Attitudes and Practices about Tobacco Smoking at a Jesuit University: Cura personalis or Individual Rights?

Purpose: This study examined opinions about tobacco use on campus from the perspectives of students and faculty on a Jesuit university, Regis University, in Denver, Colorado. Participants: Students, Faculty and Staff of Regis University were invited to participate in a survey during the fall of 2014. Method: An exploratory descriptive survey methodology using Chi-square statistics for bivariate comparisons and qualitative content analyses were utilized for this study. Results: The survey had a 27% response rate. Undergraduates comprised 56% of the sample, with 27% graduate students, and 17% faculty/staff. Eighty-eight percent of respondents reported that the presence of second hand smoke (SHS) on campus bothered them as did 83% of not current smokers. Nineteen percent of current smokers reported that walking through smoke is disagreeable. Comments from respondents revealed support for as well as against a smoking ban on campus. Conclusions: The majority of respondents support a complete ban on tobacco smoking on campus, and compared to a 2009 survey of Regis University faculty, staff, and student, support for a complete ban on smoking on campus has increased, while the rate of current daily smoking has decreased on campus. However, there is clearly tension between the concept of cura personalis and the belief in freedom and individual rights among the respondents on this campus

Chronic Systemic Immune Dysfunction in African-Americans with Small Vessel-Type Ischemic Stroke

The incidence of small vessel-type (lacunar) ischemic strokes is greater in African-Americans compared to whites. The chronic inflammatory changes that result from lacunar stroke are poorly understood. To elucidate these changes, we measured serum inflammatory and thrombotic biomarkers in African-Americans at least 6 weeks post-stroke compared to control individuals. Cases were African-Americans with lacunar stroke (n = 30), and controls were age-matched African-Americans with no history of stroke or other major neurologic disease (n = 37). Blood was obtained \u3e 6 weeks post-stroke and was analyzed for inflammatory biomarkers. Freshly isolated peripheral blood mononuclear cells were stimulated with lipopolysaccharide (LPS) to assess immune responsiveness in a subset of cases (n = 5) and controls (n = 4). After adjustment for covariates, the pro-inflammatory biomarkers, soluble vascular cadherin adhesion molecule-1 (sVCAM-1) and thrombin anti-thrombin (TAT), were independently associated with lacunar stroke. Immune responsiveness to LPS challenge was abnormal in cases compared to controls. African-Americans with lacunar stroke had elevated blood levels of VCAM-1 and TAT and an abnormal response to acute immune challenge \u3e 6 weeks post-stroke, suggesting a chronically compromised systemic inflammatory response

Quality assurance and assessment frameworks of biosystems engineering studies

Regulatory instruments at the national level to ensure high quality are crucial to achieve and maintain a regional hub of higher education in Malta. While The Malta Qualifications Council and the National Commission for Higher Education are established and operational, the legal framework to set up a quality assurance agency and a quality assurance and licensing framework is in place, but the legislations is still awaiting approval. The University of Malta has set up internal quality assurance structures, The Programme Validation Committee monitors, reviews and recommends programmes for approval by Senate, The formation of the INSTITUTE OF EARTH SYSTEMS will facilitate the means through which a Bio Systems Engineering course could be offered, Furthermore the recent establishment of a Maltese Chamber of Agrologists could in theory eventually take up the role to grant professional accreditation,peer-reviewe

Tobacco Use Treatment at the U.S. National Cancer Institute's Designated Cancer Centers

Tobacco use is a leading cause of cancer, and continued use after cancer diagnosis puts patients at greater risk for adverse health outcomes, including increased risk for cancer recurrence. This study surveyed National Cancer Institute (NCI)–designated Cancer Centers to assess the availability of tobacco use treatment (TUT) services

Impact of Tumor Pigmentation in 6934 Patients with Uveal Melanoma at a Single Center

Purpose: To evaluate clinical features and outcomes associated with degree of tumor pigmentation in patients with uveal melanoma (UM) of the choroid and ciliary body. Design: Retrospective observational study. Subjects: Six thousand nine hundred thirty-four consecutive patients with choroidal or ciliary body melanoma between 1971 and 2007 from a single ocular oncology center. Methods: Data on patient demographics, tumor characteristics, treatment approach, and clinical outcomes were collected. Comparisons between pigmented (\u3e80% pigmentation by surface area), partially pigmented (20%–80%), and nonpigmented tumors (\u3c20%) were performed using relevant hypothesis testing. Survival analyses for metastasis and melanoma-related death were conducted using the Kaplan–Meier method with log-rank tests for univariate comparisons. A multivariate Cox regression analysis was performed to assess the independent effects of multiple covariates on time-to-metastasis. Main Outcome Measures: Extraocular extension, ocular melanocytosis, time to tumor recurrence, tumor location, and melanoma-related metastasis and death. Results: There were 6934 eyes with UM and the degree of tumor pigmentation was classified as pigmented (n = 3762; 54%), partially pigmented (n = 2115; 31%), or nonpigmented (n = 1057; 15%). Pigmented UM was associated with extraocular extension (P \u3c 0.001), ocular melanocytosis (P = 0.003), earlier tumor recurrence (P \u3c 0.001), and more anterior tumor epicenter location (ciliary body, and equator to ora serrata) (P \u3c 0.001). Pigmented UMs also exhibited the highest 10-year metastasis rate at 26%, compared with 19% for partially pigmented UMs and 16% for nonpigmented UMs (P \u3c 0.001). Kaplan–Meier survival curves demonstrated differences among the tumor pigmentation groups for melanoma-related metastasis (P \u3c 0.001) and melanoma-related death (P \u3c 0.001). Multivariate Cox regression analysis for melanoma-related metastasis showed that pigmented UMs had a 29% higher relative risk of developing metastasis compared with partially pigmented UMs (P = 0.002) and a 54% higher relative risk of developing metastasis compared with nonpigmented UMs (P \u3c 0.001). Conclusions: Pigmented choroidal and ciliary body melanoma is more often associated with ocular melanocytosis, extraocular extension, anterior tumor epicenter, and earlier tumor recurrence. We also revealed that patients with pigmented UMs demonstrate a higher 10-year rate of metastatic disease and have decreased metastatic survival relative to partially pigmented and nonpigmented UMs. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article

Patient Perspectives on Tobacco Use Treatment in Primary Care

IntroductionEvidence-based tobacco cessation interventions increase quit rates, yet most smokers do not use them. Every primary care visit offers the potential to discuss such options, but communication can be tricky for patients and provider alike. We explored smokers’ personal interactions with health care providers to better understand what it is like to be a smoker in an increasingly smoke-free era and the resources needed to support quit attempts and to better define important patient-centered outcomes.MethodsThree 90-minute focus groups, involving 33 patients from 3 primary care clinics, were conducted. Participants were current or recent (having quit within 6 months) smokers. Topics included tobacco use, quit attempts, and interactions with providers, followed by more pointed questions exploring actions patients want from providers and outcome measures that would be meaningful to patients.ResultsFour themes were identified through inductive coding techniques: 1) the experience of being a tobacco user (inconvenience, shame, isolation, risks, and benefits), 2) the medical encounter (expectations of providers, trust and respect, and positive, targeted messaging), 3) high-value actions (consistent dialogue, the addiction model, point-of-care nicotine patches, educational materials, carbon monoxide monitoring, and infrastructure), and 4) patient-centered outcomes.ConclusionEngaged patient-centered smoking cessation counseling requires seeking the patient voice early in the process. Participants desired honest, consistent, and pro-active discussions and actions. Participants also suggested creative patient-centered outcome measures to consider in future research

Remembrances of Steve Ellmann, Still Present

In Memoriam: Steven Ellman

Neuronal caspase 2 activity and function requires RAIDD, but not PIDD

Caspase 2 was initially identified as a neuronally expressed developmentally down-regulated gene (HUGO gene nomenclature CASP2) and has been shown to be required for neuronal death induced by several stimuli, including NGF (nerve growth factor) deprivation and Aβ (β-amyloid). In non-neuronal cells the PIDDosome, composed of caspase 2 and two death adaptor proteins, PIDD (p53-inducible protein with a death domain) and RAIDD {RIP (receptor-interacting protein)-associated ICH-1 [ICE (interleukin-1β-converting enzyme)/CED-3 (cell-death determining 3) homologue 1] protein with a death domain}, has been proposed as the caspase 2 activation complex, although the absolute requirement for the PIDDosome is not clear. To investigate the requirement for the PIDDosome in caspase-2-dependent neuronal death, we have examined the necessity for each component in induction of active caspase 2 and in execution of caspase-2-dependent neuronal death. We find that both NGF deprivation and Aβ treatment of neurons induce active caspase 2 and that induction of this activity depends on expression of RAIDD, but is independent of PIDD expression. We show that treatment of wild-type or PIDD-null neurons with Aβ or NGF deprivation induces formation of a complex of caspase 2 and RAIDD. We also show that caspase-2-dependent execution of neurons requires RAIDD, not PIDD. Caspase 2 activity can be induced in neurons from PIDD-null mice, and NGF deprivation or Aβ use caspase 2 and RAIDD to execute death of these neurons