New study shows government spending preferences of Americans
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In its 27th survey of American spending priorities since 1973 conducted as part of its General Social Survey (GSS), NORC at the University of Chicago Wednesday released a report on its most recent findings. By a notable margin, education and health care were the top two spending priorities of Americans. And Americans are consistent in that: those two categories have finished in the top two in each of the ten surveys since 1990.
The spending priorities report is derived from recently released data of the 2010 General Social Survey which NORC has conducted for forty years. The GSS is a biennial survey that gathers data on contemporary American society in order to monitor and explain trends and constants in attitudes, behaviors, and attributes. NORC makes the high-quality data easily accessible to scholars, students, policy makers, and others. Over 16,000 research uses in articles, textbooks, monographs, dissertations, etc. have been documented. The GSS is supported by the National Science Foundation and it is the second most-referenced survey in America after the U.S. Census.
Rounding out the top ten spending priorities were (3) assistance to the poor (4) halting crime, (5) Social Security, (6) the environment, (7) dealing with drug addiction, (8) childcare, (9) drug rehabilitation, and (10) law enforcement. Finishing lowest in priority, as it has in every survey since 1973, is foreign assistance. The study surveys public preferences on twenty-two spending categories.
Rituximab combined with a TNF inhibitor and methotrexate shows no safety signal in RA treatment
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A recent trial of rituximab in combination with a tumor necrosis factor (TNF) inhibitor and methotrexate (MTX) in patients with active rheumatoid arthritis (RA) found the safety profile to be consistent with other RA trials with TNF inhibitors. While the trial reported no new safety risks, clear evidence of an efficacy advantage in RA patients receiving the combination therapy was not observed in this study sample. Results of the trial are published in the March issue of Arthritis & Rheumatism, a peer-reviewed journal of the American College of Rheumatology.
The National Arthritis Data Workgroup estimates that 1.3 million U.S. adults have RA which is characterized by systemic joint inflammation that often leads to joint damage, functional impairment and significant disability. While MTX is successfully used to treat many RA patients, the severity of the disease in some patient populations requires the use of additional disease-modifying antirheumatic drugs (DMARDs). A specific group of biologic DMARDs, called tumor necrosis factor (TNF) inhibitors and includes such therapies as etanercept and adalimumab, block the immune system response, and have been shown to be safe and effective in clinical trials.
Prior studies, however, have found that up to 40% of RA patients exhibit an inadequate response, intolerance, or inadequate slowing of the rate of joint damage with biologic therapies, and require additional treatment options. “Our objective was to assess the safety of the biologic DMARD, rituximab, in combination with a TNF inhibitor and MTX in patients with active RA,” said lead study author Maria Greenwald, M.D., from Desert Medical Advances in California. This was a small exploratory study to evaluate safety with this combination due to the prolonged effect of rituximab, and the fact that RA patients may switch to an alternate biologic such as a TNF inhibitor before the effects of rituximab may have resolved.
What doctors (and patients) can learn from air traffic controllers: What’s that you say
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A review of 35 years of scientific medical studies confirms that the social and emotional context of the doctor–patient relationship have yet to be incorporated into the equation when it comes to health care.
In spite of its strong endorsement over a decade ago by the influential Institute of Medicine report, “Crossing the Quality Chasm: A New Health System for the 21st Century,” which highlighted the benefits of care that is respectful of and responsive to patients’ needs, values and concerns, patient-centered medicine has not become part of the mainstream.
A review of the medical literature from 1975 to April 2010 found that less than one percent of the 327,219 randomized controlled studies published in peer-reviewed journals over the past 35 years included patient-centered care trials. “Behaviorally–Defined Patient-Centered Communication – A Narrative Review” appears in the February 2011 issue of the Journal of General Internal Medicine
Alcohol consumption after age 75 associated with lower risk of developing dementia
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3202 German individuals (75+) attending general practitioners , who were free of dementia were studied at baseline, were followed up 1.5 years and 3 years later by means of structured clinical interviews including detailed assessment of current alcohol consumption and DSM-IV dementia diagnoses. Associations between alcohol consumption (in grams of ethanol), type of alcohol (wine, beer, mixed alcohol beverages) and incident dementia were examined using Cox proportional hazard models, controlling for several confounders.
There was good ascertainment of the development of dementia, even among subjects who died during follow up. Of 3,202 subjects free of dementia at baseline, 217 subjects met criteria for dementia during follow up. Subjects consuming alcohol had approximately 30% less overall dementia and 40% less Alzheimer dementia than did non-drinking subjects. No significant differences were seen according to the type of alcoholic beverage consumed. Overall, these results are similar to several previous studies in the very elderly and suggest that moderate drinking is associated with less dementia, even among individuals aged 75 years and older.
The authors conclusions suggests that light-to-moderate alcohol consumption is inversely related to incident dementia, also among individuals aged 75 years and older.
Clustering gene expression changes reveals pathways toward glaucoma prevention
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Glaucoma is the second-most common cause of blindness in the US, and occurs due to loss of retinal ganglion cells and degeneration of the optic nerve. Although it is known that high levels of pressure within the eye predispose individuals to the development of glaucoma, the molecular mechanisms involved are poorly defined.
In new research from The Jackson Laboratory in Bar Harbor, Maine, Simon John and colleagues analyzed gene expression patterns in the retina and optic nerves of mice that develop age-related glaucoma. Using a method that involved the clustering of samples that showed similarity in expression profiles, the researchers were able to identify molecular signatures of early events in glaucoma progression- events that were detectable before there was morphological evidence of damage.
Activation of part of the innate immune system called the complement cascade, and upregulation of endothelin 2- a protein that can increase blood pressure- were among these early changes. Notably, the researchers found that genetically and pharmacologically interfering with these changes protected mice from developing glaucoma.
New advances in genetic studies of Fanconi anemia patients
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A consortium of thirty-two researchers worldwide, led by Dr Jordi Surrallés, professor of the Department of Genetics and Microbiology at Universitat Autònoma de Barcelona (UAB) and member of the Centre for Biomedical Network Research on Rare Diseases (CIBERER), genetically and clinically characterised almost all Spanish patients suffering from Franconi anaemia, a rare disease affecting one in every 500,000 persons and which is characterised by severe anaemia in children, congenital malformations and a high predisposition to cancer.
A hundred people in Spain suffer from Fanconi anaemia; 80% of these present mutations in the FANCA gene. In the research, 90% of these patients were studied, as well as patients in Brazil, Mexico, Argentina, Peru, United States, United Kingdom, Portugal, Germany, Pakistan and Nigeria.
The research includes characterisation of over 130 pathogenic mutations in the FANCA gene, present in two of every three cases in almost all of the countries analysed, as well as the study of the origin and world distribution of some of the most frequent mutations. The mutation predominating in Spain and in the rest of countries is an ancestral mutation of Indo-European origin which spread throughout Europe thousands of years ago and which reached America across the Atlantic, producing founder effects in areas such as La Palma, with a high prevalence of the disease, and Brazil, where half of all patients share the same gene mutation.
New study suggests ALS could be caused by a retrovirus
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A retrovirus that inserted itself into the human genome thousands of years ago may be responsible for some cases of the neurodegenerative disease amyotrophic lateral sclerosis (ALS), also known as Lou Gherig’s disease. The finding, made by Johns Hopkins scientists, may eventually give researchers a new way to attack this universally fatal condition.
While roughly 20 percent of ALS cases appear to have a genetic cause, the vast majority of cases appear to arise sporadically, with no known trigger. Research groups searching for a cause of this so-called sporadic form had previously spotted a protein known as reverse transcriptase, a product of retroviruses such as HIV, in ALS patients’ serum samples, suggesting that a retrovirus might play a role in the disease. However, these groups weren’t able to trace this reverse transcriptase to a specific retrovirus, leaving some scientists in doubt whether retroviruses are involved in ALS.
Seeking to verify whether a culprit retrovirus indeed exists, Avindra Nath, M.D., a professor of neurology at the Johns Hopkins University School of Medicine, and colleagues examined brain samples from 62 people: 28 who died from ALS, 12 who died from chronic, systemic diseases such as cancer, 10 who died from accidental causes and 12 who had another neurodegenerative disease, Parkinson’s disease, at the time of their deaths. Using a technique known as polymerase chain reaction, the researchers searched for messenger RNA (mRNA) transcripts from retroviruses, a chemical signature that retroviruses were active in these patients.
