42,556 research outputs found
Adherence to AIOM (Italian Association of Medical Oncology) lung cancer guidelines in Italian clinical practice: Results from the RIGHT-3 (research for the identification of the most effective and highly accepted clinical guidelines for cancer treatment) study
No full textObjectives: Clinical practice guidelines represent a key tool to improve quality and reduce variability of cancer care. In 2004, Italian Association of Medical Oncology (AIOM) launched the RIGHT (research for the identification of the most effective and highly accepted clinical guidelines for cancer treatment) program. The third step, RIGHT-3, evaluated the concordance between AIOM lung cancer guidelines and Italian clinical practice. Materials and methods: RIGHT-3 was a retrospective observational study, conducted in 53 Italian centers treating lung cancer. Sampling from AIOM database of 230 centers was stratified by presence of thoracic surgery and geographic distribution. To describe the adherence to AIOM guidelines (2009 edition), 11 indicators regarding diagnostic and treatment procedures were identified. Patients with non-small-cell lung cancer (NSCLC) diagnosis who had first visit in 2010 were divided into 3 groups, based on TNM stage: I-II-IIIA (5 indicators), IIIB (3 indicators) and IV (3 indicators). Results: 708 patients were enrolled; 680 were eligible: 225 patients in stage I-II-IIIA; 156 patients in stage IIIB; 299 patients in stage IV. Cyto-histological diagnosis was available in 96%, 97%, 96% of stage I-II-IIIA, IIIB, IV respectively. Positron-emission tomography was performed in 64% of stage I-II-IIIA and 46% of stage IIIB. 88% of stage I-II patients eligible for surgery underwent lobectomy; after surgery, 61% of stage II and 57% of stage IIIA patients received adjuvant chemotherapy. Among stage IIIB patients who received combined chemo- radiotherapy, sequential approach was more common than concomitant treatment (86% vs. 14%). Among stage IV patients, 87% received platinum-based first-line treatment, and 70% received second-line. Conclusion: The RIGHT-3 study showed that, in 2010, adherence to Italian NSCLC guidelines was high for many indicators (including those related to treatment of stage IV patients), but lower for some diagnostic procedures. Guidelines adherence monitoring can be useful to reduce variability in cancer care
The Christian Right and US Foreign Policy in the Twenty-first Century
No full textThe thesis discusses the role of the Christian Right in the US foreign policy decision making process. The research revealed that the Christian Right has long been fascinated with some international issues in general and US foreign policy in particular. The Christian Right’s interest in international issues increased markedly during years of the George W. Bush presidency. It successfully widened its activities from domestic social conservative issues to foreign policy issues by participating in, articulating and lobbying for its religious version of American foreign policy. In assessing the role of the Christian Right in US foreign policy making, this dissertation examines three aspects of US foreign policy, namely Israel, international religious freedom and global humanitarianism. Based on these aspects, the Christian Right is seen as skilled in framing and defining issues. The Christian Right seems effective in selecting and prioritizing international issues that have a reasonable chance of being selected by foreign policy decision makers, especially in Congress. Moreover, the Christian Right has shown its maturity in seeking engagement and cooperation with other organizations, secular and religious, in order to advance its international goals. Finally, in pursuing and conveying its international agenda, the Christian Right has adopted a more moderate and less overtly religious approach. Instead of using its traditional religious rhetoric, the Christian Right has successfully projected its foreign policy preferences into the conventional realist discourse of American foreign policy that is largely based on the objective of national interest and national security. Nevertheless, this study does not, in any way, conclude that the Christian Right was able to influence or determine the direction of US foreign policy and its outcomes; however, it does suggest that the Christian Right did contribute and have an impact on the formulation of some US foreign policy. As such, the research contends that the role of the Christian Right is similar to other interest group lobbies and that its perceived influence on US foreign policy should not be exaggerated. Finally, the research suggests that the emergence of the Christian Right as an actor in asserting its global agenda through US foreign policy can possibly provide an example of how religious beliefs and values can become a potential source of “soft power”. Together with the “climate of opinion” of the American public during the Bush administration, the “soft power” at domestic level could serve as a valuable new explanatory variable in understanding how the US foreign policy was formulated in the early 21st century
INTERNATIONAL VARIATION IN USE OF IMAGING FOR PATIENTS PRESENTING WITH RIGHT ILIAC FOSSA PAIN
No full textAim: To investigate variation in utilisation of diagnostic imaging for patients
presenting with right iliac fossa (RIF) pain across five countries.
Method: Prospective observational cohort study of adult (16 years and
above) patients presenting with RIF pain. The primary endpoint was the
overall imaging rate, including computed tomography (CT), magnetic
resonance (MRI), and ultrasound imaging. The secondary endpoint was the
negative appendicectomy rate (NAR; removal of a histologically normal
appendix).
Results: Data were collected in Ireland/UK (n1⁄47665; 169 centres), Italy
(n1⁄4782; 50 centres), and Spain/Portugal (n1⁄41046; 55 centres). Imaging
rates were lower in Ireland/UK (women: 74%, men: 41%) than in Italy
(women: 87%, men: 84%) and Spain/Portugal (89% for both women and
men). Overall CT and MRI scans rates were similar across all countries, but
ultrasound was more commonly used in Italy (77%) and Spain/Portugal
(81%) than Ireland/UK (46%). The overall NAR was higher in Ireland/UK
(16%) than in Italy (3%) and Spain/Portugal (6%).
Conclusions: Whilst rates of CT and MRI imaging were similar across the
five countries, the NAR was lowest in Italy and Spain/Portugal. It may be
possible to decrease the NAR in Ireland/UK without increasing the rate of
CT scanning
All repair and reconstruction. Techniques from the SANTI study group
No full textBackground: Combining an anterior cruciate ligament (ACL) reconstruction with an anterolateral ligament (ALL) reconstruction results in significant advantages including reduced graft rupture rates, a lower risk of reoperation for secondary meniscectomy, improved knee stability, and higher rates of return to preinjury levels of sport. Indications: The previously reported indications for combined ACL and ALL reconstruction are as follows: ACL reconstruction revision; high-grade pivot shift test; long-term ACL rupture; young patients; pivoting activities; concomitant medial meniscus repair, and, specifically, regarding the ALL repair, it must be an acute surgery (within 15 days from injury). Technique Description: Several modern techniques have been described to repair and reconstruct the ALL. This technical note details a number of these techniques performed by the Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group. Results: First, we describe a combined ACL reconstruction and double-bundle ALL reconstruction using hamstring autograft. Secondly, we describe a single-bundle ALL reconstruction using gracilis autograft. Thirdly, we describe an ALL reconstruction technique using a knotless soft anchor, which provides shallow fixation and prevents tunnel convergence. Finally, we describe a technique for ALL repair. Conclusion: Several techniques have been described to repair and reconstruct the ALL, all offering significant advantages over an isolated ACL reconstruction. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication
Hereditary conjugacy separability of right angled Artin groups and its applications
No full textWe prove that finite index subgroups of right angled Artin groups are conjugacy separable. We then apply this result to establish various properties of other classes of groups. In particular, we show that any word hyperbolic Coxeter group contains a conjugacy separable subgroup of finite index and has a residually finite outer automorphism group. Another consequence of the main result is that Bestvina-Brady groups are conjugacy separable and have solvable conjugacy proble
Religion, prejudice, and authoritarianism : Is RWA a boon or bane to the psychology of religion?
No full textIn research on religiosity and prejudice, right-wing authoritarianism (RWA) has been studied alongside variables such as fundamentalism and orthodoxy. Four concerns regarding research on the relationship between RWA and religiosity are identified: (1) the overlap of religiosity and prejudice within the RWA scale; (2) the inflation of relationships by correlating part-whole measures; (3) covariation in the extremes of the construct hiding the possible independence of components within RWA; and (4) statistical artifacts arising in multiple regression from the combination of these factors. We elaborate these four issues and then demonstrate how they can lead to different interpretations of some previously published data. The article concludes with suggestions for the management and resolution of these issues that may allow RWA to continue to be used in religiosity and prejudice research and how it might evolve to become the boon to researchers that they seek.Peer reviewe
Internal and external threat in relationship with right-wing attitudes
No full textObjective
Previous studies on the relationship between threat and right-wing attitudes have tended to focus on either internal threat, emanating from one's private life, or external threat, originating from society. However, these studies failed to examine whether these types of threats constitute two distinctive dimensions and which of these threats is most closely related to right-wing attitudes.
Method
In order to explore the dimensions underlying threat, a factor analysis on a variety of threat scales was conducted (Study 1; N?=?300). Furthermore, in a meta-analysis (Study 2; total N?=?22,086) and a questionnaire study in a large representative sample (Study 3, N?=?800) the strength of the relationships of internal and external threat with right-wing attitudes were investigated.
Results
The present studies revealed that internal and external threat can be considered as two distinct dimensions underlying threat. Moreover, whereas external threat yielded strong relationships with right-wing attitudes, internal threat only explained a minor part of the variance in these attitudes.
Conclusions
External rather than internal threat underlies the relationship between threat and right-wing attitudes
Who joins a UK right to die society and why? : a study of members of Friends at the End (FATE)
No full textPhDThe thesis presents quantitative and qualitative thematic analyses of a postal survey
and interview study of members of Friends at the End (FATE), a Glasgow-based right
to die society. This is one of the first UK studies aimed toward filling a gap in
knowledge about who joins a UK right to die society, and their reasons for doing so.
The thesis attributes responsibility for the right to die movement’s continuing existence
to contemporary socio-cultural norms of individualism and self-determination in
promoting desire for autonomy and choice surrounding dying and death. It shows how
and why a distinct group of predominantly older and higher social class individuals,
22% of whom have health and social care professional backgrounds, have decided to
join FATE. The right to die movement is shown to be a new social movement
concerned with health, ageing and death activism that challenges contemporary
biomedical models of managing dying and death. The thesis shows how ageing, social
class, religiosity, socio-medical constructs of dying, risk management and altruism
toward others all contribute toward the ongoing existence of pro-right to die attitudes
and beliefs. It also shows how personal fears about the manner of future dying, both
physical and existential are frequently informed by personal experiences, identified as
critical factors in decisions made to join the movement. FATE exists in a culture in
which assessing risk has become very pervasive, and joining FATE is, for many
members, a risk-avoidance strategy, given their concerns that future dying and death
may be unpleasant. Conditional desire for hastened death is also shown to be informed
by desire to avoid placing burden on others, a form of reciprocal altruism in which
hastened death benefits both the dying person and family members as well as society
as a whole
Maternal employment and early childhood overweight: findings from the UK Millennium Cohort Study
No full textBackground: In most developed countries, maternal employment has increased rapidly. Changing patterns of family life have been suggested to be contributing to the rising prevalence of childhood obesity. Objectives: Our primary objective was to examine the relationship between maternal and partner employment and overweight in children aged 3 years. Our secondary objective was to investigate factors related to early childhood overweight only among mothers in employment. Design: Cohort study. Subjects: A total of 13 113 singleton children aged 3 years in the Millennium Cohort Study, born between 2000 and 2002 in the United Kingdom, who had complete height/weight data and parental employment histories. Measurements: Parents were interviewed when the child was aged 9 months and 3 years, and the child's height and weight were measured at 3 years. Overweight (including obesity) was defined by the International Obesity Task Force cut-offs. Results: A total of 23% (3085) of children were overweight at 3 years. Any maternal employment after the child's birth was associated with early childhood overweight (odds ratio (OR) [95% confidence interval (CI)]; 1.14 [1.00, 1.29]), after adjustment for potential confounding and mediating factors. Children were more likely to be overweight for every 10 h a mother worked per week (OR [95% CI]; 1.10 [1.04, 1.17]), after adjustment. An interaction with household income revealed that this relationship was only significant for children from households with an annual income of pound33 000 ($57 750) or higher. There was no evidence for an association between early childhood overweight and whether or for how many hours the partner worked, or with mothers' or partners' duration of employment. These relationships were also evident among mothers in employment. Independent risk factors for early childhood overweight were consistent with the published literature. Conclusions: Long hours of maternal employment, rather than lack of money may impede young children's access to healthy foods and physical activity. Policies supporting work-life balance may help parents reduce potential barriers
Fast identification of biological pathways associated with a quantitative trait using group lasso with overlaps.
No full textWhere causal SNPs (single nucleotide polymorphisms) tend to accumulate within biological pathways, the incorporation of prior pathways information into a statistical model is expected to increase the power to detect true associations in a genetic association study. Most existing pathways-based methods rely on marginal SNP statistics and do not fully exploit the dependence patterns among SNPs within pathways.We use a sparse regression model, with SNPs grouped into pathways, to identify causal pathways associated with a quantitative trait. Notable features of our "pathways group lasso with adaptive weights" (P-GLAW) algorithm include the incorporation of all pathways in a single regression model, an adaptive pathway weighting procedure that accounts for factors biasing pathway selection, and the use of a bootstrap sampling procedure for the ranking of important pathways. P-GLAW takes account of the presence of overlapping pathways and uses a novel combination of techniques to optimise model estimation, making it fast to run, even on whole genome datasets.In a comparison study with an alternative pathways method based on univariate SNP statistics, our method demonstrates high sensitivity and specificity for the detection of important pathways, showing the greatest relative gains in performance where marginal SNP effect sizes are small
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