Bevacizumab in NF2-related vestibular schwannomas: a nationally coordinated approach to delivery and prospective evaluation

Background: NF2 patients develop multiple nervous system tumors including bilateral vestibular schwannomas (VS). The tumors and their surgical treatment are associated with deafness, neurological disability, and mortality. Medical treatment with bevacizumab has been reported to reduce VS growth and to improve hearing. In addition to evaluating these effects, this study also aimed to determine other important consequences of treatment including patient-reported quality of life and the impact of treatment on surgical VS rates. Methods: Patients treated with bevacizumab underwent serial prospective MRI, audiology, clinical, CTCAE-4.0 adverse events, and NFTI-QOL quality-of-life assessments. Tumor volumetrics were classified according to the REiNs criteria and annual VS surgical rates reviewed. Results: Sixty-one patients (59% male), median age 25 years (range, 10–57), were reviewed. Median follow-up was 23 months (range, 3–53). Partial volumetric tumor response (all tumors) was seen in 39% and 51% had stabilization of previously growing tumors. Age and pretreatment growth rate were predictors of response. Hearing was maintained or improved in 86% of assessable patients. Mean NFTI-QOL scores improved from 12.0 to 10.7 (P < .05). Hypertension was observed in 30% and proteinuria in 16%. Twelve treatment breaks occurred due to adverse events. The rates of VS surgery decreased after the introduction of bevacizumab. Conclusion: Treatment with bevacizumab in this large, UK-wide cohort decreased VS growth rates and improved hearing and quality of life. The potential risk of surgical iatrogenic damage was also reduced due to an associated reduction in VS surgical rates. Ongoing follow-up of this cohort will determine the long-term benefits and risks of bevacizumab treatment.

Translation and Psychometric Evaluation of a Standard Chinese Version of the Body Appreciation Scale-2

The present study examined the factorial and construct validity of a Standard Chinese translation of the Body Appreciation Scale (BAS-2; Tylka & Wood-Barcalow, 2015b). Participants were 191 women and 154 men from mainland China who were resident in Hong Kong at the time of recruitment. Results of confirmatory factor analysis indicated that the one-dimensional model of the BAS-2, in which all 10 items loaded onto the same factor, had adequate fit and was invariant across sex. Body appreciation scores had good internal consistency and were significantly correlated with self-esteem and life satisfaction, and, in women, with weight discrepancy and body mass index. There were no significant differences in body appreciation scores between women and men. The present findings suggest that the Standard Chinese translation of the BAS-2 has the same one-dimensional factor structure as its parent scale and may facilitate cross-cultural studies of positive body image.

City dweller aspirations for cities of the future: How do environmental and personal wellbeing feature?

This paper explores city dweller aspirations for cities of the future in the context of global commitments to radically reduce carbon emissions by 2050; cities contribute the vast majority of these emissions and a growing bulk of theworld's population lives in cities. The particular challenge of creating a carbon reduced future in democratic countries is that the measures proposed must be acceptable to the electorate. Such acceptability is fostered if carbon reduced ways of living are also felt to bewellbeing maximising. Thus the objective of the paper is to explore what kinds of cities people aspire to live in, to ascertain whether these aspirations align with or undermine carbon reduced ways of living, as well as personal wellbeing. Using a novel free associative technique, city aspirations are found to cluster around seven themes, encompassing physical and social aspects. Physically, people aspire to a city with a range of services and facilities, green and blue spaces, efficient transport, beauty and good design. Socially, people aspire to a sense of community and a safe environment. An exploration of these themes reveals that only a minority of the participants' aspirations for cities relate to lowering carbon or environmental wellbeing. Far more consensual is emphasis on, and a particular vision of, aspirations that will bring personal wellbeing. Furthermore, city dweller aspirations align with evidence concerning factors that maximise personal wellbeing but, far less, with those that produce lowcarbonways of living. In order to shape a lower carbon future that city dwellers accept the potential convergence between environmental and personal wellbeing will need to be capitalised on: primarily aversion to pollution and enjoyment of communal green space.