Talking Us Into War: Problem Definition By Presidents Lyndon B. Johnson and George W. Bush

How presidents talk us into war merges the study of problem definition in public policy with the study of rhetoric in communications. Using both qualitative and quantitative methods, this research analyzes the key words used by two presidents, Lyndon B. Johnson and George W. Bush, to persuade us into escalating a war in Vietnam and engaging in a pre-emptive war in Iraq, respectively. The findings indicate that presidents repeat words that are patriotic, emotive, metaphorical, symbolic and religious, tapping into American themes of Manifest Destiny and even predicting dire outcomes if we do not accept their definitions of the dangers and rewards involved in going to war. The study also finds that presidents develop a sustaining narrative that highlights what problem definition literature calls a causal story, which identifies the harm done, describes its cause, assigns moral blame and claims government is responsible for the remedy (Stone 1989). This research indicates that Johnson used far less antithetical, religious and repetitive language than did Bush, in some cases strikingly so. This work relies upon the literature on problem definition, presidential rhetoric and presidential leadership as a backdrop for studying the major speeches of these two presidents prior to their escalation or initiation of war. It employs content analysis using the computerized program, NVivo 7. The study concludes that while we may not be able to measure the degree to which various audiences are persuaded by presidential rhetoric, we can see that presidents, who wield the powerful bully pulpit, carefully choose their words and repeat them often to afford themselves maximum persuadability with their audiences as they try to talk us into war. Such language also appears designed to quell dissent and to enlarge the authority of the president

Development of a state wide tobacco treatment specialist training and certification programme for Massachusetts

OBJECTIVE: To describe the research conducted to structure and develop a statewide tobacco training and certification programme for tobacco treatment specialists (TTSs) in Massachusetts. DESIGN: Qualitative research strategies were used to obtain information on certification development and opinions regarding TTS training and certification from key informants. A role definition and validation study was then conducted to determine the core competencies for TTSs. A comprehensive training programme was developed, piloted, and finalised, and a certification programme was initiated. PARTICIPANTS: Key informants included: individuals involved in the development of their professional certification programmes; tobacco treatment providers from across Massachusetts; and national tobacco treatment experts. MAIN OUTCOME MEASURES: Participants\u27 opinions about the need for and structure of a training and certification programme for individuals specialising in the provision of moderate to intensive tobacco treatment; delineation of core competencies for TTSs, using the Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality) clinical practice guideline as a foundation for the development of evidence based standards of practice for the treatment of nicotine dependence. RESULTS: The data support a comprehensive training and certification programme for TTSs in Massachusetts. Main concerns include the cost of obtaining certification, the potential to exclude uncertified healthcare professionals from delivering basic tobacco treatment, and the role of the TTS in the healthcare delivery system and the community. The training programme developed for Massachusetts was piloted, and the structure of a statewide training and certification programme for TTSs was finalised. CONCLUSIONS: The research provides support for the need and acceptance of a training and certification programme for TTSs in Massachusetts, and presents the challenges to be addressed. We demonstrated the feasibility of developing and implementing an evidence based training programme, and of initiating a statewide certification programme in Massachusetts. This work will add to a national dialogue on the development of a training and certification programme for tobacco treatment providers and encourage further research into the potential impact of statewide and national certification

Differences in Trophic Level, Contaminant Load, and DNA Damage in an Urban and a Remote Herring Gull (Larus argentatus) Breeding Colony in Coastal Norway

Herring gulls (Larus argentatus) are opportunistic feeders, resulting in contaminant exposure depending on area and habitat. We compared contaminant concentrations and dietary markers between two herring gull breeding colonies with different distances to extensive human activity and presumed contaminant exposure from the local marine diet. Furthermore, we investigated the integrity of DNA in white blood cells and sensitivity to oxidative stress. We analyzed blood from 15 herring gulls from each colony—the urban Oslofjord near the Norwegian capital Oslo in the temperate region and the remote Hornøya island in northern Norway, on the Barents Sea coast. Based on d13C and d34S, the dietary sources of urban gulls differed, with some individuals having a marine and others a more terrestrial dietary signal. All remote gulls had a marine dietary signal and higher relative trophic level than the urban marine feeding gulls. Concentrations (mean ± standard deviation [SD]) of most persistent organic pollutants, such as polychlorinated biphenyl ethers (PCBs) and perfluorooctane sulfonic acid (PFOS), were higher in urban marine (PCB153 17 ± 17 ng/g wet weight, PFOS 25 ± 21 ng/g wet wt) than urban terrestrial feeders (PCB153 3.7 ± 2.4 ng/g wet wt, PFOS 6.7 ± 10 ng/g wet wt). Despite feeding at a higher trophic level (d15N), the remote gulls (PCB153 17 ± 1221 ng/g wet wt, PFOS 19 ± 1421 ng/g wet wt) were similar to the urban marine feeders. Cyclic volatile methyl siloxanes were detected in only a few gulls, except for decamethylcyclopentasiloxane in the urban colony, which was found in 12 of 13 gulls. Only hexachlorobenzene was present in higher concentrations in the remote (2.6 ± 0.42 ng/g wet wt) compared with the urban colony (0.34 ± 0.33 ng/g wet wt). Baseline and induced DNA damage (doublestreak breaks) was higher in urban than in remote gulls for both terrestrial and marine feeders.publishedVersio

Sleep Apnea and Fetal Growth Restriction (SAFER) study: Protocol for a pragmatic randomised clinical trial of positive airway pressure as an antenatal therapy for fetal growth restriction in maternal obstructive sleep apnoea

INTRODUCTION: Fetal growth restriction (FGR) is a major contributor to fetal and neonatal morbidity and mortality with intrauterine, neonatal and lifelong complications. This study explores maternal obstructive sleep apnoea (OSA) as a potentially modifiable risk factor for FGR. We hypothesise that, in pregnancies complicated by FGR, treating mothers who have OSA using positive airway pressure (PAP) will improve birth weight and neonatal outcomes. METHODS AND ANALYSIS: The Sleep Apnea and Fetal Growth Restriction study is a prospective, block-randomised, single-blinded, multicentre, pragmatic controlled trial. We enrol pregnant women aged 18-50, between 22 and 31 weeks of gestation, with established FGR based on second trimester ultrasound, who do not have other prespecified known causes of FGR (such as congenital anomalies or intrauterine infection). In stage 1, participants are screened by questionnaire for OSA risk. If OSA risk is identified, participants proceed to stage 2, where they undergo home sleep apnoea testing. Participants are determined to have OSA if they have an apnoea-hypopnoea index (AHI) ≥5 (if the oxygen desaturation index (ODI) is also ≥5) or if they have an AHI ≥10 (even if the ODI is \u3c5). These participants proceed to stage 3, where they are randomised to nightly treatment with PAP or no PAP (standard care control), which is maintained until delivery. The primary outcome is unadjusted birth weight; secondary outcomes include fetal growth velocity on ultrasound, enrolment-to-delivery interval, gestational age at delivery, birth weight corrected for gestational age, stillbirth, Apgar score, rate of admission to higher levels of care (neonatal intensive care unit or special care nursery) and length of neonatal stay. These outcomes are compared between PAP and control using intention-to-treat analysis. ETHICS AND DISSEMINATION: This study has been approved by the Institutional Review Boards at Washington University in St Louis, Missouri; Hadassah Hebrew University Medical Center, Jerusalem; and the University of Rochester, New York. Recruitment began in Washington University in November 2019 but stopped from March to November 2020 due to COVID-19. Recruitment began in Hadassah Hebrew University in March 2021, and in the University of Rochester in May 2021. Dissemination plans include presentations at scientific conferences and scientific publications. TRIAL REGISTRATION NUMBER: NCT04084990

Effect of Prior Bilateral Oophorectomy on the Presentation of Breast Cancer in BRCA1 and BRCA2 Mutation Carriers

Purpose: To compare the presentation of invasive breast cancer in BRCA1 and BRCA2 mutation carriers with and without prior bilateral oophorectomy. Patients and methods: Women with a BRCA1 or BRCA2 mutation with the diagnosis of invasive breast cancer were identified from ten cancer genetics clinics. The medical history, medical treatment records and pathology reports for the breast cancers were reviewed. Information was abstracted from medical charts, including history (and date) of oophorectomy, date of breast cancer diagnosis, stage of disease, and pathologic characteristics of the breast cancer. Women with prior bilateral oophorectomy were matched by age, year of diagnosis, and mutation with one or more women who had two intact ovaries at the time of breast cancer diagnosis. Characteristics of the breast tumours were compared between the two groups

American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136493/1/caac21319_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136493/2/caac21319-sup-0001-suppinfo1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136493/3/caac21319.pd

The Life and Times of Joseph Beuys

Program for the seventh annual RISD Cabaret held in the Waterman Building. Graphic design: Mark Snyder; program editor: Margaret Lewis; program photography: Marcin Gizycki.https://digitalcommons.risd.edu/liberalarts_cabaret_programs/1006/thumbnail.jp