When there is nothing left to do, there is everything left to do

Circle of Life Hospice in Reno, Nevada is not only a special place for patients and their families to find peace through a sense of meaning and purpose at the end of their life but is also an important place for staff to take care of each other as they take care of those who are dying. The Circle of Life Hospice provides a unique opportunity to examine carefully the power of providing an outlet for hospice staff to process their grief and offer support for one another so that they can continue to give the "everything that there is to do to" to their patients.     

The rise, decline, and future of the Swedish left

Swedish voters' support for the labor movement has decreased from about 50 percent to less than 40 percent in recent decades, with a resulting loss of the majority in parliament. Over the same period, capitalism has undergone profound changes--transfer of production across borders, the huge growth and ultra-rapid movement of financial capital, and subordination of social welfare to the interests of profit. A new phase in the development of capitalism can be detected: from welfare capitalism to financial capitalism. Large parts of the public sector have been privatized by both conservative and labor governments, even while retaining public funding. The social gaps grow, and a new line of conflict is emerging in the values and interests that should govern care-taking, schools, and living conditions. The labor movement's ideological and scientific analyses have taken a backseat to liberal-conservative think tanks. An effective response to financial capitalism, transnational production chains, and European integration will require trade union and political actions across national borders to strengthen the power resources in the hands of the majority of the population, so as to counter the increasingly destructive powers of capitalism.     

Right aortic arch, Kommerell's diverticulum and aberrant left subclavian artery

The right aberrant subclavian artery or "arteria lusoria" is the most common anatomical variant of the embryonic development of the aorta and its branches, with a presence in 0.5-2% of the population. Less frequently, a right aortic arch with aberrant left subclavian artery may be present. These anatomical variations should be included in the differential diagnosis of superior mediastinal widening seen on chest radiographs. In this report, we present a right aortic arch with left aberrant subclavian artery dilated at its origin (Kommerell's diverticulum) as a cause of superior mediastinal widening detected incidentally on a chest radiograph.     

Bayesian semiparametric mixture Tobit models with left censoring,skewness, and covariate measurement errors

Common problems to many longitudinal HIV/AIDS, cancer, vaccine, and environmental exposure studies are the presence of a lower limit of quantification of an outcome with skewness and time‐varying covariates with measurement errors. There has been relatively little work published simultaneously dealing with these features of longitudinal data. In particular, left‐censored data falling below a limit of detection may sometimes have a proportion larger than expected under a usually assumed log‐normal distribution. In such cases, alternative models, which can account for a high proportion of censored data, should be considered. In this article, we present an extension of the Tobit model that incorporates a mixture of true undetectable observations and those values from a skew‐normal distribution for an outcome with possible left censoring and skewness, and covariates with substantial measurement error. To quantify the covariate process, we offer a flexible nonparametric mixed‐effects model within the Tobit framework. A Bayesian modeling approach is used to assess the simultaneous impact of left censoring, skewness, and measurement error in covariates on inference. The proposed methods are illustrated using real data from an AIDS clinical study. Copyright © 2013 John Wiley & Sons, Ltd.     

Blood pressure, left ventricular mass, and lead exposure in battery manufacturing workers.

BACKGROUND: Although debate about the relationship between lead and blood pressure has focused on low environmental lead levels, industrial exposure remains a concern. METHODS: We measured blood pressure and left ventricular mass (LVM) in 108 battery manufacturing workers, and calculated cumulative and historic average measures of blood lead. RESULTS: Diastolic pressure increased with increasing lead levels, with a significant (P = 0.04) 5 mmHg difference in mean pressure between the highest and lowest cumulative exposure levels. Diastolic pressure increased with the log of cumulative lead (P = 0.06). Both hypertension (defined as currently medicated or systolic > 160 mmHg or diastolic > 95 mmHg) and LVM increased nonsignificantly with increasing lead exposure (P-values > or = 0.17 for hypertension and > or = 0.20 for LVM). CONCLUSIONS: We found a small effect of blood lead on diastolic blood pressure, particularly for a cumulative measure of exposure, but no convincing evidence of associations between lead and other blood-pressure-related outcomes. Published 2001 Wiley-Liss, Inc.