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On Friday, 30 January 2015, Steven Blaney, Minister of Public Safety and Emergency Preparedness, introduced Bill C-51, also known as the Anti-Terrorism Act in Canada's House of Commons. This article delineates research into the media coverage of Bill C-51 in the month after its introduction, prior to its legislation. A qualitative content analysis of 23 articles from five Canadian news sources (National Post, The Globe and Mail, The Toronto Star, The Tyee, and rabble.ca) was conducted. Data were coded and analysed using the qualitative research software NVivo 10. Themes that arose from the data include: terrorism and our need for protection; production and reinforcement of fear; oversight, accountability, and abuses of power; and dystopic future and 'big' government. Findings show that the differences between alternative and commercial news sources were not as evident as much of the literature regarding the differences between the types of media would hypothesize.

Individuals undergoing lung resections experience persistent postoperative pain and are at high risk of chronic postoperative opioid use. This study aims to identify factors associated with chronic opioid use after minimally invasive lung resections (MILR). This is a retrospective cohort study of individuals who underwent MILR from March 2019 to May 2022 at a single academic institution. The primary outcome was chronic opioid usage, defined as use at least 30 days after surgery. Postoperative pain was managed with a standardized multi-modal pain-control regimen utilizing opioids only as needed. Prescription patterns and dispensing data of opioids at 30-, 60-, and 90-days postoperatively informed usage. Univariate analysis and multivariable logistic regressions (MVLR) were performed. 376 patients were included, 38.6% male, 88.8% white, and a mean age of 64.6 years. A total of 248 (66%) underwent anatomical lung resections. 16.5% used opioids at 30 days, 10.1% at 60 days, and 8.5% at 90 days. In the multivariable model, morphine milligram equivalents (MMEs) of opioids on the day before discharge showed a statistically significant association with chronic opioid usage. Age, sex, length of stay, and surgery type were not associated. A 10-unit increase in MMEs increased odds of use at 30-days by 21% (OR 1.21, 95%CI 1.11-1.32, p < 0.001), 20% at 60-days (OR 1.20, 95%CI 1.09 1.32, p < 0.001) and 18% at 90-days (OR 1.18, 95%CI 1.06-1.30, p = 0.002). Higher pre-discharge MMEs are associated with an increased likelihood of chronic opioid usage. Future studies should focus on whether preemptive early outpatient intercostal nerve blocks or cryoablations can decrease chronic narcotic usage in high-risk patients.

We are conducting clinical trials in breast cancer (BrCa) patients to test the HER2/neu peptide vaccine (E75). We have investigated the impact of this vaccine on circulating levels of regulatory T cells (Treg) and the resulting effects on antitumor responses. Twenty-two blood samples from healthy individuals and from 22 BrCa patients including pre- and post-vaccination samples from seven vaccinated HLA-A2+ patients were stained for CD4, CD25, and CD69 as well as CD8 and E75:HLA-A2 Ig dimer and quantified by flow cytometry. Cytotoxic activity against HER2/neu+ tumors was measured by 51Cr-release. Serum from BrCa patients and normal subjects were analyzed for TGF-beta levels. BrCa patients have a greater percentage of circulating Treg (CD4+CD25+, 4.45% versus 2.96%; p=0.007) than normal subjects. HLA-A2+ BrCa patients had more Treg compared to the HLA-A2- BrCa patients (CD4+CD25+, 5.63% versus 3.28%; p=0.001). E75 vaccination increased circulating activated CD4+ T cells post-vaccination (CD4+CD69+, 1.23 versus 3.81%; p=0.03). However, T(reg) were significantly reduced after vaccination (CD4+CD25+, 5.31-1.81%; p<0.0001). Furthermore, activated Treg also decreased (CD4+CD25+CD69+, 0.23% versus 0.08%; p=0.06). Importantly, post-vaccination decreases in Treg were temporally associated with increased E75 vaccine-specific CD8+ T cells and corresponding HER2/neu+ tumor cytotoxicity. Serum TGF-beta levels were significantly elevated in BrCa patients compared to normals (3548 pg/ml versus 1007 pg/ml; p=0.007). Four of seven vaccinated patients showed decreased serum TGF-beta levels post-vaccination. Treg, are increased in BrCa patients along with serum levels of TGF-beta. E75 vaccination resulted in CD4+ recruitment but was associated with a significant decrease in circulating Treg and TGF-beta levels in the majority of the vaccinated patients. Successful cancer vaccination strategies may require the alteration of complex immune interactions.

BackgroundPancreatic cancer is projected to become the second leading cause of cancer death in the United States by 2030. Screening of high-risk individuals (HRI’s) using endoscopic ultrasound (EUS) or magnetic resonance imaging (MRI), specifically magnetic resonance cholangiopancreatography (MRCP), saves lives and reduces morbidity and mortality. Screening can detect surgically resectable lesions, which is key to survival since most lesions present as unresectable or metastatic. The specific aims of this project were to address the quality improvement process to track adherence of the patients who participate in the high-risk pancreatic cancer clinic at UMass Memorial Healthcare.MethodsPatients deemed to be high risk according to the Cancer of the Pancreas Screening (CAPS) Consortium Guidelines included having at least one first-degree relative with a diagnosis of pancreatic cancer, a genetic mutation that places them at higher risk for pancreatic cancer, or both are the cohort. The data was collected via EMR using REDCap, a secure web application to analyze high-risk patients’ adherence with yearly screening. The method utilized a quality improvement project design.ResultsResults demonstrated a majority of participants were female, 53% had a first-degree relative with pancreatic cancer, a majority of participants did not carry a genetic mutation while the highest mutation finding included 16 participants (14.4%) with a BRCA 2 gene mutation. A majority of participants, 64.9% (n=72) were non-compliant with screening while 35% (n=39) had yearly screening. Participants who were non-adherent with screening endorsed multiple factors for non-adherence including not believing surveillance was necessary, not qualifying for screening at the time of initial appointment, not receiving reminder phone calls for clinic appointments and surveillance imaging, other health concerns, high insurance deductibles, the COVID pandemic, and high anxiety.ConclusionsMitigation of the reasons for non-adherence is a crucial practice implication. Patient education regarding the importance of long-term yearly screening and teaching patients self-efficacy behaviors may improve screening adherence. Prospectively analyzing compliance will reduce missed care opportunities. Health care policies must be amended to require insurance companies to cover the screening of HRI’s.

Abstract Empathy is a critical component of social interaction that enables individuals to understand and share the emotions of others. We report a preregistered experiment in which 240 participants, including adolescents, young adults, and older adults, viewed images depicting hands and feet in physically or socially painful situations (versus nonpainful). Empathy was measured using imagined pain ratings and EEG mu suppression. Imagined pain was greater for physical versus social pain, with young adults showing particular sensitivity to social pain events compared to adolescents and older adults. Mu desynchronization was greater to pain versus no-pain situations, but the physical/social context did not modulate pain responses. Brain responses to painful situations increased linearly from adolescence to young and older adulthood. These findings highlight shared activity across the core empathy network for both physical and social pain contexts, and an empathic response that develops over the lifespan with accumulating social experience.

Purpose. This project was designed to strengthen primary care provider (PCP) knowledge and confidence in Valley fever diagnosis, treatment, and specialty-referral requirements at a Southern Arizona rural community health organization.Background. Coccidioidomycosis (i.e., Valley fever) is a fungal infection acquired by inhaling spores located in the dust of endemic regions. Southern Arizona has the highest incidence of the disease in the nation, with Maricopa, Pima, and Pinal Counties accounting for over half of all cases in the United States. Despite the fact that Valley fever is responsible for one-third of all pneumonia cases diagnosed in Southern Arizona, only 13% of Arizona PCPs appropriately test for the disease. Patients experience on average a one-month delay for diagnosis, and more than 80% of cases are initially misdiagnosed. This delay to diagnosis leads to increased healthcare costs, increased incidence of complications, and delayed specialist referral for high-risk patients. Methods. The multilevel intervention design included a 30-minute, synchronous provider education session delivered via Microsoft TEAMS. Education content was developed from Infectious Disease Society of America (IDSA) clinical practice guidelines, a 2017 CDC Valley Fever PCP training video, and the Valley Fever Center for Excellence (VFCE) training manual for PCPs. A pocket-sized handbook and printable flowchart of the educational material was also provided. Evaluation was accomplished with a post-pre survey examining provider knowledge, attitudes, and practices related to Valley fever diagnosis and management. A “Valley Fever Champion” was selected from among participating PCPs to provide quarterly educational emails and attend the annual VFCE meeting. Results. Of the 31 providers in attendance, 19 completed the post-education evaluation survey. Statistically significant improvements were seen in provider confidence in ability to diagnose (p=.001) and treat (p=.011) Valley fever, and knowledge of lab testing options (p=.031). Modest improvements were gained in knowledge of vaccine availability and health department notification requirements. Notably, among providers who obtained their clinical degree in Arizona, only 20% reported receiving prior education on Valley fever.Conclusions. This project demonstrates an effective model for providing Valley fever training to Arizona PCPs and connecting them with local specialists and resources from organizations such as the VFCE.

Detecting and responding appropriately to social information in one’s environment is a vital part of everyday social interactions. Here, we report two preregistered experiments that examine how social attention develops across the lifespan, comparing adolescents (10–19 years old), young (20–40 years old) and older (60–80 years old) adults. In two real-world tasks, participants were immersed in different social interaction situations—a face-to-face conversation and navigating an environment—and their attention to social and non-social content was recorded using eye-tracking glasses. The results revealed that, compared with young adults, adolescents and older adults attended less to social information (that is, the face) during face-to-face conversation, and to people when navigating the real world. Thus, we provide evidence that real-world social attention undergoes age-related change, and these developmental differences might be a key mechanism that influences theory of mind among adolescents and older adults, with potential implications for predicting successful social interactions in daily life. Two eye-tracking experiments revealed that adolescents and older adults look less at social stimuli during a face-to-face conversation and while navigating the real world compared with young adults, which may affect the success of their social interactions.

Violence against women is a violation of women's human rights and a priority public health issue. It is endemic worldwide. While much has been written about it in industrialized societies, there has been relatively little attention given to such violence in Asian societies. This book addresses the structural and interpersonal violences to which women are subject, both under conditions of conflict and disruption, and where civil society is relatively ordered. It explores sexual violence and coercion, domestic violence, and violence within the broader community and the state, avoiding sensationalised accounts of so-called cultural' practices in favour of nuanced explorations of violences as experienced in Cambodia, Thailand, Burma, Indonesia, Malaysia, the Philippines, Bangladesh, and India.

Purpose: We are conducting clinical trials in breast cancer (BrCa) patients to test the HER2/neu peptide vaccine (E75). We have investigated the impact of this vaccine on circulating levels of regulatory T cells (T sub(reg)) and the resulting effects on antitumor responses. Experimental design: Twenty-two blood samples from healthy individuals and from 22 BrCa patients including pre- and post-vaccination samples from seven vaccinated HLA-A2 super(+) patients were stained for CD4, CD25, and CD69 as well as CD8 and E75:HLA-A2 Ig dimer and quantified by flow cytometry. Cytotoxic activity against HER2/neu super(+) tumors was measured by super(51)Cr-release. Serum from BrCa patients and normal subjects were analyzed for TGF- beta levels. Results: BrCa patients have a greater percentage of circulating T sub(reg) (CD4 super(+)CD25 super(+), 4.45% versus 2.96%; p = 0.007) than normal subjects. HLA-A2 super(+) BrCa patients had more T sub(reg) compared to the HLA-A2 super(-) BrCa patients (CD4 super(+)CD25 super(+), 5.63% versus 3.28%; p = 0.001). E75 vaccination increased circulating activated CD4 super(+) T cells post-vaccination (CD4 super(+)CD69 super(+), 1.23 versus 3.81%; p = 0.03). However, T sub(reg) were significantly reduced after vaccination (CD4 super(+)CD25 super(+), 5.31-1.81%; p < 0.0001). Furthermore, activated T sub(reg) also decreased (CD4 super(+)CD25 super(+)CD69 super(+), 0.23% versus 0.08%; p = 0.06). Importantly, post-vaccination decreases in T sub(reg) were temporally associated with increased E75 vaccine-specific CD8 super(+) T cells and corresponding HER2/neu super(+) tumor cytotoxicity. Serum TGF- beta levels were significantly elevated in BrCa patients compared to normals (3548 pg/ml versus 1007 pg/ml; p = 0.007). Four of seven vaccinated patients showed decreased serum TGF- beta levels post-vaccination. Conclusions: T sub(reg), are increased in BrCa patients along with serum levels of TGF- beta . E75 vaccination resulted in CD4 super(+) recruitment but was associated with a significant decrease in circulating T sub(reg) and TGF- beta levels in the majority of the vaccinated patients. Successful cancer vaccination strategies may require the alteration of complex immune interactions.