BEPCP: Media Campaign to Promote Smoke-Free Facilities

Kentucky continues to have the highest lung cancer rate in the nation and is in the top 10 states for heart disease. Despite progress in local smoke-free policies, rural populations remain disproportionately affected by secondhand smoke (SHS) exposure. Due to the longstanding cultural heritage of tobacco, many rural residents think of SHS as a nuisance rather than a serious health hazard

Legitimacy intermediation in the multilevel European polity and its collapse in the euro crisis

This essay re-examines the dual – republican and liberal – foundations of democratic legitimacy in the Western traditions of normative political theory. Considered in isolation, the European Union conforms to liberal standards but cannot satisfy republican criteria. Given these conflicting standards, debates on the alleged European democratic deficit have remained inconclusive. Moreover, they have failed to pay sufficient attention to the multilevel character of the European polity and to the normative potential of legitimacy intermediation in its two-step compliance and legitimating relationships. I argue, however, that the capacity of democratic member states to legitimate the exercise of European governing functions is being destroyed in the present euro crisis, and I briefly discuss the implications of this new constellation.In der westlichen Tradition der normativen politischen Theorie beruht demokratische Legitimität auf der doppelten Grundlage republikanischer und liberaler Prinzipien. Für sich betrachtet entspricht die Europäische Union zwar liberalen Kriterien, aber eben nicht den republikanischen Anforderungen. Angesichts so unterschiedlicher Kriterien konnte es auch im Streit über das angebliche europäische Demokratiedefizit keine Einigung geben. Überdies ignorierte diese Diskussion den Mehrebenen-Charakter der europäischen Politik und das normative Potenzial der Legitimationsvermittlung zwischen Union und Bürgern durch die demokratisch verfassten Mitgliedstaaten. Die gegenwärtige Eurokrise allerdings zerstört die Fähigkeit demokratischer Mitgliedstaaten, die Ausübung europäischer Herrschaftsfunktionen zu legitimieren. Der Aufsatz erörtert die Implikationen dieser neuen Konstellation.1 Introduction 2 Legitimacy discourses The republican discourse The liberal discourse Differences 3 Constitutional democracies – and the European Union? 4 Legitimacy intermediation in the multilevel European polity 5 The end of legitimacy intermediation in the euro crisis Monetary Union and the failure of output legitimacy Rescuing the euro through supranational intervention 6 Legitimate supranational government? Input-oriented European legitimacy? 7 Reducing the burden on European legitimacy Reference

Secular Trends and Smoke-free Policy Development in Rural Kentucky

Secondhand smoke (SHS) exposure causes cardiovascular disease, lung cancer and pulmonary disorders. Smoke-free policies are the most effective way to prevent exposure to SHS. A 5-year community-based randomized control trial (RCT) is in progress to assess factors associated with smoke-free policy development in rural communities. Considering secular trends is critical when conducting community-based RCTs as they may threaten the internal validity of the study. For the purposes of this paper, secular trends are defined as patterns or recurring events that are not directly related to smoke-free policy but have the potential to influence policy development. There are no established protocols to monitor secular trends in the study of smoke-free policy in rural communities. The purpose of this paper is to (i) describe the development of a protocol to identify and monitor secular trends that may threaten the internal validity of a community-based RCT to promote smoke-free policy development and (ii) describe secular trends identified in the first 2 years of the RCT. The sample includes 854 secular events captured from media outlets covering the 40 study counties over the first 2 years of the RCT. Of these 854 events, there were 281 secular events in Year 1 and 573 in Year 2. This paper focuses on five specific categories: \u27tobacco use and cessation activities\u27, \u27farming\u27, \u27economics\u27, \u27city/county infrastructure\u27 and \u27wellness\u27. This protocol is a feasible yet time-intensive method of identifying events that may threaten the internal validity of a community-based RCT

Kentucky Tobacco Prevention and Cessation Status Report, 2004

Executive Summary: The purpose of the Kentucky Tobacco Use Prevention and Cessation Status Report 2004 is to describe tobacco use and policy patterns in the Commonwealth and local health department service areas from 1996 to 2003. Tobacco use is the single most preventable cause of death in Kentucky and the U.S. Kentucky leads the nation in adult cigarette smoking prevalence and spends over $1 billion dollars each year treating sick smokers. Although the Commonwealth of Kentucky is not making progress in reducing the percent of adults and pregnant women who smoke, the state is moving forward in reducing youth tobacco use, reducing youth access to tobacco products, adopting local voluntary smoke-free policies, and providing cessation programs. In just one year, the percent of smoke-free food establishments in the state increased from 39.6The Kentucky Department for Public Health (KDPH) Tobacco Prevention and Cessation Program supports local health departments in implementing comprehensive community-based programs that address the four Centers for Disease Control and Prevention (CDC) goals to reduce tobacco use and the associated health risks. The CDC goals are to (a) prevent initiation of tobacco use by youth and young adults; (b) promote cessation; (c) reduce exposure to secondhand smoke; and (d) identify and eliminate disparities among population groups that are disproportionately affected by tobacco use. The Kentucky Tobacco Prevention and Cessation Program has developed an Annual Plan that is based on the Healthy Kentuckians 2010 goals to reduce tobacco use. Since FY 2000-2002 the Kentucky General Assembly allocated$5.5 million biannually of the Master Settlement Agreement (MSA) monies to the Kentucky Department for Public Health for tobacco control (an average of $.60 per capita). For FY 2003,$3.1 million was allocated for tobacco control, and $2.7 million in FY 2004. The CDC recommends that Kentucky spend at least$6.42 per capita for comprehensive, evidence-based tobacco control. Since 2000, all local health departments have received funding to provide tobacco use prevention and cessation services. Prior to state MSA funding, ten local health departments received $60,000 per year from KDPH through a cooperative agreement with the CDC for comprehensive tobacco control. As of fiscal year 2004-2005, eight local health departments received additional CDC funds for tobacco prevention and cessation

Secondhand smoke and Smoke-Free Policy

Smoke-free Policy in Kentucky 2006 is designed for policymakers and community advocates who want to know more about the health effects of secondhand smoke and the effects of smoke-free laws on communities. Secondhand smoke is a toxic air contaminant. Secondhand smoke is the third leading cause of preventable death in the United States. Secondhand smoke affects nearly every organ of the body, causing heart disease, lung and other cancers, breathing disorders such as asthma, and sudden infant death syndrome. Most Kentuckians do not smoke, but at least 74% are regularly exposed to secondhand smoke in public places. Comprehensive smoke-free laws protect smokers and nonsmokers from secondhand smoke. Smoke-free laws significantly reduce air pollution. Workers who experience smoke-free laws have an almost immediate improvement in breathing symptoms. Lexington’s hospitality workers showed a dramatic 56% decline in hair nicotine levels in just three months after the smoke-free law took effect. The majority of workers and the public like smoke- free laws. There is no scientific evidence that smoke-free laws harm business. Currently, only 6.9% of Kentuckians are covered by comprehensive smoke- free laws. An additional 19.1% are covered by partial smoke-free laws. In these communities, some workers are protected from secondhand smoke, and the public is protected some of the time. Some schools and some workplaces have voluntarily adopted policies to reduce exposure to secondhand smoke. Less than half (46.6%) of Kentucky public and private middle and high schools prohibit smoking everywhere on their campuses. Similarly, 49% of Kentucky manufacturing facilities voluntarily prohibit indoor smoking. Healthy People 2010 is a nationwide health promotion initiative grounded in science and designed to promote health and prevent illness, disability, and premature death. Is Kentucky making progress toward the Healthy People 2010 Objectives for eliminating exposure to secondhand smoke? There is some progress toward increasing the percentage of smoke-free environments at schools and workplaces; and in reducing the proportion of nonsmokers exposed to secondhand smoke by implementing comprehensive smoke-free policies in public places

Liquid Biopsy Profiling with Multiple Tests in Patients with Metastatic Breast Cancer

The chief goal of the Blood Profiling Atlas in Cancer (BloodPAC) consortium is to promote collaborative efforts that support the development and implementation of liquid biopsy tests. Here, we report the results of a pilot study conducted by three BloodPAC members that aimed to demonstrate a multisite liquid biopsy testing framework using longitudinal blood specimens from 38 patients with metastatic breast cancer. Three laboratories receiving identical samples from two clinical sites each applied a different targeted sequencing platform to analyze mutations in cell-free DNA (cfDNA). The resulting mutational profiles reflected common breast cancer alterations, including clinically actionable mutations for 40% of hormone- receptor-positive patients. In 12 genes with shared target regions across sequencing panels, perfect inter-assay concordance was also observed for mutations detected above the lowest common assay limit of detection. Whole-genome copy number profiling of cfDNA and circulating tumor cells (CTCs) further revealed marked heterogeneity in copy number alterations and cfDNA tumor fractions across patients. Additionally, comparison of tumor fraction and CTC abundance demonstrated the complementary nature of cfDNA and CTC analyses. Overall, the framework described in this study may serve as a resource for future trials aiming to identify multimodal liquid biopsy biomarkers to guide clinical care