A unified theory of value-based reasoning and U.S. public opinion

Public opinion research shows that American citizens utilize domain-specific political values to guide opinion formation in the key issue areas that comprise the American political agenda. One set of political values operates on economic welfare opinions, a different set of values applies to cultural issue positions, a third set shapes foreign policy preferences, and so on in other policy domains. Drawing on Shalom Schwartz’s theory of basic human values, this paper argues that two socially focused values—self-transcendence and conservation—guide opinion formation across all major policy domains. By contrast, the personally focused values of self-enhancement and openness-to-change should play a more limited role in preference formation. These hypotheses are tested using data from a novel 2011 national survey and the 2012 General Social Survey. The statistical results affirm expectations. We show that self-transcendence and conservation values predict scores on symbolic ideology, economic conservatism, racial conservatism, cultural conservatism, civil liberties, and foreign policy opinions. Self-enhancement and openness-to-change values play a modest role in shaping preferences

Strategies for Colorectal Cancer Screening

The incidence of colorectal cancer (CRC) is increasing worldwide. CRC has high mortality when detected at advanced stages, yet it is also highly preventable. Given the difficulties in implementing major lifestyle changes or widespread primary prevention strategies to decrease CRC risk, screening is the most powerful public health tool to reduce mortality. Screening methods are effective but have limitations. Furthermore, many screen-eligible persons remain unscreened. We discuss established and emerging screening methods, and potential strategies to address current limitations in CRC screening. A quantum step in CRC prevention might come with the development of new screening strategies, but great gains can be made by deploying the available CRC screening modalities in ways that optimize outcomes while making judicious use of resources

Supplementation with progestogens in the first trimester of pregnancy to prevent miscarriage in women with unexplained recurrent miscarriage: a systematic review and meta-analysis of randomized, controlled trials

OBJECTIVE: To investigate whether treatment with progestogens in the first trimester of pregnancy would decrease the incidence of miscarriage in women with a history of unexplained recurrent miscarriage. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Women with a history of unexplained recurrent miscarriage. INTERVENTION(S): Randomized, controlled trials were identified by searching electronic databases. We included randomized, controlled trials comparing supplementation with progestogens (i.e., intervention group) in the first trimester of pregnancy with control (either placebo or no treatment) in women with a history of recurrent miscarriage. All types of progestogens, including natural P and synthetic progestins, were analyzed. MAIN OUTCOME MEASURE(S): The primary outcome was the incidence of miscarriage. The summary measures were reported as relative risk (RR) with 95% confidence interval (CI). RESULT(S): Ten trials including 1,586 women with recurrent miscarriage were analyzed. Eight studies used placebo as control and were double-blind. Regarding the intervention, two RCTs used natural P, whereas the other eight studies used progestins: medroxyprogesterone, cyclopentylenol ether of progesterone, dydrogesterone, or 17-hydroxyprogesterone caproate. Pooled data from the 10 trials showed that women with a history of unexplained recurrent miscarriage who were randomized to the progestogens group in the first trimester and before 16 weeks had a lower risk of recurrent miscarriage (RR 0.72, 95% CI 0.53-0.97) and higher live birth rate (RR 1.07, 95% CI 1.02-1.15) compared with those who did not. No statistically significant differences were found in the other secondary outcomes, including preterm birth (RR 1.09, 95% CI 0.71-1.66), neonatal mortality (RR 1.80, 95% CI 0.44-7.34), and fetal genital abnormalities (RR 1.68, 95% CI 0.22-12.62). CONCLUSION(S): Our findings provide evidence that supplementation with progestogens may reduce the incidence of recurrent miscarriages and seem to be safe for the fetuses. Synthetic progestogens, including weekly IM 17-hydroxyprogesterone caproate, but not natural P, were associated with a lower risk of recurrent miscarriage. Given the limitations of the studies included in our meta-analysis, it is difficult to recommend route and dose of progestogen therapy. Further head-to-head trials of P types, dosing, and route of administration are required

Tissue-engineered valved conduits in the pulmonary circulation

AbstractObjective: Bioprosthetic and mechanical valves and valved conduits are unable to grow, repair, or remodel. In an attempt to overcome these shortcomings, we have evaluated the feasibility of creating 3-leaflet, valved, pulmonary conduits from autologous ovine vascular cells and biodegradable polymers with tissue-engineering techniques. Methods: Endothelial cells and vascular medial cells were harvested from ovine carotid arteries. Composite scaffolds of polyglycolic acid and polyhydroxyoctanoates were formed into a conduit, and 3 leaflets (polyhydroxyoctanoates) were sewn into the conduit. These constructs were seeded with autologous medial cells on 4 consecutive days and coated once with autologous endothelial cells. Thirty-one days (±3 days) after cell harvesting, 8 seeded and 1 unseeded control constructs were implanted to replace the pulmonary valve and main pulmonary artery on cardiopulmonary bypass. No postoperative anticoagulation was given. Valve function was assessed by means of echocardiography. The constructs were explanted after 1, 2, 4, 6, 8, 12, 16, and 24 weeks and evaluated macroscopically, histologically, and biochemically. Results: Postoperative echocardiography of the seeded constructs demonstrated no thrombus formation with mild, nonprogressive, valvular regurgitation up to 24 weeks after implantation. Histologic examination showed organized and viable tissue without thrombus. Biochemical assays revealed increasing cellular and extracellular matrix contents. The unseeded construct developed thrombus formation on all 3 leaflets after 4 weeks. Conclusion: This experimental study showed that valved conduits constructed from autologous cells and biodegradable matrix can function in the pulmonary circulation. The progressive cellular and extracellular matrix formation indicates that the remodeling of the tissue-engineered structure continues for at least 6 months. (J Thorac Cardiovasc Surg 2000;119:732-40

Applying the Food-Energy-Water Nexus approach to urban agriculture: from FEW to FEWP (Food-Energy-Water-People)

Many studies examine the correlation between the use of resources such as water, energy and land, and the production of food. These nexus studies focus predominantly on large scale systems, often considering the social dimensions only in terms of access to resources and participation in the decision-making process, rather than individual attitudes and behaviours with respect to resource use. Such a concept of the nexus is relevant to urban agriculture (UA), but it requires customisation to the particular characteristics of growing food in cities, which is practiced mainly at a small scale and produces not only food but also considerable social, economic, and environmental co-benefits. To this end, this paper proposes a new concept for a UA Nexus, together with a methodology for its assessment, that explicitly includes social dimensions in addition to food, energy and water. The paper develops a new conceptual basis, introducing People, together with Food, Energy and Water, as factors of the UA Nexus. A methodological approach for its assessment is presented, aimed at measuring not only resource efficiency and food production but also motivations and health benefits, as well as the ecological awareness of urban farmers. The methodology is based on a combination of methods such as diaries of everyday UA practices, a database of UA activities, life cycle assessment (LCA), and material flow analysis to connect investigations developed at a garden scale to the city scale

The role of urban agriculture in food-energy-water nexus policies: Insights from Europe and the U.S

The growth of urban agriculture (UA) has raised the awareness of city officials and civil society organizations of its potential effects on food systems. This has led to various policies to regulate and support UA. This research characterizes existing food, energy and water (FEW nexus) policies based on policy data from five case study cities in Europe and the U.S. (Dortmund, Gorz´ow Wielkopolski, London, Nantes, and New York City) to analyze their relationships to UA, and to identify policy types that support resource-efficient UA. The paper presents the results of an analysis of 78 policy documents related to UA and the FEW nexus, and the results of a Q-sort ranking by UA policy experts on the effectiveness of 16 generalized UA policies in promoting resource-efficient UA. The number, type, and degree of support for nexus policies vary among the five case studies. The results show that the majority of policies (36) are implemented at the local scale, that few policies (19) incorporate all elements of the nexus, yet many nexus policies include UA indirectly. Regulations are more prevalent and are considered more effective at ensuring resource-efficient UA than incentives or awareness-raising policies. The study offers guidance to policy makers who want to improve resource use in future UA pointing at the increasing importance of local food policies

Differences in motivations and social impacts across urban agriculture types: Case studies in Europe and the US

Urban agriculture is an increasingly popular approach to addressing negative social and health effects of cities. Social benefits of urban agriculture include improved health and wellbeing, economic opportunities, social cohesion, and education. However, the extent to which urban agriculture participants are motivated by or experience these impacts has rarely been measured quantitatively, especially across the many different types of urban agriculture. We analysed survey data from 74 urban agriculture sites in France, Germany, Poland, the United Kingdom, and the United States to quantitatively assess the relationships between urban agriculture types, farmers and gardeners’ motivations, and the social impacts of urban agriculture. Through factor analysis, we established valid and reliable measurements of participants’ motivations and impacts. We identified four scales: general wellbeing impacts, nutritional health impacts, economic interests, and socialization motivations. Through multivariate analysis of variance, we document significant differences in motivations and reported impacts across types of urban agriculture. Finally, we conducted a multilevel multivariate analysis to explore the predictors of general wellbeing impacts. Participants with stronger economic interests, stronger socialization motivations, and who are owners or primary operators of their plots would be predicted to report greater general wellbeing impacts of urban agriculture. These results provide data about the impacts of urban agriculture projects that enable urban planners and policymakers to maximize the desired social benefits of urban agriculture

Comparing the carbon footprints of urban and conventional agriculture

Urban agriculture (UA) is a widely proposed strategy to make cities and urban food systems more sustainable. Until now, we have lacked a comprehensive assessment of the environmental performance of UA relative to conventional agriculture, and results from earlier studies have been mixed. This is the first large-scale study to resolve this uncertainty across cities and types of UA, employing citizen science at 73 UA sites in Europe and the United States to compare UA products to food from conventional farms. Results reveal that the carbon footprint of food from UA is six times greater than conventional agriculture (420 gCO2e versus 70 gCO2e per serving). However, some UA crops (for example, tomatoes) and sites (for example, 25% of individually managed gardens) outperform conventional agriculture. These exceptions suggest that UA practitioners can reduce their climate impacts by cultivating crops that are typically greenhouse-grown or air-freighted, maintaining UA sites for many years, and leveraging circularity (waste as inputs)