Bisphosphonates are effective in the prevention and treatment of bone disease in multiple myeloma (MM). Osteonecrosis of the jaw is increasingly recognized as a serious complication of long-term ...bisphosphonate therapy. Issues such as the choice of bisphosphonate and duration of therapy have become the subject of intense debate given patient safety concerns. We reviewed available data concerning the use of bisphosphonates in MM. Guidelines for the use of bisphosphonates in MM were developed by a multidisciplinary panel consisting of hematologists, dental specialists, and nurses specializing in the treatment of MM. We conclude that intravenous pamidronate and intravenous zoledronic acid are equally effective and superior to placebo in reducing skeletal complications. Pamidronate is favored over zoledronic acid until more data are available on the risk of complications (osteonecrosis of the jaw). We recommend discontinuing bisphosphonates after 2 years of therapy for patients who achieve complete response and/or plateau phase. For patients whose disease is active, who have not achieved a response, or who have threatening bone disease beyond 2 years, therapy can be decreased to every 3 months. These guidelines were developed in the interest of patient safety and will be reexamined as new data emerge regarding risks and benefits.
Multiple myeloma is a neoplastic plasma cell dyscrasia that on a yearly basis affects nearly 17,000 individuals and kills more than 11,000. Although no cure exists, many effective treatments are ...available that prolong survival and improve the quality of life of patients with this disease. The purpose of this consensus is to offer a simplified, evidence-based algorithm of decision making for patients with newly diagnosed myeloma. In cases in which evidence is lacking, our team of 18 Mayo Clinic myeloma experts reached a consensus on what therapy could generally be recommended. The focal point of our strategy revolves around risk stratification. Although a multitude of risk factors have been identified throughout the years, including age, tumor burden, renal function, lactate dehydrogenase, β2 -microglobulin, and serum albumin, our group has now recognized and endorsed a genetic stratification and patient functional status for treatment.
Europeans evaluate the European Community (EC) according to its economic performance, political salience, and role in international relations. During the last two decades their measured attitudes ...toward European integration warmed especially when inflation rates fell, as the EC share of the country's trade expanded, when EC elections and referenda increased attention to the community, and to some extend during periods when East-West relations were relaxed. Europeans did not vary their support according to their countries' shares of the Brussels budget. Thus, notwithstanding Denmark's 1992 rejection of the Maastricht treaty and the end of the cold war, recent EC reforms that increase monetary stability, intra-European trade and political attention are all likely to maintain or increase citizen support for the EC. These findings result from a model that blends comparative political economy with international relations in one of the first applications of pooled cross-sectional and time-series analysis to the comparative study of public opinion.
A quarter-century after the classic study The Crisis of Democracy was published, three distinguished political scientists find that, though the "crisis" may have disappeared, public confidence is on ...the decline in almost all the world's advanced democracies.
German unification has revived earlier scholarly debates about the nature of the German political culture and the ability of the nation to rise above its cultural heritage – now focused on the ...cultural inheritance from the German Democratic Republic. This article examines popular support for democratic attitudes as a prerequisite for successful political unification and the development of democracy in a unified Germany. Our evidence focuses on a study of democratic attitudes conducted in West Germany and East Germany by the Mannheim Research Unit for Societal Development in early 1990, with supplemental data from more recent surveys. We find that East Germans voice support for democratic attitudes that rivals or excels the expression of democratic norms in the West. The correlates of these opinions suggest that democratic norms in the East developed from an on-going process of counter-cultural socialization and from judgements about the relative economic strength of the Federal Republic.
The alignment of parties within a party system shapes the nature of electoral competition, the process of representation, and potentially the legitimacy of the system. This article describes the ...distribution of parties and the levels of party polarization in the party systems of East Asian democracies. We examine the public's perceptions of party positions on a left-right scale to map the pattern of party competition. The evidence is based on two waves of surveys from the Comparative Study of Electoral Systems. We describe considerable variation in the polarization of Asian party systems, which has direct implications for the clarity of party choice and the behavior of voters. We conclude with a discussion of the implications of our findings.
Few aspects of politics have been as variable as partisan politics in the two decades since German unification. In the East, citizens had to learn about democratic electoral politics and the party ...system from an almost completely fresh start. In the West, voters experienced a changing partisan landscape and the shifting policy positions of the established parties as they confronted the challenges of unification. This article raises the question of whether there is one party system or two in the Federal Republic. We first describe the voting results since 1990, and examine the evolving links between social milieu and the parties. Then we consider whether citizens are developing affective party ties that reflect the institutionalization of a party system and voter choice. Although there are broad similarities between electoral politics in West and East, the differences have not substantially narrowed in the past two decades.
East Asia is one of the most dynamic areas of political change in the world today-what role do citizens play in these processes of change? Drawing upon a unique set of coordinated public opinion ...surveys conducted by the World Values Survey, this book provides a dramatically new image of the political cultures of East Asia. Most East Asian citizens have strong democratic aspirations, even in still autocratic nations. Most East Asians support liberal market reforms, even in nations where state socialism has been dominant. The books findings thus provide a new perspective on the political values of Asian publics. We demonstrate that the dramatic socioeconomic changes of the past several decades have transformed public opinion, altering many of the social norms traditionally identified with Asian values, and creating public support for further political and economic modernization of the region. Political culture in East Asia is not an impediment to change, but creates the potential for even greater democratization and marketization. Comparative Politics is a series for students and teachers of political science that deals with contemporary government and politics. The General Editors are Max Kaase, Professor of Political Science, Vice President and Dean, School of Humanities and Social Science, International University Bremen, Germany; and Kenneth Newton, Professor of Comparative Politics, University of Southampton. The series is produced in association with the European Consortium for Political Research.
The Singaporean patriarch Lee Kuan Yew popularized the argument that ‘Asian values’ derived from Confucian cultural traditions are inconsistent with the development of democracy in East Asia. There ...is an active scholarly debate over whether the hierarchic and deferential social authority relations of Confucian traditions are incompatible with support for democracy. Drawing upon the newest wave of the World Values Survey, we analyze public opinion in six East Asian nations and four Western democracies. We first assess orientations toward authority, and then link these sentiments to support for democracy. The results contradict the core tenets of the ‘culture is destiny’ argument in the Asian values literature, and offer a more positive view of the prospects for political development in the region.
PDF
