3 research outputs found
Can Yamhill County Feed Itself?
In this paper, we considered the following question: If Yamhill County in northwest Oregon were to become isolated, would the population be able to survive off the agricultural products grown within its boundaries? We looked at what the farms in Yamhill County grow and how large of a population they could support. Essentially, this looked at the feasibility of a purely local food system within the borders of Yamhill County. We hypothesized that Yamhill County would not be able to feed itself without outsourcing; stemming from this hypothesis, we examined the maximum amount of food that can be produced locally and what would need to be imported to meet basic nutritional guidelines.
A study done in 2010 looked at the local food system of the Willamette Valley and compared the local agriculture with dietary needs for the population to determine if the valley could support itself. The study determined that the Willamette Valley does not meet any of the nutrient needs for a healthy diet given by the USDA for any of the food groups (Giombolini et al, 2010). Due to the scope and methods of this study, we decided to use this paper as a model for examining the local food system of Yamhill County
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Use of targeted therapies for advanced renal cell carcinoma in the Veterans Health Administration
BackgroundThe objective of this study is to describe the use of targeted therapies for the treatment of advanced renal cell carcinoma (RCC) and overall survival (OS) among patients in clinical practice in the Veterans Health Administration (VHA).MethodsA retrospective cohort of 286 patients from 24 VHA Medical Centers diagnosed with advanced clear cell RCC between Fiscal Year (FY) 2010 and FY2014 was followed through September 30, 2016. Among patients who received targeted therapy, we described the medications taken, duration of therapy, and overall survival. We also assessed the effect of the first therapy received on overall survival using Cox Proportional Hazards models.ResultsThere were 66 patients who did not receive therapy for their advanced RCC. Of the 220 treated patients, the mean (sd) number of medications received was 1.9 (1.1). The medications most commonly used first were sunitinib (61.8%), pazopanib (17.3%), and temsirolimus (10.9%). The median duration of first-line therapy was 86 days (interquartile range [IQR] 42, 210). Median total duration of therapy was 159 days (IQR 58, 397). 62.3% of patients had ā„ 1 dose of therapy held or reduced, mainly due to an adverse drug event (ADE). Median survival from the start of treatment to death was 1.08 years (IQR 0.80, 1.31). Finally, receipt of temsirolimus vs sunitinib (HR 1.95 [95%CI 1.09,3.47]) as the first targeted therapy was independently associated with an increased hazard of death.ConclusionOur analysis of targeted therapies for advanced RCC in VHA suggests duration of treatment is shorter in a real-world setting than in clinical trials, and dose reductions and ADEs are more common