An exploration of the potential impact of the designated driver campaign on bartenders' willingness to over-serve

Much has been written about the impact of the presence of a designated driver on patrons’ consumption, but heretofore, its impact on the behaviour of the server has been virtually ignored. The goal of this paper, then, was to explore the potential impact of the presence of a designated driver on alcoholic beverage servers’ self-reported willingness to knowingly serve an already intoxicated customer. χ² analysis of survey data collected from 938 licensed servers, in the state of Indiana, USA, was performed. Approximately 43% of the bartenders surveyed reported that they either would be or might be willing to over-serve an already intoxicated customer. Of those who answered the follow-up question as to under what conditions they would be willing to over-serve, almost 80% reported that they would do so if the patron were accompanied by a designated driver. The statistical significance of the relationship between these two variables (.000) raises the question of whether the Designated Driver Campaign has the latent function of enabling some servers to neutralize their responsibility for over-serving by disregarding other types of intoxication-related harm.     

The structural basis for cancer treatment decisions

Cancer treatment decisions rely on genetics, large data screens and clinical pharmacology. Here we point out that genetic analysis and treatment decisions may overlook critical elements in cancer development, progression and drug resistance. Two critical structural elements are missing in genetics-based decision-making: the mechanisms of oncogenic mutations and the cellular network which is rewired in cancer. These lay the foundation for the structural basis for cancer treatment decisions, which is rooted in the physical principles of the molecular conformational behavior of single molecules and their interactions. Improved tumor mutational analysis platforms and knowledge of the redundant pathways which can take over in cancer, may not only supplement known actionable findings, but forecast possible cancer progression and resistance. Such forward-looking can be powerful, endowing the oncologist with mechanistic insight and cancer prognosis, and consequently more informed treatment options. Examples include redundant pathways taking over after inhibition of EGFR constitutive activation, mutations in PIK3CA p110α and p85, and the non-hotspot AKT1 mutants conferring constitutive membrane localization.     

A National Survey of Older Driver Refresher Programs: Practice Readiness for a Rapidly Growing Need

ABSTRACT

Objectives. This national survey identified the content and structure of existing older driver refresher programs in Canada, along with the perceived facilitators and barriers for providing such services. Methods. A cross-Canada telephone survey was conducted with a convenience sample of 27 program managers representing 18 driver refresher programs and nine general health promotion programs for older individuals. Results. Two types of driver programs were identified: pre-road training (including classroom-style group education programs) and on-road training. Only one of the 18 driver refresher programs included visual perception and physical retraining: both interventions have some evidence of effectiveness in improving driving performance. Most program managers emphasized a strong perceived value of supporting/creating driver refresher programs to maintain safe driving. Conclusion. Findings of this study support the urgent need for evidence-based policy development and a strategic plan to ready our nation for the growing number of older drivers who require refresher programs.     

昆明市公交司机亚健康状态及其影响因素调查

目的了解昆明公交司机亚健康状态的现状及影响因素.方法采用流行病学横断面研究方法,通过现场发放调查问卷方法,将合格问卷录人数据库,共有398名司机问卷合格,排除患病人群后的被调查对象中亚健康现患率为22.4%,以亚健康为因变量,工作时间、睡眠时间、体育锻炼情况等为自变量,运用多元线性回归模型,分析亚健康与工作及生活情况的关系.结果与公交司机亚健康状态相关的因素有如下6个：睡眠时间、吃饭规律、月收入、工作时间、婚姻状况、有否借款;其中超时工作、婚姻障碍、有借款为亚健康状态发生的危险因素,睡眠时间、吃饭规律、月收入为亚健康状态发生的保护因素.结论公交司机人群健康状况不乐观,亚健康现患率为22.4%;多因素Logistic回归显示超时工作、婚姻障碍、有借款为亚健康状态发生的危险因素;睡眠时间、吃饭规律、月收入为亚健康状态发生的保护因素.对该人群进行亚健康流行病学调查,及时采取必要的预防和干预措施,对保障司机身心健康,促进公共安全及社会稳定具有重要意义.     

Top advances of the year: Precision oncology

The advent of precision medicine has changed the landscape of oncologic biomarkers, drug discovery, drug development, and, more importantly, outcomes for patients with cancer. Precision oncology entails the genomic profiling of tumors to detect actionable aberrations. The advances in clinical next-generation sequencing from both tumor tissue and liquid biopsy and availability of targeted therapies has rapidly entered mainstream clinical practice. In this review, recent major developments in precision oncology that have affected outcomes for patients with cancer are discussed. Rapid clinical development was seen of targeted agents across various mutational profiles such as KRASG12C (which was considered “undruggable” for almost 4 decades), Exon 20 insertions, and RET mutations. Approaches to precision chemotherapy delivery by the introduction of antibody drug conjugates in the armamentarium against lung cancer has been appreciated.