African-American women are more likely than all other women to die from breast cancer, and according to research presented this week at the annual meeting of the American Association for Cancer Research, doctors have gained more insight as to why that disparity exists.
For more than six years, researchers at the Kaiser Permanente Division of Research in Oakland, Calif. followed nearly 1,700 breast cancer patients who had been treated for four different subtypes of breast cancer, including luminal A, luminal B, basal-like or HER2-enriched cancer. During that period, about 500 of the patients had died, nearly 300 of them from breast cancer, researchers say.
Among them, black patients were nearly twice as likely as white patients to have died from breast cancer, regardless of the cancer subtype, findings that turn traditional thinking about black women and breast cancer on its head.
"The results seem to indicate that although African-American women are more likely to be diagnosed with less treatable subtypes of breast cancer compared with white women, it is not the only reason they have worse breast cancer mortality," said Candyce Kroenke, M.P.H., Sc.D., research scientist at Kaiser.
The Black-White difference in breast cancer survival rates has been traditionally attributed to the fact that black women are more commonly diagnosed with less treatable tumor subtypes, such as the hard-to-treat triple-negative strain. But even though triple-negative diagnoses prevailed in her study and the likelihood of black women developing the most-treatable luminal A subtype did not, Kroenke says that poor prognosis among blacks appeared consistent across the board.
"African-Americans with breast cancer appeared to have a poorer prognosis regardless of subtype," Kroenke said. "It seems from our data that the black?white breast cancer survival difference cannot be explained entirely by variable breast cancer subtype diagnosis," she went on to say.
Recent genetic profiling has suggested that not all cancer subtypes are created equal and both the tumor makeup and methods for treating them may vary by race.
Yet others maintain that factors such as poverty, silence and racial inequities -- not genetics -- are responsible for high mortality rates. Their efforts have focused less on treatment than on awareness and eliminating cultural barriers to seeking care.
There?s a common belief that the pending concussion litigation against the NFL ultimately will result only in the lawyers making money.
The so-called expert witnesses likely will, too.
Often overlooked in complex litigation involving esoteric medical knowledge and jargon is the fact that the men and women who have the education and experience to share that knowledge and jargon with a judge and a jury get paid a lot of money.
That reality routinely results in a blurring of ethical lines.? According to Steve Fainaru and Mark Fainaru-Wada of ESPN.com, Dr. Robert Cantu previously served as a senior adviser to the NFL?s Head, Neck and Spine committee ? but he also has consulted with the lawyers who are suing the NFL on behalf of thousands of former players.
?It was an informational session, just like I get paid to give a talk someplace else,? Cantu said of a February 2012 presentation to the lawyers representing the players.? He also justified working for the players suing the league by explaining that the NFL could hire him to serve as an expert witness, which would block from him talking to those suing the league.
?If [the NFL] wanted to put me on their payroll, to defend their case, then I?m not gonna say boo about those issues [to the plaintiffs],? said Cantu, who gets $800 per hour for legal services, $5,000 for depositions, and $8,000 per day for trial testimony.
Cantu?s attitude underscores one of the biggest problems with the litigation industry.? Many experts aren?t necessarily motivated by the pursuit of justice but by the supplementation of their total income with the exorbitant fees they charge.? And since there?s plenty of discretion to be exercised when telling the truth, their testimony often can be molded to help whichever side of a case hires them first.
Here?s a concrete example, for those of you who are still awake.
Eleven years ago, I represented a former employee of a major U.S. low-cost big-box retailer who had been forced to take an alcohol test under circumstances that, as the jury concluded, didn?t justify an invasion of the employee?s privacy rights via the drawing of a blood sample.? The case included testimony from an expert witness who had been hired by the employer to justify the conclusion, based on the blood-alcohol concentration measured by the test, that the employee had indeed been intoxicated at work.
On cross-examination, I confronted the expert witness with a passage from a written report on the issue of blood-alcohol testing.? In the report, the author expressed concern about the reliability of efforts to use blood-alcohol measurements to determine a person?s BAC at an earlier point in time.
I read the sentence to the expert witness, and I asked the expert witness if he agreed with the statement.
He said, ?No.?
So I read it to him again, slowly.? I asked him if he agreed with that statement.
Again, he said, ?No.?
So I handed him the report, showed him the first page of it, and asked him to tell the judge and the jury who had written the report.
The expert witness, after taking a gulp, said his own name.
And that?s pretty much all I ever needed to know about the world of expert witnesses.
Each year, ?The Munchies? People Choice Food Awards recognizes the best of the best. From chefs to shows to foodie magazines, these awards give YOU the opportunity pick your culinary favorites. Presented by General Mills? Tablespoon.com, nominees were selected by James Beard Award-winning chef Andrew Zimmern and a panel of culinary experts.
If you can?t get enough of Cooking Light, show us some love by voting for us in the Best Food Magazine category! You can vote every day April 1 ? 30. Here is a run down of all of the nominees:
Best Food Reality Show
Chopped
Iron Chef America
Master Chef
The Taste
Top Chef Seattle
Best Food TV Personality
Alton Brown-Good Eats
Andrew Zimmern-Bizarre Foods
Anthony Bourdain-The Taste
Lidia Bastianich- Lidia?s Italy
Mario Batali- The Chew
Best Food Magazine
Bon App?tit
Cooking Light
Food & Wine
Lucky Peach
Saveur
Best Food Blog or Site
Eater
Grub Street
Michael Ruhlman
Serious Eats
Smitten Kitchen
Best New Cookbook
A Girl and Her Pig
Bouchon Bakery
Canal House Cooks Every Day
Jerusalem: A Cookbook
The Sprouted Kitchen
Best Food Podcast or Radio Show
Food is the New Rock
Good Food
Main Course
NPR: Food
Spilled Milk
Best Chef
Barbara Lynch
Hugh Acheson
Paul Kahan
Suzanne Goin
Thomas Keller
Best Burger
Butcher and the Burger
DB Bistro Moderne
Father?s Office
Shake Shack
Umami Burger
Best Pizza
Bar Toma
Di Fara Pizza
Pizzeria Bianco
Pizzeria Mozza
Roberta?s Pizza
Best Taco
Big Star
Empellon Taqueria
La Condesa
La Super Rica
Salvation Taco
Best Ice Cream
Big Gay Ice Cream
Black Dog Gelato
Graeter?s
Humphrey Slocombe
Il Laboratorio del Gelato
Best BBQ
Franklin BBQ
Hill Country BBQ
Oklahoma Joe?s
Salt Lick
Scott?s BBQ
Best Breakfast
Balthazar
The Flying Biscuit Caf?
Hominy Grill
Loveless Caf?
Puerto Sagua
Best Late Night Food
Blue Ribbon
David?s Caf?
Holeman & Finch Public House
Pink?s Hot Dogs
Waffle House
Best Local Farmers Market
Ferry Plaza Farmers Market
Madison Farmers Market
North Market
Santa Monica Farmers Market
Union Square Greenmarket
Best Food Truck
AZ Canteen
Biryani Cart
Kogi BBQ Truck
Marination Mobile
Riffs Fine Street Food
Best Coffee Shop
Blue Bottle Coffee
Instelligentsia Coffee
Joe
La Columbe
Stumptown Coffee Roasters
Best Craft Brewery
Bell?s Brewery
Brooklyn Brewery
New Glarus Brewing Co
Rogue Ales
Summit Brewing Co
Best Bakery
Bouchon Bakery
Hoosier Mama Pie Co
Momofuku Milk Bar
Salty Tart
Tartine Bakery
Best Food City
Chicago
Los Angeles
New York City
Portland
San Francisco
Click here to vote Cooking Light Best Food Magazine! ?
When Michael Dell signaled intentions to take his company private for an overhaul, there were questions as to just what he wanted to do if and when shareholders weren't watching his every move: was he going to shift attention away from PCs toward the enterprise? There's no reason to worry, according to a staff memo that his company has published through the SEC. Dell tells his employees that the firm will "significantly increase investment" in PCs and tablets after going private. While he's cryptic about what that means, he does note that there would be a shift away from valuing gross margins -- in other words, the company may take a hit on profits to make its device sales sing. Other strategies are more what you'd expect from any good business: more research and development, a simpler experience and a stronger push into developing markets like Brazil and China. We can't say we're completely surprised when Microsoft made an investment in Dell's reorg precisely to safeguard PCs, but it's good to know that Dell's interest in PCs still extends well beyond the server room.s
Hand surgery enhances life quality for those with spinal cord injuriesPublic release date: 25-Mar-2013 [ | E-mail | Share ]
Contact: Johanna Wangdell johanna.wangdell@vgregion.se 46-702-992-112 University of Gothenburg
Reconstructive hand surgery can dramatically enhance the life quality and independence of those paralysed by a cervical spinal cord injury. Despite this, the operation is not frequently performed, either in Sweden or elsewhere. Researchers at the Sahlgrenska Academy, University of Gothenburg, Sweden are now hoping to change that.
A cervical spinal cord injury entails paralysis in both arms and legs, severely limiting daily life for its victims. Previous studies have shown that the capability that those with cervical spinal cord injuries most wish to recover is a functioning hand.
At the Sahlgrenska University Hospital, since the 1970's, it has been possible to improve the gripping ability for these individuals by surgical means, and at present an estimated 40 per cent of all spinal cord injury patients in Sweden undergo this operation.
The PhD student Johanna Wangdell, who also works as an occupational therapist, has in the course of her thesis interviewed (all those) patients who have had their hand function reconstructed at the Sahlgrenska University Hospital since 2003.
The thesis shows that this hand surgery, in a dramatic way, enhances the life quality of those with spinal cord injuries:
"The surgery doesn't only deliver a physical benefit in the form of increased gripping strength. The ability to eat independently, to carry out household chores and leisure activities offers mental rewards which benefit our social life, our daily habits and the roles we perform. Knowing that you can handle things yourself, of getting back your private life and restoring your identity as active parent, for example, or the guy that can go along for a beer with his mates is, in many cases, invaluable," says Johanna Wangdell.
Besides the individual progress this represents, reconstructive hand surgery also means that the requirement for personal assistance and specially adapted housing can be reduced and this can deliver savings for society as a whole.
Despite this, the hand surgery is performed only to a very modest extent outside Sweden: whereas four out of ten victims of spinal cord injuries are operated in Sweden only one out of ten undergo the surgery in the USA.
"Few clinics in the world undertake as many operations per year of this type as the Sahlgrenska University Hospital. This means that victims of spinal cord injuries from across Europe come to the hospital for this surgery," explains Johanna Wangdell.
"This is the first study that focuses on the patient viewpoint and we can demonstrate that those who undergo this surgery experience a really high level of satisfaction. I hope that my studies will contribute to the surgery becoming available much more widely, both in Sweden and the rest of the world."
###
Contact:
Johanna Wangdell, PhD Student at the Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, and registered Occupational Therapist at the Department of Hand Surgery / Spinal Cord Injury Unit, Sahlgrenska University Hospital
Tel: + 46 31-342 92 65
Mobile: +46 702-99 21 12
johanna.wangdell@vgregion.se
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Hand surgery enhances life quality for those with spinal cord injuriesPublic release date: 25-Mar-2013 [ | E-mail | Share ]
Contact: Johanna Wangdell johanna.wangdell@vgregion.se 46-702-992-112 University of Gothenburg
Reconstructive hand surgery can dramatically enhance the life quality and independence of those paralysed by a cervical spinal cord injury. Despite this, the operation is not frequently performed, either in Sweden or elsewhere. Researchers at the Sahlgrenska Academy, University of Gothenburg, Sweden are now hoping to change that.
A cervical spinal cord injury entails paralysis in both arms and legs, severely limiting daily life for its victims. Previous studies have shown that the capability that those with cervical spinal cord injuries most wish to recover is a functioning hand.
At the Sahlgrenska University Hospital, since the 1970's, it has been possible to improve the gripping ability for these individuals by surgical means, and at present an estimated 40 per cent of all spinal cord injury patients in Sweden undergo this operation.
The PhD student Johanna Wangdell, who also works as an occupational therapist, has in the course of her thesis interviewed (all those) patients who have had their hand function reconstructed at the Sahlgrenska University Hospital since 2003.
The thesis shows that this hand surgery, in a dramatic way, enhances the life quality of those with spinal cord injuries:
"The surgery doesn't only deliver a physical benefit in the form of increased gripping strength. The ability to eat independently, to carry out household chores and leisure activities offers mental rewards which benefit our social life, our daily habits and the roles we perform. Knowing that you can handle things yourself, of getting back your private life and restoring your identity as active parent, for example, or the guy that can go along for a beer with his mates is, in many cases, invaluable," says Johanna Wangdell.
Besides the individual progress this represents, reconstructive hand surgery also means that the requirement for personal assistance and specially adapted housing can be reduced and this can deliver savings for society as a whole.
Despite this, the hand surgery is performed only to a very modest extent outside Sweden: whereas four out of ten victims of spinal cord injuries are operated in Sweden only one out of ten undergo the surgery in the USA.
"Few clinics in the world undertake as many operations per year of this type as the Sahlgrenska University Hospital. This means that victims of spinal cord injuries from across Europe come to the hospital for this surgery," explains Johanna Wangdell.
"This is the first study that focuses on the patient viewpoint and we can demonstrate that those who undergo this surgery experience a really high level of satisfaction. I hope that my studies will contribute to the surgery becoming available much more widely, both in Sweden and the rest of the world."
###
Contact:
Johanna Wangdell, PhD Student at the Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, and registered Occupational Therapist at the Department of Hand Surgery / Spinal Cord Injury Unit, Sahlgrenska University Hospital
Tel: + 46 31-342 92 65
Mobile: +46 702-99 21 12
johanna.wangdell@vgregion.se
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Each year, ?The Munchies? People Choice Food Awards recognizes the best of the best. From chefs to shows to foodie magazines, these awards give YOU the opportunity pick your culinary favorites. Presented by General Mills? Tablespoon.com, nominees were selected by James Beard Award-winning chef Andrew Zimmern and a panel of culinary experts.
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Public release date: 25-Mar-2013
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