Analyzing selected risk factors for the development of kidney cancer

The aim of this study was to determine influence of selected lifestyle factors on kidney cancer. The study brings data from two centres of international multicentric hospital-based analytical observational case-control studies. Data were obtained from a group of 300 patients newly diagnosed with kidney cancer (ICD-O-2 code C64) and 335 controls from two centres in the Czech Republic. Results showed that smoking increased OR to 1.09 (95% CI 0.77–1.55) and 1.06 (95% CI 0.73–1.52), but the results were not statistically significant. Obesity (BMI⩾30) created adjusted OR 1.71 (95% CI 1.11–2.66) and 1.44 (95% CI 0.91–2.28), showing a minor, statistically insignificant, effect of obesity on the development of kidney cancer. For hypertension, adjusted OR was 1.73 (95% CI 1.25–2.40), suggesting a minor to moderate effect of hypertension on kidney cancer. The analysis results showed a positive association between hereditary predisposition and the development of kidney cancer with an OR of 1.97 (95% CI 1.41–2.76) and 1.97 (95% CI 1.40–2.77) depending on the model of adjustment. The reasons for the high incidence of kidney cancer are not fully understood. Genetic polymorphisms, together with other lifestyle and environmental factors, are likely to contribute to various rates of kidney cancer incidence throughout the world.     

A cross-sectional study of quality of life in an elderly population (75 years and over) with atrial fibrillation: secondary analysis of data from the Birmingham Atrial Fibrillation Treatment of the Aged study

AIMS: To compare the quality of life (QoL) of those in atrial fibrillation (AF) aged 75 years and over with that of the general population, to explore what factors affect the QoL of those with AF, and to assess the sensitivity of the EuroQol (EQ-5D) and Short-Form 12 (SF-12) generic health questionnaires in detecting differences in health status in those with AF in this age group. METHODS AND RESULTS: The study population was 1762 men and women aged 75 years and over with confirmed AF who attended a randomization clinic for the Birmingham Atrial Fibrillation Treatment of the Aged (BAFTA) study, a primary care based trial of stroke prevention. Patients self-completed the EQ-5D and SF-12 questionnaires, and a simple measure of disability (Rankin). Cardiovascular co-morbidities were collected and number of drugs used as an additional proxy for co-morbidity. Quality-of-life outcomes were compared with general population samples of the same age. On multiple regression, female gender, greater medication use, and disability were independently associated with lower QoL scores in AF. Those in AF with a Rankin score ≥2 had lower QoL scores, while those with a Rankin score <2 had higher scores than the general population. Increasing co-morbidity was associated with reduced QoL scores, with the EQ-5D and SF-12 Physical Component Score showing similar sensitivity to these associations, and the SF-12 Mental Component Score showing less sensitivity. CONCLUSION: In the absence of co-morbidity, chronic AF has little impact on generic QoL in an elderly non-acutely ill population.     

Socioeconomic,psychological and demographic determinants of Australian baby boomers' financial planning for retirement

Aim: Research from around the Western World has shown that psychological, socioeconomic and demographic factors can influence levels of financial planning. This study aims to determine how these factors interrelate to predict planning outcomes. Method: Data from the Ageing Baby Boomers in Australia Study were used to examine the effects of multiple factors on financial planning for 709 employed Australians nearing retirement. Results: The results showed that higher income, future time perspective (FTP) and financial knowledge independently predicted levels of retirement planning. The effects of FTP and financial knowledge on financial planning were consistent across levels of socioeconomic status. Conclusions: While similar issues in financial planning appeared across socioeconomic status, a ‘one size fits all’ approach to retirement policy may not be effective. Instead, policy should be targeted towards the diverse needs of different groups. Raising public awareness of FTP and financial knowledge may provide a useful starting point.     

Spatial Variability of Metal Bioaccumulation in Estuarine Killifish (Fundulus heteroclitus) at the Callahan Mine Superfund Site, Brooksville, ME

The former Callahan Mine Site in Brooksville, ME, is an open-pit, hardrock mine site in an intertidal system, thus providing a unique opportunity to evaluate how metal-enriched sediments and overlying water impact estuarine food webs. Copper, zinc, cadmium, and lead concentrations in sediment, whole water, and Atlantic killifish (Fundulus heteroclitus) were evaluated at sites in Goose Pond (GP; Callahan Mine Site) and at reference sites. The metal concentrations of sediment, water, and fish were spatially distinct and significantly greater at the mine site than in the reference estuary. Sediment concentrations were particularly elevated and were above probable effects levels for all four metals adjacent to the tailings pile. Even in this well-mixed system, water metal concentrations were significantly elevated adjacent to the tailings pile, and concentrations of Cu and Zn were above ambient water-quality criteria for chronic marine exposure. Neither organic matter in the sediment nor salinity or pH of the water explained the metal concentrations. Adjacent to the tailings pile, killifish metal body burdens were elevated and were significantly related to both sediment and aqueous concentrations. In conclusion, (1) the contaminated sediment and seepage from the tailings impoundment and waste rock pile no. 3 create a continual flux of metals into the water column, (2) the metals are bioavailable and bioconcentrating as evident in the killifish tissue concentrations, and (3) Callahan Mine is directly affecting metal bioaccumulation in fauna residing in the GP estuary and, potentially, in Penobscot Bay by the way of “trophic nekton relay.”     

Optimizing Sound for the Internet

A recent General Medical Council Fitness to Practice decision has highlighted the need for clinicians and medical illustrators to be particularly aware of not only consenting patients carefully for photographs but also recording the consent adequately. This article goes through the basic consenting process that should be followed, including the capacity assessment and what information should be given to patients. It makes recommendations for dealing with more complicated scenarios such as the unconscious patient and photographing children, and gives guidelines for the use of cameras on mobile phones. Consent is a key ethical and legal issue and as this recent case has shown, can result in disciplinary proceedings if the correct procedures are not adhered to.