Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA)

As the mean age of the global population increases, breast cancer in older individuals will be increasingly encountered in clinical practice. Management decisions should not be based on age alone. Establishing recommendations for management of older individuals with breast cancer is challenging because of very limited level 1 evidence in this heterogeneous population. In 2007, the International Society of Geriatric Oncology (SIOG) created a task force to provide evidence-based recommendations for the management of breast cancer in elderly individuals. In 2010, a multidisciplinary SIOG and European Society of Breast Cancer Specialists (EUSOMA) task force gathered to expand and update the 2007 recommendations. The recommendations were expanded to include geriatric assessment, competing causes of mortality, ductal carcinoma in situ, drug safety and compliance, patient preferences, barriers to treatment, and male breast cancer. Recommendations were updated for screening, primary endocrine therapy, surgery, radiotherapy, neoadjuvant and adjuvant systemic therapy, and metastatic breast cancer.

Fashionline: CSR case of a U.K. fashion retailer

This paper presents findings from a corporate social responsibility (CSR) case-study of a UK fashion retailer informed through 22 multi-level internal and 5 external semi-structured interviews. Our research explores the relationship between various stakeholders and their perceptions of CSR issues. Sixteen themes emerge. We find disparity in CSR perceptions at different levels of organization and in views of consumers. Our recommendations are that the UK fashion retailer needs to – better understand normative purpose of CSR and in doing so balance social and environmental factors more equally; engage more widely at an early stage with broader stakeholders (global supply chain; consumers, employees, local populations, regulators, industry players); and better communicate (at different levels internally) along with integrate (external policy makers and with industry) design and implementation of CSR strategies. The authors conclude a gap remains for better CSR frameworks for the UK fashion retailer.

Targeting myocardial remodelling to develop novel therapies for heart failure: a position paper from the Working Group on Myocardial Function of the European Society of Cardiology

The failing heart is characterized by complex tissue remodelling involving increased cardiomyocyte death, and impairment of sarcomere function, metabolic activity, endothelial and vascular function, together with increased inflammation and interstitial fibrosis. For years, therapeutic approaches for heart failure (HF) relied on vasodilators and diuretics which relieve cardiac workload and HF symptoms. The introduction in the clinic of drugs interfering with beta-adrenergic and angiotensin signalling have ameliorated survival by interfering with the intimate mechanism of cardiac compensation. Current therapy, though, still has a limited capacity to restore muscle function fully, and the development of novel therapeutic targets is still an important medical need. Recent progress in understanding the molecular basis of myocardial dysfunction in HF is paving the way for development of new treatments capable of restoring muscle function and targeting specific pathological subsets of LV dysfunction. These include potentiating cardiomyocyte contractility, increasing cardiomyocyte survival and adaptive hypertrophy, increasing oxygen and nutrition supply by sustaining vessel formation, and reducing ventricular stiffness by favourable extracellular matrix remodelling. Here, we consider drugs such as omecamtiv mecarbil, nitroxyl donors, cyclosporin A, SERCA2a (sarcoplasmic/endoplasmic Ca(2 +) ATPase 2a), neuregulin, and bromocriptine, all of which are currently in clinical trials as potential HF therapies, and discuss novel molecular targets with potential therapeutic impact that are in the pre-clinical phases of investigation. Finally, we consider conceptual changes in basic science approaches to improve their translation into successful clinical applications.

Uranium series disequilibria in ground waters from a fractured bedrock aquifer (Morungaba Granitoids-Southern Brazil): Implications to the hydrochemical behavior of dissolved U and Ra

Activity concentrations of dissolved U-234, U-238, Ra-226 and Ra-228 were determined in ground waters fromtwo deep wells drilled in Morungaba Granitoids (Southern Brazil). Sampling was done monthly for little longer than 1 year. Significant disequilibrium between U-238, U-234 and Ra-226 were observed in all samples. The variation of U-238 and U-234 activity concentrations and U-234/U-238 activity ratios is related to seasonal changes. Although the distance between the two wells is short (about 900m), systematic differences of activity concentrations of U isotopes, as well as of U-234/U-238, Ra-226/U-234 and Ra-228/Ra-226 activity ratios were noticed, indicating distinct host rock-water interactions. Slightly acidic ground water percolation through heterogeneous host rock, associated with different recharge processes, may explain uranium and radium isotope behavior. (c) 2008 Elsevier Ltd. All rights reserved.

Contribution of SHRIMP U-Pb zircon geochronology to unravelling the evolution of Brazilian Neoproterozoic fold belts

The South-American continent is constituted of three major geologic-geotectonic entities the homonym platform (consolidated at the end of the Cambrian) the Andean chain (essentially Meso-Cenozoic) and the Patagonian terrains affected by tectonism and magmatism through almost all of the Phanerozoic The platform is constituted by a series of cratonic nuclei (pre-Tonian fragments of the Rodinia fission) surrounded by a complex fabric of Neoproterozoic structural provinces Two major groups of orogenic processes (plate interaction cycles) constitute the evolution of these provinces the older occurred in the Tonian (smaller in area) and the younger Brasiliano that is present in all provinces The Tonian cycles (pre-Rodinia fission?) are still being sorted out and many questions still need to be answered The Brasiliano orogenic collage events (post-Rodinia fission?) developed in three main stages in part coeval from a province to another and are 650-600 580-560 and 540-500 Ma respectively (the late event reaching the Ordovician) The first group of orogenies is recorded in practically all provinces The third group is restricted to part of the Mantiqueira Province (southeast of the platform Buzios Orogeny) and present in the Pampean province (SW of the platform) For all these groups of orogenic events there are considerable records of rock assemblages related to processes of convergent plate interaction opening accretion collision and further extrusion There is a good correlation between the geologic and geotectonic data and geochemical and isotopic data The late tectonic processes (post-orogenic magmatism foreland basins etc) of the first two groups compete in time in distinct spaces with the peak of orogenic processes in the third group The introduction of the SHRIMP U-Pb methodology was fundamental to separate the Tonian and post-Tonian orogenic groups and their respective divisions in time and space Thus there are still many open points/problems which lead to expectations of addressing these issues in the near future with the more Intense use of this methodology (C) 2010 Elsevier B V All rights reserved

Satisfaction with general practitioner treatment of depression among residents of aged care facilities.

Objective: This article investigates consumer perspectives on the treatment for depression among older people in residential facilities. Method: Aged care residents who were aware of being treated for depression in the past 6 months (24 women and 7 men, mean age = 83 years) participated in an interview that assessed their perspective on treatments. Results: Although more than half of the participants in the sample reported overall satisfaction with the medical treatments received for depression, qualitative data provided indications of unsatisfactory service delivery, including perceptions of low treatment efficacy, short consultation times, the failure to assess affective symptomatology, and negative responses to residents’ disclosure of symptoms. Discussion: The findings are discussed in relation to previous research on consumer satisfaction with health services and issues that may be pertinent to the elderly depressed. Training for general practitioners providing treatment in aged care is indicated.