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.

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.

Prediction of the economic activity from the short and long-term interest rate differential: new evidences in Chile and the United States of America cases

The purpose of this work is to verify the stability of the relationship between real activity and interest rate spread. The test is based on Chen (1988) and Osorio and Galea (2006). The analysis is applied to Chile and the United States, from 1980 to 1999. In general, in both cases the relationship was statistically significant in early 80s, but a break point is found in both countries during that decades, suggesting that the relationship depends on the monetary rule follow by the Central Bank.

Racial Conflict in the United States of America : A Deconstructive Perspective on Native Speaker by Changrae Lee

Written about the time of the Golden Venture incident, Chang-rae Lee’s Native Speaker makes a particular reference to that incident, whereby implying that particular immigrants, on the grounds of their racial identities, are mistreated and considered as aliens by some Americas. While some whites discriminate against immigrants, there is widespread ethnic tension between Korean Americans and African Americans. Significantly, racial conflict between Koreans and blacks and the racist attitude of some whites toward immigrants are mirrored in the relationship between the Korean-American protagonist Henry and his American wife Lelia. That is, due to their different racial identities they do not understand each other and they always argue. However, toward the end of the novel, Henry and Lelia come to understand each other. While ethnic conflict between Koreans and blacks and certain whites’ discriminatory attitudes toward immigrants is serious one, the novel suggests the unimportance of racial identity. In other words, the novel concludes that there is no discriminatory treatment of immigrants and, in fact, every one is a native Speaker in America. In the novel there is no message of how racial conflict could be resolved. However, this essay suggests that by investigating how the tension between Henry and Lelia is resolved, one could suggest a solution for the ethnicity problem in America and in real life.

Immigration, security and the public debate on US language policy : a critical discourse analysis of language attitudes in the United States of America

The narrative of the United States is of a "nation of immigrants" in which the language shift patterns of earlier ethnolinguistic groups have tended towards linguistic assimilation through English. In recent years, however, changes in the demographic landscape and language maintenance by non-English speaking immigrants, particularly Hispanics, have been perceived as threats and have led to calls for an official English language policy.This thesis aims to contribute to the study of language policy making from a societal security perspective as expressed in attitudes regarding language and identity originating in the daily interaction between language groups. The focus is on the role of language and American identity in relation to immigration. The study takes an interdisciplinary approach combining language policy studies, security theory, and critical discourse analysis. The material consists of articles collected from four newspapers, namely USA Today, The New York Times, Los Angeles Times, and San Francisco Chronicle between April 2006 and December 2007.Two discourse types are evident from the analysis namely Loyalty and Efficiency. The former is mainly marked by concerns of national identity and contains speech acts of security related to language shift, choice and English for unity. Immigrants are represented as dehumanised, and harmful. Immigration is given as sovereignty-related, racial, and as war. The discourse type of Efficiency is mainly instrumental and contains speech acts of security related to cost, provision of services, health and safety, and social mobility. Immigrants are further represented as a labour resource. These discourse types reflect how the construction of the linguistic 'we' is expected to be maintained. Loyalty is triggered by arguments that the collective identity is threatened and is itself used in reproducing the collective 'we' through hegemonic expressions of monolingualism in the public space and semi-public space. The denigration of immigrants is used as a tool for enhancing societal security through solidarity and as a possible justification for the denial of minority rights. Also, although language acquisition patterns still follow the historical trend of language shift, factors indicating cultural separateness such as the appearance of speech communities or the use of minority languages in the public space and semi-public space have led to manifestations of intolerance. Examples of discrimination and prejudice towards minority groups indicate that the perception of worth of a shared language differs from the actual worth of dominant language acquisition for integration purposes. The study further indicates that the efficient working of the free market by using minority languages to sell services or buy labour is perceived as conflicting with nation-building notions since it may create separately functioning sub-communities with a new cultural capital recognised as legitimate competence. The discourse types mainly represent securitising moves constructing existential threats. The perception of threat and ideas of national belonging are primarily based on a zero-sum notion favouring monolingualism. Further, the identity of the immigrant individual is seen as dynamic and adaptable to assimilationist measures whereas the identity of the state and its members are perceived as static. Also, the study shows that debates concerning language status are linked to extra-linguistic matters. To conclude, policy makers in the US need to consider the relationship between four factors, namely societal security based on collective identity, individual/human security, human rights, and a changing linguistic demography, for proposed language intervention measures to be successful.

A Study in the Theology of Christian Social Action

In this paper I have attempted to present a summary of my exposition of the theology of Rauschenbusch and Niebuhr, and of my own understanding of the issues of Christian Social Action. I have tried to reproduce in this short space the thought of these men, in a manner which should make it comprehensible and which should relate it to the larger questions of social action. This year’s work as a Senior Scholar has proved invaluable because of the discipline of self-directed study which the work taught, and because of myriad possibilities of future investigation which it has suggested. I hope that someday this present manuscript may be expanded into something more substantial. The personal value of such a project, in my opinion, must be measured by the contribution which the project makes to the individual’s general experience, and not merely by the written work which is produced. Therefore, although this manuscript is rather brief, it represents a great deal of value which I feel that I can measure only by my own experience.

The historic religious buildings of Ribeira Grande: implementation of christian models in the early colonies, 15th till 17th century, on the example of Cape Verde Islands

Rui Carita

Latin-American Society Of Forensic Genetics (SLAGF) results of the Interlaboratory Quality Control Exercise 2010-2011

Latin-American Society of Forensic Genetics (SLAGF) Interlaboratory Quality Control Exercise (2010-2011) included the analysis of three bloodstain samples in FTA Classic Card (three persons, biologically unrelated) and one theoretical exercise. There were 56 participating laboratories from 13 Latin-American countries that belong to society, were reported 70 STRs, including autosomal and sex chromosome markers with consensus in 53 STRs with a rate in reporting errors of 2.3%. Fifty-six laboratories reported results in theoretical exercise with mistakes in calculation of IP for each marker. It is necessary to hold meetings to discuss the results of this exercise to reach conclusions and recommendations on all aspects of DNA forensics analysis and paternity test, to improve results and quality in the results of each laboratory. © 2011 Elsevier B.V.