Some Properties of Transforms in Culture Theory

It is shown that, in certain circumstances, systems of cultural rules may be represented by doubly stochastic matrices denoted called possibility transforms, and by certain real valued possibility densities with inner product. Using such objects we may characterize a certain problem of ethnographic and ethological description as a problem of prediction, in which observations are predicted by properties of fixed points of transforms of pure systems, or by properties of convex combinations of such pure systems. That is, ethnographic description is an application of the Birkhoff theorem regarding doubly stochastic matrices on a space whose vertices are permutations.Comment: Read at International Quantum Structures Association meetings, 200

Adolescent School-Based Sex Education: Using Developmental Neuroscience to Guide New Directions for Policy and Practice

Abstract While school-based sex education is one of the key program and policy solutions to improve adolescent sexual health outcomes, new efforts are needed to strengthen its overall impact. The cognitive, hormonal, emotional, and physical changes that accompany the onset of puberty and occur throughout the teenage years play a significant role in aspects of adolescent sexual risk taking. Thus, one approach to advancing current understanding of these complex issues is to leverage emerging knowledge in developmental affective neuroscience over the past 15 years, which suggests some potentially promising innovations that may inform new educational directions to improve adolescent sexual health. Exploring the conceptual and empirical advances in understanding adolescent brain development through the lens of the conceptualization, implementation, and evaluation of sex education, this article provides new perspectives that encourage the testing of innovative approaches to sex education policy and practice

Asbury, Chatham County, NC : a community diagnosis including secondary data analysis and qualitative data collection

To be able to fully comprehend the health of a community, an analysis of all social, psychological, political and environmental factors which affect the overall well being of both the individuals and the community should be examined. A thorough community assessment involving both qualitative and quantitative research methods was conducted in Asbury, a rural town in southeastern Chatham County, North Carolina. This document compiles all of the information from the primary and secondary sources. Merging published information with the perceptions of the community illustrates a comprehensive picture of the community. The process was carried out by five, first-year master’s students in the Department of Health Behavior and Health Education of the School of Public Health at the University of North Carolina at Chapel Hill. This project lasted from September 1997 to May 1998. This team of master’s students, Ahna Ballonoff, Molly Cannon, Cindi McPherson, Peter Reed, and Ashlee Wheeler was paired with a preceptor, Chatham County Commissioner Margaret Pollard in a joint effort to assess the community of Asbury. A community diagnosis examines health and quality of life information in order to gain an accurate picture of a community. This assessment is carried out by gathering general and specific information about the resources, strengths, needs, and culture that contribute to the well being of a community. The ultimate goal is to provide community members with information that will be useful to them as a reference or to inform future proposals. This nine-month process included collection and review of information pertinent to the health of Asbury. During the fall, secondary data was collected, consisting primarily of aggregate health and social statistics. Due to a lack of specific secondary data on Asbury, County statistics were used and an image of Asbury was attained through informal interviews. Sources, including Chatham Community Health Improvement Project (CCHIP), Log Into North Carolina (LINC), Geographic Information Service (GIS), web sites, agencies in the area and local service providers furnished secondary data on issues which contribute to the health status of a community. These sections included Geography, History, Economy, Community Profile, Politics/Government and Health. Asbury, a part of the Oakland Township in Chatham County lies nine miles south of the County seat, Pittsboro. The Deep and Rocky Rivers form a natural border around the community. Lydia Perry Road and Rosser Road comprise the remaining borders that connect the two rivers. The land, covered by trees, has some fields with crops as well as chicken farms and cow pastures. A majority of Asbury’s families have lived in the community for several generations, which significantly impacts the community today. Many of these families have grown up in the Asbury United Methodist Church which has historically defined the community. Both the families and the Church have helped to maintain a sense of pride in the traditions and history of Asbury. Asbury has shifted from a farming-based agricultural community, to a community where there are a few home-based businesses that contribute to the economy. Asbury is a relatively small community consisting of 349 people. The majority of the population is white and the largest age bracket is made up of those over 65 years of age. A large percentage of residents in Asbury own their homes implying that the majority of the people are settled in the community. Most residents travel outside of the community to near by towns such as Pittsboro, Sanford or Chapel Hill for work, shopping and leisure activities. Children are bused to either Pittsboro or Goldston for their schooling. Asbury is an unincorporated town and has no formal governmental body at the community level. The formal unit governing Asbury is at the County level. Asbury contributes a significant number of workers to the County government offices, and thus receives a high level of recognition in Pittsboro, the County seat. Some important political topics in Asbury include lack of water and growth and development. Residents of Asbury utilize health services in Chatham, Lee and surrounding counties. Also, the Chatham County Health Department provides a variety of services in primary care and health promotion. A number of social support groups exist in Asbury, providing strong social ties and enhancing mental health. Some of these include the Ruritan Club, Young at Heart Club, Coon Hunter’s Association and several groups within The Asbury United Methodist Church. Environmental problems including poor soil, water quality and water supply dominate health concerns of Asbury and Chatham County. The second phase of data collection in Asbury involved the collection of primary data. Interviews and discussions were conducted with community members and service providers to gain this information. An interview guide was created which consisted of questions about issues and topics to be explored during the course of an interview. Initial interviews, conducted with several prominent community members asked about their perceptions of different aspects of Asbury. The residents recommended others in Asbury who might agree to participate in an interview. Twenty-seven individuals participated in the interview process, which stopped when the ideas and themes remained consistent. Other opportunities for qualitative data collection included attending church services, a Ruritan Club meeting and Young at Heart Club luncheon. There also was a questionnaire based on the interview guide distributed as well as an informal focus group conducted. The data from these was treated the same as that from the interviews. The interviews were coded for themes, which emerged repeatedly during the primary data collection, and subsequently organized into chapters for the document. The issue of growth and development evokes different feelings for residents of Asbury. As new businesses and housing subdivisions spring up, outside people see the resources and are encouraged to move into the area. Everyone agrees that an influx of new people and development of new businesses and subdivisions would affect the community. However, residents have opposing opinions as to whether the effects will be positive or negative. The issue of growth and development is indeed complex and the effects expected to be varied. Another topic that is somewhat two-sided is the lack of formal resources in the community requiring residents to rely on outside resources. This is especially troublesome when it comes to the response of emergency services to the community and transportation needs of residents. Most interviewed residents do not expect to see any significant increase of commercial buildings in the community. This may require that residents continue to rely on outside resources, but it will also preserve Asbury’s small town feel. The concern of water and septic has been a problem vocalized in Asbury since 1995. Asbury is currently not hooked up to waterlines and water is pumped from wells or is purchased. Inadequate water supply or poor quality can potentially affect the health of a community. Asbury residents worry about the cost of water and septic systems. An increased water supply may result in an increase in development in the community. Due to the complexity of this issue, the problem is currently not resolved. Asbury residents worry about the presence of drugs and alcohol, especially the potential effect on the youth of the community. Some residents feel there is a drug problem, which is connected to a lack of activities for youth. Residents suggest a need for support groups, as well as increased youth opportunities and activities, especially activities including parental involvement. Throughout the interviews the theme of Asbury being a tight-knit community resonated. Residents often commented on the security they felt in the fact that they can call on friends and neighbors to help with anything. The bonds that already exist between the individuals and groups make Asbury competent and able to deal with issues. The strength of the ties between the people also makes Asbury a splendid place to live. The Asbury assessment document contains valuable information, however important limitations should be considered. Lack of specific statistics available for Asbury required the use of Chatham County data for socio-demographic and health information. Another limitation in the collection of secondary data is that the 1990 Census may not reflect the current population. Potential limitations in the primary data section include using guides that prompted interviewees to discuss specific issues and the referral method utilized to select interviewees. The community diagnosis of Asbury that identified strengths and concerns of the area culminated in a Community Gathering held February 7, 1998. Information found during the community diagnosis process was presented to Asbury community members through this Gathering. The Gathering also offered residents the opportunity to discuss their concerns and opinions about their community through facilitated discussions. It is hoped that the residents of Asbury will use the information presented to enhance their community.Master of Public Healt

Feasibility of Image-Guided Radiotherapy for Elderly Patients with Locally Advanced Rectal Cancer

PURPOSE: The study aims to assess the tolerance of elderly patients (70 years or older) with locally advanced rectal cancers to image-guided radiotherapy (IGRT). A retrospective review of 13 elderly patients with locally advanced rectal cancer who underwent preoperative chemoradiation using IGRT was performed. Grade 3-4 acute toxicities, survival, and long-term complications were compared to 17 younger patients (<70 years) with the same disease stage. RESULTS: Grade 3-4 hematologic toxicities occurred in 7.6% and 0% (p = 0.4) and gastrointestinal toxicities, and, in 15.2% and 5% (p = 0.5), of elderly and younger patients, respectively. Surgery was aborted in three patients, two in the elderly group and one in the younger group. One patient in the elderly group died after surgery from cardiac arrhythmia. After a median follow-up of 34 months, five patients had died, two in the elderly and three in the younger group. The 3-year survival was 90.9% and 87.5% (p = 0.7) for the elderly and younger group respectively. Two patients in the younger group developed ischemic colitis and fecal incontinence. There was no statistically significant difference in acute and late toxicities as well as survival between the two groups. CONCLUSIONS AND CLINICAL RELEVANCE: Elderly patients with locally advanced rectal cancers may tolerate preoperative chemoradiation with IGRT as well as younger patients. Further prospective studies should be performed to investigate the potential of IGRT for possible cure in elderly patients with locally advanced rectal cancer

Social status strategy in early adolescent girls: Testosterone and value-based decision making

There has been strong interest, spanning several disciplines, in understanding adolescence as a developmental period of increased risk-taking behavior. Our goals focus on one line of investigation within this larger developmental risk framework. Specifically, we examined levels of pubertal hormones in girls in relation to their willingness to take greater financial risks to gain social status. To this end, we tested the hypothesis that higher levels of testosterone during the ages of pubertal maturation are associated with a greater willingness to sacrifice money for social admiration. Sixty-three girls ages 10-14 (Mage=12.74) participated in laboratory measures and completed at-home saliva sample collection. The Pubertal Development Scale (PDS) and basal hormone levels (testosterone, estradiol, DHEA) measured pubertal maturation. We made use of a developmentally appropriate version of an Auction Task in which adolescents could take financial risks in order to gain socially motivated outcomes (social status). PDS and testosterone were each associated with overall levels of financial risk taking over the course of the Auction Task. In hierarchical models, PDS and testosterone were predictors of the slope of overbidding over the course of the task. Results provide evidence for the role of testosterone and pubertal maturation in girls' motivations to engage in costly decision making in order to gain social status. Findings contribute to our understanding of the developmental underpinnings of some interesting aspects of adolescent risk behavior

Phase 2 Neoadjuvant Treatment Intensification Trials in Rectal Cancer: A Systematic Review

Purpose: Multiple phase 2 trials of neoadjuvant treatment intensification in locally advanced rectal cancer have reported promising efficacy signals, but these have not translated into improved cancer outcomes in phase 3 trials. Improvements in phase 2 trial design are needed to reduce these false-positive signals. This systematic review evaluated the design of phase 2 trials of neoadjuvant long-course radiation or chemoradiation therapy treatment intensification in locally advanced rectal cancer. Methods and Materials: The PubMed, EMBASE, MEDLINE, and Cochrane Library databases were searched for published phase 2 trials of neoadjuvant treatment intensification from 2004 to 2016. Trial clinical design and outcomes were assessed, with statistical design and compliance rated using a previously published system. Multivariable meta-regression analysis of pathologic complete response (pCR) was conducted. Results: We identified 92 eligible trials. Patients with American Joint Committee on Cancer stage II and III equivalent disease were eligible in 87 trials (94.6%). In 43 trials (46.7%), local staging on magnetic resonance imaging was mandated. Only 12 trials (13.0%) were randomized, with 8 having a standard-treatment control arm. Just 51 trials (55.4%) described their statistical design, with 21 trials (22.8%) failing to report their sample size derivation. Most trials (n=84, 91.3%) defined a primary endpoint, but 15 different primary endpoints were used. All trials reported pCR rates. Only 38 trials (41.3%) adequately reported trial statistical design and compliance. Meta-analysis revealed a pooled pCR rate of 17.5% (95% confidence interval, 15.7%-19.4%) across treatment arms of neoadjuvant long-course radiation or chemoradiation therapy treatment intensification and substantial heterogeneity among the reported effect sizes (I2 = 55.3%, P<.001). Multivariable meta-regression analysis suggested increased pCR rates with higher radiation therapy doses (adjusted P=.025). Conclusions: Improvement in the design of future phase 2 rectal cancer trials is urgently required. A significant increase in randomized trials is essential to overcome selection bias and determine novel schedules suitable for phase 3 testing. This systematic review provides key recommendations to guide future treatment intensification trial design in rectal cancer

RESTATEMENT OF THE THEORY OF CULTURAL RULES

We examine a theory of cultural rules as mathematical transforms. Certain cultural rules may be represented as set functions (called here “transforms”) between possible structures (called here “configurations” denoted “C”) on generations of an evolutionary sequence. If R is a rule and R its transform, the outcome of R acting of a starting configuration C is a set denoted RC of possible configurations. The smallest fixed point of the transform R of a rule R (called the “minimal structure” of that rule) is the descriptive diagram for illustration of the operation of certain rules traditionally used by ethnographers. A combinatorial density computing certain key population statistics of a cultural system is derivable from the minimal structure of the rule, enabling empirically testable (and successfully tested) predictions of observable population measures on systems using that rule. Therefore we may conclude that cultural structure and the uncertainty inherent in cultural systems are but two parts of one framework. Cultural theory thus has a structure in some ways like that of quantum theory, and is a physically testable physical theory. But quantum theory has been under development for a century. The task for a comparable cultural theory is simply to get started