Type of Alcoholic Beverage and Risk of Head and Neck Cancer-025EFA Pooled Analysis Within the INHANCE Consortium

The authors pooled data from 15 case-control studies of head and neck cancer (9,107 cases, 14,219 controls) to investigate the independent associations with consumption of beer, wine, and liquor. In particular, they calculated associations with different measures of beverage consumption separately for subjects who drank beer only (858 cases, 986 controls), for liquor-only drinkers (499 cases, 527 controls), and for wine-only drinkers (1,021 cases, 2,460 controls), with alcohol never drinkers (1,124 cases, 3,487 controls) used as a common reference group. The authors observed similar associations with ethanol-standardized consumption frequency for beer-only drinkers (odds ratios (ORs) = 1.6, 1.9, 2.2, and 5.4 for <= 5, 6-15, 16-30, and > 30 drinks per week, respectively; P(trend) < 0.0001) and liquor-only drinkers (ORs = 1.6, 1.5, 2.3, and 3.6; P < 0.0001). Among wine-only drinkers, the odds ratios for moderate levels of consumption frequency approached the null, whereas those for higher consumption levels were comparable to those of drinkers of other beverage types (ORs = 1.1, 1.2, 1.9, and 6.3; P < 0.0001). Study findings suggest that the relative risks of head and neck cancer for beer and liquor are comparable. The authors observed weaker associations with moderate wine consumption, although they cannot rule out confounding from diet and other lifestyle factors as an explanation for this finding. Given the presence of heterogeneity in study-specific results, their findings should be interpreted with caution.

Alcohol and tobacco, and the risk of cancers of the upper aerodigestive tract in Latin America: a case-control study

Cancers of the upper aerodigestive tract (UADT; including oral cavity, pharynx, larynx and oesophagus) have high incidence rates all over the world, and they are especially frequent in some parts of Latin America. However, the data on the role of the major risk factors in these areas are still limited. We have evaluated the role of alcohol and tobacco consumption, based on 2,252 upper aerodigestive squamous-cell carcinoma cases and 1,707 controls from seven centres in Brazil, Argentina, and Cuba. We show that alcohol drinkers have a risk of UADT cancers that is up to five times higher than that of never-drinkers. A very strong effect of aperitifs and spirits as compared to other alcohol types was observed, with the ORs reaching 12.76 (CI 5.37-30.32) for oesophagus. Tobacco smokers were up to six times more likely to develop aerodigestive cancers than never-smokers, with the ORs reaching 11.14 (7.72-16.08) among current smokers for hypopharynx and larynx cancer. There was a trend for a decrease in risk after quitting alcohol drinking or tobacco smoking for all sites. The interactive effect of alcohol and tobacco was more than multiplicative. In this study, 65% of all UADT cases were attributable to a combined effect of alcohol and tobacco use. In this largest study on UADT cancer in Latin America, we have shown for the first time that a prevailing majority of UADT cancer cases is due to a combined effect of alcohol and tobacco use and could be prevented by quitting the use of either of these two agents.

Implementação e integração do modelo de acreditação da Joint Commission International na unidade de imagiologia do Hospital Privado da Boavista

Este trabalho descreve a abordagem abrangente sobre a melhoria do sistema de gestão da qualidade na Unidade de Imagiologia do Hospital da Boavista através da implementação das normas de acreditação da Joint Commission International (JCI). Fundamental para a melhoria geral da qualidade é a redução contínua de riscos para os doentes e para os profissionais da Unidade. Tais riscos podem existir ao nível do ambiente físico assim como no circuito dos exames e dos doentes. A acreditação em Saúde é uma das prioridades estratégicas do Ministério da Saúde e tem como objetivo fortalecer a confiança dos cidadãos nos profissionais de saúde bem como nas instituições de saúde. É importante que Portugal cultive a melhoria da qualidade e segurança nas instituições de saúde mantendo uma relação adequada custo/benefício. A União Europeia tem feito um esforço para que a acreditação seja harmoniosa nos seus princípios, no entanto é respeitada sempre a prevalência da legislação de cada país, bem como as suas especificações culturais e religiosas (Shaw, 2006), responsabilizando-o pelo seu sistema de saúde O trabalho aqui apresentado tem como objetivo principal fundamentar a escolha do modelo de acreditação da JCI para o Hospital da Boavista, nomeadamente para a Unidade de Imagiologia, ver se os padrões estão de acordo com os procedimentos da Unidade, identificar falhas e apontar possiveis melhorias. Pretende-se ainda mostrar a importância da implementação dos sistemas de certificação e acreditação da gestão da qualidade, documentada pela experiência profissional, bem como o know-how do Hospital da Boavista, assim como a complementaridade dos programas da gestão da qualidade, certificação e acreditação. A escolha do modelo de acreditação da JCI, foi uma opção do Hospital da Boavista baseada na credibilidade e no grau de exigência que a entidade impõe. Foi imperativo que a Unidade de Imagiologia realizasse as suas funções de forma válida e fiável e que disponibilizasse produtos / serviços de qualidade. A monitorização e consequente controlo de qualidade do serviço prestado pela Unidade de Imagiologia, foi difícil mas simplificado, em parte, devido ao sistema de gestão da qualidade ISO 9001:2008 já implementado, tendo este sido consolidado com a implementação da acreditação da JCI, com padrões específicos bem definidos na gestão do controlo de qualidade na Unidade de Imagiologia do Hospital da Boavista.

Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study

Objective. To examine the association between pre-diagnostic circulating vitamin D concentration, dietary intake of vitamin D and calcium, and the risk of colorectal cancer in European populations. Design Nested case-control study. Setting. The study was conducted within the EPIC study, a cohort of more than 520 000 participants from 10 western European countries. Participants: 1248 cases of incident colorectal cancer, which developed after enrolment into the cohort, were matched to 1248 controls. Main outcome measures. Circulating vitamin D concentration (25-hydroxy-vitamin-D, 25-(OH)D) was measured by enzyme immunoassay. Dietary and lifestyle data were obtained from questionnaires. Incidence rate ratios and 95% confidence intervals for the risk of colorectal cancer by 25-(OH)D concentration and levels of dietary calcium and vitamin D intake were estimated from multivariate conditional logistic regression models, with adjustment for potential dietary and other confounders. Results. 25-(OH)D concentration showed a strong inverse linear dose-response association with risk of colorectal cancer (P for trend <0.001). Compared with a pre-defined mid-level concentration of 25-(OH)D (50.0-75.0 nmol/l), lower levels were associated with higher colorectal cancer risk (<25.0 nmol/l: incidence rate ratio 1.32 (95% confidence interval 0.87 to 2.01); 25.0-49.9 nmol/l: 1.28 (1.05 to 1.56), and higher concentrations associated with lower risk (75.0-99.9 nmol/l: 0.88 (0.68 to 1.13); ≥100.0 nmol/l: 0.77 (0.56 to 1.06)). In analyses by quintile of 25-(OH)D concentration, patients in the highest quintile had a 40% lower risk of colorectal cancer than did those in the lowest quintile (P<0.001). Subgroup analyses showed a strong association for colon but not rectal cancer (P for heterogeneity=0.048). Greater dietary intake of calcium was associated with a lower colorectal cancer risk. Dietary vitamin D was not associated with disease risk. Findings did not vary by sex and were not altered by corrections for season or month of blood donation. Conclusions The results of this large observational study indicate a strong inverse association between levels of pre-diagnostic 25-(OH)D concentration and risk of colorectal cancer in western European populations. Further randomised trials are needed to assess whether increases in circulating 25-(OH)D concentration can effectively decrease the risk of colorectal cancer.

A Nested Case-Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC).

BACKGROUND Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown. METHODS AND FINDINGS The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI < 25 kg/m2), (2) metabolically healthy/overweight (BMI ≥ 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI < 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI ≥ 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [≥80 cm for women and ≥94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a p-value of <0.05 was considered statistically significant. In multivariable-adjusted conditional logistic regression models with BMI used to define adiposity, compared with metabolically healthy/normal weight individuals, we observed a higher colorectal cancer risk among metabolically unhealthy/normal weight (odds ratio [OR] = 1.59, 95% CI 1.10-2.28) and metabolically unhealthy/overweight (OR = 1.40, 95% CI 1.01-1.94) participants, but not among metabolically healthy/overweight individuals (OR = 0.96, 95% CI 0.65-1.42). Among the overweight individuals, lower colorectal cancer risk was observed for metabolically healthy/overweight individuals compared with metabolically unhealthy/overweight individuals (OR = 0.69, 95% CI 0.49-0.96). These associations were generally consistent when waist circumference was used as the measure of adiposity. To our knowledge, there is no universally accepted clinical definition for using C-peptide level as an indication of hyperinsulinaemia. Therefore, a possible limitation of our analysis was that the classification of individuals as being hyperinsulinaemic-based on their C-peptide level-was arbitrary. However, when we used quartiles or the median of C-peptide, instead of tertiles, as the cut-point of hyperinsulinaemia, a similar pattern of associations was observed. CONCLUSIONS These results support the idea that individuals with the metabolically healthy/overweight phenotype (with normal insulin levels) are at lower colorectal cancer risk than those with hyperinsulinaemia. The combination of anthropometric measures with metabolic parameters, such as C-peptide, may be useful for defining strata of the population at greater risk of colorectal cancer.

Will the Convention on Biological Diversity put an end to biological control?

Will the Convention on Biological Diversity put an end to biological control? Under the Convention on Biological Diversity countries have sovereign rights over their genetic resources. Agreements governing the access to these resources and the sharing of the benefits arising from their use need to be established between involved parties. This also applies to species collected for potential use in biological control. Recent applications of access and benefit sharing principles have already made it difficult or impossible to collect and export natural enemies for biological control research in several countries. If such an approach is widely applied it would impede this very successful and environmentally safe pest management method based on the use of biological diversity. The International Organization for Biological Control of Noxious Animals and Plants has, therefore, created the "Commission on Biological Control and Access and Benefit Sharing". This commission is carrying out national and international activities to make clear how a benefit sharing regime might seriously frustrate the future of biological control. In addition, the IOBC Commission members published information on current regulations and perceptions concerning exploration for natural enemies and drafted some 30 case studies selected to illustrate a variety of points relevant to access and benefit sharing. In this article, we summarize our concern about the effects of access and benefit sharing systems on the future of biological control.

Utility accommodation policy of the Iowa State Highway Commission, 1970

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa State Highway Commission exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway.

Utility accommodation policy of the Iowa State Highway Commission, 1973

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa State Highway Commission exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1973 revision to 1970 policy.)

Erosion Control on Highway Backslopes, HR-64, Progress Report, 1959

During 1959, research was continued by the Agronomy Department in cooperation with the Iowa Highway Commission on vegetative establishment and erosion control on highway backslopes (Project 1010). The work was continued at previously established sites and also several new experiments were initiated during the year. The work will be discussed for each separate experiment and location in this report.

Efficacy, safety, quality control, marketing and regulatory guidelines for herbal medicines (phytotherapeutic agents)

This review highlights the current advances in knowledge about the safety, efficacy, quality control, marketing and regulatory aspects of botanical medicines. Phytotherapeutic agents are standardized herbal preparations consisting of complex mixtures of one or more plants which contain as active ingredients plant parts or plant material in the crude or processed state. A marked growth in the worldwide phytotherapeutic market has occurred over the last 15 years. For the European and USA markets alone, this will reach about $7 billion and $5 billion per annum, respectively, in 1999, and has thus attracted the interest of most large pharmaceutical companies. Insufficient data exist for most plants to guarantee their quality, efficacy and safety. The idea that herbal drugs are safe and free from side effects is false. Plants contain hundreds of constituents and some of them are very toxic, such as the most cytotoxic anti-cancer plant-derived drugs, digitalis and the pyrrolizidine alkaloids, etc. However, the adverse effects of phytotherapeutic agents are less frequent compared with synthetic drugs, but well-controlled clinical trials have now confirmed that such effects really exist. Several regulatory models for herbal medicines are currently available including prescription drugs, over-the-counter substances, traditional medicines and dietary supplements. Harmonization and improvement in the processes of regulation is needed, and the general tendency is to perpetuate the German Commission E experience, which combines scientific studies and traditional knowledge (monographs). Finally, the trend in the domestication, production and biotechnological studies and genetic improvement of medicinal plants, instead of the use of plants harvested in the wild, will offer great advantages, since it will be possible to obtain uniform and high quality raw materials which are fundamental to the efficacy and safety of herbal drugs.

La Commission administrative et la modernisation des structures politiques et administratives de Montréal, 1918-1921

Ce mémoire revient sur la première tutelle de la Ville de Montréal, imposée par le gouvernement provincial de 1918 à 1921. Pour l’occasion, le Lieutenant-gouverneur du Québec nomme cinq administrateurs afin de gérer les affaires courantes de la municipalité. Peu connu des historiens et du public, cet événement suscite des changements profonds dans les structures politiques et administratives de la Ville qui laissent des empreintes dans la vie quotidienne actuelle des Montréalais. Puisqu’ils ne sont pas redevables devant la population, les commissaires mettent en œuvre plusieurs réformes souvent impopulaires qui permettent de rétablir l’équilibre budgétaire de la Ville. Au passage, ils tentent de moderniser l’administration municipale dont le fonctionnement est jusque-là incompatible avec les réalités d’une population grandissante et d’un espace urbain accru par les nombreuses annexions. Notre étude souligne les réformes implantées par la Commission administrative au niveau de la fiscalité, de l’organisation des services municipaux et des politiques d'urbanisme. Elles s’inspirent de réformes mises en œuvre dans plusieurs villes nord-américaines de grande taille. Durant leur mandat, les nouveaux administrateurs cherchent à imposer un modèle d’administration s’inspirant de grandes entreprises privées et réussissent à réduire de manière substantielle le déficit de la Ville. Enfin, une attention particulière est accordée à la fin du mandat de la Commission administrative et au régime administratif qui lui fait suite.

Une ville bien arrosée : Montréal durant l'ère de la prohibition (1920-1933)

Au début des années 1920, la ville de Montréal se retrouve dans une situation assez unique. À l’époque, les États-Unis et toutes les provinces canadiennes à l’exception du Québec ont adopté la prohibition de la vente d’alcool. Mais même au Québec, environ la moitié de la population de la province est alors touchée par des prohibitions locales (votées au niveau municipal), des prohibitions qui ont largement perduré tout au long de la période à l’étude. Durant cette ère de prohibition de l’alcool nord-américaine, Montréal est la plus grande ville, et une des seules sur le continent non régie par une loi sur la prohibition. C’est aussi celle qui dispose des lois les plus libérales envers l’alcool des deux côtés du 49ème parallèle grâce à la création de la Commission des Liqueurs de Québec (CLQ), le premier système de contrôle gouvernemental de l’alcool en Amérique du Nord. C’est dans ce contexte que Montréal devient une rare oasis dans un continent assoiffé et le plus grand cobaye du modèle de contrôle gouvernemental de l’alcool. Ce mémoire examine les impacts de cette conjoncture sur le développement de cette ville, de son industrie touristique, de sa vie nocturne et de sa réputation. En premier lieu, le mémoire présente une mise en contexte de la situation aux États-Unis, au Canada et au Québec afin de faire ressortir le caractère unique de Montréal pendant cette période. En deuxième lieu, l’essor du tourisme dit « de liqueur » et de la vie nocturne montréalaise, à la fois légale et illicite, est exploré. En dernier lieu, le mémoire met au jour l’impact que cette conjoncture a eu sur la construction de la réputation de la ville à travers l’examen des écrits des anti- et pro-prohibitionnistes qui ont chacun propagé des visions idéalisées et démonisées de cette ville « bien arrosée », ainsi que des documents associés à l’essor du tourisme, tels que les chansons, les guides touristiques et les récits de voyage, qui, pour leur part, ont présenté un image plus romancée de la métropole et associée à un refuge festif de la prohibition. Malgré leurs différences, ces trois visions de Montréal l’ont néanmoins associée à la liberté, que ce soit une liberté ordonnée, dangereuse ou bien émancipatrice. Ainsi, à partir de l’expérience de la prohibition et du tourisme de liqueur, Montréal devient connue comme une ville « ouverte », dans ses acceptions à la fois positives et négatives.

Satisfaction et perception des services alimentaires de la Commission scolaire de Montréal telles que rapportées par les élèves du troisième cycle du primaire et du secondaire

Contexte. Plusieurs déterminants influencent les pratiques alimentaires des jeunes Québécois. Les aliments offerts dans les établissements scolaires ainsi que les politiques publiques figurent parmi ces facteurs d’influence. En 2011, la Commission scolaire de Montréal (CSDM) a adapté la Politique pour une saine alimentation. Toutefois, depuis sa parution, très peu de données concernant l’application de la politique des écoles de la CSDM ont été recueillies. Objectifs. Évaluer la satisfaction et la perception des élèves de troisième cycle du primaire et du secondaire à l’égard des services alimentaires de la CSDM. Méthode. Soixante-cinq écoles primaires et 27 écoles secondaires ont été ciblées par cette enquête. La collecte de données s’est déroulée sur une période de six semaines par le biais de deux questionnaires distincts disponibles sur le site internet Fluid Survey. La satisfaction et la perception des élèves ont été évaluées à l’aide de questions portant sur leur utilisation du service alimentaire, leurs préférences, ainsi que leurs attitudes et opinions. Analyse statistique. À partir des résultats obtenus, des statistiques descriptives ont été générées. De plus, des tests de Chi-deux ont été produits afin d’évaluer l’association de certaines variables. Résultats. Au total, 4 446 questionnaires ont été retenus aux fins d’analyses. Sommairement, le goût et la propreté des lieux sont deux aspects pour lesquels un grand nombre de jeunes du troisième cycle du primaire et du secondaire accordent de l’importance. Toutefois, la variété de l’offre alimentaire est l’aspect le plus apprécié par les deux groupes de jeunes. Les élèves du primaire sont plus nombreux que ceux du secondaire à accorder de l’importance à l’attrait santé des aliments. Par ailleurs, les plus jeunes élèves choisissent davantage leurs aliments pour contrôler leur poids. Les résultats montrent aussi que la majorité des jeunes du primaire et du secondaire accordent de l’importance à la qualité de leur alimentation, et ce, depuis quelque temps. Finalement, l’opinion des pairs et de la famille semble avoir très peu d’influence sur les choix alimentaires des jeunes, notamment chez les élèves du secondaire. Conclusion. Bien que plusieurs autres déterminants doivent encore être étudiés, ce projet de recherche confirme la pluralité des facteurs d’influence sur les pratiques alimentaires des enfants et des adolescents. Cela dit, en plus d’être un indicateur précieux pour l’évaluation de ses services alimentaires, les résultats obtenus suggèrent également une multitude de pistes d’action pour les intervenants de la CSDM.

Supporting co-operative work in apron control and resource management offices on airports

A high demand exists to increase the efficiency of present airport ground facilities and the co-ordination of traffic and services. The Traffic Office plays a crucial role in managing the airport. The main tasks of the Traffic Office is management of equipment, services, and ressources based on the flight schedule and resolving conflicts arising from deviations from the schedule. A new tool will support information exchange between Traffic Office and other facilities on the airport.

Active control of structures with uncertain coupled subsystems and actuator dynamics

This paper deals with the problem of stabilizing a class of structures subject to an uncertain excitation due to the temporary coupling of the main system with another uncertain dynamical subsystem. A Lyapunov function based control scheme is proposed to attenuate the structural vibration. In the control design, the actuator dynamics is taken into account. The control scheme is implemented by using only feedback information of the main system. The effectiveness of the control scheme is shown for a bridge platform with crossing vehicle