been.
Kayinamura also pointed out that externalizing domestic problems of DR Congo will not solve them; it will only serve short-term goals, reiterating that Rwanda is fully committed to working with DR Congo through existing frameworks to address the root causes of the problems, including the dignified return of Congolese refugees who have stayed in neighboring countries, including Rwanda, for more than 20 years.
He added, "What DR Congo is not telling this august house is that DR Congo is home to over 130 armed groups, combining both local and foreign armed groups, including the FDLR an armed group active in DRC, and its splinter groups, which committed genocide against the Tutsi in Rwanda."
There are currently existing frameworks, agreements, and roadmaps to follow in addressing the root causes of the security issues in DR Congo, however, Kayinamura said that due to lack of political will, DR Congo has successfully failed to implement these agreements and frameworks.Editor’s note: This is a live account of COVID-19 updates from Saturday, May 2, as the day unfolded. Click here to see updates from Sunday, May 3. And click here to find resources and the latest extended coverage of the pandemic.
Gov. Jay Inslee officially announced Friday that Washington’s stay-at-home order will be extended until May 31, as he and state officials try to keep the new coronavirus from roaring back. Here’s what his four-phase plan looks like for businesses and gatherings.
Meanwhile, researchers are working tirelessly to find a vaccine for the virus. U.S. regulators on Friday approved the first