51 research outputs found
BEYOND GATEWAY CITIES: ECONOMIC RESTRUCTURING AND POVERTY AMONG MEXICAN IMMIGRANT FAMILIES AND CHILDREN
Our main objective is to better understand how new residential patterns have reshaped patterns of poverty among America's growing Mexican-origin population. We use data from the Integrated Public Use Microdata Samples (IPUMS) to document recent changes in poverty rates among native-born and foreign-born Mexicans living in the Southwest and in new regions where many Mexican families have resettled. Our analysis focuses on how changing patterns of employment (e.g., in construction and food processing industries) have altered the risk of poverty among Mexican families and children. We demonstrate that the Mexican population dispersed widely throughout the United States during the 1990s. Perhaps surprisingly, Mexican workers, especially new immigrants, had much lower rates of poverty in the new destination regions and rural areas than their counterparts that remained in traditional areas of population concentration - the Southwest. As we show in this study, the dispersion of America's Mexican native-born and immigrant populations raises questions and hopes about their economic and political incorporation into American society.Food Security and Poverty,
Reporting of Child Abuse and Neglect by Salaried Primary Care Dentists
Mandatory reporting of child protection concerns was introduced in Ireland in December 2017 for certain professionals and individuals including all dentists. Previous to this date, Irish dentists only had an ethical obligation to report. International literature indicates that dentists see themselves as having a role in child protection. However, there appears to be a significant gap between those dentists who suspect child abuse and neglect (CAN) in a given case, and those who refer the case to the relevant authorities. The aim of this study was to investigate, prior to the introduction of mandatory reporting in the Republic of Ireland, the reporting of CAN by salaried primary care dentists and to identify any barriers to reporting. Two cross-sectional surveys using web-based anonymous questionnaires were sent to all Salaried Primary Care Dental Managers (N=17) and Senior and General Dentists (N=239) in Ireland in March 2017. 64.7% (n=11) of Managers and 28% (n=67) of dentists returned questionnaires. It was found that although, 30.8% of dentists had suspected at least one case of possible CAN over the previous 12 months, only 8.1% of the HSE dentists had formally reported at least one case of concern over the same period. There were clear barriers identified to the reporting of concerns. These barriers need to be addressed if Irish dentists are to meet their legal obligations of mandatory reporting of CAN
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Literature and Education: Recalling Matthew Arnold
In a democracy, every individual is thought to have the potential to achieve what Matthew Arnold considers the supreme characteristic of intellectual freedom, "the intellectual maturity of man himself; the tendency to observe facts with a critical spirit; to search for their law, not to wander among them at random; to judge by the rule of reason, not by the impulse of prejudice or caprice" (The Complete Prose Works of Matthew Arnold, Vol. 1, p. 21). But Arnold finds a critical opposition between man's instinctive efforts to develop "fully and freely" and the economic forces of the industrial culture of modern democracies, consumed with work and wealth accumulation. He maintains that in the aesthetic experience of literature we behold the being we are capable of. First in his poetry, and later in his critical prose, Arnold confronts the malaise of modernity and the spiritual fragmentation at the heart of contemporary literature. The hope for his project for education is that it can free us to find new critical consciousness and recover the moral authority of aesthetic judgment. In this study I try to explicate Arnold's conviction that collapsing the duality of literature and science expands our knowledge of the world and that cultivating humanity through the experience of ideas in literature affirms the integrity of the individual and reconciles his or her relation to nature and the human community. The aim of this work is twofold. First it recasts Arnold's uncertain legacy among philosophers of education in the perspective of philosophy as a way of life. I hope it also invites further inquiry into his synthesis of intellect and imagination in the aesthetic phenomenon and its capacity to critique conditions of existence
Phenology of Scramble Polygyny in a Wild Population of Chrysolemid Beetles: The Opportunity for and the Strength of Sexual Selection
Recent debate has highlighted the importance of estimating both the strength of sexual selection on phenotypic traits, and the opportunity for sexual selection. We describe seasonal fluctuations in mating dynamics of Leptinotarsa undecimlineata (Coleoptera: Chrysomelidae). We compared several estimates of the opportunity for, and the strength of, sexual selection and male precopulatory competition over the reproductive season. First, using a null model, we suggest that the ratio between observed values of the opportunity for sexual selections and their expected value under random mating results in unbiased estimates of the actual nonrandom mating behavior of the population. Second, we found that estimates for the whole reproductive season often misrepresent the actual value at any given time period. Third, mating differentials on male size and mobility, frequency of male fighting and three estimates of the opportunity for sexual selection provide contrasting but complementary information. More intense sexual selection associated to male mobility, but not to male size, was observed in periods with high opportunity for sexual selection and high frequency of male fights. Fourth, based on parameters of spatial and temporal aggregation of female receptivity, we describe the mating system of L. undecimlineata as a scramble mating polygyny in which the opportunity for sexual selection varies widely throughout the season, but the strength of sexual selection on male size remains fairly weak, while male mobility inversely covaries with mating success. We suggest that different estimates for the opportunity for, and intensity of, sexual selection should be applied in order to discriminate how different behavioral and demographic factors shape the reproductive dynamic of populations
Comparative Isotope Ecology of African Great Apes
The isotope ecology of great apes is a useful reference for palaeodietary reconstructions in fossil hominins. As extant apes live in C3 dominated habitats, variation in isotope signatures is assumed to be low compared to hominoids also exploiting C4-plant resources. However, isotopic differences between sites and between and within individuals were poorly understood due to the lack of vegetation baseline data. In this comparative study we included all species of free-ranging African great apes (Pan troglodytes, Pan paniscus, Gorilla gorilla gorilla and Gorilla beringeri beringei). We explore differences in isotope baselines across different habitats and how isotopic signatures in apes can be related to feeding niches (faunivory and folivory). Secondly, we illustrate how stable isotopic variation within African ape populations compares to other primates, including hominins from the fossil record, and discuss possible implications for dietary flexibility. Using 815 carbon and nitrogen isotope data from 155 sectioned hair samples and an additional collection of 189 fruit samples we compare six different great ape sites. We investigate the relationship between vegetation baselines and climatic variables, and subsequently correct great ape isotope data to a standardized plant baseline from the respective sites. We gained temporal isotopic profiles of individual animals by sectioning hair along its growth trajectory. Isotopic signatures of great apes differed between sites, mainly as vegetation isotope baselines were correlated with site-specific climatic conditions. We show that controlling for plant isotopic characteristics at a given site is essential for data interpretation. When controlling for plant baseline effects, we found distinct isotopic profiles for each great ape population. Based on evidence from habituated groups and sympatric great ape species these differences could be related to faunivory and folivory. Dietary flexibility in extant apes varies between species and populations, but temporal isotopic variation was overall lower than in species shifting from C3 to C4-resources, including fossil hominins and extant primates
Accelerating Progress Towards the 2030 Neglected Tropical Diseases Targets: How Can Quantitative Modeling Support Programmatic Decisions?
Over the past decade, considerable progress has been made in the control, elimination, and eradication of neglected tropical diseases (NTDs). Despite these advances, most NTD programs have recently experienced important setbacks; for example, NTD interventions were some of the most frequently and severely impacted by service disruptions due to the coronavirus disease 2019 (COVID-19) pandemic. Mathematical modeling can help inform selection of interventions to meet the targets set out in the NTD road map 2021-2030, and such studies should prioritize questions that are relevant for decision-makers, especially those designing, implementing, and evaluating national and subnational programs. In September 2022, the World Health Organization hosted a stakeholder meeting to identify such priority modeling questions across a range of NTDs and to consider how modeling could inform local decision making. Here, we summarize the outputs of the meeting, highlight common themes in the questions being asked, and discuss how quantitative modeling can support programmatic decisions that may accelerate progress towards the 2030 targets
Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial
Background
Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear.
Methods
RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047.
Findings
Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths.
Interpretation
Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population
Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial
Background
Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain.
Methods
RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and
ClinicalTrials.gov
,
NCT00541047
.
Findings
Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths.
Interpretation
Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy.
Funding
Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society
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