Public stated preferences and predicted uptake for genome-based colorectal cancer screening

Background Emerging developments in nanomedicine allow the development of genome-based technologies for non-invasive and individualised screening for diseases such as colorectal cancer. The main objective of this study was to measure user preferences for colorectal cancer screening using a nanopill. Methods A discrete choice experiment was used to estimate the preferences for five competing diagnostic techniques including the nanopill and iFOBT. Alternative screening scenarios were described using five attributes namely: preparation involved, sensitivity, specificity, complication rate and testing frequency. Fourteen random and two fixed choice tasks, each consisting of three alternatives, were offered to 2225 individuals. Data were analysed using the McFadden conditional logit model. Results Thirteen hundred and fifty-six respondents completed the questionnaire. The most important attributes (and preferred levels) were the screening technique (nanopill), sensitivity (100%) and preparation (no preparation). Stated screening uptake for the nanopill was 79%, compared to 76% for iFOBT. In the case of screening with the nanopill, the percentage of people preferring not to be screened would be reduced from 19.2% (iFOBT) to 16.7%. Conclusions Although the expected benefits of nanotechnology based colorectal cancer screening are improved screening uptake, assuming more accurate test results and less preparation involved, the relative preference of the nanopill is only slightly higher than the iFOBT. Estimating user preferences during the development of diagnostic technologies could be used to identify relative performance, including perceived benefits and harms compared to competitors allowing for significant changes to be made throughout the process of developmen

The capability set for work - correlates of sustainable employability in workers with multiple sclerosis

BACKGROUND: The aim of this study was to examine whether work capabilities differ between workers with Multiple Sclerosis (MS) and workers from the general population. The second aim was to investigate whether the capability set was related to work and health outcomes. METHODS: A total of 163 workers with MS from the MS@Work study and 163 workers from the general population were matched for gender, age, educational level and working hours. All participants completed online questionnaires on demographics, health and work functioning. The Capability Set for Work Questionnaire was used to explore whether a set of seven work values is considered valuable (A), is enabled in the work context (B), and can be achieved by the individual (C). When all three criteria are met a work value can be considered part of the individual's 'capability set'. RESULTS: Group differences and relationships with work and health outcomes were examined. Despite lower physical work functioning (U = 4250, p = 0.001), lower work ability (U = 10591, p = 0.006) and worse self-reported health (U = 9091, p ≤ 0.001) workers with MS had a larger capability set (U = 9649, p ≤ 0.001) than the general population. In workers with MS, a larger capability set was associated with better flexible work functioning (r = 0.30), work ability (r = 0.25), self-rated health (r = 0.25); and with less absenteeism (r = - 0.26), presenteeism (r = - 0.31), cognitive/neuropsychiatric impairment (r = - 0.35), depression (r = - 0.43), anxiety (r = - 0.31) and fatigue (r = - 0.34). CONCLUSIONS: Workers with MS have a larger capability set than workers from the general population. In workers with MS a larger capability set was associated with better work and health outcomes. TRIAL REGISTRATION: This observational study is registered under NL43098.008.12: 'Voorspellers van arbeidsparticipatie bij mensen met relapsing-remitting Multiple Sclerose'. The study is registered at the Dutch CCMO register ( https://www.toetsingonline.nl ). This study is approved by the METC Brabant, 12 February 2014. First participants are enrolled 1st of March 2014

Mind the (yield) gap(s)

This paper explores the origin of the notion of “yield gap” and its use as a framing device for agricultural policy in sub-Saharan Africa. The argument is that while the yield gap of policy discourse provides a simple and powerful framing device, it is most often used without the discipline or caveats associated with the best examples of its use in crop production ecology and microeconomics. This argument is developed by examining how yield gap is used in a selection of recent and influential agricultural policy documents. The message for policy makers and others is clear: “mind the (yield) gap(s)”, for they are seldom what they appear

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Aplicação de deficientes físicos nas atividades da Polícia Militar do Paraná

Orientador: Ivan Santa MariaMonografia (Especialização) - Universidade Federal do Paraná,Setor de Ciências Sociais Aplicadas, Departamento de Contabilidade, Curso de Especialização em Administração PolicialResumo: O presente trabalho monográfico abordou o problema da aplicabilidade de policiais-militares em atividades consideradas meio na Organização, sendo que os mesmos poderiam ser substituídos por deficientes físicos em algumas funções básicas, como telefonista, recepcionista, digitador e outros, redundando num maior emprego de policiaismilitares nas ruas. Para tanto, buscou primeiramente retratar a realidade na PMPR; caracterizar atividades de cunho civil e de cunho militar na atividade meio; além de onde e como aplicar a pessoa portadora de deficiência física. Na parte do desenvolvimento, foram abordadas conceituações básicas, como atividade Policial Militar, atividades-meio e atividades-fim da Polícia Militar, cunho civil e militar na atividade-meio. Na seqüência, abordaram-se aspectos da pessoa portadora de deficiência, sendo navegado em assuntos a respeito da antigüidade, do renascimento, a política demográfica, deficiência em si, Programa Nacional de Direitos Humanos, a realidade social do deficiente e sua situação atual. Tratou-se também dos deficientes físicos e a Polícia Militar, em que buscou-se evidenciar o que existe em legislação peculiar e cargos privativos de militares. Quanto aos direitos dos deficientes, relatou-se a respeito dos tratados internacionais e a legislação brasileira. Ainda no capítulo referente ao desenvolvimento retratou-se a respeito do PSAV - Prestador de Serviço Auxiliar Voluntário (Deficientes Físicos); APR - Associação Paranaense de Reabilitação; ADFP -Associação dos Deficientes Físicos do Paraná; empresas que abrem caminhos para deficientes; uma importante matéria veiculada na Gazeta do Povo com o título "700 Deficientes podem Perder o Emprego", postura esta defendida pelo Estado como sendo o serviço prestado de grande importância econômica e social. Um capítulo tratou sobre a presença de pessoal civil na Polícia Militar, com seus fundamentos legais e doutrinários. Chegou-se ao final do desenvolvimento retratando como seria uma possível implantação da alocação de deficientes físicos em certas atividades-meio da Polícia Militar do Paraná Finalizou o presente estudo tratando das considerações finais, em que algumas propostas foram colocadas, ressaltando-se a importância de primeiramente serem readequadas as instalações físicas das Unidades Policiais-Militares para o ideal recebimento destes funcionário