Regression of coronary atherosclerosis: Current evidence and future perspectives

Coronary atherosclerosis has been considered a chronic disease characterized by ongoing progression in response to systemic risk factors and local pro-atherogenic stimuli. As our understanding of the pathobiological mechanisms implicated in atherogenesis and plaque progression is evolving, effective treatment strategies have been developed that led to substantial reduction of the clinical manifestations and acute complications of coronary atherosclerotic disease. More recently, intracoronary imaging modalities have enabled detailed in vivo quantification and characterization of coronary atherosclerotic plaque, serial evaluation of atherosclerotic changes over time, and assessment of vascular responses to effective anti-atherosclerotic medications. The use of intracoronary imaging modalities has demonstrated that intensive lipid lowering can halt plaque progression and may even result in regression of coronary atheroma when the highest doses of the most potent statins are used. While current evidence indicates the feasibility of atheroma regression and of reversal of presumed high-risk plaque characteristics in response to intensive anti-atherosclerotic therapies, these changes of plaque size and composition are modest and their clinical implications remain largely elusive. Growing interest has focused on achieving more pronounced regression of coronary plaque using novel anti-atherosclerotic medications, and more importantly on elucidating ways toward clinical translation of favorable changes of plaque anatomy into more favorable clinical outcomes for our patients.

DISEASE-RELATED INFORMATION NEEDS OF CANCER PATIENTS AGES 11-20: A COMPARISON OF PATIENT-PARENT AND PATIENT-PHYSICIAN PERCEPTIONS

Innovative, aggressive treatments and prolonged survival rates for patients with childhood cancers have placed new demands on the patient, parent and physician. As a result, counterproductive coping behaviors are often noted in adolescent cancer patients.^ One of the main ways the environment is manipulated by the individual to achieve personal comfort is through selectivity of information. An individual will usually pull the support personally needed to cope from the environment if sufficient resources are available. However, information provided young cancer patients is often filtered through the physicians and parents perspectives of the patient's needs without systematic input from the patient. In order to ensure that adequate information resources are available to help teenage patients cope with their illness, health professionals must have insights into the information needs of those patients. No previous efforts to address this subject were found in the literature.^ This study was designed to identify adolescent perspectives of their disease-related information needs and to compare their viewpoints with those of their parents and physicians. Sixty-five outpatient cancer patients (ages 11-20) receiving treatment at the University of Texas M. D. Anderson Hospital and Tumor Institute in Houston, Texas, 60 of their parents, and 53 physicians, who were involved in the treatment of pediatric patients at M. D. Anderson, were asked to complete self-administered questionnaires. The questionnaires used were developed, administered and analyzed by the investigator. Specific areas addressed in the questionnaires included: Perceptions of cancer-related tests and treatments, the importance of 30 disease-related items of information, responses evoked by receipt of information, current and preferred sources of information, delivery of information at the time of diagnosis, and disease-related information requested for patients, family, friends and teachers.^ Adolescent perceptions of their information needs and their preferences for delivery of information were determined. The relationships between patient-parent and patient-physician perceptions were then analyzed to determine areas in which agreements and disparities in viewpoint existed. Programmatic and research recommendations were then provided.^ Hopefully, through these efforts, the adolescent patient will be helped to receive relevant information support from those deemed to be most important to his/her efforts to cope with cancer. ^

FACTORS INFLUENCING CHOICE OF CONTRACEPTIVE METHOD AMONG MARRIED FECUND WOMEN WHO INTEND NO ADDITIONAL BIRTHS: HEALTH BELIEF MODEL AND ECONOMIC PERSPECTIVES

This research examined to what extent Health Belief Model (HBM) and socioeconomic variables were useful in explaining the choice whether or not more effective contraceptive methods were used among married fecund women intending no additional births. The source of the data was the 1976 National Survey of Family Growth conducted under the auspices of the National Center for Health Statistics. Using the HBM as a framework for multivariate analyses limited support was found (using available measures) that the HBM components of motivation and perceived efficacy influence the likelihood of more effective contraceptive method use. Support was also found that modifying variables suggested by the HBM can influence the effects of HBM components on the likelihood of more effective method use. Socioeconomic variables were found, using all cases and some subgroups, to have a significant additional influence on the likelihood of use of more effective methods. Limited support was found for the concept that the greater the opportunity costs of an unwanted birth the greater the likelihood of use of more effective contraceptive methods. This research supports the use of HBM and socioeconomic variables to explain the likelihood of a protective health behavior, use of more effective contraception if no additional births are intended.^

Retrospective Voting in Turkey: Macro and Micro Perspectives

Recent studies have shown that party systems in emerging democracies do not always adequately reflect the various cleavages of society. Under such circumstances, retrospective voting may play a more important role than cleavage voting in determining electoral outcomes. For studies of retrospective voting, the choice between macro and micro level as the independent variable is a major methodological issue. Using individual-level data on Turkey, this paper addresses two major questions: (1) Are voters' decisions based on household economic conditions or national economic conditions? Do sociopolitical conditions also count? (2) Does the future evaluation of the economy affect voting decisions apart from past evaluation? Logit models are used in this research to answer these questions.

Relationship between young women and parents in rural Ethiopia

In rural Ethiopia, parents play an important role in the major life events of their daughters such as education and marriage. However, parents’ roles have been evolving, likely due to the rapid expansion of educational opportunities for girls and the growing need of cash income among rural households. Currently, encouraging their daughters to take up further education and jobs in the formal sector contrasts with rural Ethiopian women’s conventional life course events in the past, which are characterized by early marriage and low educational profiles. An interview analysis with parents of young women indicated that under the continuing de-agrarianization among rural households, women are expected to have their own cash income generating activities to qualify as marriage partners.

Urbanism and dictatorship: perspectives of the field of urban studies

In 1933 public letter to Wilhelm Furtwängler, Joseph Goebbels synthesized the official understanding of the link between politics, art and society in the early steps of the Third Reich. By assuming the ethos of art, politics acquired a plastic agency to mold its objects —population and the state— as a unified entity in the form of a ‘national-popular community’ (Volksgemeinschaft); in turn, by infusing art with a political valence, it became part of a wider governmental apparatus that reshaped aesthetic discourses and practices. Similar remarks could be made about the ordering of cities and territories in this period. Dictatorial imaginations mobilized urbanism —including urban theory, urban design and planning— as a fundamental tool for social organization. Under their aegis the production of space became a moment in a wider production of society. Many authors suggest that this political-spatial nexus is intrinsic to modernity itself, beyond dictatorial regimes. In this light, I propose to use dictatorial urbanisms as an analytical opportunity to delve into some concealed features of modern urban design and planning. This chapter explores some of these aspects from a theoretical standpoint, focusing on the development of dictatorial planning mentalities and spatial rationalities and drawing links to other historical episodes in order to inscribe the former in a broader genealogy of urbanism. Needless to say, I don’t suggest that we use dictatorships as mere templates to understand modern productions of space. Instead, these cases provide a crude version of some fundamental drives in the operationalization of urbanism as an instrument of social regulation, showing how far the modern imagination of sociospatial orderings can go. Dictatorial urbanisms constituted a set of experiences where many dreams and aspirations of modern planning went to die. But not, as the conventional account would have it, because the former were the antithesis of the latter, but rather because they worked as the excess of a particular orientation of modern spatial governmentalities — namely, their focus on calculation, social engineering and disciplinary spatialities, and their attempt to subsume a wide range of everyday practices under institutional structuration by means of spatial mediations. In my opinion the interest of dictatorial urbanisms lies in their role as key regulatory episodes in a longer history of our urban present. They stand as a threshold between the advent of planning in the late 19th and early 20th century, and its final consolidation as a crucial state instrument after World War II. We need, therefore, to pay attention to these experiences vis-à-vis the alleged ‘normal’ development of the field in contemporary democratic countries in order to develop a full comprehension thereof.

Modeling soil processes : Review, key challenges, and new perspectives

Peer reviewed

Discovery of genes involved with learning and memory: An experimental synthesis of Hirschian and Benzerian perspectives

The biological bases of learning and memory are being revealed today with a wide array of molecular approaches, most of which entail the analysis of dysfunction produced by gene disruptions. This perspective derives both from early “genetic dissections” of learning in mutant Drosophila by Seymour Benzer and colleagues and from earlier behavior-genetic analyses of learning and in Diptera by Jerry Hirsch and coworkers. Three quantitative-genetic insights derived from these latter studies serve as guiding principles for the former. First, interacting polygenes underlie complex traits. Consequently, learning/memory defects associated with single-gene mutants can be quantified accurately only in equilibrated, heterogeneous genetic backgrounds. Second, complex behavioral responses will be composed of genetically distinct functional components. Thus, genetic dissection of complex traits into specific biobehavioral properties is likely. Finally, disruptions of genes involved with learning/memory are likely to have pleiotropic effects. As a result, task-relevant sensorimotor responses required for normal learning must be assessed carefully to interpret performance in learning/memory experiments. In addition, more specific conclusions will be obtained from reverse-genetic experiments, in which gene disruptions are restricted in time and/or space.