Young people’s civic attitudes and practices: England’s outcomes from the IEA International Civic and Citizenship Education Study (ICCS) - Research Report DFE-RR060

"ICCS is a large-scale study of pupil knowledge and understanding, dispositions and attitudes, which is administered across 38 countries worldwide. The results presented in this summary are based upon England’s national dataset, with reference to international- and European-level findings, and to findings from the IEA Civic Education Study (CIVED), which took place in 1999." - Background

The evolving dialectic between state-centric and human-centric security

This paper makes three main arguments. First, a critique of both the traditional state-centric approach to security and the more recently articulated human-centric approach suggests that each is necessary but not sufficient to address the contemporary security agenda. Second, there is however conceptual and empirical evidence that shows there is an evolving dialectic between these two approaches which is producing new thinking about security. The dialectic is between two referent objects, the state and people, between internal and external threats to these referent objects and between the various military and non-military means for enhancing the security of each. The dialectic also involves causal and constitutive connections between these elements. The final argument is that this evolving dialectic suffers from a number of problems, not least of which is the difficulty of achieving a balance between the two approaches on any given security issue. Nonetheless, in principle a dialectic between the state-centric and human-centric approaches offers a promising way of addressing the contemporary security agenda of state, trans-state and intra-state security issues and the connections between them

Lymphokine-activated killer cell susceptibility and adhesion molecule expression of multidrug resistant breast carcinoma

Reports showing susceptibility of multidrug resistant (MDR) cancer cells to immune effectors, together with P-glycoprotein (P-gp) expression in immune effector subsets, including immature natural killer (NK) cells, and some activated T cells, suggest P-gp or some changes associated with it, have implications in immune-mediated mechanisms. A series of experiments were done to determine the nature of alterations associated with susceptibility to immune effector cells of MDR tumor cells. A cell line isolated from the malignant pleural effusion of a breast cancer patient was transfected with human and murine MDR1 genes, and four variants with different levels of MDR were obtained. Lymphokine-activated killer (LAK) activity was measured by a (51)Chromium release, and conjugate formation assays. MDR1 transfectant P-gp(+ )breast carcinoma lines had increased LAK susceptibility compared to their parent line. Some part of the increased LAK susceptibility of drug-resistant cell lines was at the binding/recognition level as shown by conjugate formation assays. This suggests that differences may exist between paired cell lines with respect to the expression of cell adhesion molecules (CAMs). Monoclonal antibodies (mAbs) to CAMs and flow cytometry were used to quantitate these antigens. The CAMs studied were those previously found to be upregulated by stimulating NK cells with (interleukin-2) IL-2; ICAM-1 (CD54), LFA-3 (CD58), N-CAM (CD56), and the β chain of LFA-1 (CD18). Although no differences in these CAMs were found between the breast carcinoma line and its MDR1-transfected variants, the target susceptibility results given above suggest that IL-2 treatment could be effective in combination with current protocols using chemotherapeutics, monoclonal antibodies (mAbs) and stem cell transplantation

Predicting 1-year mortality among patients with decompensated cirrhosis:results of a multicentre evaluation of the Bristol Prognostic Score

Objective Chronic liver disease continues to be a significant cause of morbidity and mortality yet remains challenging to prognosticate. This has been one of the barriers to implementing palliative care, particularly at an early stage. The Bristol Prognostic Score (BPS) was developed to identify patients with life expectancy less than 12 months and to act as a trigger for referral to palliative care services. This study retrospectively evaluated the BPS in a cohort of patients admitted to three Scottish hospitals. Method Routinely collated healthcare data were used to obtain demographics, BPS and analyse 1-year mortality for patients with decompensated liver disease admitted to three gastroenterology units over two 90-day periods. Statistical analysis was undertaken to assess performance of BPS in predicting mortality. Results 276 patients were included in the final analysis. Participants tended to be late middle-aged men, socioeconomically deprived and have alcohol-related liver disease. A similar proportion was BPS+ve (>3) in this study compared with the original Bristol cohort though had more hospital admissions, higher ongoing alcohol use and poorer performance status. BPS performed poorer in this non-Bristol group with sensitivity 54.9% (72.2% in original study), specificity 58% (83.8%) and positive predictive value (PPV) 43.4% (81.3%). Conclusion BPS was unable to accurately predict mortality in this Scottish cohort. This highlights the ongoing challenge of prognostication in patients with chronic liver disease, furthering the call for more work in this field.Publisher PDFPeer reviewe

Evaluacija inovativno digitalno kontroliranog Er:YAG lasera u liječenju leukoplakije - probno istraživanje

The use of lasers for treatment of oral leukoplakia has gained a lot of interest in the past years, however, data on the use of Er:YAG laser are scarce. The aim of this study was to compare the efficacy of Er:YAG laser and 1% topical isotretinoin in the treatment of 27 oral leukoplakia patients. Er:YAG laser (LightWalker AT, Fotona, Slovenia) was used in 27 patients with 27 leukoplakia lesions. Postoperative pain was assessed by use of visual analog scale (VAS), and the impact of laser treatment on the quality of life was assessed by the OHIP-14 questionnaire (Croatian version). Control group consisted of the same 27 patients previously treated with 1% topical isotretionin three times a day during the period of one year. No improvement in the size of leukoplakia lesions was observed after treatment with topical isotretinoin. There were significant differences between men and women according to leukoplakia localization, number of laser sessions and VAS (p<0.05). At follow-up after six months and one year, there was no recurrence of lesions. Er:YAG laser is a successful treatment for oral leukoplakia. Topical isotretionin treatment is unsuccessful in patients with oral leukoplakia.Posljednjih godina postoji veliko zanimanje za upotrebu lasera u liječenju oralne leukoplakije, ali su podatci o upotrebi Er:YAG lasera malobrojni. Cilj ovoga istraživanja bio je usporediti učinak Er:YAG lasera i 1%-tnog topikalnog izotretinoina u liječenju 27 bolesnika s oralnom leukoplakijom. Er:YAG laser (LightWalker AT, Fotona, Slovenia) je korišten u 27 bolesnika s 27 leukoplakičnih lezija. Poslijeoperacijska bol je određena uz pomoć vizualne analogne ljestvice (visual analog scale, VAS), a utjecaj na kvalitetu života mjeren je pomoću upitnika OHIP-14 (hrvatska verzija). Kontrolna skupina se sastojala od istih 27 bolesnika koji su prije toga liječeni 1%-tnim topikalnim izotretioninom tri puta na dan tijekom tri mjeseca. Nije bilo poboljšanja u veličini lezija leukoplakije nakon topikalno primijenjenog izotretinoina. Utvrđene su značajne razlike između muškaraca i žena s obzirom na lokalizaciju leukoplakije, broj laserskih zahvata i rezultata VAS (p<0,05). Šest mjeseci i godinu dana od laserskog zahvata nije bilo recidiva oralne leukoplakije. Er:YAG laser je uspješna terapija u liječenju oralne leukoplakije. Topikalna primjena izotretionina nije uspješna u liječenju oralne leukoplakije

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19

Importance: Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality. // Objective: To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality. // Design, Setting, and Participants: The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis. // Exposures: SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated. // Main Outcomes and Measures: The primary end point was all-cause mortality within the primary hospitalization. // Results: Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86). // Conclusions and Relevance: The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed