The downhill slide in U.S. union membership has stalled.?
After steep declines since 2008, the unionization rate leveled off last year, pointing to what is either a number that just can?t go any lower, a lull in yet more union membership hemorrhaging, or the beginning of a labor turnaround.?
Union membership plummeted by nearly 1.4 million workers between 2008 and 2010, but ?hit a plateau in 2011,? according to the Center for Economic Policy Research, an economic think tank that reviewed data from the Bureau of Labor Statistics.?
The private sector led the way with a union membership increase of 110,000 employees, while the public sector saw a 61,000 decline, mainly due to government cutbacks.?
The data shows a stabilization following years of unionization declines, but could it be the early signs of a union renaissance??
?No, not yet,? surmised John Budd, a professor of work and organizations at the?University?of Minnesota?s Carlson School of Management and director of the Center for Human Resources and Labor Studies.?
?We?ve reached a core group that doesn?t have much left to shrink,? he said, about traditional unionized workers in industries such as auto, airlines, and healthcare. On the other hand, he added, it could be a sign ?people are turning to unionization again.??
The growing perception among many that economic inequities are rampant could fuel a rethinking of the role unions can play, he maintained. ?That?s something that unions fight for, equality and economic fairness,? he said. ?In terms of workers getting frustrated and unions turning the corner as a result, the signs of that potential have been around for a number of years now.??
A positive sign, he noted, is that in a political environment that has vilified organized labor and has spawned movements to hamper organizing rights in states such as Minnesota and Wisconsin, membership numbers have stabilized.?
Others aren?t as hopeful.?
Gary Chaison, professor of Industrial Relations at Clark University?s Graduate School of Management, believes the worst is yet to come. ?There?will be greater layoffs in the public sector as cities and states have to lay off workers to narrow the budget?shortfalls caused by?excessive pension obligations,? he said. ?And as the economy stalls, perhaps the?result of continuing?high employment and low consumer confidence, or the banking crisis in Europe, employers in manufacturing will be reluctant to add to their workforces.??
Here are some details of the CEPR report:?
The largest net increases in unionization came from health care and social assistance; construction; and durable goods manufacturing.?
The biggest declines came from professional and business services; utilities; and non-durable manufactured goods.?
Florida saw the biggest gains in union members in 2011; followed by Michigan Colorado, Illinois and Missouri.?
New York, the most heavily unionized state, saw the sharpest drop, followed by California.
Overall, women represented the biggest increase in union membership with an increase of 36,000 female members, compared to about 12,000 men.?
?I don't think that men or woman have a greater natural propensity to join unions, but?it's all about industry,? Chaison said. ?Apparently there have been fewer job losses or health care occupations or service occupations -- hotels and restaurants -- dominated by women.?
NEW YORK ? Wendy's new CEO on Monday called the dour results of the past few years "self-inflicted wounds" and vowed to do better, laying out plans that included hiring top-tier workers and reclaiming market share from higher-end competitors like Five Guys and Smashburger.
Emil Brolick, the CEO since September, told investors on Monday that he was intent on winning back customers, jaded by a stale menu and inconstant service, as well as investors, who have grown weary of "a little bit of overpromising and under-delivering."
And rather than blaming the struggling economy for the revenue declines and quarterly losses of the past few years, Brolick said that the company's problems were its own fault. Though Wendy's had carved out a niche in the restaurant business as fast food for grownups, it had lost its way in recent years.
"These are not DNA issues," said Brolick, who also worked at Wendy's during more halcyon days of the late '80s and early '90s. "These are issues we caused, and any time you have self-inflicted wounds, you can correct self-inflicted wounds."
Brolick said he was intent on taking back lost market share from the likes of fast-casual competitors like Panera and Chipotle, offering food that was just as good but at a lower price. The company has revamped its menu and is remodeling stores. It sold Arby's, which had been a drag on earnings, over the summer. And it's now intent on hiring top-tier employees, Brolick said.
Brolick, who was most recently a top executive at Yum Brands Inc., said he's bringing all Wendy's locations up to consistent standards for friendliness and cleanliness, rather than current, unpredictable state of "one there is really, really good but this one over here isn't quite what it needs to be."
"We've made great progress in getting rid of those F restaurants and getting more A's and B's, but we're still in that territory," Brolick said.
He also said he'd hire store managers on par with the people he sees at higher-end competitors like Chipotle and Panera. "Those folks at the bottom corner, there's a job waiting for them at our competitors," said Brolick, who has also hired a new general counsel at the Ohio headquarters and is adding a chief marketing officer and chief people officer.
Brolick said it was important to grab market share from higher-end competitors because he doesn't want to "be caught in the middle." Companies need to appeal to either low-end shoppers, such as Wal-Mart and Costco do, he said, or to high-end shoppers, such as Tiffany or Nordstrom.
Like many fast-food chains, Wendy's is taking some of its turnaround plans from McDonald's book. The much-larger burger chain has introduced new offerings like fancy coffee drinks and smoothies meant to appeal to higher-end customers who previously might have shunned it. It has remodeled restaurants and added wireless access for the same reasons. And it has kept prices at fast-food levels so that its reliable base of cash-strapped customers don't flee for cheaper hamburgers at the gas stations.
It has run into some resistance from franchisees who sometimes have to foot the bill for the changes. Brolick said Wendy's franchisees were "very, very supportive "of the plans. He acknowledged that "we are going to spend a lot of their money," then added later: "The economics have to work. They do work."
Brolick's message to investors, who gathered at the Nasdaq building in New York, came a few hours after the company reported mixed results for the fourth quarter.
Wendy's income from continuing operations fell 30 percent to $4.3 million in the last three months of the year, down from $6.1 million in the fourth quarter of 2010.
However, that number offers the company some vindication for its oft-repeated argument that Arby's was to blame for the dour results of the past few years. The $6.1 million profit a year ago was far better than the $10.8 million loss it originally reported for that period, when it was still bundling its results with Arby's.
Wendy's marriage with Arby's was short-lived. It began in the depths of the financial crisis in fall 2008 and ended last summer when Wendy's sold Arby's to a private-equity firm, saying it wanted to focus on the Wendy's brand. Wendy's said Monday it spent nearly $46 million over 2011 to break up with Arby's, including severance costs for some employees and retention bonuses for others.
Revenue rose 5.6 percent to $615 million, narrowly beating the $613 million predicted by analysts. The chain credited more customers visiting and spending more when they did, including on the revamped Dave's Hot 'N Juicy cheeseburger. Higher prices also helped.
Revenue at restaurants open at least a year climbed 4.4 percent in North America, the highest number in nearly 8 years, according to the company. That's a key measure of a company's health because it strips out the effect of newly opened or closed stores.
On a per-share basis, adjusted earnings were 4 cents, in line with the expectations of analysts polled by FactSet. That number excluded one-time charges like the costs for selling Arby's and writing down the value of some of its assets. With those charges, per-share earnings would have been 1 cent per share.
Last week, Barclays Capital analyst Jeffrey Bernstein spoke favorably of the changes at Wendy's, listing the stock as a buy and saying that it was trading at a discount compared to other fast-food companies. Sanford C. Bernstein analyst Sara Senatore said Monday that revenue numbers beat her expectations. But she also said that the company's guidance for the year ? it said it's expecting a low single-digit increase in a key measure called adjusted earnings before interest, taxes, depreciation and amortization ? was below Wall Street's estimates of 7 percent growth.
Wendy's shares fell 11 cents, or 2.2 percent, to $5.09 in midday trading.
Debris and wreckage lie along the highway after a multi-vehicle accident that killed at least nine people, on Interstate 75 near Gainesville, Fla., Sunday, Jan. 29, 2012. (AP Photo/Phil Sandlin)
Public release date: 25-Jan-2012 [ | E-mail | Share ]
Contact: RIKEN Global Relations Office gro-pr@riken.jp RIKEN
A new diagnosis technique developed by researchers at the RIKEN Omics Science Center (OSC) has succeeded in detecting influenza virus infection in only 40 minutes and with one hundred times the sensitivity of conventional methods. Clinical research conducted in 2009 and 2010 confirms the new technique accurately identified the 2009 pandemic (pdm) influenza virus in Japanese patients less than 24 hours after fever onset, much faster than standard diagnostic tests.
The human-to-human transmission of new, highly pathogenic strains of influenza virus poses today a major threat to human health and to the security of global society. With its rapid global spread, the 2009 pandemic (pdm) influenza virus reminded the world of this threat, resulting in an estimated 18,000 deaths worldwide. In Japan, infected patients over the winter season of 2009 accounted for a staggering 16% of the total population.
Tackling the challenge of such global pandemics requires new technology for rapid clinical diagnosis. To answer this need, Toshihisa Ishikawa and colleagues at the RIKEN OSC developed the RT-SmartAmp assay, a technique to rapidly detect the 2009 pdm influenza A(H1N1) virus from patient swab samples. By combining both reverse transcriptase (RT) and isothermal DNA amplification reactions in one step, the RT-SmartAmp assay does away with the need for RNA extraction and PCR reaction. The researchers adapted the RT-SmartAmp technique using a fluorescent primer to specifically detect the 2009 pdm influenza A(H1N1) virus within 40 minutes, without cross-reacting with the seasonal A(H1N1), A(H3N2), or B-type (Victoria) viruses.
The effectiveness of the RT-SmartAmp method was confirmed in clinical research carried out at Japanese hospitals during the period of October 2009 to January 2010, where it outperformed standard diagnosis tests in both speed and sensitivity. Of a total 255 clinical samples, 140 (54.9%) were identified as 2009 pdm A(H1N1)-positive by RT-SmartAmp, compared to only 110 (43.1%) detected by standard diagnostic tests. In 72.8% of all 140 infection-positive cases, the RT-SmartAmp assay detected the presence of the pdm influenza virus within 24 hours of fever onset.
Taken together, these results set a new standard for infection diagnosis speed, providing a highly-effective tool for rapidly detecting sub-types of the H5N1 virus and oseltamivir-resistant influenza viruses and promising support in the battle to prevent global pandemic infection.
###
About RIKEN
RIKEN is Japan's flagship research institute devoted to basic and applied research. Over 2500 papers by RIKEN researchers are published every year in reputable scientific and technical journals, covering topics ranging across a broad spectrum of disciplines including physics, chemistry, biology, medical science and engineering. RIKEN's advanced research environment and strong emphasis on interdisciplinary collaboration has earned itself an unparalleled reputation for scientific excellence in Japan and around the world.
About the Omics Science Center
Omics is the comprehensive study of molecules in living organisms. The complete sequencing of genomes (the complete set of genes in an organism) has enabled rapid developments in the collection and analysis of various types of comprehensive molecular data such as transcriptomes (the complete set of gene expression data) and proteomes (the complete set of intracellular proteins). Fundamental omics research aims to link these omics data to molecular networks and pathways in order to advance the understanding of biological phenomena as systems at the molecular level.
Here at the RIKEN Omics Science Center, we are developing a versatile analysis system, called the "Life Science Accelerator (LSA)", with the objective of advancing omics research. LSA is a multi-purpose, large-scale analysis system that rapidly analyzes molecular networks. It collects various genome-wide data at high throughput from cells and other biological materials, comprehensively analyzes experimental data, and thereby aims to elucidate the molecular networks of the sample. The term "accelerator" was chosen to emphasize the strong supporting role that this system will play in supporting and accelerating life science research worldwide.
Reach us on Twitter: @rikenresearch
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Clinical technique sets new standard for speed in battle to prevent pandemic infectionPublic release date: 25-Jan-2012 [ | E-mail | Share ]
Contact: RIKEN Global Relations Office gro-pr@riken.jp RIKEN
A new diagnosis technique developed by researchers at the RIKEN Omics Science Center (OSC) has succeeded in detecting influenza virus infection in only 40 minutes and with one hundred times the sensitivity of conventional methods. Clinical research conducted in 2009 and 2010 confirms the new technique accurately identified the 2009 pandemic (pdm) influenza virus in Japanese patients less than 24 hours after fever onset, much faster than standard diagnostic tests.
The human-to-human transmission of new, highly pathogenic strains of influenza virus poses today a major threat to human health and to the security of global society. With its rapid global spread, the 2009 pandemic (pdm) influenza virus reminded the world of this threat, resulting in an estimated 18,000 deaths worldwide. In Japan, infected patients over the winter season of 2009 accounted for a staggering 16% of the total population.
Tackling the challenge of such global pandemics requires new technology for rapid clinical diagnosis. To answer this need, Toshihisa Ishikawa and colleagues at the RIKEN OSC developed the RT-SmartAmp assay, a technique to rapidly detect the 2009 pdm influenza A(H1N1) virus from patient swab samples. By combining both reverse transcriptase (RT) and isothermal DNA amplification reactions in one step, the RT-SmartAmp assay does away with the need for RNA extraction and PCR reaction. The researchers adapted the RT-SmartAmp technique using a fluorescent primer to specifically detect the 2009 pdm influenza A(H1N1) virus within 40 minutes, without cross-reacting with the seasonal A(H1N1), A(H3N2), or B-type (Victoria) viruses.
The effectiveness of the RT-SmartAmp method was confirmed in clinical research carried out at Japanese hospitals during the period of October 2009 to January 2010, where it outperformed standard diagnosis tests in both speed and sensitivity. Of a total 255 clinical samples, 140 (54.9%) were identified as 2009 pdm A(H1N1)-positive by RT-SmartAmp, compared to only 110 (43.1%) detected by standard diagnostic tests. In 72.8% of all 140 infection-positive cases, the RT-SmartAmp assay detected the presence of the pdm influenza virus within 24 hours of fever onset.
Taken together, these results set a new standard for infection diagnosis speed, providing a highly-effective tool for rapidly detecting sub-types of the H5N1 virus and oseltamivir-resistant influenza viruses and promising support in the battle to prevent global pandemic infection.
###
About RIKEN
RIKEN is Japan's flagship research institute devoted to basic and applied research. Over 2500 papers by RIKEN researchers are published every year in reputable scientific and technical journals, covering topics ranging across a broad spectrum of disciplines including physics, chemistry, biology, medical science and engineering. RIKEN's advanced research environment and strong emphasis on interdisciplinary collaboration has earned itself an unparalleled reputation for scientific excellence in Japan and around the world.
About the Omics Science Center
Omics is the comprehensive study of molecules in living organisms. The complete sequencing of genomes (the complete set of genes in an organism) has enabled rapid developments in the collection and analysis of various types of comprehensive molecular data such as transcriptomes (the complete set of gene expression data) and proteomes (the complete set of intracellular proteins). Fundamental omics research aims to link these omics data to molecular networks and pathways in order to advance the understanding of biological phenomena as systems at the molecular level.
Here at the RIKEN Omics Science Center, we are developing a versatile analysis system, called the "Life Science Accelerator (LSA)", with the objective of advancing omics research. LSA is a multi-purpose, large-scale analysis system that rapidly analyzes molecular networks. It collects various genome-wide data at high throughput from cells and other biological materials, comprehensively analyzes experimental data, and thereby aims to elucidate the molecular networks of the sample. The term "accelerator" was chosen to emphasize the strong supporting role that this system will play in supporting and accelerating life science research worldwide.
Reach us on Twitter: @rikenresearch
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
WASHINGTON (Reuters) ? The Federal Reserve looks set to keep monetary policy on hold on Wednesday, even as it releases forecasts expected to show interest rates will be near zero for at least two more years.
Given recent improvement in the U.S. economy, the central bank will probably remain non-committal regarding the prospect for additional bond purchases, but will leave the door open to further action if Europe's banking problems spill over into the United States.
As part of an effort to provide more insight on its thinking to financial markets and the public, the Fed will begin publishing individual policymakers' projections for the appropriate path of the benchmark federal funds rate.
In so doing, the Federal Open Market Committee, the central bank's policy-setting arm, will probably reveal that it does not expect to begin raising rates until at least early 2014. Since August, it has only said after every policy session that it expected to keep rates ultra-low until at least mid-2013.
If the Fed can convince financial markets it will be on hold longer than they had anticipated, long-term interest rates could drop as investors price in the new information.
"A significant contingent of the committee views this exercise not so much as a process improvement but more as an opportunity to ease again via the forward rate communications channel," said Stephen Stanley, economist at Pierpoint Securities.
There is also the possibility that officials will announce an explicit inflation target, perhaps a hard marker of 2 percent or a range of 2 percent or a bit below. The Fed has been debating a statement on its long-run goals, but whether one will be released on Wednesday is unclear.
The Fed will release a statement outlining its views on the economy and monetary policy at about 12:30 p.m. The rate projections, along with regular quarterly economic forecasts, will be issued at 2 p.m.
While forecasters expect the U.S. economy grew at a 3 percent annual rate in the last three months of 2011, Fed officials will probably shy away from any explicit hints on the likelihood of further unconventional monetary easing.
However, many analysts think the recent momentum in the U.S. recovery will wane as Europe's economy falters, potentially prompting another spurt of Fed bond buying - probably one focused on mortgage debt.
Since December 2008, in response to the deepest recession in generations, the Fed slashed rates to effectively zero and also more than tripled the size of its balance sheet to around $2.9 trillion through two separate bond purchase programs.
The policy is credited with having prevented an even longer downturn, but has been insufficient to bring down unemployment to levels considered normal during good economic times.
In December, the U.S. jobless rate stood at 8.5 percent, and some 13 million Americans were still actively looking for work but could not find it.
Analysts note that the Fed's shift in communications, which has led to considerable confusion about just what exactly will be announced, will put an even greater emphasis on a post-meting news conference by Fed Chairman Ben Bernanke at 2:15 p.m.
"The chairman is likely to remain non-committal to any additional policy easing, but he is likely to reinforce the Fed's commitment to 'review the size and composition of its securities holdings' and be 'prepared to adjust those holdings as appropriate,'" said Millan Mulraine, senior macro strategist at TD Securities.
UNITED NATIONS ? Representatives from around the world will be returning to Rio de Janeiro this June ? 20 years after the U.N. Earth Summit ? but this time the focus will be on sustainable development, not climate change, a Brazilian diplomat said Tuesday.
Andre Correa do Lago, who heads the Brazilian delegation negotiating a draft of the outcome document for "Rio plus 20," said that climate change was too sensitive an issue for many countries, while sustainable development was something everybody could get behind.
"Climate change has very strong resistance from sectors that are going to be substantially altered, like the oil industry," Correa do Lago said. "The feeling we have, when we are discussing with such different countries, is that sustainable development is the right answer."
He said the refusal of many U.S. Republican candidates vying to challenge President Barack Obama in this year's elections to even acknowledge global warming was a problem highlighted the difficulty of addressing the issue in an international forum.
While the 1992 Earth Summit focussed the world's attention on the dangers of global warming, this year's conference takes place in a world where economic concerns overshadow almost every other issue.
And while some fear that may doom the conference's chances of having much impact, Correa do Lago says it could also present an opportunity.
"We know we have an environmental crisis, we have a financial crisis, we have a job crisis, we have many crises at the same time now, in some countries many of these crises together and the fact is that sustainable development is the answer to that," Correa do Lago said.
The Earth Summit ended with a great spirit of optimism with representatives from 172 countries, including 108 heads of state or government, signing on to the United Nations Framework on Climate Change.
But since then, with United States failing to ratify the Kyoto Protocols on global warming, and no real progress in reducing the emissions of the greenhouse gases believed to cause global warming, public interest has waned.
So June's conference will seek figure out how to implement policies that allow the world to grow and develop in a manner that is sustainable, not just environmentally but economically and socially as well, Correa do Lago said.
"To really make a change it has to have an economic logic, that's why we come back to the issue of having sustainable development as a paradigm for the economic sector," he said.
HPV testing: Indications of a benefit in primary screeningPublic release date: 24-Jan-2012 [ | E-mail | Share ]
Contact: Dr. Anna-Sabine Ernst presse@iqwig.de 49-221-356-850 Institute for Quality and Efficiency in Health Care
Precursors of cervical cancer can be detected and treated earlier; risk of over-treatment
This release is available in German.
Studies currently available provide indications and a "hint" that precursors of cervical cancer can be detected and treated earlier, and consequently tumours occur less often, in women who underwent testing for human papillomavirus (HPV). In this context, an HPV test can be used alone or in addition to a Papanicolaou test (Pap smear). However, both screening procedures also carry a risk of harm in the form of unnecessary treatments after testing (over-treatment). This is the result of a final report published by the German Institute for Quality and Efficiency in Health Care (IQWiG) on 24th of January 2012.
HPV testing is not reimbursed by SHI funds
In screening for cervical cancer, the German statutory health insurance (SHI) funds currently offer an annual (cytologic) examination of mucosal cells from a smear taken from the neck of the womb (cervix). This test is called a Pap smear. Since it became known that infection with HPV is the main risk factor for developing cervical cancer, experts have been discussing whether HPV testing is also a suitable screening method or is even superior to a cytologic test.
The SHI funds currently only reimburse HPV testing in exceptional cases, for example, in cases where the result of a Pap smear is unclear. The Federal Joint Committee (G-BA) therefore commissioned IQWiG to assess the benefit of HPV testing in primary screening and also to compare different screening strategies with each other.
Lower rates of cancers and their precursors are independent outcome criteria
Cancer screening is usually assessed by determining whether this procedure demonstrably contributes to the prevention of cancer-related deaths. However, in cervical cancer the fact whether or not fully developed (invasive) tumours occur less often can also be a criterion for a screening benefit. Similar to the case of colon cancer, screening for cervical cancer aims to detect and treat cellular changes (dysplasia) from which a cancerous tumour could develop, as treatment of such (advanced) precursors of cancer is far less burdensome for patients than later treatment of a tumour.
Studies with a total of 235,613 participants included
IQWiG searched for studies comparing primary screening strategies for cervical cancer based on different screening tests: a strategy including HPV testing alone or in combination with cytology-based testing and a strategy including cytology-based testing alone.
Six randomized controlled trials conducted in the United Kingdom, Finland, Sweden, the Netherlands, and Italy were included in the assessment. A total of 235,613 women had been recruited for the studies in order to be examined for precursors of invasive cervical cancer in at least two screening rounds with an interval of at least three years. However, all of these studies were susceptible to bias, which limits their informative value.
Fewer cancer diagnoses in the second screening round
In the assessment IQWiG distinguished between different outcome criteria. The composite outcome "CIN3+" was analysed, which comprises both invasive cervical cancer and advanced precursors of cancer (high grade cervical intraepithelial dysplasia or in-situ cervical cancer, i.e. CIN3/CIS). In addition, the outcomes "invasive cervical cancer"- that is, not just the occurrence of a cancer precursor but of a tumour - as well as "CIN3/CIS" were analysed separately.
In the second screening round, the number of diagnoses for the two outcomes "CIN3+" and "invasive cervical cancer" was lower in the HPV group than in the group of women who had only been examined with a cytology-based screening strategy (e.g. Pap smear) in the first screening round. IQWiG therefore determined an indication of a benefit for these two outcomes.
If solely the advanced precursors of cancer are considered (CIN3/CIS), the data only provide a "hint" of a benefit. This is primarily due to a relatively large study that showed no difference between the HPV group and the comparator group. The new category "hint" expresses that certain minimum requirements for the available studies are fulfilled, but that conclusions on benefit and harm are only of low certainty.
No evaluable data on survival and quality of life
Conclusions on overall survival, mortality related to cervical cancer, and quality of life are not possible, as no data or no evaluable data were available for these outcomes.
Neither were evaluable data on potential screening-related harm available. For instance, unnecessary diagnostic procedures (e.g. biopsies) as a result of false-positive test results may harm patients. Moreover, the diagnosis itself can be a psychological burden, triggering anxieties or feelings of guilt.
Harm can also be caused by over-treatment. It is notable that women with moderate grade (CIN2) or sometimes even low grade cancer precursors were also treated in the included studies; in a great number of cases these precursors regress and only rarely progress into cancer. However, it cannot be estimated on the basis of these studies how often women who underwent HPV testing and/or a Pap smear were subjected to unnecessary treatment.
No recommendation for specific screening strategy possible
The complex screening strategies applied in the studies varied greatly and can therefore hardly be compared with each other. This applies to the participants' age and the intervals between follow-up examinations, as well as to the questions in which sequence or combination the HPV or cytology test should be applied and what measures should be undertaken after certain test results.
The study results therefore do not allow a recommendation for a specific screening strategy in the German health care system. The few common factors of the studies include the fact that the screening interval lasted at least three years and the screening programme was conducted in an organized population-based and quality assured context.
###
Procedure of report production
IQWiG published the preliminary results in the form of the preliminary report in June 2011 and interested parties were invited to submit comments. When the commenting procedure ended, the preliminary report was revised and sent as a final report to the contracting agency, the G-BA, in November 2011. The written comments were published in a separate document at the same time as the final report. The report was produced in collaboration with external experts.
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
HPV testing: Indications of a benefit in primary screeningPublic release date: 24-Jan-2012 [ | E-mail | Share ]
Contact: Dr. Anna-Sabine Ernst presse@iqwig.de 49-221-356-850 Institute for Quality and Efficiency in Health Care
Precursors of cervical cancer can be detected and treated earlier; risk of over-treatment
This release is available in German.
Studies currently available provide indications and a "hint" that precursors of cervical cancer can be detected and treated earlier, and consequently tumours occur less often, in women who underwent testing for human papillomavirus (HPV). In this context, an HPV test can be used alone or in addition to a Papanicolaou test (Pap smear). However, both screening procedures also carry a risk of harm in the form of unnecessary treatments after testing (over-treatment). This is the result of a final report published by the German Institute for Quality and Efficiency in Health Care (IQWiG) on 24th of January 2012.
HPV testing is not reimbursed by SHI funds
In screening for cervical cancer, the German statutory health insurance (SHI) funds currently offer an annual (cytologic) examination of mucosal cells from a smear taken from the neck of the womb (cervix). This test is called a Pap smear. Since it became known that infection with HPV is the main risk factor for developing cervical cancer, experts have been discussing whether HPV testing is also a suitable screening method or is even superior to a cytologic test.
The SHI funds currently only reimburse HPV testing in exceptional cases, for example, in cases where the result of a Pap smear is unclear. The Federal Joint Committee (G-BA) therefore commissioned IQWiG to assess the benefit of HPV testing in primary screening and also to compare different screening strategies with each other.
Lower rates of cancers and their precursors are independent outcome criteria
Cancer screening is usually assessed by determining whether this procedure demonstrably contributes to the prevention of cancer-related deaths. However, in cervical cancer the fact whether or not fully developed (invasive) tumours occur less often can also be a criterion for a screening benefit. Similar to the case of colon cancer, screening for cervical cancer aims to detect and treat cellular changes (dysplasia) from which a cancerous tumour could develop, as treatment of such (advanced) precursors of cancer is far less burdensome for patients than later treatment of a tumour.
Studies with a total of 235,613 participants included
IQWiG searched for studies comparing primary screening strategies for cervical cancer based on different screening tests: a strategy including HPV testing alone or in combination with cytology-based testing and a strategy including cytology-based testing alone.
Six randomized controlled trials conducted in the United Kingdom, Finland, Sweden, the Netherlands, and Italy were included in the assessment. A total of 235,613 women had been recruited for the studies in order to be examined for precursors of invasive cervical cancer in at least two screening rounds with an interval of at least three years. However, all of these studies were susceptible to bias, which limits their informative value.
Fewer cancer diagnoses in the second screening round
In the assessment IQWiG distinguished between different outcome criteria. The composite outcome "CIN3+" was analysed, which comprises both invasive cervical cancer and advanced precursors of cancer (high grade cervical intraepithelial dysplasia or in-situ cervical cancer, i.e. CIN3/CIS). In addition, the outcomes "invasive cervical cancer"- that is, not just the occurrence of a cancer precursor but of a tumour - as well as "CIN3/CIS" were analysed separately.
In the second screening round, the number of diagnoses for the two outcomes "CIN3+" and "invasive cervical cancer" was lower in the HPV group than in the group of women who had only been examined with a cytology-based screening strategy (e.g. Pap smear) in the first screening round. IQWiG therefore determined an indication of a benefit for these two outcomes.
If solely the advanced precursors of cancer are considered (CIN3/CIS), the data only provide a "hint" of a benefit. This is primarily due to a relatively large study that showed no difference between the HPV group and the comparator group. The new category "hint" expresses that certain minimum requirements for the available studies are fulfilled, but that conclusions on benefit and harm are only of low certainty.
No evaluable data on survival and quality of life
Conclusions on overall survival, mortality related to cervical cancer, and quality of life are not possible, as no data or no evaluable data were available for these outcomes.
Neither were evaluable data on potential screening-related harm available. For instance, unnecessary diagnostic procedures (e.g. biopsies) as a result of false-positive test results may harm patients. Moreover, the diagnosis itself can be a psychological burden, triggering anxieties or feelings of guilt.
Harm can also be caused by over-treatment. It is notable that women with moderate grade (CIN2) or sometimes even low grade cancer precursors were also treated in the included studies; in a great number of cases these precursors regress and only rarely progress into cancer. However, it cannot be estimated on the basis of these studies how often women who underwent HPV testing and/or a Pap smear were subjected to unnecessary treatment.
No recommendation for specific screening strategy possible
The complex screening strategies applied in the studies varied greatly and can therefore hardly be compared with each other. This applies to the participants' age and the intervals between follow-up examinations, as well as to the questions in which sequence or combination the HPV or cytology test should be applied and what measures should be undertaken after certain test results.
The study results therefore do not allow a recommendation for a specific screening strategy in the German health care system. The few common factors of the studies include the fact that the screening interval lasted at least three years and the screening programme was conducted in an organized population-based and quality assured context.
###
Procedure of report production
IQWiG published the preliminary results in the form of the preliminary report in June 2011 and interested parties were invited to submit comments. When the commenting procedure ended, the preliminary report was revised and sent as a final report to the contracting agency, the G-BA, in November 2011. The written comments were published in a separate document at the same time as the final report. The report was produced in collaboration with external experts.
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Seemingly minute shifts in the position of the cruise ship that partially sank in an Italian port is hampering the underwater search for 21 passengers and crew missing for more than a week. NBC's Michelle Kosinki reports from Giglio, Italy.
By NBC News and msnbc.com news services
Updated at 11:10 a.m. ET: GIGLIO, Italy -- Italian Coast Guard divers on Saturday found a woman's body in a corridor of a submerged section of the capsized Costa Concordia, raising to at least 12 the number of dead in the cruise liner accident.
Coast Guard Cmdr. Cosimo Nicastro told The Associated Press that the victim, who was wearing a life vest, was found during a particularly risky inspection of an evacuation staging point at the ship's rear.
"The corridor was very narrow, and the divers' lines risked snagging" on objects in the passageway, Nicastro said. To permit the coast guard divers to get into the area, Italian navy divers had preceded them, setting off charges to blast holes for easier entrance and exit, he said.
The woman's nationality and identity were not immediately known.
The body was brought to Giglio, the Tuscan island where the cruise liner hit a reef and ran aground on Jan. 14. Twenty people remain?missing.
DigitalGlobe
The Costa Concordia ran aground Jan. 13 off the coast of Italy, resulting in the evacuation of thousands of passengers as the ship began heavily listing.
Search and rescue efforts for survivors and bodies have meant that an operation to remove heavy fuel in the Concordia's tanks hasn't yet begun, although specialized equipment has been standing by for days.
On Saturday, light fuel, apparently from machinery aboard the capsized Costa Concordia, was detected near the ship.
But Nicastro said there was no indication that any of the nearly 500,000 gallons (2,200 metric tons) of heavy fuel oil has leaked from the ship's double-bottomed tanks. He said the leaked substance appears to be diesel, which is used to fuel rescue boats and dinghies and as a lubricant for ship machinery.
There are 185 tons of diesel and lubricants on board the crippled vessel, which is lying on its side just outside Giglio's port. Nicastro described the light fuel's presence in the sea as "very light, very superficial" and appearing to be under control.
NBC's Michelle Kosinski reports.
Updated at 9:30 a.m. ET:? The captain of the cruise ship Costa Concordia, which struck a rock and capsized off Italy, told magistrates he informed the ship's owners of the accident immediately, denying he had delayed raising the alarm, judicial sources said on Saturday.
Capt. Francesco Schettino has been blamed for causing the January 13 accident in which at least 11 people died. He is under house arrest, accused of multiple manslaughter, causing a shipwreck and abandoning ship before all passengers were evacuated.
His statements to prosecutors investigating the disaster, reported in the Italian press and confirmed by judicial sources, underline the growing battle between him and Costa Cruise Lines which operates the 114,500 ton vessel.?
According to transcripts of his questioning by prosecutors leaked to Italian media, he said that immediately after hitting the rock he sent two of his officers to the engine room to check on the state of the vessel.
As soon as he realized the scale of the damage, he called Roberto Ferrarini, marine operations director for Costa Cruises.
"I told him: I've got myself into a mess, there was contact with the seabed. I am telling you the truth, we passed under Giglio and there was an impact," Schettino said.
"I can't remember how many times I called him in the following hour and 15 minutes. In any case, I am certain that I informed Ferrarini about everything in real time," he said, adding he had asked the company to send tug boats and helicopters.
Costa Cruises Chief Executive Pier Luigi Foschi says Schettino delayed issuing the SOS and evacuation orders and gave false information to the company headquarters.
"Personally, I think he wasn't honest with us," Foschi told Corriere della Sera Friday. He said the first phone conversation between Schettino and Ferrarini took place 20 minutes after the ship hit the rock.
Published at 5:40 a.m. ET: Divers resumed the search of the wreckage of the capsized Costa Concordia after data indicated the cruise ship had stabilized in the sea off Tuscany.
Italian coastguard spokesman Cosimo Nicastro told NBC News Saturday that the navy had punctured two holes in the carcass of the ship, which has been lying on its side near the port of Giglio island since shortly after it crashed into a reef on Jan. 13.
Divers were expected to search the area around bridge number four, an emergency meeting point near to where other bodies were found. They had been hoping to reach that area for days, NBC reported.
They are searching for bodies or survivors, although it is unlikely any of the missing in the accident could still be alive. The search was suspended on Friday after the Concordia shifted, prompting fears the ship could roll off a rocky ledge of sea bed and plunge deeper into the sea.
There are also fears the Concordia's fuel could leak, polluting pristine waters.
More from msnbc.com and NBC News:
The Associated Press and Reuters contributed to this report.
ARLINGTON, Va. ? On the same day that retired Air Force Lt. Col. Luke Weathers Jr. took his resting place among other war and military heroes, his real-life story as a World War II aviator played out on movie screens across the country.
Weathers was buried Friday at Arlington National Cemetery in a service that began with a flyover of four F-16 jets in the Missing Man formation, a special honor reserved for pilots, by the 113th Wing of the D.C. Capital Guardians, the same unit that guards the airspace over the nation's capital.
Weathers died Oct. 15 in Tucson, Ariz., of pneumonia at age 90. His burial coincided with the official opening in theaters of "Red Tails," a George Lucas-produced movie retelling the story of the Tuskegee Airmen who debunked widely held beliefs that black pilots were incapable of fighting in combat.
Shortly after the flyover, in which one of the three jets departed from formation, a caisson pulled by six horses carried Weathers' body to his burial spot amid hundreds of the stark marble tombstones that cover the grounds of the national cemetery. An Air Force band accompanied the wagon, its drummer thumping a solemn beat as family followed on the chilly, overcast Friday morning. Family members wore red ties and scarves, as they had at Weathers' Memphis funeral, as a nod to the aviators who painted their aircrafts' tails red to set themselves apart.
Luke Weathers III, 61, said his father and other black Americans who fought in World War II did so to prove they were men, "and then they wanted their country to love them, but that didn't happen, either." Friday's ceremony, however, finally delivered recognition of his father as a national hero, Weathers said.
This kind of attention to the Tuskegee Airmen is what the elder Weathers wanted throughout his life, said his daughter, Trina Weathers Boyce. Weathers was not vain, but he wanted to share the lessons of the airmen's courage in war, their struggles for equality and their victory over a wartime enemy and over racism, she said.
"He would talk about his hard trials and tribulations to others, to children, because he never wanted us to feel like this (racism) is a reason we couldn't make it," Weathers Boyce said in a telephone interview Thursday. "He would tell us nothing good comes easy. He'd say there are going to be barriers ... and you can overcome them."
Before the Tuskegee Airmen were formed in 1941, black men were forbidden to fly for the U.S. military, even though they could be drafted. After years of struggle, the Army Air Corps began to allow African Americans to train for flight, albeit in still-segregated units.
Many of the tens of thousands of Tuskegee airmen, which included navigators, mechanics, medical personnel and others in support roles, trained from 1941 to 1949 at the Tuskegee Institute, which was founded by Booker T. Washington and was already home to an aeronautical engineering program. In the home state of the institute, Alabama Gov. Robert Bentley signed a proclamation honoring the airmen, saying they changed Americans attitudes about race relations.
More than 900 Tuskegee Airmen were U.S. pilots, said Trent Dudley, an Air Force lieutenant colonel who is president of the East Coast Tuskegee Airmen Inc. chapter. An estimated 250 to 300 Tuskegee airmen are still alive. The exact number is not known because some have not registered with chapters.
"As with all the airmen, when we lose one of them, there is a chunk of history that goes with them," Dudley said.
Defying social norms was already a family trait when Weathers was born in Grenada, Miss.
At the time, the town's railroad track served as the economic dividing line. Weather's mixed-race father and black mother defied that dividing line, which led them to move to Memphis, where they opened their own grocery store.
Years later, Weathers was studying biology at Lane College in Jackson, Tenn., when he stumbled on an article in an international newspaper about the Tuskegee Experiment, the federal government's name for the Army Air Corps training of African Americans, Weathers Boyce said.
His mother turned to the prominent Memphis family she worked for and, with the help of the family's connections, Weathers was considered and eventually accepted into their program.
He always talked about the maneuver that save his life, Weathers Boyce said. A skillful pilot, he was a target of the Germans. In one combat flight, German aircraft were pursuing him and firing. He was forced to dip down and make a few turns in his plane to keep from getting shot, she said.
Weathers flew P-51 and P-39 fighters during his service from 1942 to 1945 and earned a Distinguished Flying Cross, according to the National Guard Bureau. He and other Tuskegee Airmen were awarded the Congressional Gold Medal in 2007.
After the war, Weathers went on to become the first African American air controller, run a coin-operated laundry, raise five children, open a flight school, provide vocational rehabilitation for veterans and write a book about his life story that has not yet been published, Weathers Boyce said.
"We are still educating people on the Tuskegee history," Weathers said, "because it's a big part of American history, not African American or black history, but American history."
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Online:
Arlington National Cemetery: http://www.arlingtoncemetery.mil/
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Suzanne Gamboa can be reached at http://www.twitter.com/APsgamboa
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Public release date: 25-Jan-2012
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