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Research Roundup

Penn Study: In-Car Breathalyzers for DUI Offenders Curb Drunk-Driving Deaths by 15%

State laws that require drivers who have been convicted of drunk driving to pass a breathalyzer-type test before starting their cars saved an estimated 915 lives between 2004 and 2013, according to a study published in the American Journal of Public Health by researchers at the Perelman School of Medicine at the University of Pennsylvania. The findings represent a 15% reduction in drunk driving-related deaths compared to states without legislation requiring DUI offenders to use “mandatory ignition interlock.”

The research, led by Elinore J. Kaufman, a student in Penn’s Health Policy master’s degree program and a resident at New York-Presbyterian Weill Cornell Medical College, used National Highway Traffic Safety Administration data to compare alcohol-related crash deaths in the 18 states that required ignition interlocks for all those convicted of DUI as of 2013 with the number of alcohol-related crash deaths in states without mandatory interlocks. 

States with mandatory interlock laws saw a 0.8 decrease in deaths for every 100,000 people each year—which is comparable to lives shown to have been saved from mandatory airbag laws and the 21-year minimum legal drinking age combined (0.9 and 0.2 lives saved per 100,000 people, respectively).

Car crashes involving alcohol make up 30% of vehicular fatalities, resulting in 11,000 deaths each year. The National Highway Traffic and Safety Administration estimates that for each of the million drunk driving convictions each year, there are 88 previous instances of drunk driving.

“These laws are proven feasible and effective, and they are low-hanging fruit for the remaining half of states, including Pennsylvania, that don’t have this protection in place yet,” Dr. Kaufman said.

Following increasing support for interlock laws in other states, Pennsylvania’s House of Representative’s Transportation Committee is considering legislation (SB 290) that would require first-time DUI offenders with a blood-alcohol content of .10 or higher to install these devices.

“Our findings show that by preventing intoxicated drivers from starting their vehicles, these ignition interlock laws can directly prevent drunk driving and save lives,” Dr. Kaufman said. “We are encouraged by growing public and governmental support for expansion of interlock programs and innovative ways to use this technology to prevent more lives lost resulting from drunk driving.”

Penn English Professor Studies Sexuality by Looking at Renaissance Love Lyrics

Expressions of unrequited desire quoted in romantic comedies and in poems of everlasting devotion read at weddings have their roots in centuries-old texts. Melissa E. Sanchez says a careful look at the language and history of 16th- and 17th-century poetry provides insights on issues of gender, sexuality and romance, both past and modern-day. 

Dr. Sanchez, associate professor of English in the School of Arts & Sciences and core faculty of gender, sexuality & women’s studies at Penn, says that reading Renaissance texts enriches understanding of both the historical insights about the period when the literature was written, and about current cultural conditions.

Typically, Dr. Sanchez says, this poetry is read with the assumption that the Protestant Reformation of the 16th century gave rise to normative thinking in the Western world that sex in marriage is healthy and good and sex outside marriage damnable and dangerous. But, looking at poetry from the period, Dr. Sanchez says, marriage was not idealized as it is today. Rather, poets such as Philip Sidney, William Shakespeare and Katherine Phillips considered the consequences of the early Protestant conviction that, even within marriage, sexual desire is dangerous because it represents the irrational and uncontrollable human will more generally.

“One of the poets I work with, John Donne, who was married and by all accounts very much in love with his wife, wrote in a poem,” Dr. Sanchez says, “...that it’s good that she’s with God now, but also that her death is good for Donne because now his love for her—itself a part of the world, flesh and devil—is not tempting him to forget his relationship with God.”

Dr. Sanchez conducts research on 16th- and 17th-century literature and focuses on gender, sexuality and politics in early modern England. 

“I try not to come to texts with preconceived notions of what someone writing in the 16th or 17th centuries would have meant. I linger over the points where I’m surprised or stumped: that’s strange, it doesn’t fit into the narratives we have, what do I make of it? One poet appears to be endorsing promiscuity, another is saying that he’s glad that his wife is dead, still another is writing love poems to both men and women.”

Dr. Sanchez had been at Penn for five years when her first book was published in 2011. Erotic Subjects: The Sexuality of Politics in Early Modern English Literature examined the works of politically active 16th- and 17th-century writers from Philip Sidney to John Milton, looking at their use of erotic violence and cross-gender identification.

Renaissance poetry, says Dr. Sanchez, has been too easily shoehorned into a simplified narrative about the rise of marriage. By widening the context to understand what marriage meant to the culture as well as thinking about what the poems actually say about desire that doesn’t fit a married or monogamous model, readers can rethink some of their assumptions of what is normal and good when it comes to desire and gender roles. 

Dr. Sanchez has presented her research on non-normative constructions of womanhood, sexuality and identity at numerous conferences and symposia nationally and internationally. She says that the state of the field of Renaissance literature is at an interesting place, with much debate about historicist methods, how much scholars should contextualize literary work within its historical moment and what can be learned about a moment in history based on non-literary writing, political pamphlets, laws or medical books, as well as how early literature can help theorize issues of gender and desire more generally.

Tapping into Twitter to Help Recruit Cancer Patients into #ClinicalTrials

Twitter may be an effective, untapped resource to stimulate interest in cancer clinical trials and boost enrollment, physicians at the Abramson Cancer Center (ACC) of the University of Pennsylvania suggest in a new research letter in JAMA Oncology. Analyzing thousands of lung cancer tweets on the social media site revealed that a surprisingly large number were about clinical trials, particularly ones on immunotherapy, although none were used for recruitment. 

Enrollment into clinical trials can provide promising, new treatment options for patients. But only about 5% of adult cancer patients participate in these studies. 

“This is an unsolved societal problem,” said Mina S. Sedrak, a fellow in the division of hematology/oncology at the Perelman School of Medicine at the University of Pennsylvania and ACC, and lead author of the study. “Twitter provides a promising and novel avenue for exploring how cancer patients conceptualize and communicate about their health, and may have the potential to promote much-needed clinical trial recruitment.” 

In the pilot study, Dr. Sedrak and his co-authors analyzed a randomly chosen sample of 1,516 tweets out of a total of 15,346 unique tweets that contained “lung cancer” from January 5-21, 2015. Although the majority of tweets analyzed (56%) focused on psychological support or dialogues about prevention, the study found that nearly 18% of tweets were about clinical trials, 42% of which were tweeted by individuals (including self-identified patients, health professionals, advocates and non-health users).

“We were surprised to see that after dialogues concerning support and prevention, the next largest category of tweets were about clinical trials,” Dr. Sedrak said. The majority of these clinical trial tweets were about human research involving a drug or a device, and quite a number were focused on the excitement around immunotherapy, which was still investigational at the time of the study. Among the therapeutic clinical trial tweets, 79% (144 of 183), in fact, concerned immunotherapy and 86% (158 of 183) had embedded links directing users to relevant news articles.

What the study also uncovered was that virtually none of these tweets were used for recruitment, nor did they provide links to enrollment websites. Only one tweet linked to a patient recruitment website. 

Although this work adds to the emerging literature and helps us understand how the public uses Twitter to get information about lung cancer, further efforts are needed to see if Twitter may be a viable method of disseminating health information, which may not only improve treatment and support for cancer patients and survivors, but also enhance public awareness of and enrollment into cancer clinical trials, the authors said. 

What’s more, social media patient recruitment and retention programs may pose some new challenges to institutional review boards (IRBs) with respect to both non-coercive content and the assurance of privacy. IRBs will need to contemplate appropriate policies on how to review social media recruitment campaigns and address emerging ethical dilemmas inherent to the use of social media and research, the authors said.

“We need to learn more about the ecology of social media, because it is clearly not consistently directing patients to the right places,” Dr. Sedrak said. “Social media may provide an infrastructure for cancer centers, researchers and physicians to interact with the public in new and productive ways, including stimulating interest in new clinical trials with targeted messages that connect patients, caregivers and families with trial enrollment websites. This potential remains largely untapped.”

Penn co-authors of the study include Roger B. Cohen, a professor of medicine in hematology/oncology, Raina M. Merchant, an assistant professor of emergency medicine and director of the Penn Social Media & Health Innovation Lab, and Marilyn M. Schapira, an associate professor of medicine in the department of internal medicine.

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