Objective. Surveys demonstrate somewhat consistent gender differences in environmental concern, but there is no consensus on reasons for these differences. This research makes the case that ...differences in perceived vulnerability to risk explain the gender gap found in environmental surveys and other, quite distinct, areas of potential risk as well. Methods. Two national surveys, administered simultaneously and each involving very different environmental risks (hazardous waste sites and global warming), are analyzed in terms of gender differences. Results. In both surveys, in every question that involves reactions to a specific risk, women are more concerned than men. Standard deviations also are consistently smaller for women. When health-risk perceptions enter equations accounting for environmental concerns, however, the gender gap disappears. Conclusions. Questionnaire items that imply specific risks tend to produce significant gender differences. These types of survey results can be construed as communication events in which respondents who feel vulnerable answer in ways that urge caution on policymakers.
Abstract Nonurgent commercial air travel in patients who have experienced a nonhemorrhagic cerebrovascular accident (CVA) may occur, particularly in the elderly traveling population. A recent CVA, ...particularly occurring during a person's travel, presents a significant challenge to the patient, companions, family, and health care team. Specific medical recommendation, based on accumulated scientific data and interpreted by medical experts, is needed so that travel health care professionals can appropriately guide the patient. Unfortunately, such recommendations are almost entirely lacking despite the relative frequency of CVA and air travel. This article reviews the existing recommendations with conclusions based on both these limited data and rationale conjecture.
Abstract Abdominal aortic aneurysm (AAA) presents across a spectrum of severity. Although some resources suggest a theoretic risk for rupture related to air travel, this claim remains unproven. In ...fact, there are little data from which to make evidence-based recommendations. Air medical evacuation of a patient with either an AAA at risk of imminent rupture or status post recent rupture can be performed, assuming that local surgical care is not available and that transfer is taking the patient to a higher level of medical intervention. Furthermore, medical opinion suggests that patients with asymptomatic and/or surgically corrected AAA can safely travel by commercial aircraft for nonurgent reasons, assuming that other issues including postoperative needs are appropriately addressed. In this discussion, answers to the following issues are sought: flight safety for urgent evacuation and nonurgent repatriation scenarios, waiting time to fly nonurgently after AAA diagnosis, and the need for medical accompaniment.
...local public safety agencies, including police, fire, and emergency medical services entities, were made aware of all phases of the plan. ...concern for liability is the most frequent stated ...reason for both individual rescuers as well as various owner-leaders to avoid involvement in such events and programs.
Using survey data, the authors developed an architecture of climate change beliefs in Norway and their correlation with support for policies aimed at reducing greenhouse gas emissions. A strong ...majority of respondents believe that anthropogenic climate change is occurring and identify carbon dioxide emissions as a cause. Regression analysis shows that respondents recognize the effectiveness of direct actions that require difficult trade-offs, such as imposing a carbon tax. Yet, their voting intentions suggest a preference for policies that have at best an indirect effect on reducing climate change. Most respondents favor policy options that are generally good for the environment and cause no personal hardship. The disconnection between perceptions about the effectiveness of direct actions and support for less effective mitigation approaches may reflect the respondents’ collective distancing from the problem of climate change. This could be an important consideration in the design of communication strategies that promote emission abatement policies.
The current treatment of choice for metastatic pancreatic cancer involves single-agent gemcitabine or a combination of gemcitabine with capecitabine or erlotinib (a tyrosine kinase inhibitor). Only ...25-30% of patients respond to this treatment and patients who do respond initially ultimately exhibit disease progression. Median survival for pancreatic cancer patients has reached a plateau due to inherent and acquired resistance to these agents. Key molecular factors implicated in this resistance include: deficiencies in drug uptake, alteration of drug targets, activation of DNA repair pathways, resistance to apoptosis and the contribution of the tumor microenvironment. Moreover, for newer agents including tyrosine kinase inhibitors, overexpression of signaling proteins, mutations in kinase domains, activation of alternative pathways, mutations of genes downstream of the target and/or amplification of the target represent key challenges for treatment efficacy. Here we will review the contribution of known mechanisms and markers of resistance to key pancreatic cancer drug treatments.
Aims: The study examined the impact of a 6-week dance programme on frequency of activity participation, falls efficacy, and quality of life for community dwelling adults aged 50 years and over. It ...also explored participants' perceptions of the programme impact and delivery. Methods: The programme was delivered by two dance instructors and targeted community dwelling adults aged 50 years and over, who were independently mobile. Sixty-two participants were recruited and provided baseline data. Thirty-five participants provided immediate follow-up data. Outcome measures were conducted at baseline and immediately post-intervention. Measures included frequency of participation in activities (The Frenchay Activities Index); falls efficacy (Falls Efficacy Scale- International); and quality of life (EQ-5D-3L). Focus groups explored participants' perceptions of the programme. Results: Significant differences were found post-programme in frequency of activity participation (p = 0.036), including domestic activity (p = 0.048). No significant differences were found in falls efficacy or quality of life. Focus group data indicated participants enjoyed the programme and perceived enhanced physical abilities, emotional and psychological well-being and increased activity participation as a result of programme participation. Conclusion: Findings suggest that a dance programme may increase activity participation in social and community-based activities, however given the study limitations, further research is required to corroborate this.
What do self-professed democrats mean when they hedge their opposition to military coups? Many believe that some coups improve democracy by unclogging political logjams and are an acceptable ...component of the democratic political game. Political culture theory labels this view of coups a mediating orientation. Do mediating political orientations operate differently from more ephemeral political attitudes? In Venezuela, persisting and overwhelming support of procedural democracy has coexisted with substantial backing for coups in the abstract. Political culture theorists would expect this result from mediating orientations. In contrast, views of specific coups are linked to opinions about specific political circumstances and change depending on these circumstances.
Abstract 4882
Thalidomide is an oral drug with anti myeloma activity. However, some patients fail to respond and serious side effects are common including thrombo-embolic disease and peripheral ...neuropathy. Identifying patients likely to respond has huge potential to better individualise treatment. Using proteomic methods, we have sought to identify a signature capable of distinguishing patients likely to respond to thalidomide-based therapy.
Serum samples from 36 consecutive newly diagnosed multiple myeloma patients were collected prior to initial treatment with thalidomide-based regimens. Samples were initially immunodepleted to enrich the low abundance proteins. This was followed by 2D-DIGE analysis, to identify differential expressed proteins. Identification of proteins found to be statistically significant different in expression between responders and non-responders to thalidomide was carried out using LC-MS/MS. These proteins Using commercially available ELISAs kits, the levels of candidate biomarker proteins was validated using the un-fractionated serum samples from the original cohort of patients. The expression levels of each of these proteins were used to generate a Receiver Operating Characteristic (ROC) curve. This permitted us to undertake a systematic diagnostic performance evaluation of each bio-marker alone and in combination..
Based on Day 100 re-staging investigations and using International Myeloma Working Group uniform response criteria for multiple myeloma, 20 thalidomide responders and 16 non-responders were identified. The median patient age was 67 years (range 57-79 years), 18 male and 18 female. Six proteins were found to demonstrate a statistically different expression pattern between the responders/non-responders. Proteins found to have higher abundance level in the serum from thalidomide non-responders in comparison to responders, included Zinc alpha 2-glycoprotein (ZAG), Vitamin D binding Precursor (VDB), Transthyretin (TYR), Serum Amyloid A protein (SAA), beta-2-microglobulin (B2M), while Haptoglobin (Hp) had a lower abundance level in non-responders. Initially, Logistic regression (LR)was used to develop predictive models for each individual differentially expressed protein (Fig 1A, 1B). Using single protein LR models, B2M and SAA levels had the best predictive ability with Area Under Curve (AUC) values of 0.8 and 0.79, respectively, demonstrating acceptable performance. The remaining single protein models had AUC values less than 0.7, indicating minimal predictive ability. The predictive capability of models developed using combinations of proteins was also assessed. Logistic regression models were constructed and ROC analyses carried out on all possible permutations of the differentially expressed proteins. The most successful combinations of the bio-markers' models are shown (Fig 2A &2B). The combination of three proteins (Hp+SAA+VDB) yields AUC values of 0.91. The best possible AUC resulted from the combination of Hp+SAA+VDB+ZAG+VDB, which yields an AUC of 95%, indicating an outstanding predictive capability.
Accurate prediction of an individual patient's drug response is an important prerequisite of personalized medicine. Using a panel of proteomic biomarkers, we have demonstrated the feasibility of predicting sensitivity and response to thalidomide in previously untreated myeloma. In the multiple of 3 or 4 protein combinations, these potential biomarkers can differentiate responders and non responders to thalidomide at diagnosis in up to 95 % of multiple myeloma patients.
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No relevant conflicts of interest to declare.
Objective. The purpose of this paper is to explore racial and interstate differences in Head Start enrollment, including the capability of socioeconomic, political, and racial factors to account for ...differences in state enrollment success. Methods. Data for the dependent variable are Head Start enrollment reports and eligibility figures derived from the Census Bureau's Public Use Microdata Sample. Independent variables include Hero and Tolbert's minority diversity measure. Results. Head Start enrolls a much higher proportion of eligible blacks than eligible whites. State differences, however, are enormous. For all children, rural states do better. Blacks do better in wealthier states and those with less minority diversity. For whites, minority diversity also is a powerful predictor of lower enrollment. The political variables do not help to account for Head Start enrollments.Conclusions.The minority diversity variable stands out as warranting attention in future research. For Head Start specifically, the appearance of favoritism for poor blacks over poor whites would seem to increase Head Start's political vulnerability in several states.
