A Feasibility Study on a Men’s Cancer Support Group at the Mayo Clinic Health System, Mankato Andreas Cancer Center

The Institute of Medicine published a report in 2007 which outlined numerous sources of psychosocial distress that, ideally, should be managed when working with patients with cancer. Typically, they involve a lack of information available to the patient, emotional problems such as depression or anxiety, a lack of transportation and other resources, and disruptions to their daily life. Combined, these factors all contribute to poor adherence to prescribed treatments, and a slower return to health. Attending social support groups is a popular approach to coping with health problems such as these in the United States, and is considered to be clinically effective. Despite the buffering effects played by social support groups, however, men are found to be less likely than women to participate in support groups. The most commonly reported barrier to utilization of support groups is a lack of awareness of or lack of availability of these services. The goal of this project was to determine if there is a need for a men’s cancer support group at the Mayo Clinic Health System, Mankato Andreas Cancer Center through the use of a survey of men with a cancer diagnosis

Politics and Economics of Ethanol and Biodiesel Production and Consumption in Brazil

Biofuel production has grown considerably between 2004 and 2009. Global ethanol production more than doubled from 30 to 76 billion litres (1,609 PJ1) while global biodiesel grew eight-fold from 2 to 17 billion litres (550 PJ2) (REN21 Secretariat 2010, 13). In 2008, biofuels provided 2,109 PJ of fuel consumption, while global oil and natural gas consumption for the transport sector amounted to 93,282 PJ (International Energy Agency 2010). Mandatory blending of biofuels has been enacted in at least 41 states/provinces and 24 countries at the national level in 2009, and the EU Directive 2009/28/EC mandates the member states to ensure that at least 10% of the final consumption of energy in transport shall come from renewable sources (European Parliament 2009). Although specific framework conditions and objectives of these programmes differ from country to country, the following overall driving forces can be identified since they represent global challenges (International Transport Forum of the Organisation for Economic Co-operation and Development 2008a, 4). [... aus der Einleitung

Biotreibstoffe in Brasilien

Im Folgenden sollen anhand von einigen Tabellen und Grafiken die Erfahrungen Brasiliens mit Ethanol dargestellt und seine Pläne auch im Hinblick auf Biodiesel erläutert werden. Dabei stehen die Kosten-Nutzen-Analyse und die political economy im Vordergrund, die wiederum eingebettet sind in die landesspezifischen kulturellen und sozialen Rahmen-bedingungen. Es soll überprüft werden, ob - so wie Abbildung 1 suggeriert - mittels der Produktion von Biotreibstoffen für die Automobilzivilisation die Versöh-nung des alten agrarischen Brasiliens mit dem biotechnologischen Zeitalter gelingen kann. Stets wird dabei der Bezug zu den globalen und den europäischen Diskursen und Interessen im Auge behalten. Anstelle von konkreten Handlungsempfehlungen werden am Ende verschiedene Szenarien und mögliche Pfade für eine nachhaltige Treibstoffpolitik vorgestellt

Biotreibstoffe in Brasilien

Im Folgenden sollen anhand von einigen Tabellen und Grafiken die Erfahrungen Brasiliens mit Ethanol dargestellt und seine Pläne auch im Hinblick auf Biodiesel erläutert werden. Dabei stehen die Kosten-Nutzen-Analyse und die political economy im Vordergrund, die wiederum eingebettet sind in die landesspezifischen kulturellen und sozialen Rahmen-bedingungen. Es soll überprüft werden, ob - so wie Abbildung 1 suggeriert - mittels der Produktion von Biotreibstoffen für die Automobilzivilisation die Versöh-nung des alten agrarischen Brasiliens mit dem biotechnologischen Zeitalter gelingen kann. Stets wird dabei der Bezug zu den globalen und den europäischen Diskursen und Interessen im Auge behalten. Anstelle von konkreten Handlungsempfehlungen werden am Ende verschiedene Szenarien und mögliche Pfade für eine nachhaltige Treibstoffpolitik vorgestellt. --

Identifying and tracking mobile elements in evolving compost communities yields insights into the nanobiome

Microbial evolution is driven by rapid changes in gene content mediated by horizontal gene transfer (HGT). While mobile genetic elements (MGEs) are important drivers of gene flux, the nanobiome-the zoo of Darwinian replicators that depend on microbial hosts-remains poorly characterised. New approaches are necessary to increase our understanding beyond MGEs shaping individual populations, towards their impacts on complex microbial communities. A bioinformatic pipeline (xenoseq) was developed to cross-compare metagenomic samples from microbial consortia evolving in parallel, aimed at identifying MGE dissemination, which was applied to compost communities which underwent periodic mixing of MGEs. We show that xenoseq can distinguish movement of MGEs from demographic changes in community composition that otherwise confounds identification, and furthermore demonstrate the discovery of various unexpected entities. Of particular interest was a nanobacterium of the candidate phylum radiation (CPR) which is closely related to a species identified in groundwater ecosystems (Candidatus Saccharibacterium), and appears to have a parasitic lifestyle. We also highlight another prolific mobile element, a 313 kb plasmid hosted by a Cellvibrio lineage. The host was predicted to be capable of nitrogen fixation, and acquisition of the plasmid coincides with increased ammonia production. Taken together, our data show that new experimental strategies combined with bioinformatic analyses of metagenomic data stand to provide insight into the nanobiome as a driver of microbial community evolution

Do Associations Support Authoritarian Rule? Tentative Answers from Algeria, Mozambique, and Vietnam

Whether associations help to democratise authoritarian rule or support those in power is a contested issue that so far lacks a cross-regional perspective. Drawing on relational sociology, this paper explores the impact of state power in Algeria, Mozambique, and Vietnam on associations and vice versa. We focus on decision-making in associations and on three policy areas - welfare policy concerning HIV/AIDS, economic policy concerning small and mediumsized enterprises, policies concerning gender equality and the rights of women and sexual minorities - to assess the relations between associations and the state's infrastructural and discursive power. Most associations interviewed by us in the three countries accept or do not openly reject the state's and/or the state ruling party's various forms of interference in internal decision-making processes. Whereas associations in Algeria and Vietnam help to maintain the state's control through welfare provision, associations in Mozambique can weaken this form of infrastructural state power. Moreover, business and professionals' associations in all three countries help maintain the state's control through limited participation, i.e. another form of infrastructural state power. Finally, associations in all three countries support the state's discourse and policies in the area of gender equality and women's rights, though in all three countries at least some NGOs help weaken this form of state power

Patients' and Observers' Perceptions of Involvement Differ. Validation Study on Inter-Relating Measures for Shared Decision Making

OBJECTIVE: Patient involvement into medical decisions as conceived in the shared decision making method (SDM) is essential in evidence based medicine. However, it is not conclusively evident how best to define, realize and evaluate involvement to enable patients making informed choices. We aimed at investigating the ability of four measures to indicate patient involvement. While use and reporting of these instruments might imply wide overlap regarding the addressed constructs this assumption seems questionable with respect to the diversity of the perspectives from which the assessments are administered. METHODS: The study investigated a nested cohort (N = 79) of a randomized trial evaluating a patient decision aid on immunotherapy for multiple sclerosis. Convergent validities were calculated between observer ratings of videotaped physician-patient consultations (OPTION) and patients' perceptions of the communication (Shared Decision Making Questionnaire, Control Preference Scale & Decisional Conflict Scale). RESULTS: OPTION reliability was high to excellent. Communication performance was low according to OPTION and high according to the three patient administered measures. No correlations were found between observer and patient judges, neither for means nor for single items. Patient report measures showed some moderate correlations. CONCLUSION: Existing SDM measures do not refer to a single construct. A gold standard is missing to decide whether any of these measures has the potential to indicate patient involvement. PRACTICE IMPLICATIONS: Pronounced heterogeneity of the underpinning constructs implies difficulties regarding the interpretation of existing evidence on the efficacy of SDM. Consideration of communication theory and basic definitions of SDM would recommend an inter-subjective focus of measurement. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN25267500

How do family physicians communicate about cardiovascular risk? Frequencies and determinants of different communication formats

Background: Patients understand information about risk better if it is communicated in numerical or visual formats (e.g. graphs) compared to verbal qualifiers only. How frequently different communication formats are used in clinical primary care settings is unknown. Methods: We collected socioeconomic and patient understanding data using questionnaires and audio-recorded consultations about cardiovascular disease risk. The frequencies of the communication formats were calculated and multivariate regression analysis of associations between communication formats, patient and general practitioner characteristics, and patient subjective understanding was performed. Results: In 73% of 70 consultations, verbal qualifiers were used exclusively to communicate cardiovascular risk, compared to numerical (11%) and visual (16%) formats. Female GPs and female patient's gender were significantly associated with a higher use of verbal formats compared to visual formats (p = 0.001 and p = 0.039, respectively). Patient subjective understanding was significantly higher in visual counseling compared to verbal counseling (p = 0.001). Conclusions: Verbal qualifiers are the most often used communication format, though recommendations favor numerical and visual formats, with visual formats resulting in better understanding than others. Also, gender is associated with the choice of communication format. Barriers against numerical and visual communication formats among GPs and patients should be studied, including gender aspects. Adequate risk communication should be integrated into physicians' education

The State Socialist Mortality Syndrome

Death rates for working-age men in European state socialist countries deviated from general improvements in survival observed in the rest of Europe during the 20th century. The magnitude of structural labor force changes across countries correlates with lagged increases in death rates for men in the working ages. This pattern is consistent with a hypothesis that hyper-development of heavy industry and stagnation (even contraction) of the service sector created anomic conditions leading to unhealthy lifestyles and self-destructive behavior among men moving from primary-sector to secondary-sector occupations. Occupational contrasts within countries similarly show concentration of rising male death rates among blue collar workers. Collapse of state socialist systems produced rapid corrections in labor force structure after 1990, again correlated with a fading of the state socialist mortality syndrome in following decades