Insurance impacts survival for children, adolescents, and young adults with bone and soft tissue sarcomas.

BackgroundWhile racial/ethnic survival disparities have been described in pediatric oncology, the impact of income has not been extensively explored. We analyzed how public insurance influences 5-year overall survival (OS) in young patients with sarcomas.MethodsThe University of California San Francisco Cancer Registry was used to identify patients aged 0-39 diagnosed with bone or soft tissue sarcomas between 2000 and 2015. Low-income patients were defined as those with no insurance or Medicaid, a means-tested form of public insurance. Survival curves were computed using the Kaplan-Meier method and compared using log-rank tests and Cox models. Causal mediation was used to assess whether the association between public insurance and mortality is mediated by metastatic disease.ResultsOf 1106 patients, 39% patients were classified as low-income. Low-income patients were more likely to be racial/ethnic minorities and to present with metastatic disease (OR 1.96, 95% CI 1.35-2.86). Low-income patients had significantly worse OS (61% vs 71%). Age at diagnosis and extent of disease at diagnosis were also independent predictors of OS. When stratified by extent of disease, low-income patients consistently had significantly worse OS (localized: 78% vs 84%, regional: 64% vs 73%, metastatic: 23% vs 30%, respectively). Mediation analysis indicated that metastatic disease at diagnosis mediated 15% of the effect of public insurance on OS.ConclusionsLow-income patients with bone and soft tissue sarcomas had decreased OS regardless of disease stage at presentation. The mechanism by which insurance status impacts survival requires additional investigation, but may be through reduced access to care

The influence of attachment styles, dyadic processes and affective states on health outcomes of women with breast cancer and their identified significant other

Breast cancer is one of the most common diagnosed cancers in Ireland (National Cancer Registry Ireland (NCRI), 2014). In today’s healthcare system women with breast cancer are now more than ever being supported through their disease trajectory by the significant others in their lives. While significant others of women with breast cancer are increasingly being involved in their care, little research has been conducted that explores the relationship between women with breast cancer and their significant other. The rationale for this study was prompted by the current change within the Irish healthcare system whereby a transference of breast cancer services to outpatient settings and day procedures means that now more than ever significant others of women with breast cancer are involved in their care. Exploring this relationship is beneficial to healthcare professionals who care for these women as it can aid in further understanding the care needs of these individuals. This study aimed to examine the influence of attachment style, dyadic processes and affective states on quality of life for women with breast cancer and their identified significant other, using the principles of attachment theory (Bowlby, 1969) and underpinned by a framework devised by Pietromonaco, Uchino and Schetter, (2013). A cross sectional correlational survey design was used. Data were collected using a multi-scale questionnaire devised by the researcher, consisting of validated instruments which were administered to both the woman with breast cancer and her significant other. The questionnaire consisted of: questions assessing socio-demographics, The Relationship Questionnaire (RQ), The Berlin Social Support Scale, The Hospital Anxiety and Depression (HADS) Scale, The Relationship Satisfaction subscale and the Functional Assessment to Cancer Therapy scale (for use with both Breast Cancer and General Populations). Data were analysed using SPSS software 22.0. The Actor-Partner Interdependence Model (APIM) was used in analysing dyadic data. A convenience sample of women with breast cancer (n=147) and significant others (n=127) was recruited from a pre assessment and an outpatient clinic within a breast care centre, at a large urban hospital in the South of Ireland. A significant other was defined as the individual the woman identified as being most significant in their care, at the current time. Data from 114 dyad pairs (i.e. both the woman with breast cancer and her identified significant other) who completed the questionnaire, were extracted to form the dyad sample in the study. It was found that affective states relating to anxiety and depressive symptoms were strongly and negatively correlated with quality of life for both the women with breast cancer and their significant other (p≤0.001). Significant others were found to report poorer quality of life (M=77.3, SD=4.25) than women with breast cancer (M=88.6, SD=10.61). Furthermore, the dyadic data analysis identified that being a significant other of a woman with breast cancer was associated with a lower quality of life (p≤0.05). The study identified that the principles of attachment theory are applicable to the breast cancer context. The framework devised by Pietromonaco et al., (2013) was found to be applicable to this context, although adaptation was required. This research has provided substantial rationale for studying dyads in the breast cancer context as it has highlighted the impact that a breast cancer diagnosis has not only on the woman with breast cancer but on her significant other and their relationship. Thus, clinicians, practitioners and researchers need to be aware of the important role that dyadic relationships play in the care trajectory of the woman with a breast cancer diagnosis and their impact on the woman’s significant other

Atypical emotion recognition from bodies is associated with perceptual difficulties in healthy aging.

A range of processes are required for recognizing others’ affective states. It is particularly important that we process the perceptual cues providing information about these states. These experiments tested the hypothesis that difficulties with affective state identification in older adults (OAs) arise, at least partly, from deficits in perceptual processing. To this end we presented “point light display” whole body stimuli to healthy OAs and comparison younger adults (YAs) in 3 signal detection experiments. We examined the ability of OAs to recognize visual bodily information—posture and kinematics—and whether impaired recognition of affective states can be explained by deficits in processing these cues. OAs exhibited reduced sensitivity to postural cues (Experiment 1) but not to kinematic cues (Experiment 2) in affectively neutral stimuli. Importantly, they also exhibited reduced sensitivity only to affective states conveyed predominantly through posture (Experiment 3) —that is, the cue they were impaired in perceiving. These findings highlight how affective state identification difficulties in OAs may arise from problems in perceptual processing and demonstrate more widely how it is essential to consider the contribution of perceptual processes to emotion recognition. (APA PsycInfo Database Record (c) 2019 APA, all rights reserved

Atypical emotion recognition from bodies is associated with perceptual difficulties in healthy aging

A range of processes are required for recognizing others’ affective states. It is particularly important that we process the perceptual cues providing information about these states. These experiments tested the hypothesis that difficulties with affective state identification in older adults (OAs) arise, at least partly, from deficits in perceptual processing. To this end we presented ‘point light display’ whole body stimuli to healthy OAs and comparison younger adults (YAs) in three signal detection experiments. We examined the ability of OAs to recognize visual bodily information – posture and kinematics – and whether impaired recognition of affective states can be explained by deficits in processing these cues. OAs exhibited reduced sensitivity to postural cues (Experiment 1) but not to kinematic cues (Experiment 2) in affectively-neutral stimuli. Importantly, they also exhibited reduced sensitivity only to affective states conveyed predominantly through posture (Experiment 3) – i.e., the cue they were impaired in perceiving. These findings highlight how affective state identification difficulties in OAs may arise from problems in perceptual processing, and demonstrate more widely how it is essential to consider the contribution of perceptual processes to emotion recognition

‘If you’d had my life, you’d have done it too’: exploring the experiences of adult males who rape elderly females

This study focused on adult males who have committed a sexual offence against elderly victims (aged 55 and over) in order to increase our understanding of this group of offenders. Semi-structured interviews were conducted with five such individuals. Interview data were analysed using Interpretative Phenomenological Analysis (IPA). Four main themes emerged: life's been really tough (where participants talked about difficulties they had faced); I'm not bad, I did what anyone would do (where participants sought to explain their behaviour); Other people haven't helped or have made things worse (where participants highlighted challenges they faced in relationships and the impact they felt this had); and Coping and pleasure (which highlights the use of sex and alcohol in their lives). Implications for the practice and treatment of individuals offending against elderly victims are discussed

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

Repression of the type I interferon pathway underlies MYC & KRAS-dependent evasion of NK & B cells in pancreatic ductal adenocarcinoma

MYC is implicated in the development and progression of Pancreatic cancer, yet the precise level of MYC deregulation required to contribute to tumour development has been difficult to define. We used modestly elevated expression of human MYC, driven from the Rosa26 locus, to investigate the pancreatic phenotypes arising in mice from an approximation of MYC trisomy. We show that this level of MYC alone suffices to drive pancreatic neuroendocrine tumours, and to accelerate progression of KRAS-initiated precursor lesions to metastatic pancreatic ductal adenocarcinoma. Our phenotype exposed suppression of the Type I Interferon pathway by the combined actions of MYC and KRAS and we present evidence of repressive MYC/MIZ1 complexes binding directly to the promoters of type I Interferon regulators IRF5, IRF7, STAT1 and STAT2. De-repression of Interferon regulators allows pancreatic tumour infiltration of B and NK cells, resulting in increased survival

The wide-field, multiplexed, spectroscopic facility WEAVE : survey design, overview, and simulated implementation

Funding for the WEAVE facility has been provided by UKRI STFC, the University of Oxford, NOVA, NWO, Instituto de Astrofísica de Canarias (IAC), the Isaac Newton Group partners (STFC, NWO, and Spain, led by the IAC), INAF, CNRS-INSU, the Observatoire de Paris, Région Île-de-France, CONCYT through INAOE, Konkoly Observatory (CSFK), Max-Planck-Institut für Astronomie (MPIA Heidelberg), Lund University, the Leibniz Institute for Astrophysics Potsdam (AIP), the Swedish Research Council, the European Commission, and the University of Pennsylvania.WEAVE, the new wide-field, massively multiplexed spectroscopic survey facility for the William Herschel Telescope, will see first light in late 2022. WEAVE comprises a new 2-degree field-of-view prime-focus corrector system, a nearly 1000-multiplex fibre positioner, 20 individually deployable 'mini' integral field units (IFUs), and a single large IFU. These fibre systems feed a dual-beam spectrograph covering the wavelength range 366-959 nm at R ∼ 5000, or two shorter ranges at R ∼ 20,000. After summarising the design and implementation of WEAVE and its data systems, we present the organisation, science drivers and design of a five- to seven-year programme of eight individual surveys to: (i) study our Galaxy's origins by completing Gaia's phase-space information, providing metallicities to its limiting magnitude for ∼ 3 million stars and detailed abundances for ∼ 1.5 million brighter field and open-cluster stars; (ii) survey ∼ 0.4 million Galactic-plane OBA stars, young stellar objects and nearby gas to understand the evolution of young stars and their environments; (iii) perform an extensive spectral survey of white dwarfs; (iv) survey  ∼ 400 neutral-hydrogen-selected galaxies with the IFUs; (v) study properties and kinematics of stellar populations and ionised gas in z 1 million spectra of LOFAR-selected radio sources; (viii) trace structures using intergalactic/circumgalactic gas at z > 2. Finally, we describe the WEAVE Operational Rehearsals using the WEAVE Simulator.PostprintPeer reviewe

The wide-field, multiplexed, spectroscopic facility WEAVE: Survey design, overview, and simulated implementation

WEAVE, the new wide-field, massively multiplexed spectroscopic survey facility for the William Herschel Telescope, will see first light in late 2022. WEAVE comprises a new 2-degree field-of-view prime-focus corrector system, a nearly 1000-multiplex fibre positioner, 20 individually deployable 'mini' integral field units (IFUs), and a single large IFU. These fibre systems feed a dual-beam spectrograph covering the wavelength range 366$-$959\,nm at $R\sim5000$, or two shorter ranges at $R\sim20\,000$. After summarising the design and implementation of WEAVE and its data systems, we present the organisation, science drivers and design of a five- to seven-year programme of eight individual surveys to: (i) study our Galaxy's origins by completing Gaia's phase-space information, providing metallicities to its limiting magnitude for $\sim$3 million stars and detailed abundances for $\sim1.5$ million brighter field and open-cluster stars; (ii) survey $\sim0.4$ million Galactic-plane OBA stars, young stellar objects and nearby gas to understand the evolution of young stars and their environments; (iii) perform an extensive spectral survey of white dwarfs; (iv) survey $\sim400$ neutral-hydrogen-selected galaxies with the IFUs; (v) study properties and kinematics of stellar populations and ionised gas in $z<0.5$ cluster galaxies; (vi) survey stellar populations and kinematics in $\sim25\,000$ field galaxies at $0.3\lesssim z \lesssim 0.7$; (vii) study the cosmic evolution of accretion and star formation using $>1$ million spectra of LOFAR-selected radio sources; (viii) trace structures using intergalactic/circumgalactic gas at $z>2$. Finally, we describe the WEAVE Operational Rehearsals using the WEAVE Simulator.Comment: 41 pages, 27 figures, accepted for publication by MNRA