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Summary Background Healthcare-associated infections (HCAIs) are a major public health concern and a significant cause of morbidity and mortality. A robust and current evidence base that is specific to local, national and Europe-wide settings is necessary to inform the development of strategies to reduce HCAI and contain antimicrobial resistance. Aim To measure the prevalence of HCAI and antimicrobial prescribing and identify key priority areas for interventions to reduce the burden of infection. Methods A national rolling point-prevalence survey (PPS) in National Health Service (NHS) acute, NHS non-acute, NHS paediatric, and independent hospitals was carried out between September and November 2016 using the European Centre for Disease Prevention and Control protocol designed for the European PPS. Findings The prevalence of HCAI was 4.6%, 2.7%, and 3.2% in acute adults, paediatric and non-acute patient groups, respectively. The most frequent HCAI types reported in adult patients were urinary tract infection and pneumonia. The prevalence of antimicrobial prescribing was 35.7%, 29.3%, and 13.8% in acute adults, paediatric, and non-acute patient groups, respectively. Respiratory, skin and soft tissue, gastrointestinal, and urinary tract infections were the most common infections being treated at the time of survey. Conclusion HCAI continues to be a public health concern in Scotland. Urinary tract infection and pneumonia continue to place a significant burden on patients and on healthcare delivery, including those that develop in the community and require hospital admission. A broader population health approach which focuses on reducing the risk of infection upstream would reduce these infections in both community and hospital settings.

Beginning in the 1970s, South America became a testing ground for the imposition of neoliberal policies, with profound implications for governance. Countries across the region moved away from earlier structuralist/ISI policies (see Rivera-Quinones in this volume) and adopted orthodox neoliberal policies associated with marketization, deregulation and commodification. At the heart of these policies were new models of state–society relations that required the selective retreat of the state and wrenching changes to traditional models of political and social regulation. As the name ‘Washington Consensus’ suggests, the new policy regime also involved a fundamental change in the relationship between South American states and the international system, as international actors acquired increased power over national and local actors through coercion, cooptation and ideological suasion (see O’Brien and Battaglino in this same volume). (Publisher summary)

Governance in South America is signified by strategies pursued by state and non-state actors directed to enhancing (some aspect of) their capabilities and powers of agency. It is about the spaces and the practices available, demanded or created to ‘make politics happen’. This framework lends explanatory power to understand how governance has been defined and practiced in South America. Pia Riggirozzi and Christopher Wylde bring together leading experts to explore what demands and dilemmas have shaped understanding and practice of governance in South America in and across the region. The Handbook suggests that governance dilemmas of inequitable and unfulfilled political economic governance in South America have been constant historical features, yet addressed and negotiated in different ways. Building from an introduction to key issues defining governance in South America, this Handbook proceeds to examine institutions, actors and practices in governance focusing on three core processes: evolution of socio-economic and political justice claims as central to the demands of governance; governance frameworks foregrounding particular issues and often privileging particular forms of political practice; and iterative and cumulative processes leading to new demands of governance addressing recognition and identity politics. This Handbook will be a key reference for those concerned with the study of South America, South American political economy, regional governance, and the politics of development.

Violence in Latin America and the Caribbean is no longer perpetrated primarily by states against their citizens, but by a variety of state and non-state actors struggling to control resources, territories, and populations. This book examines violence at the subnational level to illuminate how practices of violence are embedded within subnational configurations of space and clientelistic networks. In societies shaped by centuries of violence and exclusion, inequality and marginalization prevail at the same time that democratization and neoliberalism have decentralized power to regional and local levels, where democratic and authoritarian practices coexist. Within subnational arenas, unique configurations - of historical legacies, economic structures, identities, institutions, actors, and clientelistic networks - result in particular patterns of violence and vulnerability that are often strikingly different from what is portrayed by aggregate national-level statistics. The chapters of this book examine critical cases from across the region, drawing on new primary data collected in the field to analyze how a range of political actors and institutions shape people's lives and to connect structural and physical forms of violence.

Sedentary behaviour is an emerging risk factor for poor health. This study aimed to identify ecological determinants of sedentary behaviour, for which evidence is currently scarce. The study participants were community dwelling adults from, respectively, the Lothian Birth Cohort 1936 (n = 271, mean age 79) and the 1930s (n = 119, mean age 83) and 1950s (n = 310, mean age 64) cohorts of the West of Scotland Twenty-07 study. The outcome measure, percentage of waking time spent sedentary (sedentary time), was measured using an activPAL activity monitor worn continuously for seven days. Potential determinants included objective and subjective neighbourhood measures such as natural space, crime, social cohesion and fear of crime. Other determinants included measures of social participation such as social support, social group membership and providing care. Results from multivariable regression analyses indicated that providing care was associated with reduced sedentary time in retired participants in all cohorts. Fear of crime and perceived absence of services were associated with increased sedentary time for retired 1950s cohort members. Higher crime rates were associated with increased sedentary time in all cohorts but this was not significant after adjustment for socio-demographic characteristics. Most other neighbourhood and social participation measures showed no association with sedentary time.

This article examines the lessons that can be drawn from social protection programs in Mexico at both the national and sub-national scales for the Social Protection Floor (SPF) initiative for the implementation of the Global Social Floor proposal in Mexico. Mexico’s federal anti-poverty program, Progresa/Oportunidades, was a pioneer in the application of a social investment paradigm to the provision of social benefits to the extreme poor, and the targeting of benefits. At the same time, the left-leaning Partido de la Revolución Democrática (PRD) governments of the Federal District have introduced an ambitious new series of social programs at the municipal scale. PRD governments have directly criticized the targeting and surveillance involved in the Oportunidades program. Instead, the PRD has advocated more universalistic approaches to social policy, based on principles of social rights. This article examines the areas of congruence and dissonance between these Mexican innovations in social policy and the SPF initiative.

Every year thousands of Mexicans travel to Canada to work in Canadian fields and greenhouses under the Mexico-Canada Seasonal Agricultural Worker Program. While the programme is often praised, it has also been the subject of persistent criticism about its failure to meet certain human rights standards. In this article, we examine the legal strategies civil society advocates of migrant workers have adopted to promote migrant workers' rights in Canada. Specifically, we examine legal struggles undertaken by the United Food and Commercial Workers union to challenge Ontario government legislation that does not permit collective bargaining by farmworkers in the province. We argue that this case demonstrates that despite the fact that many of the workers involved are transnationalized, appeals to international bodies or to international human rights standards have been of limited utility in promoting their rights. Despite frequent arguments about the increased relevance of international human rights and citizens...

AIMS: To examine how glassware functions as a marketing tool. METHODS: Content analysis of trade journals. RESULTS: Glassware is used as an integral part of marketing activity to recruit customers, revive brands, build profits and increase consumption. CONCLUSION: Glassware should be subject to the same control as other forms of marketing. Glasses could be re-engineered to promote safer drinking. Language: en

This paper investigates new directions in the evolution of Latin American welfare regimes by focusing on the extension of early childhood education and care (ECEC) policies in Argentina and Mexico, particularly in the last decade. Both states have paid increased attention to ECEC policies for several reasons: the failure of first-generation structural adjustment reforms to address problems of poverty; women's increased participation in the paid labor force and the adoption of a new investment social paradigm which emphasizes human capital formation. We argue that these factors play out in different ways in the two countries, as a result of different ideologies and political agendas of the governments and their different degrees of openness to the influence of international ideas. When looking at gender dimensions of their welfare regimes, Argentina and Mexico show very similar patterns of gender stratification, and both states display similarities between their policies in the area of early education. In the area of day care, however, Mexico encourages women to work via defamilialization of services, while Argentina reveals preference for low-income mothers to stay at home and work in the informal sector.

Lemurs are the most olfactory-oriented of primates, yet there is still only a basic level of understanding of what their scent marks communicate. We analyzed scent secretions from Milne-Edwards' sifakas (Propithecus edwardsi) collected in their natural habitat of Ranomafana National Park, Madagascar. We sought to test whether the scent mark could signal genetic relatedness in addition to species, sex, season, and individuality. We not only found correlations (r 2 = 0.38, P = 0.017) between the total olfactory fingerprint and genetic relatedness but also between relatedness and specific components of the odor, despite the complex environmental signals from differences in diet and behavior in a natural setting. To the best of our knowledge, this is the first demonstration of an association between genetic relatedness and chemical communication in a wild primate population. Furthermore, we found a variety of compounds that were specific to each sex and each sampling period. This research shows that scent marks could act as a remote signal to avoid inbreeding, optimize mating opportunities, and potentially aid kin selection.

Associations between different alcohol outcomes and outlet density measures vary between studies and may not be generalisable to adolescents. In a cross-sectional study of 979 15-year old Glaswegians, we investigated the association between alcohol outlet availability (outlet density and proximity), outlet type (on-premise vs. off-premise) and frequent (weekly) alcohol consumption. We adjusted for social background (gender, social class, family structure). Proximity and density of on-premise outlets were not associated with weekly drinking. However, adolescents living close (within 200 m) to an off-sales outlet were more likely to drink frequently (OR 1.97, p=0.004), as were adolescents living in areas with many nearby off-premises outlets (OR 1.60, p=0.016). Our findings suggest that certain alcohol behaviours (e.g. binge drinking) may be linked to the characteristics of alcohol outlets in the vicinity., Highlights ► We examined the link between adolescent alcohol use and alcohol outlet availability. ► Proximity and density of on-premises outlets is unrelated to adolescent alcohol use. ► Adolescents in close proximity to off-licence outlets have elevated alcohol use.

Background: It is usually assumed that housing tenure and car access are associated with health simply because they are acting as markers for social class or income and wealth. However, previous studies conducted in the late 1990s found that these household assets were associated with health independently of social class and income. Here, we set out to examine if this is still the case.\ud \ud Methods: We use data from our 2010 postal survey of a random sample of adults (n=2092) in 8 local authority areas in the West of Scotland. Self-reported health measures included limiting longstanding illness (LLSI), general health over the last year and the Hospital Anxiety and Depression Scale.\ud \ud Results: We found a statistically significant relationship between housing tenure and all 4 health measures, regardless of the inclusion of social class or income as controls. Compared with owner occupiers, social renters were more likely to report ill-health (controlling for social class—LLSI OR: 3.24, general health OR: 2.82, anxiety η2: 0.031, depression η2: 0.048, controlling for income—LLSI OR: 3.28, general health OR: 2.82, anxiety η2: 0.033, depression η2: 0.057) (p

Integration of oral-systemic science into clinical care holds promise for improving patient outcomes and presenting opportunities for individuals in various health care professions to learn with, from, and about each other. The aim of this study was to examine whether an interprofessional continuing education program dedicated to oral-systemic health improved participants' attitudes toward interprofessional education and collaboration between dental and non-dental health care professionals and whether it influenced the physicians' practice of screening for debilitating oral diseases. The study took place in 2014 and used a mixed-methods approach, consisting of Readiness for Interprofessional Learning Scale (RIPLS) surveys conducted before, immediately after, and six months after the intervention, as well as surveys of self-reported practice behaviors and semi-structured interviews. A total of 231 health care professionals participated in the lectures and roundtable discussions. Of those, 134 responded to the pre-program survey (58% response rate), 110 responded to the post-program survey (48% response rate), and 58 responded to the survey six months after the program (25% response rate). The participants' median total RIPLS score at baseline was 76.5, which increased significantly immediately following the program (81.0) but returned to baseline six months later (76.5). Participants' RIPLS domain scores also increased significantly by profession from before to after the event, with effects returning to baseline after six months. Significantly more physicians reported screening for caries and periodontal disease after the intervention. An overall theme of "learning with, from, and about each other" was drawn from the interviews with 15 participants. The physicians took away a message of "just look in the mouth," while the dental professionals reported feeling valued as members of the health care team. Although reported improvements in oral-systemic health practice immediately after the intervention were encouraging, further research is necessary to understand why collaborative behaviors were not sustained.

Background Oral leukoplakia is a relatively common oral lesion that, in a small proportion of people, precedes the development of oral cancer. Most leukoplakias are asymptomatic; therefore, the primary objective of treatment should be to prevent onset of cancer. This review updates our previous review, published in 2006. Objectives To assess the effectiveness, safety and acceptability of treatments for leukoplakia in preventing oral cancer. Search methods We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 16 May 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 4), MEDLINE Ovid (1946 to 16 May 2016), Embase Ovid (1980 to 16 May 2016) and CancerLit via PubMed (1950 to 16 May 2016). We searched the metaRegister of Controlled Trials (to 10 February 2015), ClinicalTrials.gov (to 16 May 2016) and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials (to 16 May 2016). We placed no restrictions on the language or date of publication when searching electronic databases. Selection criteria We included randomised controlled trials (RCTs) that enrolled people with a diagnosis of oral leukoplakia and compared any treatment versus placebo or no treatment. Data collection and analysis We collected data using a data extraction form. Oral cancer development, demonstrated by histopathological examination, was our primary outcome. Secondary outcomes were clinical resolution of the lesion, improvement of histological features and adverse events. We contacted trial authors for further details when information was unclear. When valid and relevant data were available, we conducted a meta-analysis of the data using a fixed-effect model when we identified fewer than four studies with no heterogeneity. For dichotomous outcomes, we calculated risk ratios (RRs) and 95% confidence intervals (CIs). We assessed risk of bias in studies by using the Cochrane tool. We assessed the overall quality of the evidence by using standardised criteria (Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE)). Main results We included 14 studies (909 participants) in this review. Surgical interventions, including laser therapy and cryotherapy, have never been studied by means of an RCT that included a no treatment or placebo arm. The included trials tested a range of medical and complementary treatments, in particular, vitamin A and retinoids (four studies); beta carotene or carotenoids (three studies); non-steroidal anti-inflammatory drugs (NSAIDs), specifically ketorolac and celecoxib (two studies); herbal extracts (four studies), including tea components, a Chinese herbal mixture and freeze-dried black raspberry gel; bleomycin (one study); and Bowman-Birk inhibitor (one study). We judged one study to be at low risk of bias, seven at unclear risk and six at high risk. In general, we judged the overall quality of the evidence to be low or very low, so findings are uncertain and further research is needed. Five studies recorded cancer incidence, only three of which provided useable data. None of the studies provided evidence that active treatment reduced the risk of oral cancer more than placebo: systemic vitamin A (RR 0.11, 95% CI 0.01 to 2.05; 85 participants, one study); systemic beta carotene (RR 0.71, 95% CI 0.24 to 2.09; 132 participants, two studies); and topical bleomycin (RR 3.00, 95% CI 0.32 to 27.83; 20 participants, one study). Follow-up ranged between two and seven years. Some individual studies suggested effectiveness of some proposed treatments, namely, systemic vitamin A, beta carotene and lycopene, for achieving clinical resolution of lesions more often than placebo. Similarly, single studies found that systemic retinoic acid and lycopene may provide some benefit in terms of improvement in histological features. Some studies also reported a high rate of relapse. Side effects of varying severity were often described; however, it seems likely that interventions were well accepted by participants because drop-out rates were similar between treatment and control groups. Authors' conclusions Surgical treatment for oral leukoplakia has not been assessed in an RCT that included a no treatment or placebo comparison. Nor has cessation of risk factors such as smoking been assessed. The available evidence on medical and complementary interventions for treating people with leukoplakia is very limited. We do not currently have evidence of a treatment that is effective for preventing the development of oral cancer. Treatments such as vitamin A and beta carotene may be effective in healing oral lesions, but relapses and adverse effects are common. Larger trials of longer duration are required to properly evaluate the effects of leukoplakia treatments on the risk of developing oral cancer. High-quality research is particularly needed to assess surgical treatment and to assess the effects of risk factor cessation in people with leukoplakia.

Background The Diabetes Education and Resource for Children and Adolescents (DER-CA), Children's Hospital, Winnipeg, Manitoba and the University of Manitoba, School of Dental Hygiene (SDH/UM) developed an oral hygiene component to add to the education and surveillance of youth with type 2 diabetes mellitus and their families. Objective This article describes the 4-year experience of this interprofessional collaboration and the effective “fit” for the dental hygiene screening and education as part of the DER-CA diabetes care, education and support. Method The iterative process of the interprofessional collaboration, pilot run and implementation of the curriculum is described. Results The partnership has resulted in the development of a dental hygiene student experiential interprofessional education program, the inclusion of oral health with diabetes education for the youth of the DER-CA, and the development of a collaborative relationship between the DER-CA and SDH/UM. Four graduating classes of dental hygiene students (n=104) have participated in the program. Over 280 youth (6 to 18 years of age) with type 2 diabetes have had oral health screening and education. Conclusions The interprofessional collaboration between the DER-CA and SDH/UM is a successful innovative partnership informed by the evidence-base in interprofessional education and type 2 diabetes and oral health that integrated an oral hygiene component in the surveillance and education to youth with type 2 diabetes.

This article examines the implications of the multi-scalar politics of Mexican anti-poverty policy for the long-term process of democratization. The federal anti-poverty policy, Progresa/Oportunidades, was designed to eliminate traditional clientelistic practices. While more obvious practices of pork-barrel politics have been eliminated in poverty alleviation programs, continued practices of top-down processes of program design and implementation strategies have resulted in the emergence of semi-clientelism. Argued in this paper is that municipal and state political actors have responded to these federal policies in ways that may or may not promote deeper levels of democracy, and which have led to the reconstitution of semi-clientelism. The paper draws upon recent revisionist approaches to political clientelism, and introduces a multi-scalar approach borrowed from political geography. Based on this theoretical approach, the article examines the role of state and municipal authorities in the delivery of federal anti-poverty benefits within the Oportunidades conditional cash transfer program.

Background Understanding transport satisfaction can inform national and local policy aimed at providing a sustainable transport infrastructure, which can have important national and international benefits for both health and the environment. The aim of the study was to examine changes over time in satisfaction with usual transport mode, explore individual and area level characteristics as mediators in the likelihood of transport satisfaction, and whether any changes in transport satisfaction varied by these factors over time. Methods Adults from West Central Scotland, United Kingdom, who participated at both waves of the repeat cross-sectional ‘Transport, Health and Well-being Study’ conducted in 1997 (n=2735) and 2010 (n=2024) were assessed. Individuals completed a detailed postal questionnaire at both time points including self-rated satisfaction with usual transport mode (using a seven point scale subsequently dichotomised to a binary outcome of satisfied (1-2) and other (3-7)). Participants reported usual transport mode for travel to the following various destinations or events: day out, evening out, health appointment, sports facility, visiting friends/family, taking children to school, supermarket, and work/education . A multilevel logistic regression model was used and individuals were nested within areas (c.4,000 population). The dependent (outcome variable) was transport satisfaction (binary yes/no) and the independent covariates were travel mode, age, sex, health status, access to car, urban/rural classification, and socio-economic status. Results At the 2010 sweep, two thirds (n=1345) of individuals were satisfied with their transport choice. Those with fair/poor health were less satisfied with their usual transport compared to those in better health (Odds Ratio (OR) 0.49, p Conclusions The proportion of those who travelled using public transport, active modes or by multiple mode increased journey satisfaction over time at a greater rate than those travelled by car, highlighting that continued efforts should be made to promote these more active transport modes which have potential to impact on health.

Environmental movements depend on mass media to reach the public and shape political decision-making. Without media access, social movements experience political marginality. In this paper, we examine whether the internet is a more open space than traditional media for activists to speak on behalf of non-human nature. Our analysis is based upon newspaper coverage and environmental organization websites that focus on the conflict over the proposed Jumbo Glacier Resort ski resort development in British Columbia. Environmental websites and mass media texts both define Jumbo Pass as wilderness and grizzly bear habitat, while focusing on ecological issues and questions of local democracy. However, environmental group websites discuss a greater range of environmental risks and provide more detailed discussion of these issues. Environmentalist websites also integrate scientific experts and celebrity supporters to a greater degree than mass media texts, which are dominated by environmentalist, ski industry, and provincial government news sources.

This article evaluates the role civil society organizations play in helping noncitizen migrant workers access to social rights in Canada. The study focuses on the bilateral Canadian Seasonal Agricultural Workers Program, a temporary worker scheme that brings Mexicans to Canada to work as harvesters for a four-to-eight-month period. Despite the common description of this program as “best practice,” questions are raised about the ability of workers to access citizenship rights and even limited labor protections. We draw on primary field research conducted in the province of Ontario's agricultural sector to consider how involvement of civil society state actors operating at a variety of scales—local, national, international, and the extra territorial—in a range of social justice struggles expands access to social citizenship rights for Mexican migrant workers. Este articulo evalua el rol que juegan las organizaciones de la sociedad civil en la ayuda a los trabajadores migrantes no-ciudadanos en el acceso a derechos sociales en Canada. El estudio se enfoca en el Programa Bilateral Canadiense de Trabajadores Agricolas Temporales (SAWP, por sus siglas en ingles), un esquema de trabajo temporal que lleva mexicanos a Canada a trabajar como segadores por un periodo de entre cuatro y ocho meses. A pesar de la descripcion de este programa como de una “buena politica/practica,” surgen preguntas acerca de la habilidad de los trabajadores de acceder a derechos ciudadanos y hasta de proteccion laboral limitada. Analizamos a partir de una investigacion primaria conducida en el sector agricola de la provincia de Ontario, considerar como la participacion de actores estatales de la sociedad civil en una variedad de niveles—local, nacional, internacional y extraterritorial—en el ambito de la justicia social amplia el acceso de los trabajadores migrantres mexicanos a los derechos sociales.

Thyroid cancer is the most common endocrine malignancy, and incidence has been steadily increasing, suggesting occurrence will exceed that of colon cancer by 2030. Papillary and follicular thyroid cancer subtypes are most common, which are activated by BRAF and HRAS mutations, respectively. Interestingly, papillary and follicular thyroid cancers are associated with different pathologies and metastases. Currently, both papillary and follicular thyroid cancers are treated by surgical removal of the thyroid, followed by radioactive iodine treatment to eliminate any remaining tumor cells. Unfortunately, for individuals with progressive thyroid cancer, these treatment options are not effective, highlighting a need for increased investigation into mechanisms of drug sensitivity. In this study, we sought to evaluate mechanisms of differential drug sensitivity through RNA-seq analysis of cell lines derived from mouse models of papillary and follicular thyroid cancer. Additionally, we evaluated the effects of MAPK, AKT, and mTOR inhibitors on murine papillary and follicular thyroid cancer cell proliferation. To accurately assess drug efficacy, we calculated GR50 concentrations for each inhibitor in six papillary and follicular thyroid cancer cell lines. We discovered that papillary and follicular thyroid cancer cell lines responded differently to MAPK and AKT inhibitors, suggesting that treatment approaches should be tailored to subtype despite having mutations in the same signaling pathway. Citation Format: Brianna LeBoeuf, Braxton Anderson, Margaret Young, Aime Franco, Laura MacDonald. Evaluating the effectiveness of MAPK, AKT, and mTOR inhibitors in reducing proliferation in cellular models of papillary and follicular thyroid cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2887.

Thyroid cancer is the most common endocrine cancer, and incidence is increasing worldwide. Thyroid cancer can be classified as either well differentiated or poorly differentiated. Of well-differentiated thyroid cancers, papillary thyroid cancer is most common, and is associated with activating BRAF mutations. While our understanding of the genetic basis for thyroid cancer is fairly extensive, less is known about how the tumor microenvironment alters characteristics of tumor cells. Recently, Jolly and others reported that papillary thyroid tumors derived from cells harboring BRAFV600E mutations and PTEN deletions are enriched with fibrillar collagen. Notably, overexpression of collagen was also associated with decreased survival and worse overall prognosis in patient samples. In this study, we investigated whether growth on collagen enhanced tumorigenic characteristics of papillary thyroid cancer cell lines with BRAFV600E mutations. Three distinct cell lines derived from mouse papillary thyroid cancer tumors were grown in the presence and absence of collagen and assessed for changes in morphology, proliferation, and drug resistance. Interestingly, our results suggest that growth on collagen contributes to a more mesenchymal morphology, increased proliferation, and decreased sensitivity to chemotherapy drugs. These and other results implicate an important role for collagen in the progression of thyroid cancer. Citation Format: Anna Sharabura, Jonathan Jenkins, Laura MacDonald. Collagen increases tumorigenic characteristics of papillary thyroid cancer cells harboring BRAFV600Emutations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 172.

Health status has been demonstrated to vary by neighbourhood socioeconomic status (SES). However, neighbourhood effects may vary between countries. In this study, neighbourhood variations in health outcomes are compared across four socially contrasting neighbourhoods in Glasgow, Scotland and Hamilton, Ontario Canada. Data came from the 2001 wave of the West of Scotland Twenty-07 Longitudinal Study and a 2000/2001 cross-sectional survey conducted in Hamilton. The results of the comparison point to important variations in the relationship between neighbourhood SES and health. While both cities display a socioeconomic gradient with respect to various measures of health and health behaviours, for some outcome measures the high SES neighbourhoods in Glasgow display distributions similar to those found in the low SES neighbourhoods in Hamilton. Our results suggest that a low SES neighbourhood in one country may not mean the same for health as a low SES neighbourhood in another country. As such, country context may explain the distribution of health status and health behaviours among socially contrasting neighbourhoods, and neighbourhood variations in health may be context specific.

In recent years, governments at different scales in both North and South have been experimenting with alternative methods of alleviating poverty, and redesigning social welfare regimes. While these changes are not entirely congruent across regimes in North and South, there are interesting points of overlap and intersection. The article lays out three broad alternatives to “roll-back” neoliberalism: intrusive liberalism; inclusive liberalism, and a renewed version of social citizenship. It then lays out how these alternatives have played out in anti-poverty politics in Toronto and Mexico City, two sites where creative strategies contesting neoliberalism have been pursued. While both cities occupy a critical place within their respective political economies, they are not usually compared because of their very different positions in the North American division of labour. Yet, as we argue, they face similar challenges in the form of poverty reduction strategies at the national scale that are based on neoliberal principles that do little to meet the needs of their inhabitants. In response, both cities have provided a site for mobilising resources behind alternative anti-poverty policies, inspired by the principles of social citizenship.

Aims The aim of this study was to examine the distribution of alcohol outlets by area deprivation across Glasgow, Scotland. Methods All alcohol outlets were mapped and density per 1000 residents and proximity to nearest outlet calculated across quintiles of area deprivation. Results The socio-spatial distribution of alcohol outlets varies by deprivation across Glasgow but not systematically. Some deprived areas contain the highest concentration while others in similar deprivation quintiles contain very few. Conclusions Considerations of the local context are important in examining access to alcohol but more research is also required on purchasing behaviour.

The HIV/AIDS patient population is known to use natural health products (NHPs) in addition to the several antiretroviral drugs that constitute the treatment regimen for this disease. This review focuses on NHPs and their potential for interactions with antiretroviral agents resulting in therapeutic alterations or resistance. There are conflicting published medical literature reports and very few well-documented human clinical studies that unequivocally demonstrate if this concomitant use increases the risk of interaction/adverse reaction with these therapeutic products. This article outlines some findings from the Canadian domestic adverse reaction case reports associated with the use of antiretrovirals and NHPs. These adverse reaction case reports were specifically examined for patients taking NHPs together with their highly active antiretroviral therapy during or around the time when the adverse reaction developed. Together, the case reports and limited human clinical studies suggest that the risk for therapeutic alterations and resistance can exist due to changes in pharmacokinetic parameters with concomitant use of these therapeutic products.

It has commonly been suggested that in modern cities individual or household deprivation (for example, low income or education) is amplified by area level deprivation (for example, lack of jobs or good schools), in ways which damage the health of the poorest and increase health inequalities. The aim of this study was to determine the location of a range of resources and exposures by deprivation in a UK city. We examined the location of 42 resources in Glasgow City, Scotland, in 2005–2006, by quintile of small area deprivation. Measures included number per 1000 population, network distance to nearest resource, and percentage of data zones containing at least one of each type of resource. Twelve resources had higher density in, and/or were closer to or more common in, more deprived neighbourhoods: public nurseries, public primary schools, police stations, pharmacies, credit unions, post offices, bus stops, bingo halls, public swimming pools, public sports centres, outdoor play areas, and vacant and derelict land/buildings. Sixteen had higher density in, and/or were closer to, or more common in, more affluent neighbourhoods: public secondary schools, private schools, banks, building societies, museums/art galleries, railway stations, subway stations, tennis courts, bowling greens, private health clubs, private swimming pools, colleges, A & E hospitals, parks, waste disposal sites, and tourist attractions. Private nurseries, Universities, fire stations, general, dental and ophthalmic practices, pawn brokers, ATMs, supermarkets, fast food chains, cafes, public libraries, golf courses, and cinemas showed no clear pattern by deprivation. Thus it appears that in the early 21st century access to resources does not always disadvantage poorer neighbourhoods in the UK. We conclude that we need to ensure that theories and policies are based on up-to-date and context-specific empirical evidence on the distribution of neighbourhood resources, and to engage in further research on interactions between individual and environmental factors in shaping health and health inequalities.

Background Bisphosphonate drugs can be used to prevent and treat osteoporosis and to reduce symptoms and complications of metastatic bone disease; however, they are associated with a rare but serious adverse event: osteonecrosis of the maxillary and mandibular bones. This condition is called bisphosphonate-related osteonecrosis of the jaw or BRONJ. BRONJ is diagnosed when people who are taking, or have previously taken, bisphosphonates have exposed bone in the jaw area for more than eight weeks in the absence of radiation treatment. There is currently no "gold standard" of treatment for BRONJ. The three broad categories of intervention are conservative approaches (e.g. mouth rinse, antibiotics), surgical interventions and adjuvant non-surgical strategies (e.g. hyperbaric oxygen therapy, platelet-rich plasma), which can be used in combination. Objectives To determine the efficacy and safety of any intervention aimed at treating BRONJ. Search methods We searched the following databases to 15 December 2015: the Cochrane Oral Health Group Trials Register, the Cochrane Breast Cancer Group Trials Register (20 September 2011), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via Ovid, EMBASE via Ovid, CancerLit via PubMed, CINAHL via EBSCO and AMED via Ovid. We scanned the references cited in retrieved articles and contacted experts in the field, the first authors of included papers, study sponsors, other bisphosphonates investigators and pharmaceutical companies. We searched for ongoing trials through contact with trialists and by searching the US National Institutes of Health Trials Register (clinicaltrials.gov) and the World Health Organization Clinical Trials Registry Platform. We also conducted a grey literature search to September 2015. Selection criteria Randomised controlled trials (RCTs) comparing the effects of any treatment for BRONJ with another treatment or placebo. Data collection and analysis Two review authors independently screened the search results, assessed the risk of bias in the included trials and extracted data. When in dispute, we consulted a third review author. Main results One small trial at high risk of bias met the inclusion criteria. The trial randomised 49 participants, most of whom had cancer. It compared standard care (defined as surgery, antibiotics and oral rinses at the discretion of the oral-maxillofacial surgeon) to standard care plus hyperbaric oxygen therapy (2 atmospheres twice a day for 40 treatments). The trial measured the percentage of participants who improved or healed at three, six, 12 and 18 months and last contact. It also measured mean weekly pain scores. At three months, the study found that the participants in intervention group were more likely to have an improvement in their osteonecrosis than the standard care group participants (risk ratio (RR) 1.94, 95% confidence interval (CI) 1.01 to 3.74). There was no clear difference between the groups for the outcome 'healed' at three months (RR 3.60, 95% CI 0.87 to 14.82). There was no clear difference between the groups for improvement or healing when they were evaluated at six, 12 and 18 months and last contact. The study did not give any information on adverse events. Although the findings suggest adjunctive hyperbaric oxygen improved BRONJ, the quality of the evidence is very low since the only study was underpowered and was at high risk of bias due to lack of blinding, cross-over of participants between groups and very high attrition (50% at 12 months and 80% at 18 months in this study, which was designed for an intended follow-up of 24 months). Authors' conclusions There is a lack of evidence from randomised controlled trials to guide treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). One small trial at high risk of bias evaluated hyperbaric oxygen therapy (HBO) as an adjunct to "standard" care and could not confirm or refute the effectiveness of HBO. There are two ongoing trials of teriparatide treatment for BRONJ. We found no randomised controlled trials of any other BRONJ treatments. High quality randomised controlled trials are needed. We provide recommendations for their focus and design.

The chemical analysis of urine tells much about the physiological status of mammals, and often reveals compounds that function as chemical signals to conspecifics. Such is the case with mature male African (Loxodonta africana) and Asian (Elephas maximus) elephants in which there is odoriferous drainage from the temporal gland and dribbling of urine during musth, a periodic state in which serum androgens are elevated, food intake typically decreases, and aggressiveness between male conspecifics increases. We have employed solid phase dynamic extraction (SPDE)/GC-MS to identify a series of alkan-2-ones, alkan-2-ols, and a few simple aromatic compounds that increase in abundance in musth elephant urine. The primary focus of this report is on the alkan-2-ones and their corresponding alkan-2-ols, specifically: (1) the probable biosynthesis of these compounds via a secondary pathway for fatty acid metabolism, (2) the proximate cause for their increased abundance in musth urine, and (3) the role of bacteria in the increased abundance of these compounds exogenously in aged urine.

INTRODUCTION: Many clinical questions about brain and spinal cord tumours remain unanswered. Objectives of the Neuro-Oncology Priority Setting Partnership (PSP) were: To identify the top 10 treatment uncertainties in diagnosis and management of primary central nervous system (CNS) tumours; To highlight the necessity of a brain tumour community collaborative approach to priority setting in clinical research; To encourage other countries to use the PSP methodology to draw international comparisons. METHOD: 30 stakeholder representatives from a cross section of the UK brain tumour community were recruited. The scope was: clinical uncertainties of interventions for primary brain or spinal cord tumours. The first public survey was widely publicised by websites, MDMs, professional and charity databases. Questions were categorised and standardised into the PICO format. A Cochrane style literature search was performed to ensure these were genuine “uncertainties”. Initial prioritisation used standard James Lind Alliance (JLA) methodology. A second public survey was performed using the prioritised questions, to ask the community to rate the questions. A final workshop determined the top 10 questions using a modified Delphi and Nominal Group technique. RESULTS: Over 600 individual questions were generated from the initial survey, a patient forum and the Database of Treatment Uncertainties (DUETS). These were analysed and reduced to 44 PICO questions. These were sent out in a second public survey. The penultimate group of 25 questions was discussed at a final workshop, reaching agreement on the final top 10 uncertainties. CONCLUSION: To focus attention on what really matters to those affected by brain and spinal cord tumours, it is crucial to promote the 10 clinical research uncertainties (http://www.neuro-oncology.org.uk) to governmental, neuroscience and charity funders throughout 2015/16. This has been a very successful and rewarding joint collaboration between CNS patients/carers, major charities and multidisciplinary professional organisations.

Background:\ud A number of studies based in the US, Canada, and Australia, have found evidence of associations between the built environment (BE) and mode of transport to school, and links between active travel and deprivation. Limited research in the UK compares potential BE supports for walking to school by area deprivation. Within this study, we gathered data on BE attributes previously linked to active travel, i.e., street/path connectivity, and dwelling density, created a composite ‘walkability score’ (WS) for areas around primary schools across urban Scotland, and explored whether poorer areas exhibit lower scores than more affluent areas, or vice versa. We consider this to be a novel approach as few studies have compared BE features by deprivation across a whole country.\ud \ud Methods:\ud Address and road/path maps were obtained and primary schools (N = 937) across mainland Scotland were mapped. Schools were attributed income deprivation scores (scores divided into quintiles (Q1: least deprived, Q5: most deprived)). Catchment area (CA) boundaries, i.e., the geographic area representing eligibility for local school attendance, were drawn around schools, and WS calculated for each CA. We compared mean WS by income quintile (ANOVA), for all local authorities (LAs) combined (N = 29), and separately for the four LAs with the greatest number of schools included in the analysis.\ud \ud Results:\ud For all LAs combined, the least deprived quintile (Q1) showed a significantly lower WS (−0.61), than quintiles 3, 4 and 5 (Q2: −0.04 (non-sig), Q3: 0.38, Q4: 0.09, Q5: 0.18); while for Glasgow the second least deprived quintile (Q2) showed significantly higher WS (Q1: 1.35, Q2: 1.73), than middling (Q3: 0.18) and most deprived quintiles (Q4: 0.06, Q5: −0.10).\ud \ud Conclusion:\ud WS differ by deprivation with patterns varying depending on the spatial scale of the analysis. It is essential that less walkable areas are provided with the resources to improve opportunities to engage in active travel.