The Effect of Urban Street Gang Densities on Small Area Homicide Incidence in a Large Metropolitan County, 1994–2002

The presence of street gangs has been hypothesized as influencing overall levels of violence in urban communities through a process of gun–drug diffusion and cross-type homicide. This effect is said to act independently of other known correlates of violence, i.e., neighborhood poverty. To test this hypothesis, we independently assessed the impact of population exposure to local street gang densities on 8-year homicide rates in small areas of Los Angeles County, California. Homicide data from the Los Angeles County Coroners Office were analyzed with original field survey data on street gang locations, while controlling for the established covariates of community homicide rates. Bivariate and multivariate regression analyses explicated strong relationships between homicide rates, gang density, race/ethnicity, and socioeconomic structure. Street gang densities alone had cumulative effects on small area homicide rates. Local gang densities, along with high school dropout rates, high unemployment rates, racial and ethnic concentration, and higher population densities, together explained 90% of the variation in local 8-year homicide rates. Several other commonly considered covariates were insignificant in the model. Urban environments with higher densities of street gangs exhibited higher overall homicide rates, independent of other community covariates of homicide. The unique nature of street gang killings and their greater potential to influence future local rates of violence suggests that more direct public health interventions are needed alongside traditional criminal justice mechanisms to combat urban violence and homicides

Feeding the rural tourism strategy? Food and notions of place and identity

The humble rural cuisine has now been thrust at the forefront of economic development strategies. This conceptual paper is a contribution to a growing critical awareness of the operations of the food industry and helps to foster a critical understanding of how, if at all, local food and its associated culture can help sustain rural tourism particularly and rural communities generally. It is inspired by literature about the international political economy of food and the many experiences of local food development, and is aware of the contrast between the structure of the industry and the hopes associated with its practice on the ground. The paper thus argues that, beyond the glamour and hype, there are those who gain, as well as those who lose, from the current food fad. While it explains the causes of the contemporary craze with food, the paper also interrogates the naı¨ve expectations often placed in food as a motor of rural development, and as the panacea for struggling rural communities. The empirical data on which this chapter is based are drawn from 18 short chapters explaining the history of various “traditional dishes” from the islands of the broad North Atlantic that feature in a recent food publication.peer-reviewe

Efficacy of the new long-acting formulation of lanreotide (lanreotide Autogel) in somatostatin analogue naive patients with acromegaly

ABSTRACT. Objective: To evaluate efficacy and safety of lanreotide autogel (ATG) 120 mg injections every 4-8 weeks in somatostatin analogue-na\uefve patients with acromegaly. Design: Open, non-comparative, phase III, multicenter clinical study. Methods: Fifty-one patients (28 women, aged 19-78 yr): 39 newly diagnosed (de novo) and 12 who had previously undergone unsuccessful surgery (post-op, 11 macro and 1 micro) were studied. ATG 120 mg was initially given every 8 weeks for 24 weeks and subsequently changed according to GH levels: if !2.5 \u3bcg/l every 8 weeks (group A, 17patients); if 2.5-5 \u3bcg/l every 6 weeks (group B, 15 patients); and if >5 \u3bcg/l every 4 weeks (group C, 19 patients). Treatment duration was 48-52 weeks. The primary objective was to control GH and IGF-I levels (GH!2.5 \u3bcg/l and IGF-I normalized for age/gender). Secondary objectives were to assessGH, IGF-I, and acid-labile subunit (ALS) decrease, improvement of clinical symptoms and quality of life (QoL). Results:GH levels normalized in 32 patients (63%), similarly in de novo and post-op patients (72% vs 50%, p=0.48); in100% of group A, in 73% of group B and in 21% of group C(p<0.0001). IGF-I levels normalized in 19 patients (37%), similarly in the de novo and post-op patients (33% vs 50%,p=0.48): in 65% of group A, 33% of group B, and in 16% of group C. Circulating GH levels decreased by 80\ub117%, IGF I levels by 44\ub127%, and ALS by 30\ub117%. Symptoms (hyperhidrosis (68.6%), swelling (68.6%), asthenia (58.8%),spine arthralgia (54.9%), and paresthesias (52.9%) and QoL(from 9.1\ub17.9 to 6.1\ub16.6) significantly improved (p<0.001).No patient withdrew from the study because of adverse events (AE). The most frequent AE was diarrhea (76.2% of patients): at study end 16 mild and 1 moderate diarrhea were recorded. Gallstones developed in 12% of patients. Conclusion: ATG 120 mg in somatostatin-na\uefve patients with acromegaly controls GH secretion in 63% and IGF-I secretion in 37% during a 48-52 week period without any difference between de novo and post-op patients. The treatment was associated with improvement in clinical symptoms and QoL and with a good, safe profile. (J. Endocrinol. Invest. 32: 202-209, 2009

Lung cancer risk test trial: study design, participant baseline characteristics, bronchoscopy safety, and establishment of a biospecimen repository

BACKGROUND: The Lung Cancer Risk Test (LCRT) trial is a prospective cohort study comparing lung cancer incidence among persons with a positive or negative value for the LCRT, a 15 gene test measured in normal bronchial epithelial cells (NBEC). The purpose of this article is to describe the study design, primary endpoint, and safety; baseline characteristics of enrolled individuals; and establishment of a bio-specimen repository. METHODS/DESIGN: Eligible participants were aged 50-90 years, current or former smokers with 20 pack-years or more cigarette smoking history, free of lung cancer, and willing to undergo bronchoscopic brush biopsy for NBEC sample collection. NBEC, peripheral blood samples, baseline CT, and medical and demographic data were collected from each subject. DISCUSSION: Over a two-year span (2010-2012), 403 subjects were enrolled at 12 sites. At baseline 384 subjects remained in study and mean age and smoking history were 62.9 years and 50.4 pack-years respectively, with 34% current smokers. Obstructive lung disease (FEV1/FVC \u3c0.7) was present in 157 (54%). No severe adverse events were associated with bronchoscopic brushing. An NBEC and matched peripheral blood bio-specimen repository was established. The demographic composition of the enrolled group is representative of the population for which the LCRT is intended. Specifically, based on baseline population characteristics we expect lung cancer incidence in this cohort to be representative of the population eligible for low-dose Computed Tomography (LDCT) lung cancer screening. Collection of NBEC by bronchial brush biopsy/bronchoscopy was safe and well-tolerated in this population. These findings support the feasibility of testing LCRT clinical utility in this prospective study. If validated, the LCRT has the potential to significantly narrow the population of individuals requiring annual low-dose helical CT screening for early detection of lung cancer and delay the onset of screening for individuals with results indicating low lung cancer risk. For these individuals, the small risk incurred by undergoing once in a lifetime bronchoscopic sample collection for LCRT may be offset by a reduction in their CT-related risks. The LCRT biospecimen repository will enable additional studies of genetic basis for COPD and/or lung cancer risk. TRIAL REGISTRATION: The LCRT Study, NCT 01130285, was registered with Clinicaltrials.gov on May 24, 2010

Violence and local development in Fortaleza, Brazil: A spatial regression analysis

Fortaleza is the fifth largest city of Brazil, and has become the most violent state capital in the last years. In this paper, we investigate whether violent crime rates are associated with the local development of the city. Using an unexplored data source about georeferenced murders and deaths due to bodily injury and theft, we show that violent crime rates exhibit a positive spatial dependence across clusters of census tracts. In other words, small urban areas with high (low) violent crime rates have neighbors, on average, with similar pattern of violent crime rates. Investigating the relationship between violent crime rates and variables associated with local development, spatial regressions suggest that high violent crime rates are related with low-income neighborhood, with high spatial isolation of poor households, low access to urban infrastructure, and high prevalence of illiterate adolescents and young black males. The study also provides important evidence about spillover effects that helps to understand how the absence of local development can expose neighbors to violence

Acromegaly is associated with increased cancer risk: A survey in Italy

It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 \uc2\ub1 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18-1.68, P &lt; 0.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95% CI, 1.07-2.58, P = 0.022), kidney cancer (SIR 2.87; 95% CI, 1.55-5.34, P &lt; 0.001) and thyroid cancer (SIR 3.99; 95% CI, 2.32-6.87, P &lt; 0.001). The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk