Density, crowding, and satisfaction with the residential environment

The relationships between a set of measures of various components of environmental density and perceived crowding are examined in a data set from a sample of residents of a large metropolitan area. While there are meaningful patterns observed among the correlations, the primary finding is the weakness of the relationships between density and crowding. The implications of the weak relationship between objective and subjective measures intended to measure components of the quality of life, of which the present findings are an example, are discussed; the usefulness of subjective measures may lie primarily in their capacity to define what aspects of society should be monitored and included in a system of social accounting.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43679/1/11205_2004_Article_BF00287219.pd

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common

Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

To estimate risk of NEC for ELBW infants as a function of preterm formula and maternal milk (MM) intake and calculate the impact of suboptimal feeding on NEC incidence and costs

Functional and quality of life outcomes of localised prostate cancer treatments (prostate testing for cancer and treatment [ProtecT] study)

Objective To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision-making. Patients and Methods Men aged 50–69 years diagnosed with localised prostate cancer by prostate-specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external-beam radiotherapy (EBRT) with concurrent androgen-deprivation therapy (ADT) and 77 low-dose-rate brachytherapy (BT, not a randomised treatment). Patient-reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores. Results Treatment-received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL. Conclusion Treatment decision-making for localised prostate cancer can be informed by these 6-year functional and QoL outcomes

Paleotectonic Investigations of the Permian System in the United States

(A) Allegheny region, by Henry L. Berryhill, Jr (B) Gulf Coast region, by Eleanor J. Crosby (C) West Texas Permian basin region, by Steven S. Oriel, Donald A. Myers, and Eleanor J. Crosby (D) Northeastern New Mexico and Texas-Oklahoma Panhandles, by George H. Dixon (E) Oklahoma, by Marjorie E. MacLachlan (F) Central Midcontinent region, by Melville R. Mudge (G) Eastern Wyoming, eastern Montana, and the Dakotas, by Edwin K. Maughan (H) Middle Rocky Mountains and northeastern Great Basin, by Richard P. Sheldon, Earl R. Cressman, Thomas M. Cheney, and Vincent E. McKelvey (I) Western Colorado, southern Utah, and northwestern New Mexico, by Walter E. Hallgarth (J) Arizona and western New Mexico, by Edwin D. McKee (K) West Coast region, by Keith B. Ketner References cited (284pp) This professional paper is a supplementary volume to Paleotectonic Maps of the Permian System by McKee, Oriel, and others (1967), published by the U.S. Geological Survey as Miscellaneous Geologic Investigations Map I-450. The I-450 publication consists of 20 plates isopach and lithofacies maps, cross sections to accompany the maps, and interpretive and environmental maps and a summary of available geological information on each part of the Permian Period, an interpretation or reconstruction of Permian history, and brief discussions of environment, tectonics, and other significant features. The present volume explains and documents the maps and conclusions presented there. This study of the Permian System was made by 15 geologists, who were individually responsible for coverage of 18 regions. These authors are: Henry L. Berryhill, Jr. • Walter E. Hallgarth • Vincent E. McKelvey • Thomas M. Cheney • Keith B. Ketner • Melville R. Mudge • Earl R. Cressman • Marjorie E. MacLachlan • Donald A. Myers • Eleanor J. Crosby • Edwin K. Maughan • Steven S. Oriel • George H. Dixon • Edwin D. McKee • Richard P. Sheldon The Permian System of the 18 regions is described in 11 chapters. Each chapter presents an analysis of the basic data used, points out significant trends, and presents an interpretation, as well as alternative explanations where each occur, for the region concerned. The chapters and accompanying illustrations were coordinated and assembled by E. J. Crosby, E. D. McKee, W. W. Mallory, E. K. Maughan, and S. S. Oriel. Descriptive and documentary data are organized according to region, from east to west, and according to chronological sequence. Each chapter discusses, in order, rocks that underlie the Permian, the several intervals or divisions of the Permian (from oldest to youngest (table 1, in pocket)), and, finally, the rock units that directly overlie the Permian. Stratigraphic problems, the nature of contacts, trends in thickness and lithology, possible sources of sediment, environments of deposition, and paleotectonic implications of each interval are treated in that order