Serving IPV Survivors in Culturally Diverse Communities: Perspectives From Current Service Providers.

This qualitative study examines current IPV service providers' perspectives on service delivery methods that best reach and serve IPV survivors from culturally diverse communities. Semi-structured interviews were conducted with 11 service providers, and transcripts were analyzed for themes related to service providers' experiences. Five themes emerged from the data that suggest best practices for reaching and serving survivors from culturally diverse backgrounds, including understanding survivors' backgrounds, promoting trust and inclusivity, building community relationships, providing culturally responsive education on IPV, and supporting current and future staff with training. Study findings provide implications for the education and training of future service providers.

Broken Promises: Racism and Access to Medicines in Canada.

BACKGROUND: Discriminatory policies, attitudes, and practices have had deleterious impacts on the health of Black, Indigenous, and other racialized groups. The aim of this study was to investigate racism as barrier to access to medicines in Canada. The study investigated the characteristics of structural racism and implicit biases that affect medicines access. METHODS: A scoping review using the STARLITE literature retrieval approach and analysis of census tract data in Toronto, Ontario, Canada, were undertaken. Government documents, peer-reviewed articles from public policy, health, pharmacy, social sciences, and gray literature were reviewed. RESULTS: Structural racism that created barriers to access to medicines and vaccines was identified in policy, law, resource allocation, and jurisdictional governance. Institutional barriers included health care providers' implicit biases about racialized groups, immigration status, and language. Pharmacy deserts in racialized communities represented a geographic barrier to access. CONCLUSION: Racism corrupts and impedes equitable allocation and access to medicine in Canada. Redefining racism as a form of corruption would obligate societal institutions to investigate and address racism within the context of the law as opposed to normative policy. Public health policy, health systems, and governance reform would remove identified barriers to medicines, vaccines, and pharmaceutical services by racialized groups.

Mode of Presentation of Laryngeal Cancer: A Single Radiotherapy Institute Experience in Iraq.

PURPOSE: Laryngeal cancer is relatively common and usually presents with hoarseness due to a lesion in the glottis. We noticed that many of our patients had presented with supraglottic lesions and we could not find local literature in support of this observation. Mode of presentation and site of the lesion of these patients will be addressed in this review. MATERIALS AND METHODS: A retrospective cross-sectional descriptive study for laryngeal cancer patients who received radiotherapy at a tertiary radiotherapy center in Iraq, from January 2010 to December 2015, and who are residents in the Sulaimani governorate. RESULTS: In 6 years, laryngeal cancer patients from Sulaimani were 83 (out of 123 in total), which constituted the most common, 40.8%, head and neck cancers. 86.7% were males and the median age was 68.3 year. Most common presentation was hoarseness, 79.5%, and the least was dysphagia and stridor, 28.9%. Pain and neck swelling were found in 51.8%, 34.9%, respectively. Site of the cancer lesions were in supraglottis in 53%, glottis in 32.5%, transglottis in 8.4%, and subglottis in 6%. Commonest stage was IVA in 54.2% while the least was IVB 2.4%. Squamous cell carcinoma was the pathological type in all of our patients. CONCLUSION: Laryngeal cancer is the most common head and neck cancer in our institutional registry. While all the pathologies were of squamous cell carcinoma, hoarseness was the most common presentation and supraglottis was the most common site of involvement.

Treatment Outcomes of Pediatric Patients With Ewing Sarcoma in a War-Torn Nation: A Single-Institute Experience From Iraq.

PURPOSE: Ewing sarcoma (ES) is a relatively rare, highly malignant tumor of the musculoskeletal system. It is the second most common malignant bone tumor in children and adolescents in the age group of 5 to 20 years. The aim of this study was to identify the treatment outcomes of pediatric patients with ES in Sulaimani governorate, Iraq. PATIENTS AND METHODS: This was a retrospective study that reviewed the medical records of pediatric patients with ES who were managed between 2009 and 2015, with follow-up until late 2017. Patient- and tumor-related factors were correlated with clinical outcomes. RESULTS: A total of 31 pediatric patients with ES were included in this study. All the patients received chemotherapy and radiotherapy, whereas only 14 patients underwent surgical resection and just eight had free surgical margins. The median age at diagnosis was 13 years, 58% were male, and 42% were female. The presenting symptoms at diagnosis were mostly pain (67.7%) and palpable mass (25.8%). The primary tumor was located in the extremities (51.6%), the thoracic cage (19.4%), the pelvis (16.1%), and the lumbar vertebrae (12.9%). Approximately two thirds of the patients (61.3%) had localized disease at the time of presentation. The 5-year overall survival was 19%, and the 5-year recurrence-free survival was 34%. CONCLUSION: Clinical outcomes of ES in pediatric patients in our war-torn nation, Iraq, are still markedly inferior to the published outcomes from stable, developed nations. Additional large and multicenter national studies are required. Diagnostic and therapeutic measures need improvement, and multidisciplinary and comprehensive cancer-integrated approaches are vital for better outcomes.