How university diversity rationales inform student preferences and outcomes.

It is currently commonplace for institutions of higher education to proclaim to embrace diversity and inclusion. Though there are numerous rationales available for doing so, US Supreme Court decisions have consistently favored rationales which assert that diversity provides compelling educational benefits and is thus instrumentally useful. Our research is a quantitative/experimental effort to examine how such instrumental rationales comport with the preferences of White and Black Americans, specifically contrasting them with previously dominant moral rationales that embrace diversity as a matter of intrinsic values (e.g., justice). Furthermore, we investigate the prevalence of instrumental diversity rationales in the American higher education landscape and the degree to which they correspond with educational outcomes. Across six experiments, we showed that instrumental rationales correspond to the preferences of White (but not Black) Americans, and both parents and admissions staff expect Black students to fare worse at universities that endorse them. We coded university websites and surveyed admissions staff to determine that, nevertheless, instrumental diversity rationales are more prevalent than moral ones are and that they are indeed associated with increasing White-Black graduation disparities, particularly among universities with low levels of moral rationale use. These findings indicate that the most common rationale for supporting diversity in American higher education accords with the preferences of, and better relative outcomes for, White Americans over low-status racial minorities. The rationales behind universities' embrace of diversity have nonlegal consequences that should be considered in institutional decision making.

Performance of the adaptive optics system for Laser Communications Relay Demonstration's Ground Station 1.

The Laser Communications Relay Demonstration is NASA's multi-year demonstration of laser communication from the Earth to a geosynchronous satellite. The mission currently has two optical ground stations (OGSs), with one in California (OGS1) and one in Hawaii (OGS2). Each ground terminal optical system consists of a high-order adaptive optics (AO) system, a laser transmit system, and a camera for target acquisition. The OGS1 AO system is responsible for compensating for the downlink beam for atmospheric turbulence and coupling it into the modem's single mode fiber. The mission requires a coupling efficiency of 50%, which necessitates a high-order AO system. To achieve this performance, the AO system uses two deformable mirrors with one mirror correcting for low-spatial-frequency aberrations with large amplitude and a second deformable mirror correcting for high-spatial-frequency aberrations with small amplitude. Turbulence is sensed with a Shack-Hartmann wavefront sensor. To meet its performance requirements in the most stressing conditions, the system can operate at frame rates of 20 kHz. This high frame rate is enabled by the design of the real-time control system. We present an overview of both the hardware and software design of the system, and describe the control system and methods of reducing non-common path aberrations. Finally, we show measured system performance.

Are uninsured women in a national screening program having longer intervals between cervical cancer screening tests?

With increased understanding of the natural history of cervical cancer, cervical cancer screening recommendations have evolved (Schiffman & Wentzensen, 2013). As research better quantified the balance of benefits and harms of screening, new recommendations called for longer intervals between screening tests. Adherence to longer screening intervals detects similar numbers of abnormalities and decreases harms associated with overscreening/overtreatment. In this descriptive study, we examined the cervical cancer screening intervals from 2010 to 2018 in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). There were 1,397,899 women aged 21-64 who were screened for cervical cancer from 2010 to 2018 and 556,743 rescreenings of average risk women were performed. The median cervical screening interval increased from 2.02 years in 2010 to 3.88 years in 2018. Providers serving uninsured women in a national screening program are following the recommendations of longer intervals between cervical cancer screenings.

Geographic variation in the use of lymphadenectomy and external-beam radiotherapy for endometrial cancer: a cross-sectional analysis of population-based data.

OBJECTIVE: To quantify geographic variation in the use of lymphadenectomy and/or external-beam radiotherapy (EBRT) for endometrial cancer in England. DESIGN: Cross-sectional analysis of population-based data. SETTING: English cancer registry data, linked to chemotherapy, radiotherapy and hospital episodes statistics data. POPULATION: Twenty-two thousand four hundred and eighty-three women with endometrial cancer presenting without clinical or radiological evidence of distant metastatic spread, diagnosed in England from 2013 to 2016. METHODS: Proportions of patients receiving lymphadenectomy and/or EBRT were compared across 19 Cancer Alliances, to identify variations in clinical practice. Two separate logistic regression models assessed the impact on variation of adjustment for tumour and patient characteristics. MAIN OUTCOME MEASURES: Receipt of lymphadenectomy, receipt of EBRT. RESULTS: There was substantial variation by Cancer Alliance in the adjusted proportion of women with endometrial cancer receiving lymphadenectomy (range 5% [95% CI 4-6%] to 48% [95% CI 45-52%]) and EBRT (range 10% [95% CI 7-12%] to 31% [95% CI 28-33%]), after adjusting for variation in pathological grade, age, comorbidities, deprivation, ethnic group and (EBRT only) FIGO stage. Different approaches to clinical practice were identified; (i) one Cancer Alliance had significantly higher than average lymphadenectomy and significantly lower than average EBRT use, (ii) three had high use of both lymphadenectomy and EBRT, (iii) one had low lymphadenectomy use and high EBRT use, and (iv) three had low use of both lymphadenectomy and EBRT. CONCLUSIONS: Lymphadenectomy is probably used to triage for EBRT when lymphadenectomy use is high and EBRT use is low. This is probably a result of variation in local endometrial cancer management guidelines, suggesting that UK recommendations should be clarified. TWEETABLE ABSTRACT: There is geographic variation in England in the use of lymphadenectomy and radiotherapy to treat endometrial cancer.

Variation in 'fast-track' referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites.

BACKGROUND: In England, 'fast-track' (also known as 'two-week wait') general practitioner referrals for suspected cancer in symptomatic patients are used to shorten diagnostic intervals and are supported by clinical guidelines. However, the use of the fast-track pathway may vary for different patient groups. METHODS: We examined data from 669 220 patients with 35 cancers diagnosed in 2006-2010 following either fast-track or 'routine' primary-to-secondary care referrals using 'Routes to Diagnosis' data. We estimated the proportion of fast-track referrals by sociodemographic characteristic and cancer site and used logistic regression to estimate respective crude and adjusted odds ratios. We additionally explored whether sociodemographic associations varied by cancer. RESULTS: There were large variations in the odds of fast-track referral by cancer (P<0.001). Patients with testicular and breast cancer were most likely to have been diagnosed after a fast-track referral (adjusted odds ratios 2.73 and 2.35, respectively, using rectal cancer as reference); whereas patients with brain cancer and leukaemias least likely (adjusted odds ratios 0.05 and 0.09, respectively, for brain cancer and acute myeloid leukaemia). There were sex, age and deprivation differences in the odds of fast-track referral (P<0.013) that varied in their size and direction for patients with different cancers (P<0.001). For example, fast-track referrals were least likely in younger women with endometrial cancer and in older men with testicular cancer. CONCLUSIONS: Fast-track referrals are less likely for cancers characterised by nonspecific presenting symptoms and patients belonging to low cancer incidence demographic groups. Interventions beyond clinical guidelines for 'alarm' symptoms are needed to improve diagnostic timeliness.

Cobalt ions stimulate a fibrotic response through matrix remodelling, fibroblast contraction and release of pro-fibrotic signals from macrophages.

Many studies report the adverse responses to metal-on-metal (MoM) hip prostheses, with tissues surrounding failed MoM hip prostheses revealing abundant tissue necrosis and fibrosis. These local effects appear to be initiated by metal ions released from the prosthesis causing the secretion of inflammatory mediators. However, little is known about the effect of the metal ions on tissue remodelling and pseudotumor formation, which are also associated with the failure of MoM hip prostheses. The peri-prosthetic soft tissue masses can lead to pain, swelling, limited range of joint movement and extensive tissue lesion. To elucidate this cellular response, a multidisciplinary approach using both two- and three-dimensional (2D and 3D) in vitro culture systems was employed to study the effects of Co2+ and Cr3+ on human fibroblast activation and mechanobiology. Co2+ induced a fibrotic response, characterised by cytoskeletal remodelling and enhanced collagen matrix contraction. This was associated with increased cell stiffness and contractile forces as measured by atomic force microscopy and traction force microscopy, respectively. These effects were triggered by the generation of reactive oxygen species (ROS). Moreover, this fibrotic response was enhanced in the presence of macrophages, which increased the prevalence of a-smooth muscle actin (a-SMA)-positive fibroblasts and collagen synthesis. Cr3+ did not show any significant effect on fibroblast activation. Co2+ promoted matrix remodelling by fibroblasts that was further enhanced by macrophage signalling. Use of alternative implant materials or manipulation of this fibrotic response could provide an opportunity for enhancing the success of prostheses utilising CoCr alloys.

Quantitative Attachment of Bimetal Combinations of Transition-Metal Ions to the Surface of TiO2 Nanorods.

We report the sequential, quantitative loading of transition-metal ions (Cr3+, Mn2+, Fe2+, Co2+, Ni2+, and Cu2+) onto the surface of rod-shaped anatase TiO2 nanocrystals in bimetallic combinations (6 C2 = 15) to form M,M'-TiO2 nanocrystals. The materials were characterized with transmission electron microscopy (TEM), powder X-ray diffraction (XRD), elemental analysis, X-ray photoelectron spectroscopy (XPS), and UV-visible spectroscopy. TEM and XRD data indicate that the sequential adsorption of metal ions occurs with the retention of the phase and morphology of the nanocrystal. Atomistic models of the M,M'-TiO2 nanocrystals were optimized with density functional theory calculations. Calculated UV-visible absorption spectra and partial charge density maps of the donor and acceptor states for the electronic transitions indicate the importance of metal-to-metal charge transfer (MMCT) processes.

Municipal Wastewater as a Microbial Surveillance Platform for Enteric Diseases: A Case Study for Salmonella and Salmonellosis.

Municipal wastewater (MW) contains a conglomeration of human enteric microbiota from a community and, hence, represents a potential surveillance tool for gastrointestinal infectious disease burden at the community level. To evaluate this, the concentration of Salmonella in MW samples from Honolulu, Hawaii, was monitored over a 54-week period, which showed positive and significant linear and rank correlation with clinical salmonellosis case numbers over the same period. Salmonella isolates were obtained from the MW samples and then compared with clinical isolates obtained by the Hawaii Department of Health State Laboratories over the same period. The MW isolate collection contained 34 serotypes, and the clinical isolate collection contained 47 serotypes, 21 of which were shared between the two isolate collections, including nine of the 12 most commonly detected clinical serotypes. Most notably, nine Salmonella strains, including one outbreak-associated Paratyphi B strain and eight other clinically rare strains, were shared and concurrently detected between the MW and the clinical isolate collections, indicating the feasibility of using enteric pathogens in the MW as a timely indication of community enteric disease activity.

"A threat on the ground": The consequences of witnessing stereotype-confirming ingroup members in interracial interactions.

OBJECTIVES: Three studies explored interpersonal consequences of engaging in interracial interactions after witnessing racial ingroup members' stereotypical behavior. METHOD: Study 1 used experience-sampling methodology to assess ethnic minority students' (n = 119) intergroup anxiety, metastereotypes, and anticipatory behaviors following one of three types of interpersonal interactions: (a) a White person and a racial ingroup member who had behaved stereotypically, (b) a White person and a nonstereotypical ingroup member, or (c) neither. Studies 2 (n = 273) and 3 (n = 379) experimentally examined whether witnessing an ingroup member's stereotypically negative behavior in interracial interactions, compared to stereotypically positive (Study 2) or nonstereotypically negative behavior (Study 3) differentially affected anxiety, metastereotypes, and anticipatory behaviors in interracial versus intraracial interactions among Black Americans. RESULTS: In Study 1, minorities reported greater anxiety, metastereotypes, and motivation to disprove stereotypes, but less interest in future interracial contact, following interracial interactions involving stereotype-confirming ingroup members compared to other interactions. In Studies 2 and 3, adverse interaction consequences were most severe when ingroup behavior was both negative and stereotypical compared to neutral, stereotypically positive, and nonstereotypically negative ingroup behavior. Additionally, metastereotypes (and, to a lesser degree, anxiety) mediated individuals' motivation to disprove stereotypes and desire future interactions with White witnesses following stereotypically negative ingroup behavior in interracial (vs. intraracial) interactions. CONCLUSIONS: This research highlights the emotional, metaperceptual, and motivational outcomes following ingroup members' stereotypical behavior in intergroup contexts that extend beyond dyadic encounters. (PsycINFO Database Record

Clinical outcomes and the role of adjuvant therapy sequencing in Type II uterine cancer following definitive surgical treatment.

PURPOSE OF INVESTIGATION: Because of rarity, consensus on adjuvant therapies for Type II endometrial cancers (BC) remains undefined. Reporting their institutional outcomes, the present authors assessed the impact of adjuvant therapies on recurrence and overall survival in women with 2009 FIGO Stage I-III Type II BC. MATERIAL AND METHODS: The authors identified 108 women, treated with definitive surgery between 2000-2013, with pathologically-confirmed Type II EC (non-endometrioid [NEM, n=801 and high grade endometrioid [G3EEC, n=28]) Cox proportional hazard models were used to assess the effect of prognostic variables on disease-free (DFS) and overall survival (OS). Kaplan-Meier method was used to assess survival. RESULTS: Of the 108 women, 83 (77%) were African American (AA). Fifty-nine (55%), 12 (11%), and 37 (34%) were Stage I, II, and III, respectively. Ninety-seven patients received adjuvant therapy: 52 (radiation only), four (chemotherapy only), and 40 (combined). During follow-up (median 41 months), 44 patients (41%) recurred. Five-year DFS was 53% overall (48% [NEM], 80% [G3EEC]). Five-year OS was 75% overall (68% [NEM], 95% [G3EEC]). On multivariate analysis, lower stage and adjuvant radiation improved DFS. Higher stage, NEM, and increasing age were poor prognostic indicators of OS. CONCLUSION: Representing a large single institutional cohort for Type II BC, the present study's observed sur- vival rates are consistent with previous studies, despite the relatively high frequency of carcinosarcoma and Stage III/nodal disease. The protective effect on recurrence was not lost when radiation was delayed for chemotherapy. The present results support a multimodal adjuvant approach for treating all stages of invasive NEM EC.

Assessing the impact of an English national initiative for early cancer diagnosis in primary care.

BACKGROUND: The Cancer Networks Supporting Primary Care programme was a National Health Service (NHS) initiative in England between 2011 and 2013 that aimed to better understand and improve referral practices for suspected cancer. METHODS: A mixed methods evaluation using semi-structured interviews with purposefully sampled key stakeholders and an analysis of Cancer Waiting Times and Hospital Episode Statistics data for all 8179 practices in England were undertaken. We compared periods before (2009/10) and at the end (2012/13) of the initiative for practices taking up any one of four specified quality improvement initiatives expected to change referral practice in the short to medium term and those that did not. RESULTS: Overall, 38% of general practices were involved in at least one of four quality improvement activities (clinical audit, significant event analysis, use of risk assessment tools and development of practice plans). Against an overall 29% increase in urgent cancer referrals between 2009/10 and 2012/13, these practices had a significantly higher increase in referral rate, with reduced between-practice variation. There were no significant differences between the two groups in conversion, detection or emergency presentation rates. Key features of successful implementation at practice and network level reported by participants included leadership, organisational culture and physician involvement. Concurrent health service reforms created organisational uncertainty and limited the programme's effectiveness. CONCLUSIONS: Specific primary care initiatives promoted by cancer networks had an additional and positive impact on urgent referrals for suspected cancer. Successful engagement with the programmes depended on effective and well-supported leadership by cancer networks and their general practitioner (GP) leads.

Cancer-specific variation in emergency presentation by sex, age and deprivation across 27 common and rarer cancers.

BACKGROUND: Although overall sociodemographic and cancer site variation in the risk of cancer diagnosis through emergency presentation has been previously described, relatively little is known about how this risk may vary differentially by sex, age and deprivation group between patients with a given cancer. METHODS: Data from the Routes to Diagnosis project on 749,645 patients (2006-2010) with any of 27 cancers that can occur in either sex were analysed. Crude proportions and crude and adjusted odds ratios were calculated for emergency presentation, and interactions between sex, age and deprivation with cancer were examined. RESULTS: The overall proportion of patients diagnosed through emergency presentation varied greatly by cancer. Compared with men, women were at greater risk for emergency presentation for bladder, brain, rectal, liver, stomach, colon and lung cancer (e.g., bladder cancer-specific odds ratio for women vs men, 1.50; 95% CI 1.39-1.60), whereas the opposite was true for oral/oropharyngeal cancer, lymphomas and melanoma (e.g., oropharyngeal cancer-specific odds ratio for women vs men, 0.49; 95% CI 0.32-0.73). Similarly, younger patients were at higher risk for emergency presentation for acute leukaemia, colon, stomach and oesophageal cancer (e.g., colon cancer-specific odds ratio in 35-44- vs 65-74-year-olds, 2.01; 95% CI 1.76-2.30) and older patients for laryngeal, melanoma, thyroid, oral and Hodgkin's lymphoma (e.g., melanoma specific odds ratio in 35-44- vs 65-74-year-olds, 0.20; 95% CI 0.12-0.33). Inequalities in the risk of emergency presentation by deprivation group were greatest for oral/oropharyngeal, anal, laryngeal and small intestine cancers. CONCLUSIONS: Among patients with the same cancer, the risk for emergency presentation varies notably by sex, age and deprivation group. The findings suggest that, beyond tumour biology, diagnosis through an emergency route may be associated both with psychosocial processes, which can delay seeking of medical help, and with difficulties in suspecting the diagnosis of cancer after presentation.

Improvements in patient-reported outcomes in patients with psoriasis receiving etanercept plus topical therapies: results from REFINE.

BACKGROUND: The REFINE study examined the efficacy and safety of adding topical corticosteroid therapy to etanercept when stepping down from the initial dose of etanercept to the maintenance dose. Clinical responses were shown to be similar in patients who remained on etanercept 50 mg twice weekly (BIW) and those who received etanercept 50 mg once weekly (QW) plus topical therapies through week 24. OBJECTIVE: The purpose of this analysis was to evaluate the effect of treatment on health-related quality of life (HRQoL) for patients in REFINE. METHODS: All patients received etanercept 50 mg BIW for 12 weeks and were then randomized to etanercept 50 mg BIW or etanercept 50 mg QW plus topical corticosteroid as required to clear through week 24. HRQoL measures included the Dermatology Life Quality Index (DLQI), Treatment Satisfaction Questionnaire for Medication (TSQM) and the Economic Implications of Psoriasis Patient Questionnaire. No comparative testing was performed for this descriptive analysis. Missing data were imputed using the last observation carried forward. RESULTS: For 287 randomized patients (144 etanercept; 143 etanercept plus topical), the mean change [standard deviation (SD)] in DLQI from baseline to week 24 was 10.7 (7.8) for etanercept and 9.9 (6.9) for etanercept plus topical. Mean change (SD) in TSQM effectiveness, convenience, side-effects and global satisfaction was 27.1 (36.1), 14.8 (25.9), -0.7 (22.0) and 26.7 (32.5) for the etanercept arm and 32.5 (40.3), 18.5 (29.0), 1.3 (19.4) and 28.4 (35.9) for etanercept plus topical. Economic implications, including healthcare visits, employment status, work productivity, ability to perform daily activities and out-of-pocket expenses were similar between treatment arms. CONCLUSION: At week 24 of REFINE, measures of HRQoL were numerically similar in patients who stayed on etanercept 50 mg BIW and patients who received etanercept 50 mg QW plus topical therapies.

A Randomized, blinded assessor study to Evaluate the efFIcacy and safety of etanercept 50 mg once weekly plus as Needed topical agent vs. Etanercept 50 mg twice weekly in patients with moderate to severe plaque psoriasis (REFINE).

BACKGROUND: Topical corticosteroids are used with systemic therapies for treatment of plaque psoriasis, but data from randomized clinical trials to document efficacy of combination therapy are lacking. OBJECTIVE: To evaluate efficacy and safety of adding topical corticosteroid therapy from the time that etanercept dosage is reduced from initial label dose [50 mg twice weekly (BIW)] to maintenance dose [50 mg once weekly (QW)]. METHODS: In this phase 3b, multicentre, randomized, open-label study, patients with moderate-to-severe plaque psoriasis received etanercept 50 mg BIW for 12 weeks, and then were randomized to etanercept 50 mg BIW or 50 mg QW plus topical agent as needed to achieve static physician global assessment (sPGA) status of clear for 12 weeks. Endpoints included percentage change in Psoriasis Area and Severity Index (PASI) score from week 12 to week 24 (primary endpoint); proportion of patients achieving 50% improvement in (PASI 50), PASI 75 and PASI 90; patients achieving sPGA of clear/almost clear; and change in affected body surface area (BSA). RESULTS: Mean difference [95% confidence interval (CI)] between etanercept arm (n = 140) and etanercept plus topical arm (n = 142) in change in PASI score from week 12 to week 24 was 16.2% (-3.5%, 35.8%). PASI response rates were similar between groups. Percentage (95% CI) of patients achieving sPGA status of clear/almost clear was 40.6% (32.5%, 48.6%) and 45.8% (37.6%, 54.0%) at week 12 for patients in etanercept and etanercept plus topical arms, respectively, and 53.5% (45.3%, 61.7%) and 45.4% (37.2%, 53.6%) at week 24. Difference (95% CI) between groups in change in affected BSA from week 12 to week 24 was 4.9% (-23.4%, 33.2%). CONCLUSION: Patients who received etanercept 50 mg QW at week 12 plus as-needed topical therapy and those who stayed on etanercept 50 mg BIW maintained clinical response through week 24 with no notable differences in PASI responses.

"I thought you were Japanese": Ethnic miscategorization and identity assertion.

Across 2 studies we examined how ethnic minorities respond to ethnic miscategorization. Using a 21-day experience sampling procedure (Study 1), we found that ethnic minorities exhibited greater ethnic identity assertion when they had reported being ethnically miscategorized the previous day. Similarly, we found that ethnic minorities who were ethnically miscategorized (vs. not) by a White partner in the laboratory exhibited greater ethnic identity assertion and expressed greater dislike of their partner (Study 2). In both studies, these effects were stronger for individuals whose ethnic identity was central to their self-concept. The implications of these findings for ethnic identity development and intergroup relations are discussed. (PsycINFO Database Record

Outcome analysis of cubital tunnel decompression.

BACKGROUND: Cubital tunnel decompression is a commonly undertaken upper limb procedure. Most studies compare the different techniques of decompression; however, only a few have specifically investigated the outcome of ulnar nerve decompression. AIM: The aim of this study was to investigate the outcome of ulnar nerve decompression following cubital tunnel syndrome. METHODS AND RESULTS: A total of 174 ulnar nerve decompression cases were identified from the upper limb surgery database with complete data available for 136 cases. Simple decompression was performed in 110 (80.88%) cases, and in 26 (19.12%), anterior subcutaneous transposition was also supplemented. These operations were performed at three different hospitals by surgeons of different levels of experience. The most common cause of cubital tunnel syndrome was idiopathic. The outcome was satisfactory in 86% of cases. No obvious association was demonstrated between the outcome of surgery and duration of symptoms, presence of co-morbidities or the type of surgery performed. CONCLUSION: This is the largest outcome analysis of the results of ulnar nerve decompression at the elbow. Good results following nerve decompression were attained in 86% of cases without any significant effect of duration of symptoms or co-morbidities on the outcome of surgery. It is hoped that the findings of the current study will help general practitioners, junior doctors and surgeons in their management and pre-operative consultation with patients having cubital tunnel syndrome.

Disease characteristics in patients with and without psoriatic arthritis treated with etanercept.

BACKGROUND: Patients with psoriasis (PsO) and psoriatic arthritis (PsA) have functional disability, pain and emotional problems, and experience lower quality of life (QoL) than patients with PsO alone. OBJECTIVES: Examine effectiveness of etanercept (ETN) in patients with PsO alone, and with PsA, and determine whether PsA patients on ETN experience rapid QoL improvement. METHODS: Data from three phase III trials using ETN in adults with moderate-to-severe PsO were pooled. Patients with (n = 523) and without (n = 1330) PsA received ETN 25 mg once weekly to 50 mg twice weekly or placebo for 12-24 weeks. Assessments included Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), EuroQoL-5D (EQ-5D), Study 36-item Short Form Health Survey (SF-36) and Hamilton Depression Rating Scale (HAM-D). RESULTS: Baseline PASI, EQ-5D and SF-36 physical component summary scores were worse for PsA patients. With ETN, PASI for PsA and non-PsA groups improved as early as week 2. Scores for both groups converged by week 12. EQ-5D and SF-36 physical component improved faster in PsA patients, with EQ-5D scores converged by week 2. For total DLQI and most components, both groups had similar baseline scores and improved over 24 weeks on ETN. While the PsA group had more depressed patients at baseline, after 24 weeks on ETN it showed a greater reduction in the number of depressed patients than the non-PsA group. CONCLUSIONS: In patients with PsO involving ≥10% of body surface area, skin disease and QoL are worse in PsA patients. With ETN, QoL improved rapidly in PsA patients.

Intragroup contact and anxiety among ethnic minority adolescents: considering ethnic identity and school diversity transitions.

Everyday interactions with same-racial/ethnic others may confer positive benefits for adolescents, but the meaning of these interactions are likely influenced by individual differences and larger structural contexts. This study examined the situation-level association between contact with same-ethnic others and anxiety symptoms among a diverse sample of 306 racial/ethnic minority adolescents (Mage = 14 years; 66% female), based on (1) individual differences in ethnic identity centrality and (2) developmental histories of transitions in diversity between elementary, middle, and high school. The results indicated that at the level of the situation, when adolescents interacted with more same-ethnic others, they reported fewer anxiety symptoms. Further, for adolescents who had experienced a transition in school diversity, the positive benefits of contact with same-ethnic others was only conferred for those who felt that their ethnicity was very important to them. The importance of examining individual differences within larger developmental histories to understand the everyday experiences of ethnic minority adolescents are discussed.

Emergency presentation of cancer and short-term mortality.

BACKGROUND: The short-term survival following a cancer diagnosis in England is lower than that in comparable countries, with the difference in excess mortality primarily occurring in the months immediately after diagnosis. We assess the impact of emergency presentation (EP) on the excess mortality in England over the course of the year following diagnosis. METHODS: All colorectal and cervical cancers presenting in England and all breast, lung, and prostate cancers in the East of England in 2006-2008 are included. The variation in the likelihood of EP with age, stage, sex, co-morbidity, and income deprivation is modelled. The excess mortality over 0-1, 1-3, 3-6, and 6-12 months after diagnosis and its dependence on these case-mix factors and presentation route is then examined. RESULTS: More advanced stage and older age are predictive of EP, as to a lesser extent are co-morbidity, higher income deprivation, and female sex. In the first month after diagnosis, we observe case-mix-adjusted excess mortality rate ratios of 7.5 (cervical), 5.9 (colorectal), 11.7 (breast ), 4.0 (lung), and 20.8 (prostate) for EP compared with non-EP. CONCLUSION: Individuals who present as an emergency experience high short-term mortality in all cancer types examined compared with non-EPs. This is partly a case-mix effect but EP remains predictive of short-term mortality even when age, stage, and co-morbidity are accounted for.