The Movement Action Plan: A Strategic Framework Describing The Eight Stages of Successful Social Movements

Social movements are collective actions in which the populace is alerted, educated, and mobilized, over years and decades, to challenge the powerholders and the whole society to redress social problems or grievances and restore critical social values. By involving the populace directly in the political process, social movements also foster the concept of government of, by, and for the people. The power of movements is directly proportional to the forcefulness with which the grassroots exert their discontent and demand change. The central issue of social movements, therefore, is the struggle between the movement and the powerholders to win the hearts (sympathies), minds (public opinion), and active support of the great majority of the populace, which ultimately holds the power to either preserve the status quo or create change

Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice : A microsimulation screening analysis

BACKGROUND: Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus “good practice.”. METHODS: Microsimulation screening analysis (MISCAN) was used to evaluate the effect on quality-adjusted life-years (QALYs) if 4 recommendations were followed: limited screening in older men, selective biopsy in men with elevated PSA, active surveillance for low-risk tumors, and treatment preferentially delivered at high-volume centers. Outcomes were compared with a base model in which annual screening started at ages 55 to 69 years and were simulated using data from the European Randomized Study of Screening for Prostate Cancer. RESULTS: In terms of QALYs gained compared with no screening, for 1000 screened men who were followed over their lifetime, recommended good practice led to 73 life-years (LYs) and 74 QALYs gained compared with 73 LYs and 56 QALYs for the base model. In contrast, common practice led to 78 LYs gained but only 19 QALYs gained, for a greater than 75% relative reduction in QALYs gained from unadjusted LYs gained. The poor outcomes for common practice were influenced predominantly by the use of aggressive treatment for men with low-risk disease, and PSA testing in older men also strongly reduced potential QALY gains. CONCLUSIONS: Commonly used PSA screening and treatment practices are associated with little net benefit. Following a few straightforward clinical recommendations, particularly greater use of active surveillance for low-risk disease and reducing screening in older men, would lead to an almost 4-fold increase in the net benefit of prostate cancer screening. Cancer 2016;122:3386–3393

Expected population impacts of discontinued prostate‐specific antigen screening

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109652/1/cncr28932-sup-0001-suppinfo.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/109652/2/cncr28932.pd

The epidemiology of high-risk prostate cancer

Purpose of reviewConcern for over and under-treatment of men with prostate cancer has led to an increased focus on the identification and selective treatment of men with high-risk features. The purpose of this review is to summarize the epidemiology, risk factors, and treatment trends of men with high-risk prostate cancer.Recent findingsFindings from recent trials on prostate-specific antigen-based screening suggest that screening has substantially reduced the incidence of high-risk prostate cancer. Men with high-risk disease tend to be older at diagnosis than those with low-risk disease. There is marked variation in the treatment of men with high-risk features; contemporary studies favor multimodal therapy, but high-risk disease is often under-treated with androgen deprivation alone, particularly among older men.SummaryVariations in the incidence, mortality, and treatment of men with high-risk prostate cancer may reflect heterogeneity among studies in the definition of high-risk disease. Future research should attempt to standardize definitions of high-risk prostate cancer to allow better comparison between studies and provide a more homogeneous assessment of natural history

Empirical estimates of prostate cancer overdiagnosis by age and prostate-specific antigen

Background: Prostate cancer screening depends on a careful balance of benefits, in terms of reduced prostate cancer mortality, and harms, in terms of overdiagnosis and overtreatment. We aimed to estimate the effect on overdiagnosis of restricting prostate specific antigen (PSA) testing by age and baseline PSA.Methods: Estimates of the effects of age on overdiagnosis were based on population based incidence data from the US Surveillance, Epidemiology and End Results database. To investigate the relationship between PSA and overdiagnosis, we used two separate cohorts subject to PSA testing in clinical trials (n = 1,577 and n = 1,197) and a population-based cohort of Swedish men not subject to PSA-screening followed for 25 years (n = 1,162).Results: If PSA testing had been restricted to younger men, the number of excess cases associated with the introduction of PSA in the US would have been reduced by 85%, 68% and 42% for age cut-offs of 60, 65 and 70, respectively. The risk that a man with screen-detected cancer at age 60 would not subsequently lead to prostate cancer morbidity or mortality decreased exponentially as PSA approached conventional biopsy thresholds. For PSAs below 1 ng/ml, the risk of a positive biopsy is 65 (95% CI 18.2, 72.9) times greater than subsequent prostate cancer mortality.Conclusions: Prostate cancer overdiagnosis has a strong relationship to age and PSA level. Restricting screening in men over 60 to those with PSA above median (>1 ng/ml) and screening men over 70 only in selected circumstances would importantly reduce overdiagnosis and change the ratio of benefits to harms of PSA-screening

The Movement Action Plan: A Strategic Framework Describing The Eight Stages of Successful Social Movements

The Movement Action Plan is a strategic model for waging nonviolent social movements developed by Bill Moyer, a US social change activist. The MAP, initially developed by Moyer in the late 1970s, uses case studies of successful social movements to illustrate eight distinct stages through social movements' progress, and is designed to help movement activists choose the most effective tactics and strategies to match their movements' current stage

Invited Paper

Minimization of power consumption in portable and batterypowered embedded systems has become an important aspect of processor and system design. Opportunities for power optimization and tradeoffs emphasizing low power are available across the entire design hierarchy. A review of low-power techniques applied at many levels of the design hierarchy is presented, and an example of low-power processor architecture is described along with some of the design decisions made in implementation of the architecture. Keywords—Circuit design, clock distribution, clock gating, CMOS circuits, CPU microarchitecture, instruction set design, low-power architecture, low-power design, low-power synthesis, low-power systems, power dissipation, power minimization, power optimization, RISC, state assignment, system design. I