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Obama Administration's Filings On Asylum For Abused Foreign Women Brings 'Overdue Dose Of Clarity,' Editorial Says
The Obama administration recently laid out "a clear but narrow pathway" toward asylum for foreign women who have experienced severe physical or sexual abuse, a New York Times editorial states, noting that the U.S. government has debated the issue for 15 years. According to the editorial, the "question is not the fact of persecution, but whether the women would qualify for protection under the law, which limits asylum to those who suffer due to their race, religion, nationality, political opinion or "membership in a particular social group."" It adds that attorneys general under former Presidents Clinton and George W. Bush "have gone both ways and in circles" in their decisions.Although "[n]ot all victims will qualify," the Obama administration "made it clear that some could," the editorial states. "A petitioner would have to demonstrate to a judge that domestic violence was widely tolerated by society and government in her country, that women were viewed as subordinate to men and that she had no place within its borders to find a safe haven," the editorial adds.Department of Homeland Security lawyers say the new definition could apply to a severely abused Mexican woman, identified only by her initials, whose asylum petition is before a San Francisco immigration court. The editorial notes that DHS "did not immediately recommend asylum" for the woman, but "it did urge that she be allowed to continue to gather evidence and to refine her case according to the standards it proposed." The editorial concludes, "Advocates who have fought for years to advance women"s rights are celebrating the department"s action, which brings reasoned compassion, and an overdue dose of clarity, to an issue of anguish and difficulty" (New York Times, 7/19).
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Discovery Of New Proteins May Lead To More Effective Treatment Of Endocarditis And Infections Associated With Implants
A research team at the Faculty of Odontology at Malmo University in Sweden has discovered two new proteins that are of importance to the survival of bacteria and their colonization of the human body. Besides enhancing our knowledge of the ability of bacteria to spread, the findings may also lead to more effective treatment of endocarditis and infections associated with implants.
News of the day
Most Neuropsychological Tests Don't Tell Alzheimer's Disease From Vascular Dementia
Most of the cognitive tests that have been used to decide whether someone has Alzheimer"s disease or vascular dementia have not been very helpful when used alone. A new report published by the American Psychological Association concluded that when older people are confused and forgetful, doctors should base their diagnoses on many different types of information, including medical history and brain imaging.
Oncology

Two Studies Find Patients Have Lower Health-Related Quality Of Life After Cancer Diagnosis

Cancer patients who are older than 65 years have poorer physical health and, in some cases, mental health when compared with people of the same age group without cancer, according to a study in the June 9 online issue of the Journal of the National Cancer Institute. Because health-related quality of life (HRQOL) before cancer is not often measured, the impact of cancer on HRQOL is poorly understood. To quantify the changes before and up to 2 years after cancer diagnosis, Bryce B. Reeve, of the Division of Cancer Control and Population Sciences at the National Cancer Institute in Bethesda, Md., and colleagues looked at changes in HRQOL from 1998 through 2003 in 1,432 patients aged 65 years or older. They compared the patients who were enrolled in Medicare managed care plans with 7,160 matched control subjects, by using data from the Surveillance, Epidemiology, and End Results registry linked with Medicare Health Outcomes Survey (MHOS). For patients diagnosed with prostate, breast, bladder, colorectal, kidney, or non-small cell lung cancers, or non-Hodgkin lymphoma, the researchers observed a statistically significantly greater decline in physical health of patients compared with control subjects without cancer. They also found that patients with prostate, colorectal, or non-small cell lung cancer experienced statistically significantly decreased mental health relative to matched control subjects without cancer. "We expect this study to provide a benchmark for capturing the burden of cancer on HRQOL and an evidence base for future research and clinical interventions aimed at understanding and remediating these effects," the authors write. In another study, also published in this issue, John L. Gore, of the Robert Wood Johnson Clinical Scholars Program at the University of California, Los Angeles, and colleagues describe HRQOL outcomes among patients 48 months after treatment for localized prostate cancer. This team, which used questionnaires that measure generic physical and mental health, as well as dysfunction specific to prostate cancer treatment, found that urinary incontinence was more common after prostatectomy than after brachytherapy or external beam radiation therapy and that sexual dysfunction "profoundly" affected all treatment groups. "These results may guide decision making for treatment selection and clinical management of patients with health-related quality-of-life impairments after treatment for localized prostate cancer," the authors write. In an accompanying editorial, Pamela J. Goodwin, M.D., and Srikala S. Sridhar, M.D., of the Princess Margaret Hospital and the Samuel Lunenfield Research Institute at Mount Sinai Hospital in Toronto reiterate the importance of the studies, but point out several limitations to both. They point out that Reeve et al. left out younger age groups, had a short study period, and produced findings not sufficiently linked to specific cancer treatments to assist patients with making decisions about treatment. Gore et al., according to the editorialists, did not address multimodality treatment and the impact of this combined approach--a growing trend for patients with aggressive disease. "These two reports have added to our knowledge about quality of life in cancer patients," the editorialists write. "However, further research is needed to better understand the short and longer term impact of cancer diagnosis and treatment on overall quality of life, especially as screening becomes more common, our anticancer treatments improve, and patients live longer after a diagnosis of cancer." Citations: Article 1: "Impact of Cancer on Health-Related Quality of Life of Older Americans." Reeve et al. J Natl Cancer Inst 2009, 101: 860-868. Article 2: "Survivorship Beyond Convalescence: 48-Month Quality-of-Life Outcomes After Treatment for Localized Prostate Cancer." Gore et al. J Natl Cancer Inst 2009, 101: 888-892. Editorial: "Health-Related Quality of Life in Cancer Patients - More Answers but Many Questions Remain." Goodwin P and Srikala Sridhar. J Natl Cancer Inst 2009, 101: 838-839. Journal of the National Cancer Institute


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