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The article discusses the risks and benefits of prescribing benzodiazepine (BZD) for anxiety and depression. Topics covered include the problems associated with BZDs, including misuse and dependence, worsening cognition, potential for tolerance, rebound anxiety, and difficulties associated with withdrawal. Also discussed are the disadvantages associated with the long-term use of BZDs.

Indigenous peoples' roles in Canadian forestry have expanded enormously during recent decades, encouraged by a variety of policies and programs from governments, industry, and Indigenous organizations. Many Indigenous communities have chosen to engage with non-Indigenous actors in multiple ways, both collaborative and conflictual, and this study investigates the extent to which these represent strategic choices. Through a study with the Atikamekw Nehirowisiwok, Huron-Wendat, and Mi'gmaq nations in Quebec, Canada, we examined processes used to present and promote their visions and objectives for their traditional forestlands, over more than 30 years. This analysis highlights the number and diversity of processes in which Indigenous peoples engage. Examining the series of processes and the roles of Indigenous participants in them allowed us to characterize the strategies adopted by each nation. This analysis helps us understand factors such as the roles of transformative and incremental change, the interactions between processes, and the importance of governing organizations. We conclude that rather than being stakeholders in state-sponsored initiatives, these Indigenous nations are constantly and actively using such processes as institutional and procedural spaces in which they are able to negotiate, promote, implement, and articulate multiple strategies that contribute to enhancing their role in forest and resource management. [ABSTRACT FROM AUTHOR]

The objective of this study was to review the origin and the factors that contributed to the development of collaborative processes that enabled the Atikamekw Nehirowisiwok to engage in forest planning activities on their traditional lands, over the past 30 years. Based on an historical, inductive, and qualitative approach, we analyzed data from written sources (reports, minutes of meeting, etc.) and semi-structured interviews with representatives from the Nehirowisiwok communities, the forest industry, and the Quebec government. Results show that in the early 1990s, the Atikamekw Nehirowisiwok had little input in forest planning, despite their willingness to do so. By the end of the 1990s, the Atikamekw Nehirowisiwok and the forest industry were able to set up a harmonization process aiming to reconcile occupation of the land and forestry activities. Then, the Haïda and Taku River (2004) decisions and the adoption of new forest legislation (2010) resulted in the provincial government playing a more significant role in the harmonization process. The implementation of a new forestry regime (2013) reversed the relationships between the groups, obliging the Atikamekw Nehirowisiwok to collaborate with the provincial ministry, which had become responsible for forest planning. [ABSTRACT FROM AUTHOR]

The goal of this study is to better understand the qualities of regulatory interaction and its effects through the analysis of two case studies involving the Forest Stewardship Council's (FSC) requirements for free and informed consent during the period 2012 to 2015 in Quebec. The first case describes events related to the transfer of FSC certificates from the forest industry to the Quebec government, proposed as a result of the introduction of the new forest policy regime in 2013. The second case describes a contested FSC certificate in the Lac-St-Jean region, spearheaded by an Indigenous nation, over the issue of free and informed consent. Both cases are documented through secondary data. Results reveal that forestry certification acted as a catalyst, obliging parties to more clearly define their positions on the application of Indigenous rights, but also creating dissonance within the regulatory system. Pathways of regulatory interaction were characterized by mutual influence, negotiation, and readjustment. [ABSTRACT FROM AUTHOR]

Collaborative natural resource governance is increasingly relied upon to resolve conflicts, generate social and ecological benefits, and increase implementation of decisions. Trust is widely recognized as critical to successful collaborative natural resource governance; however, the multidimensional nature of trust has been underexplored in this context, and few studies specifically address collaborations involving Indigenous Peoples. Literature on collaborative governance involving Indigenous Peoples emphasizes issues of power-sharing, participation, and intercultural purpose and insights into how trust created with these considerations in mind have the potential to improve processes and outcomes. This paper used a case study of collaborative forest governance on Haida Gwaii, an archipelago located off the coast of British Columbia, Canada, to identify linkages between power-sharing and individual, interpersonal, and institutional influences on trust. Collaborative forest resource governance on Haida Gwaii formally began following signing of the Strategic Land Use Agreement (2007) and the Kunst'aa guu-Kunst'aayah Reconciliation Protocol (2009) and had led the Haida to achieve several of their goals for resource management. The research linked theoretical and empirical literature on collaborative governance and trust with empirical evidence gathered from 19 semi-structured interviews with current and former members of the Haida Gwaii Management Council and the Solutions Table and identified five individual influences, five interpersonal influences, and four institutional influences on trust. [ABSTRACT FROM AUTHOR]

This article considers how competing interpretations of rights upon forestland affect indigenous peoples' ability to derive benefits from forests, using interviews and an evaluation exercise in 13 First Nations communities in New Brunswick, Canada. We asked first what First Nations expect from provincial forest governance arrangements, and second, what is preventing them from attaining their expectations? Informants attached greatest importance to rights and environmental protection, but tangible outcomes fall far short of expectations. Economic benefits are promoted by the government, but are least important for informants and results are mediocre. Undertaking an access analysis, we observe that governance arrangements do not deliver the benefits sought by First Nations, that control mechanisms provide limited participation in governance, and that power remains firmly with government and private industry. We conclude that rights alone do not enable First Nations to access benefits and that governance arrangements do not provide certainty for sustainable management. [ABSTRACT FROM AUTHOR]

Objectives: Diseases of the heart and malignant neoplasms (all-cancers) are the leading causes of death in the United States. The gap between the two has been closing in recent years. To assess the gap status in Texas and to establish a baseline to support evaluation efforts for the Cancer Prevention Research Institute of Texas, mortality data from 2006 to 2009 were analyzed. Methods: Immediate cause of death data in Texas for the years 2006-2009 were analyzed and rates developed by sex, race/ethnicity, and four metropolitan counties. Results: Overall, for the years 2006-2009, the age-adjusted mortality rates (AARs) among Texas residents for both diseases of the heart and all-cancers decreased; however, during this time frame, there was greater improvement in diseases of the heart AARs as compared with all-cancers AARs. For the four large metropolitan counties of Bexar, Dallas, Harris, and Travis, data were analyzed by sex and race/ ethnicity, and 11 of the 12 largest percent mortality rate decreases were for diseases of the heart. Conclusions: Age-adjusted mortality rates among Texas residents from diseases of the heart are showing improvement as compared with the rates for all-cancers. [ABSTRACT FROM AUTHOR]

This paper examines collaborative arrangements between Aboriginal peoples and the forest sector across Canada. Using a broad definition of collaboration, we identified 1378 arrangements in 474 Aboriginal communities in all Canadian provinces and territories, except Nunavut. We categorize these collaborative arrangements into five broad types: treaties and other formal agreements; planning and management activities; influence on decision-making; forest tenures; and economic roles and partnerships. Consistent data was available for only the first three types, which showed that close to 60% of Aboriginal communities use each approach. However, this masks significant differences between provinces. For example, economic roles and partnerships are in place in all New Brunswick communities and 74% of communities in British Columbia, but only 12% of Manitoban communities. The proportion of communities that have been involved in participatory processes in forest decision-making (such as advisory committees and consultation processes) is particularly high in Quebec with 88% of communities, but only 32% of communities hold forest tenures. We also find that three-quarters of all communities choose to engage in two or more approaches, despite the demands that this can place upon the time and energy of community members. We finally consider how policy environments in different jurisdictions affect the frequency of certain types of collaboration. This empirical study, and the typology that it demonstrates, can inform policy development for Aboriginal involvement in Canadian forestry and help guide future research into broader issues of collaborative governance of natural resources. [Copyright &y& Elsevier]

Over the last thirty years, Aboriginal peoples, forestry companies and governments in Canada have developed a wide variety of arrangements and mechanisms aimed at fostering collaboration and establishing an increasing Aboriginal role in managing and harvesting forestlands. This paper seeks to facilitate the analysis and investigation of various forms of collaboration by presenting a typology based upon institutional arrangements and desired outcomes. Development of the typology followed an iterative process of categorisation, description, testing and revision, using scientific and grey literature combined with testing against an ever-widening number of communities; firstly in Quebec, then in six provinces and finally with 474 communities across the country. We identify five principal forms of collaborative arrangement, each with a number of sub-types: treaties and other formal agreements that establish roles and responsibilities; planning and management activities; influence on decision-making; forest tenures; and economic roles. The application and utility of this typology is illustrated through the examples of four communities, each of which is engaged in several different collaborative arrangements. The typology demonstrates the variety of arrangements that are available to encourage Aboriginal involvement in Canada's forest sector while also provided a basis for future work in comparing the benefits of different arrangements or in analysing the effectiveness of policies. [Copyright &y& Elsevier]

Aboriginal peoples are increasingly being invited to participate in sustainable forest management processes as a means of including their knowledge, values, and concerns. However, it is justifiable to ask if this participation does lead to changes in forest management plans and to outcomes in management activities. We review four forest management plans over 10 years (1999-2009) in Labrador, Canada, to determine if increasing involvement by the Aboriginal Innu Nation has led to changes in plan content. We also compare these plans with three plans from another forest management district where there is no Innu presence and with two provincial forest strategies . Analysis shows that Labrador plans prepared since 2000, when the Innu and the provincial government established a collaborative process, are different from all other plans reviewed. Four principal characteristics distinguish these plans: a structure based around ecological, cultural, and economic landscapes, a network of cultural and ecological protected areas, increased attention to social and cultural values, and greater emphasis on research and monitoring. This suggests that Innu involvement has in fact influenced the contents of these plans, developing an innovative approach to implementing ecosystem management and demonstrating the utility of involving Aboriginal peoples in forest management planning processes. [ABSTRACT FROM AUTHOR]

Certification is increasingly important in Canada as a tool for promoting, monitoring, and rewarding sustainable forest management. However, success in certifying large public or industry-owned forests has not been matched by small-scale private forests, which nevertheless provide an important range of social, economic, and environmental benefits. In this exploratory research, we examine the presence and absence of certification systems in three adjoining regions of New Brunswick and Quebec, Canada, reviewing documents and interviewing woodlot owners and representatives of their organizations and the timber industry to identify factors contributing to the success or absence of certification. Industry demand, the role of organizations, and owner interest were highlighted as key factors in certification. However, there is also uncertainty around both the effectiveness of certification in achieving its goals and instability in the woodlot sector. We conclude with a series of questions to guide further research in this field. [ABSTRACT FROM AUTHOR]

The article discusses the effect of red clover vein mosaic virus (RCVMV) found in chickpea and lentil crops. RCVMV is an infection found in pea crops responsible for the plant's death due to infection carried by a pea aphid. Symptoms for RCVMV infected peas include chlorosis, rosetting of leaves, and vein clearing. RCVMV is an approved species of the genus Carlavirus. It also presents the complete nucleotide sequence and genome organization of the RCVMV in an infected chickpea.

The term “aboriginal forestry” is used increasingly to describe the evolving role of First Nations peoples in Canadian forestry over the last 30 years. This paper reviews a diversity of experiences and identifies issues that have important implications for governments, forest planners, and First Nations: a forestry regime that reflects the interests of governments and industry rather than those of First Nations; variable implementation of aboriginal rights in forestry practice; benefits and problems of economic partnerships; limitations on consultation, traditional knowledge, and comanagement in forestry; and finally, different forestry paradigms. Among these experiences and issues, we recognise different visions for the participation of First Nations peoples in Canadian forestry. At one end of the spectrum, “forestry excluding First Nations” is no longer accepted. The most common form may be “forestry by First Nations,” representing a role for First Nations within existing forestry regimes. Other options include “forestry for First Nations,” in which forest managers seek to incorporate aboriginal values and knowledge in management activities and “forestry with First Nations,” in which aboriginal peoples are equal partners in forest management. However, aboriginal forestry is better understood as a potential new form of forestry that uses knowledge and techniques drawn from both traditions and conventional forestry and is based on aboriginal rights, values, and institutions. Au Canada, le terme « foresterie autochtone »gagne en popularité pour décrire le rôle grandissant des Premières nations en foresterie au cours des trente dernières années. Cet article passe en revue de nombreuses expériences et identifie des enjeux aux conséquences importantes pour les gouvernements, les gestionnaires forestiers et les Premières nations. Un régime forestier qui reflète les intérêts des gouvernements et des industriels plutôt que ceux des Premières nations, la reconnaissance inégale des droits autochtones dans les pratiques forestières, les bénéfices et les problèmes associés aux partenariats d’affaires, les limites propres à la consultation, la place des savoirs traditionnels et de la cogestion en foresterie et enfin, la variété des paradigmes forestiers composent ces enjeux. Parmi ces expériences et enjeux, nous reconnaissons l’expression de différentes façons de concevoir la participation autochtone à la foresterie canadienne. À un bout du spectre, « une foresterie qui exclut les Premières nations »n’est plus une option acceptable. La vision la plus répandue est probablement celle d’« une foresterie par les Premières nations »signifiant que celles-ci ont un rôle à jouer dans les régimes forestiers existants. Une autre conception est celle de « la foresterie pour les Premières nations »lorsque les gestionnaires forestiers tentent d’intégrer des valeurs et des savoirs autochtones à leurs activités d’aménagement. Enfin, les situations où les autochtones sont partenaires à part entière dans l’aménagement de la forêt s’inscrivent sous la rubrique « la foresterie avec les Premières nations ». Cependant, la foresterie autochtone est mieux comprise lorsqu’elle implique la possibilité d’une nouvelle foresterie qui a recours à des savoirs et des techniques inspirés à la fois des traditions et de la foresterie conventionnelle et qui est fondée sur des droits, des valeurs et des institutions autochtones. [ABSTRACT FROM AUTHOR]

Trust is critical to collaborative governance, including of natural resources. Existing frameworks variously emphasize the impact of individual propensity, interpersonal dynamics, and institutional characteristics on trust. However, few frameworks consider the impacts of these influences on trust simultaneously. This study uses a survey of 51 representatives of Indigenous and non-Indigenous governments from across Canada with experience in natural resource collaborations to test a multidimensional framework for trust. Results show that interpersonal influences may have a bidirectional relationship with trusting behaviors, in which constraints imposed by governments on the actions of collaborators have a mediating effect. However, only institutional influences and experiences of discrimination were observed to predict trust behaviors between collaborators. Discrimination perpetrated against Indigenous Peoples in Canada has a pervasive effect on trust in collaborative natural resource governance. [ABSTRACT FROM AUTHOR]

An introduction is presented which discusses several reports within the issue on topics including Indigenous participation in resource management; shifting patterns of governance in the forest sector and intersection of Indigenous participation and the forest sector.

Background: Prescription drug overdose and misuse has reached alarming numbers. A persistent problem in clinical care is lack of easy, immediate access to all relevant information at the actionable time. Prescribers must digest an overwhelming amount of information from each patient's record as well as remain up-to-date with current evidence to provide optimal care. This study aimed to describe prescriber response to a prospective clinical decision support intervention designed to identify patients at risk of adverse events associated with misuse of prescription opioids/benzodiazepines and promote adherence to clinical practice guidelines. Methods: This study was conducted at a large multi-center healthcare system, using data from the electronic health record. A prospective observational study was performed as clinical decision support (CDS) interventions were sequentially launched (January 2016–July 2019). All data were captured from the medical record prospectively via the CDS tools implemented. A consecutive series of all patient encounters including an opioid/benzodiazepine prescription were included in this study (n = 61,124,172 encounters; n = 674,785 patients). Physician response to the CDS interventions was the primary outcome, and it was assessed over time using control charts. Results: An alert was triggered in 23.5% of encounters with a prescription (n = 555,626). The prescriber decision was influenced in 18.1% of these encounters (n = 100,301). As the number of risk factors increased, the rate of decision being influenced also increased (p = 0.0001). The effect of the alert differed by drug, risk factor, specialty, and facility. Conclusion: The delivery of evidence-based, patient-specific information had an influence on the final prescription in nearly 1 in 5 encounters. Our intervention was sustained with minimal prescriber fatigue over many years in a large and diverse health system. [ABSTRACT FROM AUTHOR]

Background: Telehealth usage has been promoted in all settings but has been identified as a panacea to issues of access and equity in the rural context. However, uptake and widespread integration of telehealth across all parts of the health system has been slow, with a myriad of barriers documented, including in rural settings. The crisis of the COVID-19 pandemic, saw barriers rapidly overturned with the unprecedented and exponential rise in telehealth usage. The uniqueness of the crisis forced telehealth adoption, but as the urgency stabilises, pandemic learnings must be captured, utilised, and built upon in a post-pandemic world. The aim of this study was to document staff experiences and perceptions of delivering rural psychological therapies via telehealth during the pandemic and to capture learnings for future rural telehealth delivery. Methods: An online cross-sectional survey that explored mental health professional's experiences, use, and perceptions of telehealth before and after pandemic-enforced changes to service delivery. Results: Sixty-two respondents completed the questionnaire (response rate 68%). Both the delivery of telehealth via telephone and online video conferencing significantly increased during the pandemic (66% vs 98%, p <.001 for telephone and 10% vs 89%, p < 0.001 for online video). Respondents indicated that client's access to services and attendance had improved with telehealth use but their attention and focus during sessions and non-verbal communication had been negatively affected. The challenges for older adults, people with learning and sensory disabilities, and residents in remote areas with poorer mobile/internet connectivity were identified. Despite these challenges, none of the respondents indicated a preference to return to fully face-to-face service delivery with most (86%) preferring to deliver psychological therapies fully or mostly via telehealth. Conclusions: This study addresses three major gaps in knowledge: the experience of delivering local telehealth solutions to address rural mental health needs, the provision of strong rural-specific telehealth recommendations, and the dearth of rural research emanating from the United Kingdom. As the world settles into a living with COVID-19 era, the uniqueness of the rural telehealth context may be forgotten as urban myopia continues to dominate telehealth policy and uptake. It is critical that rural resourcing and digital connectivity are addressed. [ABSTRACT FROM AUTHOR]

The article announces that the "Journal of Addictive Diseases" is being sponsored by the American Osteopathic Academy of Addiction Medicine (AOAAM). The organization, which is dedicated to improving the understanding of addiction as a disease in the field of medicine and the community, is striving to attain science-based core competencies by all osteopathic physicians. The mission statements of the AOAAM are identified, including sponsoring 15 Office Based Opioid Treatment Seminars throughout the U.S.

Background and Objectives: Posttraumatic stress disorder (PTSD) is associated with higher rates of chronic pain and increased risk of developing Opioid use disorder. This paper evaluates the impact of PRIMUM, an electronic health record‐embedded (EHR) clinical decision support intervention on opioid prescribing patterns for patients with diagnosis of PTSD. Methods: Inpatient, emergency department (ED), urgent care, and outpatient encounters with ICD‐10 codes F43.1 (PTSD), F43.10 (PTSD, unspecified), F43.11 (PTSD, acute), and F43.12 (PTSD, chronic) at Atrium Health between 1/1/2016 and 12/29/2018 were included in the study. Results: A total of 3121 patients with a diagnosis of PTSD were seen in 37,443 encounters during the study period. Ten percent (n = 3761) of the encounters resulted in prescriptions for opioids and PRIMUM alerts were triggered in 1488 of these encounters. These alerts resulted in "decision influenced" for 17% of patients (n = 255) or no prescriptions for opioids or benzodiazepines for 5.8% (n = 86). The majority of the prescriptions were below 50 Morphine milligram equivalents (MME)/day, but there were 570 (15.5%) prescriptions for doses of 50–90 MME and 721 (19.6%) prescriptions for >90 MME/day. Discussion and Conclusion: The PRIMUM alert system helps improve patient safety. PRIMUM affected clinician decisions 17% of the time, and the effect was greater in patients with opioid overdose history and those presenting for early refills. Scientific Significance: The effectiveness of clinical support interventions for opioid prescribing for patients with PTSD has not been documented previously. Our findings provide novel evidence that the EHR can be used to improve patient safety among patients with PTSD in the context of substance use. [ABSTRACT FROM AUTHOR]

The article presents a study on the monitoring and screening of cancer in Texas in 2008 and 2010. It looks into the establishment of the Cancer Prevention Research Institute of Texas (CPRIT) and its effort to increase evidence-based screening for cancers of the breast, cervix, and colon and rectum. It explores the estimates of screening rates in the state.

The article presents a study, which determines whether the use hormone replacement therapy (HRT) is associated with survival of postmenopausal women with lung cancer. Study shows that hormone replacement therapy (HRT) may play a significant role in lung cancer development. Study shows that HRT plays a significant role in the development of lung cancer as well as subsequent survival. It is concluded that the study reflects on the complexity of the role of HRT use in the survival of the patients.

During the 1999 to 2001 growing seasons, symptoms consisting of mosaic, stunting, yellowing, wilting, shortening of internodes, and phloem discoloration were observed in chickpea (Cicer arietinum) grown in the Department of Chuquisaca in southern Bolivia. In some fields, approximately 10% of the plants exhibited virus-like symptoms and suffered greatly reduced seed yields. Lentil (Lens culinaris) was also observed to be infected but not pea (Pisum sativum) or faba bean (Vicia faba) growing in nearby fields. Infected chickpea tissue reacted positively to the potyvirus group-specific monoclonal antibody (MAb), but there was no serological reaction with antisera to the potyviruses Bean yellow mosaic virus, Clover yellow vein virus, Cowpea aphid-borne mosaic virus, Pea seedborne mosaic virus, Bean common mosaic virus, or Bean common mosaic necrosis virus. Western blots of total protein extracts probed with the potyvirus MAb revealed a single band ca. 32 kDa. Comparative sequence analysis of cDNA clones generated from the putative coat protein gene consisted of 282 amino acids (31.9 kDa) and showed moderate identities of 67, 66, 63, 63, and 61% with the coat proteins of potyviruses Pepper severe mosaic virus, Pepper yellow mosaic virus, Potato virus Y, Plum pox virus, and Pepper mottle virus, respectively. Phylogenetic analysis of the coat protein amino acid sequence revealed that this virus is a unique member of the family Potyviridae and is phylogenetically most closely related to a group of Solanaceae-infecting potyviruses rather than to other legume infecting potyviruses. The proposed name for the new causal agent is Chickpea yellow mosaic virus. [ABSTRACT FROM AUTHOR]

This paper reviews the emerging effects of the 2012 decision of the Constitutional Court of Indonesia relating to the customary management of Indonesia's traditional forests. It focuses on the challenge of moving from legal to political and societal recognition of Indigenous peoples' rights. In its advocacy of customary land rights, Aliansi Masyarakat Adat Nusantara (AMAN) successfully applied to the Constitutional Court for judicial review of the Forest Law 41 1999. It argued the law breached the constitutional rights of its members in permitting the state to permit exploitation and development rights over traditional forest without their consent. The flow‐on effect of allocating such rights included widespread deforestation and land use change without agreement from customary communities that have used and occupied these forests for centuries, thus ignoring traditional customary law that regards these forests as the property of such communities. The paper reflects critically on international experience in the interface between legal recognition of Indigenous peoples' rights, and their translation into sustainable and meaningful societal transformation. [ABSTRACT FROM AUTHOR]

Many Indigenous communities in Canada have established economic development corporations (EDCs) to support economic development that meets community goals. Indigenous EDCs, like social enterprises, typically prioritize multiple socio‐economic goals and may be used to limit political influence on business operations; however, complete separation can be detrimental to success. This article explores formal mechanisms used by Indigenous EDCs to maintain accountability between levels of governance and ensure Indigenous community‐owned businesses remain focused on community objectives. A literature review, interviews and document analysis were used to identify formal mechanisms to maintain accountability in the context of Indigenous community‐owned forestry businesses in British Columbia, Canada. [ABSTRACT FROM AUTHOR]

We often hear about the resistance of First Nation (FN) communities to the industrial model of forestry, but we hear less about what they wish to achieve. Translating FN perspectives into concepts that are understood by the mainstream society can help inform current and future forest policies. Such translation can support initiatives that seek ways to increase FN participation in the forest sector. This paper documents one process of translation. It identifies the principles and objectives for forest-based development of the Essipit Innu First Nation in Quebec, Canada, reflective of the deep roots that anchor the Essipit to their territory. Based on participatory research carried out between January and July 2013, we identify 34 objectives folded into three core FN principles: Nutshimiu-Aitun (identity-territoriality), Mishkutunam (sharing-exchange), and Pakassitishun (responsibility-autonomy). Our analysis shows that the economic aims of the dominant forestry model are too narrow for FN communities. This paper contributes to expanding FN engagement in forestry through management and economic approaches that are better adapted to their culture and values. [ABSTRACT FROM AUTHOR]

Purpose: This study examined interest in and attitudes toward genetic testing in 5 different population groups. Methods: The survey included African American, Asian American, Latina, Native American, and Appalachian women with varying familial histories of breast cancer. A total of 49 women were interviewed in person. Descriptive and nonparametric statistical techniques were used to assess ethnic group differences. Results: Overall, interest in testing was high. All groups endorsed more benefits than risks. There were group differences regarding endorsement of specific benefits and risks: testing to "follow doctor recommendations" (p=0.017), "concern for effects on family" (p=0.044), "distrust of modern medicine" (p=0.036), "cost" (p=0.025), and "concerns about communication of results to others" (p=0.032). There was a significant inverse relationship between interest and genetic testing cost (p<0.050), with the exception of Latinas, who showed the highest level of interest regardless of increasing cost. Conclusion: Cost may be an important barrier to obtaining genetic testing services, and participants would benefit by genetic counseling that incorporates the unique cultural values and beliefs of each group to create an individualized, culturally competent program. Further research about attitudes toward genetic testing is needed among Asian Americans, Native Americans, and Appalachians for whom data are severely lacking. Future study of the different Latina perceptions toward genetic testing are encouraged. [ABSTRACT FROM AUTHOR]

Success of the Clinical Translational Science Award (CTSA) program implicitly demands team science efforts and well-orchestrated collaboration across the translational silos (T1-T4). Networks have proven to be useful abstractions of research collaborations. Networks provide novel system-level insights and exhibit marked changes in response to external interventions, making them potential evaluation tools that complement more traditional approaches. This study is part of our ongoing efforts to assess the impact of the CTSA on Biomedical Research Grant Collaboration (BRGC). Collaborative research grants are a complex undertaking and an outcome of sustained interaction among researchers. In this report, BRGC networks representing collaborations among CTSA-affiliated investigators constructed from grants management system data at the University of Kentucky across a period of six years (2007-2012) corresponding to pre- and post-CTSA are investigated. Overlapping community structure detection algorithms, in conjunction with surrogate testing, revealed the presence of intricate research communities rejecting random graphs as generative mechanisms. The deviation from randomness was especially pronounced post-CTSA, reflecting an increasing trend in collaborations and team-science efforts potentially as a result of CTSA. Intercommunity cross talk was especially pronounced post-CTSA. [ABSTRACT FROM AUTHOR]

Classifying communities as forest dependent based on economic indicators implies that residents of these communities share a utilitarian view of forest management whereby resource extraction and economic benefits are the primary focus. In this study, we test this hypothesis by examining the relationship between forest dependency, value orientation, and views on forest management. Data were collected by mail survey from 1521 residents of the Province of New Brunswick, Canada, in 2007. We classify respondents based on levels of forest dependency of their area of residence and their forest value orientation. We examine variation in beliefs about forest management, goals of forest management, and public involvement across levels of forest dependency and forest value orientation. Results showed some differences among residents from regions with different levels of forest dependence. Considerably greater variation, however, occurred among forest value orientation clusters. This study suggests that regardless of the level of forest dependency, communities comprised a mix of value orientations and that examining populations based on level of forest dependency may mask a plurality of views on forest management within communities. [ABSTRACT FROM AUTHOR]

The introduction of the new General Medical Services (GMS) contract with its Quality and Outcomes Framework (QOF) provided the first opportunity for a detailed study of all practices' clinical and organisational achievements, using data from the central computer Quality Management and Analysis System (QMAS). We studied practices in the Birmingham and Black Country Strategic Health Authority (SHA) area (population of 2.6 million, with 12 primary care trusts (PCTs) and 510 practices, including 113 training practices) to test the null hypothesis that 'there is no difference in the quality of organisation of care between training and non-training practices'. Training practices scored significantly more total QOF points (999) than nontraining practices (905) with the mean for all practices at 926 points. There were statistically significantly higher scores in every clinical and non-clinical domain, apart from provision of maternity and contraceptive services. Since training practices were significantly larger in list size, 83 pairs of training and non-training practices, closely matched for list size and deprivation, were re-analysed with very similar results. Training practices scored 996 points compared to non-training practices' scores of 933 (P<0.001), and also scored signifi- cantly higher in all of the main summary domains except access. Training practices also scored significantly higher in ten out of 15 clinical domains. There were no significant differences between GMS practices and Personal Medical Services (PMS) practices. QOF scores showed that training practices demonstrated better organisation of patient care than non-training practices. We can identify low-scoring, failing training practices and other high-achieving potential training practices. We feel that practices aspiring to training status should reach a minimum QOF score of 900 points. [ABSTRACT FROM AUTHOR]

Abstract: Introduction.: The study objectives were to assess the effect of age, to evaluate the impact of smoking, and to determine the effect of rural residence on tumor characteristics, treatment modalities, and outcomes for Kentucky''s endometrial cancer patients. Methods.: The Kentucky Cancer Registry identified Kentucky residents diagnosed with endometrial cancer from 1995 to 2002. Data abstracted included demographics, tumor characteristics, treatment, and recurrence/survival status. Results.: Three thousand five hundred and sixty-two women were diagnosed with endometrial cancer. Mean age at diagnosis decreased significantly (P =0.0388) over the 7-year period. Smokers had higher grade, stage, and worse outcomes. Rural women more often lacked commercial insurance, underwent less comprehensive surgical evaluation, and had less multimodality treatment. Increasing age (P <0.0001), positive or unknown smoking status (P =0.0003), black race (P <0.0001), no commercial insurance (P <0.0001), increasing grade or advanced stage (P <0.0001), small size of treating hospital (P <0.0001), and unknown nodal status (P <0.0001) were negatively associated with disease-specific survival. Lymph node sampling was performed in only 38.6% of women. On multivariate analysis, age (RR 1.38 for 10 year increments; P <0.0001), smoking (RR 1.38; P =0.008), no commercial insurance or Medicaid (RR 1.87; P =0.0007), rural residence (RR 0.77; P =0.011), advanced stage and grade (RR 7.96, 3.96; P <0.0001), and no nodal evaluation or unknown nodal status (RR 2.32, 2.51; P <0.0001) significantly effected disease-specific survival. Conclusions.: Our data support a trend toward a younger age for endometrial cancer diagnosis, confirm the adverse impact of smoking and socioeconomic factors, and demonstrate an association between incomplete surgical staging and decreased survival. [Copyright &y& Elsevier]

A strain of Bean common mosaic necrosis virus (BCMNV) from Idaho was identified by enzyme-linked immunosorbent assay using monoclonal antibodies and determined to be similar to the NL-3 D strain (of Drifjhout) by reaction of differential bean cultivars. However, this BCMNV strain (designated NL-3 K) caused earlier and more severe symptoms on bean plants representing host groups 0, 4, and 5. The nucleotide sequence encoding the predicted polyprotein of NL-3 K was 9,893 nucleotides (nt) in length, yielding a peptide with a molecular size of 362.1 kDa compared with a 9,626-nt, 350.9-kDa polyprotein for NL-3 D. Sequence analysis of the putative P1 protein suggests that the NL-3 K strain is a recombinant between NL-3 D and the Russian strain (RU1) of Bean common mosaic virus. The P1 protein of NL-3 K consisted of 415 amino acids compared with 317 for NL-3 D. The first 114 predicted amino acids of the NL-3 K P1 region were 98% identical with RU1. The remaining 301 amino acids of the protein shared only 34% identity with RU1 but were 98% identical with NL-3 D. Primers were designed that flanked the recombination point in the P1 coding sequence of NL-3 K. An amplicon of the expected size was produced by reverse-transcriptase polymerase chain reaction of total nucleic acid extracts of bean plants inoculated with NL-3 K, but not from those with NL-3 D or RU1. The increased symptom severity on selected common bean lines induced by NL-3 K suggests that the P1 gene may play a significant role in pathogenicity and virulence. [ABSTRACT FROM AUTHOR]