Sample records for change empiric treatment

  1. Salmonella typhi time to change empiric treatment

    DEFF Research Database (Denmark)

    Gade, C.; Engberg, J.; Weis, N.


    In the present case series report we describe seven recent cases of typhoid fever. All the patients were travellers returning from Pakistan, where typhoid is endemic. Salmonella typhi isolated from the patients by blood culture were reported as intermediary susceptible to fluoroquinolones in six...... out of seven cases. We recommend that empiric treatment of suspected cases of typhoid fever includes a third generation cephalosporin such as ceftriaxon. Furthermore, the present report stresses the importance of typhoid vaccination of travellers to areas where typhoid is endemic Udgivelsesdato: 2008/9/29...

  2. Empirical studies on changes in oil governance (United States)

    Kemal, Mohammad

    Regulation of the oil and gas sector is consequential to the economies of oil-producing countries. In the literature, there are two types of regulation: indirect regulation through taxes and tariffs or direct regulation through the creation of a National Oil Company (NOC). In the 1970s, many oil-producing countries nationalized their oil and gas sectors by creating and giving ownership rights of oil and gas resources to NOCs. In light of the success of Norway in regulating its oil and gas resources, over the past two decades several countries have changed their oil governance by changing the rights given to NOC from ownership right to mere access rights like other oil companies. However, empirical literature on these changes in oil governance is quite thin. Thus, this dissertation will explore three research questions to investigate empirically these changes in oil governance. First, I investigate empirically the impact of the changes in oil governance on aggregate domestic income. By employing a difference-in-difference method, I will show that a country which changed its oil governance increases its GDP per-capita by 10%. However, the impact is different for different types of political institution. Second, by observing the changes in oil governance in Indonesia , I explore the impact of the changes on learning-by-doing and learning spillover effect in offshore exploration drilling. By employing an econometric model which includes interaction terms between various experience variables and changes in an oil governance dummy, I will show that the change in oil governance in Indonesia enhances learning-by-doing by the rigs and learning spillover in a basin. Lastly, the impact of the changes in oil governance on expropriation risk and extraction path will be explored. By employing a difference-in-difference method, this essay will show that the changes in oil governance reduce expropriation and the impact of it is different for different sizes of resource stock.

  3. Evaluation of empirical treatment for blood culture-negative endocarditis. (United States)

    Menu, Estelle; Gouriet, Frédérique; Casalta, Jean-Paul; Tissot-Dupont, Hervé; Vecten, Maude; Saby, Ludivine; Hubert, Sandrine; Salaun, Erwan; Theron, Alexis; Grisoli, Dominique; Lavoute, Cécile; Collart, Frédéric; Habib, Gilbert; Raoult, Didier


    Much progress has been made in understanding the main causes of blood culture-negative endocarditis (BCNE). Few studies concerning BCNE treatment (due to previous antibiotics used or fastidious pathogens) are available. We performed this study to evaluate the effectiveness of our therapeutic protocol in BCNE, based on compliance with the protocol, outcome and 1 year mortality. We collected prospectively and analysed retrospectively cases of BCNE between 2002 and 2014, using a simplified and standardized protocol developed by our multidisciplinary team. We apply two kinds of protocols to treat BCNE, which include only four intravenous antimicrobial agents: amoxicillin, vancomycin, gentamicin and amphotericin B. We had 177 patients with definite BCNE. There were 154 (87.0%) patients treated with both appropriate antimicrobial agents and appropriate duration of treatment. We analysed the causes of inappropriate treatment in 13 (7.3%) cases and inappropriate duration in 10 (5.6%) cases. The treatment changes were justified in all cases except one of discharge against medical advice. The fatality rate was 5.1% (nine cases) and all deaths occurred in the group of patients who were treated with appropriate treatment; however, four deaths were not attributable to empirical treatment failure. Concerning the other deaths, the lack of surgical management, in association with empirical treatment, could explain our protocol's failure, such as poorly tolerated surgery. Our protocol is efficient and our mortality rate was low, compared with the literature review. This may result from a strategy that uses a sampling procedure and a standardized protocol at the same time. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail:

  4. Treatments for Sleep Changes (United States)

    ... Contributing medical factors Non-drug strategies Medications Common sleep changes Many people with Alzheimer’s experience changes in ... at night. Subscribe now Non-drug treatments for sleep changes Non-drug treatments aim to improve sleep ...

  5. Empirically Supported Treatment's Impact on Organizational Culture and Climate (United States)

    Patterson-Silver Wolf, David A.; Dulmus, Catherine N.; Maguin, Eugene


    Objectives: With the continued push to implement empirically supported treatments (ESTs) into community-based organizations, it is important to investigate whether working condition disruptions occur during this process. While there are many studies investigating best practices and how to adopt them, the literature lacks studies investigating the…

  6. empiric treatment based on helicobacter pylori serology cannot ...

    African Journals Online (AJOL)


  7. Climate change, income and happiness: An empirical study for Barcelona

    NARCIS (Netherlands)

    Sekulova, F.; van den Bergh, J.C.J.M.


    The present article builds upon the results of an empirical study exploring key factors which determine life satisfaction in Barcelona. Based on a sample of 840 individuals we first look at the way changes in income, notably income reductions, associated with the current economic situation in Spain,

  8. Salmonella typhi time to change empiric treatment

    DEFF Research Database (Denmark)

    Gade, C.; Engberg, J.; Weis, N.


    In the present case series report we describe seven recent cases of typhoid fever. All the patients were travellers returning from Pakistan, where typhoid is endemic. Salmonella typhi isolated from the patients by blood culture were reported as intermediary susceptible to fluoroquinolones in six...

  9. An empirical perspective for understanding climate change impacts in Switzerland (United States)

    Henne, Paul; Bigalke, Moritz; Büntgen, Ulf; Colombaroli, Daniele; Conedera, Marco; Feller, Urs; Frank, David; Fuhrer, Jürg; Grosjean, Martin; Heiri, Oliver; Luterbacher, Jürg; Mestrot, Adrien; Rigling, Andreas; Rössler, Ole; Rohr, Christian; Rutishauser, This; Schwikowski, Margit; Stampfli, Andreas; Szidat, Sönke; Theurillat, Jean-Paul; Weingartner, Rolf; Wilcke, Wolfgan; Tinner, Willy


    Planning for the future requires a detailed understanding of how climate change affects a wide range of systems at spatial scales that are relevant to humans. Understanding of climate change impacts can be gained from observational and reconstruction approaches and from numerical models that apply existing knowledge to climate change scenarios. Although modeling approaches are prominent in climate change assessments, observations and reconstructions provide insights that cannot be derived from simulations alone, especially at local to regional scales where climate adaptation policies are implemented. Here, we review the wealth of understanding that emerged from observations and reconstructions of ongoing and past climate change impacts in Switzerland, with wider applicability in Europe. We draw examples from hydrological, alpine, forest, and agricultural systems, which are of paramount societal importance, and are projected to undergo important changes by the end of this century. For each system, we review existing model-based projections, present what is known from observations, and discuss how empirical evidence may help improve future projections. A particular focus is given to better understanding thresholds, tipping points and feedbacks that may operate on different time scales. Observational approaches provide the grounding in evidence that is needed to develop local to regional climate adaptation strategies. Our review demonstrates that observational approaches should ideally have a synergistic relationship with modeling in identifying inconsistencies in projections as well as avenues for improvement. They are critical for uncovering unexpected relationships between climate and agricultural, natural, and hydrological systems that will be important to society in the future.


    Directory of Open Access Journals (Sweden)

    Ghulam Mustafa


    Full Text Available Climatic variations affect agriculture in a process with no known end means. Adaptations help to reduce the adverse impacts of climate change. Unfortunately, adaptation has never been considered as a process. Current study empirically identified the adaptation process and its different stages. Moreover, little is known about the farm level adaptation strategies and their determinants. The study in hand found farm level adaptation strategies and determinants of these strategies. The study identified three stages of adaptation i.e. perception, intention and adaptation. It was found that 71.4% farmers perceived about climate change, 58.5% intended to adapt while 40.2% actually adapted. The study further explored that farmers do adaptations through changing crop variety (56.3%, changing planting dates (44.6%, tree plantation (37.5%, increase/conserve irrigation (39.3% and crop diversification (49.2%. The adaptation strategies used by farmers were autonomous and mostly determined perception to climate change. It was also noted that the adaptation strategies move in a circular process and once they are adapted they remained adapted for a longer period of time. Some constraints slow the adaptation process so; we recommend farmers should be given price incentives to speed-up this process.

  11. Predicting coastal morphological changes with empirical orthogonal functionmethod

    Directory of Open Access Journals (Sweden)

    Fernando Alvarez


    Full Text Available In order to improve the accuracy of prediction when using the empirical orthogonal function (EOF method, this paper describes a novel approach for two-dimensional (2D EOF analysis based on extrapolating both the spatial and temporal EOF components for long-term prediction of coastal morphological changes. The approach was investigated with data obtained from a process-based numerical model, COAST2D, which was applied to an idealized study site with a group of shore-parallel breakwaters. The progressive behavior of the spatial and temporal EOF components, related to bathymetric changes over a training period, was demonstrated, and EOF components were extrapolated with combined linear and exponential functions for long-term prediction. The extrapolated EOF components were then used to reconstruct bathymetric changes. The comparison of the reconstructed bathymetric changes with the modeled results from the COAST2D model illustrates that the presented approach can be effective for long-term prediction of coastal morphological changes, and extrapolating both the spatial and temporal EOF components yields better results than extrapolating only the temporal EOF component.

  12. Empiric treatment based on Helicobacter Pylori serology cannont ...

    African Journals Online (AJOL)

    Background: Evidence that chronic gastric Helicobacter pylori (HP) infection is an aetiological factor in dyspepsia, peptic ulcer disease, gastric carcinoma and lymphoma has led to the suggestion that all serologically positive dyspeptic patients should be treated empirically with antibiotics to eradicate the infection, without ...

  13. Climate Change and Maize Production: Empirical Evidence from ...

    African Journals Online (AJOL)

    Michael Madukwe

    humanity with food and fiber, while climate is the primary determinant of agricultural ... Extension systems can help farmers deal with climate change by providing them information on causes and effects of climate change as well as adaptive ...

  14. Urban and regional change in Australia: an empirical introduction


    K O'Connor


    The distribution of Australian population has changed in recent years, and preliminary analysis has interpreted that change as consistent with North American experience. That interpretation involved an understanding of population change associated with climate factors, and a restructuring of industry which favoured new sectors in new locations. To explore patterns in Australian population change, shares of national population in each state for the period 1971 - 1981 were analysed. That inform...

  15. Empirical treatment of bacterial keratitis: an international survey of corneal specialists. (United States)

    Austin, Ariana; Schallhorn, Julie; Geske, Mike; Mannis, Mark; Lietman, Tom; Rose-Nussbaumer, Jennifer


    New antibiotic agents and changing susceptibility patterns may have changed the empirical treatment of bacterial keratitis. Our objective in this study was to survey cornea specialists' practice patterns in the initial treatment of bacterial ulcers. This study consisted of a short online survey emailed to members of the Cornea Society listserv for an international sample of cornea specialists. Data collection began July 2014 and ended October 2014. A total of 1009 surveys were emailed, and we received 140 (14%) responses. The majority of US clinicians surveyed (n=83, 80%) chose fortified antibiotics empirically, with 55% (n=57) selecting fortified vancomycin and 16% (n=17) using fluoroquinolone alone. International respondents were twice as likely to use fluoroquinolone monotherapy (31%, n=11, p=0.07) and less likely to use fortified vancomycin (33%, n=12, p=0.03). Forty-five per cent (n=46) of US respondents reported that their initial antibiotic choice covered methicillin-resistant Staphylococcus aureus , compared with 22% (n=8) of international respondents (p<0.01). Overall, respondents who were concerned about availability of antibiotics and toxicity were 20.86 (p<0.001) and 7.48 (p<0.001) times more likely to choose fluoroquinolone monotherapy, respectively. If respondents' primary considerations were broad spectrum coverage or antibiotic resistance they had 7.10 (p<0.001) and 12.51 (p<0.001) times the odds of using fortified vancomycin, respectively. Practice patterns for the initial treatment of bacterial keratitis vary with clinicians in the USA being more likely to use fortified antibiotics versus fluoroquinolone monotherapy and more concerned with resistant organisms than their international peers.

  16. Empirical methods for modeling landscape change, ecosystem services, and biodiversity (United States)

    David Lewis; Ralph. Alig


    The purpose of this paper is to synthesize recent economics research aimed at integrating discrete-choice econometric models of land-use change with spatially-explicit landscape simulations and quantitative ecology. This research explicitly models changes in the spatial pattern of landscapes in two steps: 1) econometric estimation of parcel-scale transition...

  17. Climate Change and Maize Production: Empirical Evidence from ...

    African Journals Online (AJOL)

    Michael Madukwe

    The study examined the adaptation strategies to climate change in Oke ... adverse effects of climate on their health and well-being and take advantage of the ... to climate change at the farm level of the food crop farmers in Oke-Ogun area of ... of the famers were married while 7.5% were divorced. The educational level of the ...

  18. Climate Change and Maize Production: Empirical Evidence from ...

    African Journals Online (AJOL)

    An estimated 80% of the maize crop suffers periodic yield reduction due to drought stress. Drought at flowering and grain filling period may cause losses of 40-90%. Predicated on the argument that climate change resulted from changes in climatic elements such as rainfall, this study aimed at investigating the relationship ...

  19. Climate Change and Maize Production: Empirical Evidence from ...

    African Journals Online (AJOL)

    Michael Madukwe

    been argued for as major reasons for global climate change. IPCC (2007) confirmed global fluctuations in ... examine adaptation strategies for climate change; and analyse fishers' livelihoods and adaptive capacity. ... (vii) Average annual income from fishing: Respondents were asked to state their income from fishing. 2.

  20. Matchmaking in organizational change : does every employee value participatory leadership? An empirical study


    Rogiest, Sofie; Segers, Jesse; Witteloostuijn, van, Arjen


    Abstract: Although leadership is generally considered an important lever to increase commitment during organizational change, empirical research has yet to unravel many of the underlying mechanisms. In this paper, we propose that the impact of participative leadership on affective commitment to change will be contingent on employees orientation toward leadership. In our empirical study in two police organizations, we find evidence that followers orientation toward leadership is a useful inter...

  1. Empiric validation of a process for behavior change. (United States)

    Elliot, Diane L; Goldberg, Linn; MacKinnon, David P; Ranby, Krista W; Kuehl, Kerry S; Moe, Esther L


    Most behavior change trials focus on outcomes rather than deconstructing how those outcomes related to programmatic theoretical underpinnings and intervention components. In this report, the process of change is compared for three evidence-based programs' that shared theories, intervention elements and potential mediating variables. Each investigation was a randomized trial that assessed pre- and post- intervention variables using survey constructs with established reliability. Each also used mediation analyses to define relationships. The findings were combined using a pattern matching approach. Surprisingly, knowledge was a significant mediator in each program (a and b path effects [pbehavior change.

  2. Urban and regional change in Australia: an empirical introduction. (United States)

    O'connor, K


    Recent changes in the spatial distribution of the population in Australia are examined. In particular, changes in population by state are analyzed for the period 1971-1981. The relationship of these changes to shifts in economic activity, private investment, and banking activity is considered. "Results show there have been only small shifts toward population growth areas. These results are interpreted in part as a consequence of nonlocal multipliers and linkages back to established areas, but also as a reflection of the unique features of the Australian urban and regional system." excerpt

  3. Is Openness to Using Empirically Supported Treatments Related to Organizational Culture and Climate? (United States)

    Patterson Silver Wolf Adelv Unegv Waya, David A; Dulmus, Catherine N; Maguin, Eugene


    The overall purpose of this study is to investigate workers' openness towards implementing a new empirically supported treatment (EST) and whether the workers' openness scores relate to their workplace culture and climate scores. Participants in this study (N=1273) worked in a total of 55 different programs in a large child and family services organization and completed a survey measuring their attitudes toward ESTs. Results indicate that work groups that measure themselves as being more open to using ESTs rated their organizational cultures as being significantly more proficient and significantly less resistant to change. With ESTs becoming the gold standard for professional social work practices, it is important to have accessible pathways to EST implementation.

  4. Empirical analysis of change metrics for software fault prediction

    NARCIS (Netherlands)

    Choudhary, Garvit Rajesh; Kumar, Sandeep; Kumar, Kuldeep; Mishra, Alok; Catal, Cagatay


    A quality assurance activity, known as software fault prediction, can reduce development costs and improve software quality. The objective of this study is to investigate change metrics in conjunction with code metrics to improve the performance of fault prediction models. Experimental studies are

  5. Climate Change and Maize Production: Empirical Evidence from ...

    African Journals Online (AJOL)

    Michael Madukwe

    Farmers' Adaptation Initiatives to the Impact of Climate Change on Agriculture in Northern ... Environment Department, University of York, United Kingdom, E– mail: ... The 2005 Food and Agriculture Organization (FAO) Global Forest Resources ... The out migration of indigenous youths to seek for economic opportunities.

  6. Hypnosis Treatment of Gastrointestinal Disorders: A Comprehensive Review of the Empirical Evidence. (United States)

    Palsson, Olafur S


    Hypnotherapy has been investigated for 30 years as a treatment for gastrointestinal (GI) disorders. There are presently 35 studies in the published empirical literature, including 17 randomized controlled trials (RCTs) that have assessed clinical outcomes of such treatment. This body of research is reviewed comprehensively in this article. Twenty-four of the studies have tested hypnotherapy for adult irritable bowel syndrome (IBS) and 5 have focused on IBS or abdominal pain in children. All IBS hypnotherapy studies have reported significant improvement in gastrointestinal symptoms, and 7 out of 10 RCTs in adults and all 3 RCTs in pediatric patient samples found superior outcomes for hypnosis compared to control groups. Collectively this body of research shows unequivocally that for both adults and children with IBS, hypnosis treatment is highly efficacious in reducing bowel symptoms and can offer lasting and substantial symptom relief for a large proportion of patients who do not respond adequately to usual medical treatment approaches. For other GI disorders the evidence is more limited, but preliminary indications of therapeutic potential can be seen in the single randomized controlled trials published to date on hypnotherapy for functional dyspepsia, functional chest pain, and ulcerative colitis. Further controlled hypnotherapy trials in those three disorders should be a high priority. The mechanisms underlying the impact of hypnosis on GI problems are still unclear, but findings from a number of studies suggest that they involve both modulation of gut functioning and changes in the brain's handling of sensory signals from the GI tract.

  7. Rare severe mycotic infections in children receiving empirical caspofungin treatment for febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Deniz Yilmaz Karapinar


    Full Text Available Empirical antifungal therapy is most often given to patients with leukemia. However breakthrough fungal infections under antifungal therapy are not uncommon. Four children, with hematologic malignant disease developed mycotic breakthrough infections while on empirical caspofungin treatment for a median of 14 (range 11–19 days. Trichosporon asahii was detected in the blood culture of two patients and Geotrichum capitatum in the other two (one patient also had positive cerebrospinal fluid culture. Because the patients’ clinical situation worsened, voriconazole was empirically added for two patients three and five days before the agent was detected. The first sterile blood culture was obtained 3–7 days of voriconazole treatment. All patients reached clear cultures but one patient died. One patient with central nervous system infection with G. capitatum had severe neurological sequelae. Very severe fungal infections can occur during empirical caspofungin therapy. Therefore, patients should be followed closely.

  8. Management of genetic epilepsies: From empirical treatment to precision medicine. (United States)

    Striano, Pasquale; Vari, Maria Stella; Mazzocchetti, Chiara; Verrotti, Alberto; Zara, Federico


    Despite the over 20 antiepileptic drugs (AEDs) now licensed for epilepsy treatment, seizures can be effectively controlled in about ∼70% of patients. Thus, epilepsy treatment is still challenging in about one third of patients and this may lead to a severe medically, physically, and socially disabling condition. However, there is clear evidence of heterogeneity of response to existing AEDs and a significant unmet need for effective intervention. A number of studies have shown that polymorphisms may influence the poor or inadequate therapeutic response as well as the occurrence of adverse effects. In addition, the new frontier of genomic technologies, including chromosome microarrays and next-generation sequencing, improved our understanding of the genetic architecture of epilepsies. Recent findings in some genetic epilepsy syndromes provide insights into mechanisms of epileptogenesis, unrevealing the role of a number of genes with different functions, such as ion channels, proteins associated to the vesical synaptic cycle or involved in energy metabolism. The rapid progress of high-throughput genomic sequencing and corresponding analysis tools in molecular diagnosis are revolutionizing the practice and it is a fact that for some monogenic epilepsies the molecular confirmation may influence the choice of the treatment. Moreover, the novel genetic methods, that are able to analyze all known genes at a reasonable price, are of paramount importance to discover novel therapeutic avenues and individualized (or precision) medicine. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Empirically defining rapid response to intensive treatment to maximize prognostic utility for bulimia nervosa and purging disorder. (United States)

    MacDonald, Danielle E; Trottier, Kathryn; McFarlane, Traci; Olmsted, Marion P


    Rapid response (RR) to eating disorder treatment has been reliably identified as a predictor of post-treatment and sustained remission, but its definition has varied widely. Although signal detection methods have been used to empirically define RR thresholds in outpatient settings, RR to intensive treatment has not been investigated. This study investigated the optimal definition of RR to day hospital treatment for bulimia nervosa and purging disorder. Participants were 158 patients who completed ≥6 weeks of day hospital treatment. Receiver operating characteristic (ROC) analysis was used to create four definitions of RR that could differentiate between remission and nonremission at the end of treatment. Definitions were based on binge/vomit episode frequency or percent reduction from pre-treatment, during either the first four or first two weeks of treatment. All definitions were associated with higher remission rates in rapid compared to nonrapid responders. Only one definition (i.e., ≤3 episodes in the first four weeks of treatment) predicted sustained remission (versus relapse) at 6- and 12-month follow-up. These findings provide an empirically derived definition of RR to intensive eating disorder treatment, and provide further evidence that early change is an important prognostic indicator. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Identifying Empirically Supported Treatments for Pica in Individuals with Intellectual Disabilities (United States)

    Hagopian, Louis P.; Rooker, Griffin W.; Rolider, Natalie U.


    The purpose of the current study was to critically examine the existing literature on the treatment of pica displayed by individuals with intellectual disabilities. Criteria for empirically supported treatments as described by Divisions 12 and 16 of APA, and adapted for studies employing single-case designs were used to review this body of…

  11. Reasons for Choice of Antibiotic for the Empirical Treatment of CAP by Canadian Infectious Disease Physicians

    Directory of Open Access Journals (Sweden)

    Jacob Pendergrast


    Full Text Available BACKGROUND: Previous studies have documented substantial variation in physician prescribing practices for the treatment of community-acquired pneumonia. Much of this variation is the result of empirical treatment, in which physicians must choose antibiotics in the a8bsence of culture and sensitivity data.

  12. Training addiction professionals in empirically supported treatments: perspectives from the treatment community. (United States)

    Hartzler, Bryan; Rabun, Carl


    Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. In this mixed-method study, data were collected in 64 semistructured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and 2 direct-service clinicians. Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMMs), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimensional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, "Seeking Safety," and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMMs and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles. As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as well as practical obstacles that challenge

  13. Management strategy for patients with gastroesophageal reflux disease: a comparison between empirical treatment with esomeprazole and endoscopy-oriented treatment. (United States)

    Giannini, Edoardo G; Zentilin, Patrizia; Dulbecco, Pietro; Vigneri, Sergio; Scarlata, Pamela; Savarino, Vincenzo


    Whether patients with typical gastroesophageal reflux disease (GERD) symptoms and without alarm features should be treated empirically or undergo endoscopy first is a debated issue. In this study, our aim was to assess the efficacy, and to compare the direct costs and impact on health-related quality of life (HRQL), of two treatment strategies (empirical vs endoscopy-oriented treatment) in a large population of patients with GERD. In total, 612 patients were randomized to either empirical treatment with esomeprazole 40 mg once daily (od) (group 1, N = 309) or endoscopy and treatment according to endoscopic findings (group 2, N = 303, esomeprazole 40 mg od in patients with reflux esophagitis and esomeprazole 20 mg od in patients without esophagitis) for 4 wk, followed by esomeprazole 20 mg od maintenance treatment in both groups. Direct costs and HRQL were analyzed in both treatment arms. At the end of the acute treatment phase (week 4), 267 patients in group 1 (86.4%) and 265 patients in group 2 (87.5%) were considered responders to treatment (intention-to-treat analysis, P= 0.878). Empirical treatment proved to be cost-effective by saving 38.72 euros per treated patient. At the end of the maintenance phase (week 24), a similar proportion of patients responded to treatment in the two groups (71.8%vs 68.3%, P= 0.389). HRQL improved from baseline to week 24 in both groups (difference between study groups not significant). In patients with GERD, empirical treatment with esomeprazole proved to be cost-effective compared with endoscopy-oriented treatment, and did not negatively affect patient HRQL. These results should be taken into account in the management of GERD patients in clinical practice.

  14. Matchmaking in organizational change : Does every employee value participatory leadership? An empirical study

    NARCIS (Netherlands)

    Rogiest, Sofie; Segers, Jesse; van Witteloostuijn, Arjen


    Although leadership is generally considered an important lever to increase commitment during organizational change, empirical research has yet to unravel many of the underlying mechanisms. In this paper, we propose that the impact of participative leadership on affective commitment to change will be

  15. Substance Abuse Counselors’ Recovery Status and Self-Schemas: Preliminary Implications for Empirically Supported Treatment Implementation (United States)

    Nielson, Elizabeth M.


    Purpose The purpose of this paper is to better understand the relationship between substance abuse counselors’ personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders. Methods A phenomenological qualitative study enrolled 12 practicing substance abuse counselors. Results Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecovering counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients’ struggles. Discussion Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that counselors’ recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments. PMID:28626597

  16. Substance Abuse Counselors' Recovery Status and Self-Schemas: Preliminary Implications for Empirically Supported Treatment Implementation. (United States)

    Nielson, Elizabeth M


    The purpose of this paper is to better understand the relationship between substance abuse counselors' personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders. A phenomenological qualitative study enrolled 12 practicing substance abuse counselors. Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecovering counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients' struggles. Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that counselors' recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments.

  17. Sensitivity and Specificity of Empiric Treatment for Sexually Transmitted Infections in a Pediatric Emergency Department. (United States)

    Breslin, Kristen; Tuchman, Lisa; Hayes, Katie L; Badolato, Gia; Goyal, Monika K


    To determine test characteristics of provider judgment for empiric antibiotic provision to patients undergoing testing for a sexually transmitted infection. We conducted a retrospective cross-sectional electronic health record review of all patients aged 13-19 years who had Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) testing sent from an urban, academic pediatric emergency department in 2012. We abstracted data, including patient demographics, chief complaint, sexually transmitted infection test results, and treatment. We calculated test characteristics comparing clinician judgment for presumptive treatment for a sexually transmitted infection with the reference standard of the actual results of testing for a sexually transmitted infection. Of 1223 patient visits meeting inclusion criteria, 284 (23.2%) had a positive GC and/or CT test result. Empiric treatment was provided in 615 encounters (50.3%). Provider judgment for presumptive treatment had an overall sensitivity of 67.6% (95% CI, 61.8-73.0) and a specificity of 55% (95% CI, 51.7-58.2) for accurate GC and/or CT detection. Many adolescents tested for GC and CT receive empiric treatment at the initial emergency department visit. Provider judgment may lack sufficient sensitivity and specificity for identifying infected patients, resulting in the potential for undertreatment of true disease, overtreatment of uninfected patients, or both. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Moving Clinical Deliberations on Administrative Discharge in Drug Addiction Treatment Beyond Moral Rhetoric to Empirical Ethics. (United States)

    Williams, Izaak L


    Patients' admission to modern substance use disorder treatment comes with the attendant risk of being discharged from treatment-a widespread practice. This article describes the three mainstream theories of addiction that operate as a reference point for clinicians in reasoning about a decision to discharge a patient from treatment. The extant literature is reviewed to highlight the pathways that patients follow after administrative discharge. Little scientific research has been done to investigate claims and hypotheses about the therapeutic function of AD, which points to the need for empirical ethics to inform clinical addictions practice. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

  19. Perspectives on empirical approaches for ocean color remote sensing of chlorophyll in a changing climate. (United States)

    Dierssen, Heidi M


    Phytoplankton biomass and productivity have been continuously monitored from ocean color satellites for over a decade. Yet, the most widely used empirical approach for estimating chlorophyll a (Chl) from satellites can be in error by a factor of 5 or more. Such variability is due to differences in absorption and backscattering properties of phytoplankton and related concentrations of colored-dissolved organic matter (CDOM) and minerals. The empirical algorithms have built-in assumptions that follow the basic precept of biological oceanography--namely, oligotrophic regions with low phytoplankton biomass are populated with small phytoplankton, whereas more productive regions contain larger bloom-forming phytoplankton. With a changing world ocean, phytoplankton composition may shift in response to altered environmental forcing, and CDOM and mineral concentrations may become uncoupled from phytoplankton stocks, creating further uncertainty and error in the empirical approaches. Hence, caution is warranted when using empirically derived Chl to infer climate-related changes in ocean biology. The Southern Ocean is already experiencing climatic shifts and shows substantial errors in satellite-derived Chl for different phytoplankton assemblages. Accurate global assessments of phytoplankton will require improved technology and modeling, enhanced field observations, and ongoing validation of our "eyes in space."

  20. The effectiveness of empirical anti-parasitic treatment in returning travellers with persistent abdominal symptoms. (United States)

    Nissan, Batel; Lachish, Tamar; Schwartz, Eli


    Persistent abdominal symptoms (PAS) are common among returning-travellers. In the absence of sensitive tests to identify intestinal parasites, gastrointestinal (GI) symptoms often remain a diagnostic challenge. In this study we examined the effectiveness of empirical anti-parasitic treatment in returning-travellers with PAS despite no positive stool-test. A retrospective study among returning travellers who approached the clinic between the years 2014 and 2016 with GI complaints without a positive stool-test. The empirical treatment included broad-spectrum anti-parasitic agents-oral Tinidazole and Albendazole. A follow-up questionnaire was performed at least 6 months post-treatment. A total of 102 patients responded the questionnaire-50% women; average age 31.14 (±12.20) years. The average duration of complaints before treatment was 16.52 (±30.06) months. Common GI symptoms included abdominal pain (83.3%) and diarrhoea (78.4%); 67.6% of the patients complained of extreme fatigue. Overall, 69% of the patients reported an improvement in GI symptoms, 37% of them reported full recovery within a few weeks post-treatment. Furthermore, there was an improvement in the energy level and general well-being in 68% and 70% of the patients, respectively. Only 33% of the patients reported minor side effects related to the treatment. The improvement in GI symptoms, energy level and general well-being shortly after anti-parasitic treatment justifies this empirical approach in returning-travellers with PAS despite negative stool-tests. The association between fatigue and PAS post-travel and the improvement in both as a response to treatment defines fatigue as part of a new syndrome-'Post-travel fatigue and abdominal symptoms'. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail:

  1. A simple empirical model for the clarification-thickening process in wastewater treatment plants. (United States)

    Zhang, Y K; Wang, H C; Qi, L; Liu, G H; He, Z J; Fan, H T


    In wastewater treatment plants (WWTPs), activated sludge is thickened in secondary settling tanks and recycled into the biological reactor to maintain enough biomass for wastewater treatment. Accurately estimating the activated sludge concentration in the lower portion of the secondary clarifiers is of great importance for evaluating and controlling the sludge recycled ratio, ensuring smooth and efficient operation of the WWTP. By dividing the overall activated sludge-thickening curve into a hindered zone and a compression zone, an empirical model describing activated sludge thickening in the compression zone was obtained by empirical regression. This empirical model was developed through experiments conducted using sludge from five WWTPs, and validated by the measured data from a sixth WWTP, which fit the model well (R² = 0.98, p settling was also developed. Finally, the effects of denitrification and addition of a polymer were also analysed because of their effect on sludge thickening, which can be useful for WWTP operation, e.g., improving wastewater treatment or the proper use of the polymer.

  2. Pharmacoeconomic evaluation of caspofungin versus liposomal amphotericin B in empirical treatment of invasive fungal infections in Turkey. (United States)

    Turner, S J; Senol, E; Kara, A; Al-Badriyeh, D; Kong, D C M; Dinleyici, E C


    Invasive fungal infections (IFIs) are a major concern within healthcare systems. This pharmacoeconomic study evaluated the use of caspofungin (CAS) versus liposomal amphotericin B (L-AmB) in the empirical treatment of IFIs within the Turkish healthcare system. A decision-analytic model was adopted, utilising data from a randomised, non-inferiority clinical trial and a panel of clinical experts in Turkey. A five-point composite outcome measure was used to evaluate both agents. Sensitivity analyses were performed. In the base-case scenario, CAS was preferred over L-AmB by Turkish Lira (TL) 3961 per patient treated, TL 12 904 per successfully treated patient and TL 3972 per death averted. One-way sensitivity analysis did not change the study outcome. Monte Carlo simulation concluded a 71.0% chance of the outcome favouring CAS. The results were most sensitive to changes in length of stay. This is the first economic evaluation of the empirical treatment of IFIs in Turkey and suggests that CAS is more cost effective than L-AmB. Copyright © 2013 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  3. Evaluating Process Quality Based on Change Request Data - An Empirical Study of the Eclipse Project (United States)

    Schackmann, Holger; Schaefer, Henning; Lichter, Horst

    The information routinely collected in change request management systems contains valuable information for monitoring of the process quality. However this data is currently utilized in a very limited way. This paper presents an empirical study of the process quality in the product portfolio of the Eclipse project. It is based on a systematic approach for the evaluation of process quality characteristics using change request data. Results of the study offer insights into the development process of Eclipse. Moreover the study allows assessing applicability and limitations of the proposed approach for the evaluation of process quality.

  4. Secular trends in the appropriateness of empirical antibiotic treatment in patients with bacteremia: a comparison between three prospective cohorts. (United States)

    Daitch, Vered; Akayzen, Yulia; Abu-Ghanem, Yasmin; Eliakim-Raz, Noa; Paul, Mical; Leibovici, Leonard; Yahav, Dafna


    The objective of this study was to explore whether the percentage of inappropriate empirical antibiotic treatment in patients with bacteremia changed over time and to understand the factors that brought on the change. Three prospective cohorts of patients with bacteremia in three different periods (January 1st, 1988 to December 31st, 1989; May 1st, 2004 to November 30, 2004; May 1st, 2010 to April 30, 2011) were compared. Analysis was performed on a total of 811 patients. In 2010-2011, 55.9% (76/136) of patients with bacteremia received inappropriate empirical treatment, compared with 34.5% (170/493) and 33.5% (55/164) in the first and second periods, respectively, in a significant upward trend (p = 0.001). Resistance to antibiotics increased significantly during the study period. The following variables were included in the multivariate analysis assessing risk factors for inappropriate empirical treatment: study period (third period) [odds ratio, OR = 2.766 (95% confidence interval, CI, 1.655-4.625)], gender (male) [OR = 1.511 (1.014-2.253)], pathogen carrying extended-spectrum beta-lactamases [OR = 10.426 (4.688-23.187)], multidrug-resistant Acinetobacter baumannii [OR = 5.428 (2.181-13.513)], and skin/soft infections [OR = 3.23 (1.148-9.084)]. A model excluding microbiological data included: gender (male) [OR = 1.648 (1.216-2.234)], study period (third period) [OR = 2.446 (1.653-3.620)], hospital-acquired infection [OR = 1.551 (1.060-2.270)], previous use of antibiotics [OR = 1.815 (1.247-2.642)], bedridden patient [OR = 2.019 (1.114-3.658)], and diabetes mellitus [OR = 1.620 (1.154-2.274)]. We have observed a worrisome increase in the rate of inappropriate empirical treatment of bacteremia. We need tools that will allow us better prediction of the pathogen and its susceptibilities during the first hours of managing a patient suspected of a severe bacterial infection.

  5. Dispelling myths about dissociative identity disorder treatment: an empirically based approach. (United States)

    Brand, Bethany L; Loewenstein, Richard J; Spiegel, David


    Some claim that treatment for dissociative identity disorder (DID) is harmful. Others maintain that the available data support the view that psychotherapy is helpful. We review the empirical support for both arguments. Current evidence supports the conclusion that phasic treatment consistent with expert consensus guidelines is associated with improvements in a wide range of DID patients' symptoms and functioning, decreased rates of hospitalization, and reduced costs of treatment. Research indicates that poor outcome is associated with treatment that does not specifically involve direct engagement with DID self-states to repair identity fragmentation and to decrease dissociative amnesia. The evidence demonstrates that carefully staged trauma-focused psychotherapy for DID results in improvement, whereas dissociative symptoms persist when not specifically targeted in treatment. The claims that DID treatment is harmful are based on anecdotal cases, opinion pieces, reports of damage that are not substantiated in the scientific literature, misrepresentations of the data, and misunderstandings about DID treatment and the phenomenology of DID. Given the severe symptomatology and disability associated with DID, iatrogenic harm is far more likely to come from depriving DID patients of treatment that is consistent with expert consensus, treatment guidelines, and current research.

  6. Empirical Validation of a Thermal Model of a Complex Roof Including Phase Change Materials

    Directory of Open Access Journals (Sweden)

    Stéphane Guichard


    Full Text Available This paper deals with the empirical validation of a building thermal model of a complex roof including a phase change material (PCM. A mathematical model dedicated to PCMs based on the heat apparent capacity method was implemented in a multi-zone building simulation code, the aim being to increase the understanding of the thermal behavior of the whole building with PCM technologies. In order to empirically validate the model, the methodology is based both on numerical and experimental studies. A parametric sensitivity analysis was performed and a set of parameters of the thermal model has been identified for optimization. The use of the generic optimization program called GenOpt® coupled to the building simulation code enabled to determine the set of adequate parameters. We first present the empirical validation methodology and main results of previous work. We then give an overview of GenOpt® and its coupling with the building simulation code. Finally, once the optimization results are obtained, comparisons of the thermal predictions with measurements are found to be acceptable and are presented.

  7. Impact of climate change on human infectious diseases: Empirical evidence and human adaptation. (United States)

    Wu, Xiaoxu; Lu, Yongmei; Zhou, Sen; Chen, Lifan; Xu, Bing


    Climate change refers to long-term shifts in weather conditions and patterns of extreme weather events. It may lead to changes in health threat to human beings, multiplying existing health problems. This review examines the scientific evidences on the impact of climate change on human infectious diseases. It identifies research progress and gaps on how human society may respond to, adapt to, and prepare for the related changes. Based on a survey of related publications between 1990 and 2015, the terms used for literature selection reflect three aspects--the components of infectious diseases, climate variables, and selected infectious diseases. Humans' vulnerability to the potential health impacts by climate change is evident in literature. As an active agent, human beings may control the related health effects that may be effectively controlled through adopting proactive measures, including better understanding of the climate change patterns and of the compound disease-specific health effects, and effective allocation of technologies and resources to promote healthy lifestyles and public awareness. The following adaptation measures are recommended: 1) to go beyond empirical observations of the association between climate change and infectious diseases and develop more scientific explanations, 2) to improve the prediction of spatial-temporal process of climate change and the associated shifts in infectious diseases at various spatial and temporal scales, and 3) to establish locally effective early warning systems for the health effects of predicated climate change. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Rape treatment outcome research: empirical findings and state of the literature. (United States)

    Vickerman, Katrina A; Margolin, Gayla


    This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. Thirty-two articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs. The majority of studies focus on posttraumatic stress disorder (PTSD), depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the four studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery.

  9. Rape Treatment Outcome Research: Empirical Findings and State of the Literature (United States)

    Vickerman, Katrina A.; Margolin, Gayla


    This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. Thirty-two articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs. The majority of studies focus on posttraumatic stress disorder (PTSD), depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the four studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery. PMID:19442425

  10. Different recommendations for empiric first-choice antibiotic treatment of uncomplicated urinary tract infections in Europe

    DEFF Research Database (Denmark)

    McQuiston Haslund, Josephine; Rosborg Dinesen, Marianne; Nielsen, Anni Brit Sternhagen


    OBJECTIVE: Uncomplicated urinary tract infection (uUTI) is a common reason for antibiotic treatment in primary health care. Due to the increasing prevalence of antibiotic-resistant uropathogens it is crucial to use the most appropriate antibiotics for first-choice empiric treatment of uUTI....... Particularly, it is important to avoid antibiotics associated with a high rate of antimicrobial resistance. This study compares national recommendations from six European countries, investigating recommendations for first-choice antibiotic therapy of uUTI. SETTING: General practice in six European countries...... at least one antibiotic associated with a low (UTI could not be explained by differences in local bacterial aetiology or by different patterns of antimicrobial resistance. Despite resistance rates exceeding 10...

  11. Climate change and the collapse of the Akkadian empire: Evidence from the deep sea

    Energy Technology Data Exchange (ETDEWEB)

    Cullen, H.M.; Menocal, P.B. de; Hemming, S.; Hemming, G.; Brown, F.H.; Guilderson, T.; Sirocko, F.


    The Akkadian empire ruled Mesopotamia from the headwaters of the Tigris-Euphrates Rivers to the Persian Gulf during the late third millennium B.C. Archeological evidence has shown that this highly developed civilization collapsed abruptly near 4,170 {+-} 150 calendar yr B.P., perhaps related to a shift to more arid conditions. Detailed paleoclimate records to test this assertion from Mesopotamia are rare, but changes in regional aridity are preserved in adjacent ocean basins. The authors document Holocene changes in regional aridity using mineralogic and geochemical analyses of a marine sediment core from the Gulf of Oman, which is directly downwind of Mesopotamian dust source areas and archeological sites. Results document a very abrupt increase in eolian dust and Mesopotamian aridity, accelerator mass spectrometer radiocarbon dates to 4,025 {+-} 125 calendar yr B.P., which persisted for {approximately} 300 yr. Radiogenic (Nd and Sr) isotope analyses confirm that the observed increase in mineral dust was derived from Mesopotamian source areas. Geochemical correlation of volcanic ash shards between the archeological site and marine sediment record establishes a direct temporal link between Mesopotamian aridification and social collapse, implicating a sudden shift to more arid conditions as a key factor contributing to the collapse of the Akkadian empire.

  12. Empirical likelihood based detection procedure for change point in mean residual life functions under random censorship. (United States)

    Chen, Ying-Ju; Ning, Wei; Gupta, Arjun K


    The mean residual life (MRL) function is one of the basic parameters of interest in survival analysis that describes the expected remaining time of an individual after a certain age. The study of changes in the MRL function is practical and interesting because it may help us to identify some factors such as age and gender that may influence the remaining lifetimes of patients after receiving a certain surgery. In this paper, we propose a detection procedure based on the empirical likelihood for the changes in MRL functions with right censored data. Two real examples are also given: Veterans' administration lung cancer study and Stanford heart transplant to illustrate the detecting procedure. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Environmental policy instruments and technological change in the energy sector: findings from comparative empirical research

    International Nuclear Information System (INIS)

    Skjaerseth, J.B.; Christiansen, A.C.


    This article explores the extent to which and in what ways environmental policy instruments may affect patterns of environmental friendly technological change in the energy sector. Our argument is based on the assumption, however, that technological change is also affected by the political context in which the instruments are applied and by the nature of the problem itself. Comparative empirical research involving different European countries, sectors and policy fields were examined, including climate change, air pollution and wind power. The relationship between environmental policy instruments and technological change is extremely complex, not least due to the impact of other factors that may be more decisive than environmental ones. Against this backdrop, it was concluded that: 1) a portfolio of policy instruments works to the extent that different types of policy instruments affect the different drivers and stages behind technological change needed to solve specific problems. The need for a portfolio of policy instruments depends on the technological challenge being faced; 2) voluntary approaches facilitated constructive corporate strategies, but mandatory approaches tended to be more effective in stimulating short term major technological change; 3) voluntary approaches work well in the short term when the problem to be solved is characterized by lack of information and coordination. (author)

  14. Predicting treatment noncompliance among criminal justice-mandated clients: a theoretical and empirical exploration. (United States)

    Sung, Hung-En; Belenko, Steven; Feng, Li; Tabachnick, Carrie


    Compliance with therapeutic regimens constitutes an important but infrequently studied precursor of treatment engagement and is a necessary condition of successful treatment. This study builds on recent treatment process research and provides a theory-driven analysis of treatment compliance. Five hypotheses are formulated to predict treatment noncompliance among criminal justice-mandated clients. These hypotheses tap different determinants of treatment progress, including physical prime, supportive social network, conventional social involvement, treatment motivation, and risk-taking propensity. Data from 150 addicted felons participating in a diversion program are analyzed to test the hypotheses. Predictors related to these hypotheses correctly identify 58% of the fully compliant clients and 55-88% of the noncompliant clients. Most hypotheses are at least partially corroborated and a few strong correlates emerge across analyses. Clients in their physical prime, those with poorer social support, and those lacking internal desires for change were found especially likely to violate treatment program rules. Clinical implications are discussed.


    Spece, Roy; Yokum, David; Okoro, Andrea-Gale; Robertson Christopher


    The law has long been concerned with the agency problems that arise when advisors, such as attorneys or physicians, put themselves in financial relationships that create conflicts of interest. If the financial relationship is "material" to the transactions proposed by the advisor, then non-disclosure of the relationship may be pertinent to claims of malpractice, informed consent, and even fraud, as well as to professional discipline. In these sorts of cases, materiality is closely related to the question of causation, roughly turning on whether the withheld information might have changed the decision of a reasonable advisee (i.e., a patient). The injured plaintiff will predictably testify that the information would have impacted his or her choice, but that self-serving testimony may be unreliable. The fact finder is left to speculate about the counterfactual world in which the information was disclosed. This Article shows how randomized vignette-based experimentation may create a valuable form of evidence to address these questions, for both litigation and policymaking. To demonstrate this method and investigate conflicts of interest in healthcare in particular, we recruited 691 human subjects and asked them to imagine themselves as patients facing a choice about whether to undergo a cardiac stenting procedure recommended by a cardiologist. We manipulated the vignettes in a 2 x 3 between-subjects design, where we systematically varied the appropriateness of the proposed treatment, which was described in terms of patient risk without the procedure (low or high), and manipulated the type of disclosure provided by the physician (none, standard, or enhanced). We used physician ownership of the specialty hospital where the surgery would be performed as the conflict of interest, disclosed or not, and the "enhanced" disclosure included notice that such relationships have been associated with biases in prescribing behavior. We found that the mock patients were

  16. Testing the robustness of the anthropogenic climate change detection statements using different empirical models

    KAUST Repository

    Imbers, J.; Lopez, A.; Huntingford, C.; Allen, M. R.


    This paper aims to test the robustness of the detection and attribution of anthropogenic climate change using four different empirical models that were previously developed to explain the observed global mean temperature changes over the last few decades. These studies postulated that the main drivers of these changes included not only the usual natural forcings, such as solar and volcanic, and anthropogenic forcings, such as greenhouse gases and sulfates, but also other known Earth system oscillations such as El Niño Southern Oscillation (ENSO) or the Atlantic Multidecadal Oscillation (AMO). In this paper, we consider these signals, or forced responses, and test whether or not the anthropogenic signal can be robustly detected under different assumptions for the internal variability of the climate system. We assume that the internal variability of the global mean surface temperature can be described by simple stochastic models that explore a wide range of plausible temporal autocorrelations, ranging from short memory processes exemplified by an AR(1) model to long memory processes, represented by a fractional differenced model. In all instances, we conclude that human-induced changes to atmospheric gas composition is affecting global mean surface temperature changes. ©2013. American Geophysical Union. All Rights Reserved.

  17. Testing the robustness of the anthropogenic climate change detection statements using different empirical models

    KAUST Repository

    Imbers, J.


    This paper aims to test the robustness of the detection and attribution of anthropogenic climate change using four different empirical models that were previously developed to explain the observed global mean temperature changes over the last few decades. These studies postulated that the main drivers of these changes included not only the usual natural forcings, such as solar and volcanic, and anthropogenic forcings, such as greenhouse gases and sulfates, but also other known Earth system oscillations such as El Niño Southern Oscillation (ENSO) or the Atlantic Multidecadal Oscillation (AMO). In this paper, we consider these signals, or forced responses, and test whether or not the anthropogenic signal can be robustly detected under different assumptions for the internal variability of the climate system. We assume that the internal variability of the global mean surface temperature can be described by simple stochastic models that explore a wide range of plausible temporal autocorrelations, ranging from short memory processes exemplified by an AR(1) model to long memory processes, represented by a fractional differenced model. In all instances, we conclude that human-induced changes to atmospheric gas composition is affecting global mean surface temperature changes. ©2013. American Geophysical Union. All Rights Reserved.

  18. Empiric 131I treatment of high thyroglobulin levels in differentiated thyroid carcinoma after remnant ablation

    International Nuclear Information System (INIS)

    Kalender, E.; Elboga, U.; Celen, Y.; Demir, H.; Yilmaz, M.; Sahin, E.


    Full text of publication follows. Objective: serum thyroglobulin (Tg) measurements are usually the best marker of residual or metastatic disease after the treatment of differentiated thyroid carcinoma (DTC). It is not rare to find patients with detectable serum Tg levels after ablative 131 I treatment (AIT). The objective of this study is to establish the efficacy of empiric 131 I treatment (EIT) given for patients whose Tg levels remained high after AIT. Materials and methods: 28 patients (23 women, 5 men; mean age 47.4 ± 16.8) without distant metastasis, who were treated empirically for high Tg levels after AIT in our clinic were studied retrospectively. In all patients stimulated Tg levels before AIT (Tg I) and 6 months after AIT (Tg II) were measured. The Tg cutoff level for EIT was accepted 10 ng/ml. After EIT, post-therapeutic whole-body scintigraphy (PWBS) was performed to all patients. 18 F-FDG PET CT was performed to patients who had negative PWBS but continued high Tg II levels. Results: PWBS was positive in 14 patients (50%) and negative in 14 patients (50%). 14 patients did not respond to EIT (50%), and 14 patients (50%) responded to EIT at different rates. Eight patients (28.6%) responded to EIT completely, and 6 patients (21.4%) responded to EIT partially. Tg I was 60.7 ± 40 ng/ml and Tg II was 31 ± 20.4 ng/ml in responded patients. Tg I was 87.6 ± 96 ng/ml and Tg II was 114.3 ± 106 ng/ml in non-responding patients. 18 F-FDG PET CT was performed to 14 patients who had negative PWBS. 18 F-FDG PET CT was positive in 11 patients and negative in 3 patients. 18 F-FDG PET CT positive patients were referred to surgery. Conclusion: Our findings, suggested that the EIT is not beneficial in patients who have higher Tg II than Tg I and the cure rate is low in increasing Tg levels. The patients who have high Tg II but lower than Tg I can be treated empirically with 131 I. In these patients EIT may be beneficial. (authors)

  19. Moving empirically supported practices to addiction treatment programs: recruiting supervisors to help in technology transfer. (United States)

    Amodeo, Maryann; Storti, Susan A; Larson, Mary Jo


    Federal and state funding agencies are encouraging or mandating the use of empirically supported treatments in addiction programs, yet many programs have not moved in this direction (Forman, Bovasso, and Woody, 2001 ; Roman and Johnson, 2002 ; Willenbring et al., 2004 ). To improve the skills of counselors in community addiction programs, the authors developed an innovative Web-based course on Cognitive Behavioral Therapy (CBT), a widely accepted empirically-supported practice (ESP) for addiction. Federal funding supports this Web course and a randomized controlled trial to evaluate its effectiveness. Since supervisors often play a pivotal role in helping clinicians transfer learned skills from training courses to the workplace, the authors recruited supervisor-counselor teams, engaging 54 supervisors and 120 counselors. Lessons learned focus on supervisor recruitment and involvement, supervisors' perceptions of CBT, their own CBT skills and their roles in the study, and implications for technology transfer for the addiction field as a whole. Recruiting supervisors proved difficult because programs lacked clinical supervisors. Recruiting counselors was also difficult because programs were concerned about loss of third-party reimbursement. Across the addiction field, technology transfer will be severely hampered unless such infrastructure problems can be solved. Areas for further investigation are identified.

  20. Future scenarios of land change based on empirical data and demographic trends (United States)

    Sleeter, Benjamin M.; Wilson, Tamara; Sharygin, Ethan; Sherba, Jason


    Changes in land use and land cover (LULC) have important and fundamental interactions with the global climate system. Top-down global scale projections of land use change have been an important component of climate change research; however, their utility at local to regional scales is often limited. The goal of this study was to develop an approach for projecting changes in LULC based on land use histories and demographic trends. We developed a set of stochastic, empirical-based projections of LULC change for the state of California, for the period 2001–2100. Land use histories and demographic trends were used to project a “business-as-usual” (BAU) scenario and three population growth scenarios. For the BAU scenario, we projected developed lands would more than double by 2100. When combined with cultivated areas, we projected a 28% increase in anthropogenic land use by 2100. As a result, natural lands were projected to decline at a rate of 139 km2 yr−1; grasslands experienced the largest net decline, followed by shrublands and forests. The amount of cultivated land was projected to decline by approximately 10%; however, the relatively modest change masked large shifts between annual and perennial crop types. Under the three population scenarios, developed lands were projected to increase 40–90% by 2100. Our results suggest that when compared to the BAU projection, scenarios based on demographic trends may underestimate future changes in LULC. Furthermore, regardless of scenario, the spatial pattern of LULC change was likely to have the greatest negative impacts on rangeland ecosystems.

  1. Future Scenarios of Land Change Based on Empirical Data and Demographic Trends (United States)

    Sleeter, Benjamin M.; Wilson, Tamara S.; Sharygin, Ethan; Sherba, Jason T.


    Changes in land use and land cover (LULC) have important and fundamental interactions with the global climate system. Top-down global scale projections of land use change have been an important component of climate change research; however, their utility at local to regional scales is often limited. The goal of this study was to develop an approach for projecting changes in LULC based on land use histories and demographic trends. We developed a set of stochastic, empirical-based projections of LULC change for the state of California, for the period 2001-2100. Land use histories and demographic trends were used to project a "business-as-usual" (BAU) scenario and three population growth scenarios. For the BAU scenario, we projected developed lands would more than double by 2100. When combined with cultivated areas, we projected a 28% increase in anthropogenic land use by 2100. As a result, natural lands were projected to decline at a rate of 139 km2 yr-1; grasslands experienced the largest net decline, followed by shrublands and forests. The amount of cultivated land was projected to decline by approximately 10%; however, the relatively modest change masked large shifts between annual and perennial crop types. Under the three population scenarios, developed lands were projected to increase 40-90% by 2100. Our results suggest that when compared to the BAU projection, scenarios based on demographic trends may underestimate future changes in LULC. Furthermore, regardless of scenario, the spatial pattern of LULC change was likely to have the greatest negative impacts on rangeland ecosystems.

  2. [Lung abscess: changes in treatment?]. (United States)

    Clottu, E; Nicod, L P


    Lung abscess occurs in very pleomorphic according to germs initially involved. The mechanism commonly found is an aspiration of the oropharyngeal flora in patients with disorders of consciousness or swallowing. The infection is polymicrobial, with presence of anaerobic germs in 2/3 of the cases. The support consists of a prolonged antibiotic treatment, as well as anaerobic until resolution or stability of the radiological image. In case of prolonged toxic state, drainage of the abscess is to be discussed especially if there is no airways drainage. Surgical sanctions is rarely needed regardless of the size of the abscess, unless underlying carcinoma is present.

  3. Antibiotic stewardship and empirical antibiotic treatment: How can they get along? (United States)

    Zuccaro, Valentina; Columpsi, Paola; Sacchi, Paolo; Lucà, Maria Grazia; Fagiuoli, Stefano; Bruno, Raffaele


    The aim of this review is to focus on the recent knowledge on antibiotic stewardship and empiric antibiotic treatment in cirrhotic patients. The application of antimicrobial stewardship (AMS) rules appears to be the most appropriate strategy to globally manage cirrhotic patients with infectious complications: indeed they represent a unique way to provide both early diagnosis and appropriate therapy in order to avoid not only antibiotic over-prescription but, more importantly, selection and spread of antimicrobial resistance. Moreover, cirrhotic patients must be considered "frail" and susceptible to healthcare associated infections: applying AMS policies would assure a cost reduction and thus contribute to the improvement of public health strategies. Copyright © 2017. Published by Elsevier Ltd.

  4. Empirically derived personality subtyping for predicting clinical symptoms and treatment response in bulimia nervosa. (United States)

    Haynos, Ann F; Pearson, Carolyn M; Utzinger, Linsey M; Wonderlich, Stephen A; Crosby, Ross D; Mitchell, James E; Crow, Scott J; Peterson, Carol B


    Evidence suggests that eating disorder subtypes reflecting under-controlled, over-controlled, and low psychopathology personality traits constitute reliable phenotypes that differentiate treatment response. This study is the first to use statistical analyses to identify these subtypes within treatment-seeking individuals with bulimia nervosa (BN) and to use these statistically derived clusters to predict clinical outcomes. Using variables from the Dimensional Assessment of Personality Pathology-Basic Questionnaire, K-means cluster analyses identified under-controlled, over-controlled, and low psychopathology subtypes within BN patients (n = 80) enrolled in a treatment trial. Generalized linear models examined the impact of personality subtypes on Eating Disorder Examination global score, binge eating frequency, and purging frequency cross-sectionally at baseline and longitudinally at end of treatment (EOT) and follow-up. In the longitudinal models, secondary analyses were conducted to examine personality subtype as a potential moderator of response to Cognitive Behavioral Therapy-Enhanced (CBT-E) or Integrative Cognitive-Affective Therapy for BN (ICAT-BN). There were no baseline clinical differences between groups. In the longitudinal models, personality subtype predicted binge eating (p = 0.03) and purging (p = 0.01) frequency at EOT and binge eating frequency at follow-up (p = 0.045). The over-controlled group demonstrated the best outcomes on these variables. In secondary analyses, there was a treatment by subtype interaction for purging at follow-up (p = 0.04), which indicated a superiority of CBT-E over ICAT-BN for reducing purging among the over-controlled group. Empirically derived personality subtyping appears to be a valid classification system with potential to guide eating disorder treatment decisions. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:506-514). © 2016 Wiley Periodicals, Inc.

  5. Recommendations for the empirical treatment of complicated urinary tract infections using surveillance data on antimicrobial resistance in the Netherlands

    NARCIS (Netherlands)

    Koningstein, Maike; van der Bij, Akke K.; de Kraker, Marlieke E. A.; Monen, Jos C.; Muilwijk, Jan; de Greeff, Sabine C.; Geerlings, Suzanne E.; van Hall, Maurine A. Leverstein-; Vlaspolder, F.; Cohen Stuart, J. W. T.; van Hees, B. C.; Wintermans, R. G. F.; Altorf-van der Kuil, W.; Alblas, J.; van der Bij, A. K.; Frentz, D.; Leenstra, T.; Monen, J. C.; Muilwijk, J.; Notermans, D. W.; de Greeff, S. C.; van Keulen, P. H. J.; Kluytmans, J. A. J. W.; Mattsson, E. E.; Sebens, F. W.; Frenay, H. M. E.; Maraha, B.; Heilmann, F. G. C.; Halaby, T.; Versteeg, D.; Hendrix, R.; Schellekens, J. F. P.; Diederen, B. M. W.; de Brauwer, E. I. G. B.; Stals, F. S.; Bakker, L. J.; Dorigo-Zetsma, J. W.; van Zeijl, J. H.; Bernards, A. T.; de Jongh, B. M.; Vlaminckx, B. J. M.; Horrevorts, A.; Kuipers, S.; Moffie, B.; Brimicombe, R. W.; Jansen, C. L.; Renders, N. H. M.; Hendrickx, B. G. A.; Buiting, A. G. M.; Kaan, J. A.


    Complicated urinary tract infections (c-UTIs) are among the most common nosocomial infections and a substantial part of the antimicrobial agents used in hospitals is for the treatment of c-UTIs. Data from surveillance can be used to guide the empirical treatment choices of clinicians when treating

  6. Organizational change in its context. A theoretical and empirical study of the linkages between organizational change projects and their administrative, strategic and institutional environment

    NARCIS (Netherlands)

    Man, Huibert de


    This dissertation deals with the multi-level analysis of organizational change projects. Empirical examples are taken from the COB-SER participation experiments which took place in the Netherlands between 1977 and 1983. ... Zie: Summary

  7. Stability of an empirical psychosocial taxonomy across type of diabetes and treatment. (United States)

    Nouwen, A; Breton, M-C; Urquhart Law, G; Descôteaux, J


    The aims of the study were (i) to examine whether an empirical psychosocial taxonomy, based on key diabetes-related variables, is independent of type of diabetes and treatment, and (ii) to further establish the external validation of the taxonomy. In a cross-sectional study, 82 patients with Type 1 and 86 patients with Type 2 diabetes mellitus were assigned to one of three psychosocial patient profiles based on their Multidimensional Diabetes Questionnaire (MDQ) scores. General psychological and diabetes-specific measures were obtained through self-report and HbA(1c) was measured. Equal proportions of Type 1 and Type 2 patients, and of patients using insulin and oral medication/diet only were classified within each of the three psychosocial profiles. External validation confirmed the validity and distinctiveness of the patients' profiles. The patient profiles were independent of demographic variables, body mass index, duration of diabetes, complexity of treatment, number of complications, social desirability, and major stress levels. The Psychosocial Taxonomy for Patients with Diabetes provides a new way to categorize individuals who may have more in common than just their type of diabetes and/or its treatment and can help target interventions to individual patients' needs.

  8. The regulatory treatment of adverse outcomes: Empirical evidence from the electric utility industry

    International Nuclear Information System (INIS)

    Ryan, N.E.


    This dissertation consists of two essays, both of them empirical studies using data from the US electric utility industry. Part I focuses on utilities' investment behavior, while Part II examines regulatory policy toward the industry. The first paper presents an analysis of utilities' decisions about whether to continue or cancel nuclear construction projects. During the seventies and eighties, changes in economic conditions and regulatory policy radically altered the costs and benefits of nuclear power. This study seeks to determine whether regulators pursued policies which induced utilities to employ socially efficient criteria in re-evaluating ongoing projects. The analysis also yields insights into regulators' distributional goals. Results based on data for 1978-84 are consistent with the capture theory hypothesis, which holds that regulators weigh industry interests more heavily than consumer interests. A test for structural change provides no support for the contention that the relative importance of consumer interests increased over this period. These empirical findings are inconsistent with a standard (and essential) assumption of theoretical principal-agent models of rate-of-return regulation, that regulators value consumers' payoffs more than utility profits. The second paper examines regulatory policy toward generating facilities that entered commercial service during the years 1983-88. In a significant departure from past practice, state public utility commissions often denied utilities full recovery of their investments in new plants. Although such ex post disallowances have an important efficiency rationale, they also provide a means for opportunistic regulators to effect transfers between utilities' ratepayers and shareholders. A probit model was used to assess the impact on the probability of a disallowance of firm and project characteristics as well as attributes of a state's political and institutional environment

  9. New GRACE-Derived Storage Change Estimates Using Empirical Mode Extraction (United States)

    Aierken, A.; Lee, H.; Yu, H.; Ate, P.; Hossain, F.; Basnayake, S. B.; Jayasinghe, S.; Saah, D. S.; Shum, C. K.


    Estimated mass change from GRACE spherical harmonic solutions have north/south stripes and east/west banded errors due to random noise and modeling errors. Low pass filters like decorrelation and Gaussian smoothing are typically applied to reduce noise and errors. However, these filters introduce leakage errors that need to be addressed. GRACE mascon estimates (JPL and CSR mascon solutions) do not need decorrelation or Gaussian smoothing and offer larger signal magnitudes compared to the GRACE spherical harmonics (SH) filtered results. However, a recent study [Chen et al., JGR, 2017] demonstrated that both JPL and CSR mascon solutions also have leakage errors. We developed a new postprocessing method based on empirical mode decomposition to estimate mass change from GRACE SH solutions without decorrelation and Gaussian smoothing, the two main sources of leakage errors. We found that, without any post processing, the noise and errors in spherical harmonic solutions introduced very clear high frequency components in the spatial domain. By removing these high frequency components and reserve the overall pattern of the signal, we obtained better mass estimates with minimum leakage errors. The new global mass change estimates captured all the signals observed by GRACE without the stripe errors. Results were compared with traditional methods over the Tonle Sap Basin in Cambodia, Northwestern India, Central Valley in California, and the Caspian Sea. Our results provide larger signal magnitudes which are in good agreement with the leakage corrected (forward modeled) SH results.

  10. Biomarker-based strategy for early discontinuation of empirical antifungal treatment in critically ill patients: a randomized controlled trial. (United States)

    Rouzé, Anahita; Loridant, Séverine; Poissy, Julien; Dervaux, Benoit; Sendid, Boualem; Cornu, Marjorie; Nseir, Saad


    The aim of this study was to determine the impact of a biomarker-based strategy on early discontinuation of empirical antifungal treatment. Prospective randomized controlled single-center unblinded study, performed in a mixed ICU. A total of 110 patients were randomly assigned to a strategy in which empirical antifungal treatment duration was determined by (1,3)-β-D-glucan, mannan, and anti-mannan serum assays, performed on day 0 and day 4; or to a routine care strategy, based on international guidelines, which recommend 14 days of treatment. In the biomarker group, early stop recommendation was determined using an algorithm based on the results of biomarkers. The primary outcome was the percentage of survivors discontinuing empirical antifungal treatment early, defined as a discontinuation strictly before day 7. A total of 109 patients were analyzed (one patient withdraw consent). Empirical antifungal treatment was discontinued early in 29 out of 54 patients in the biomarker strategy group, compared with one patient out of 55 in the routine strategy group [54% vs 2%, p strategy compared with routine strategy [median (IQR) 6 (4-13) vs 13 (12-14) days, p strategy increased the percentage of early discontinuation of empirical antifungal treatment among critically ill patients with suspected invasive Candida infection. These results confirm previous findings suggesting that early discontinuation of empirical antifungal treatment had no negative impact on outcome. However, further studies are needed to confirm the safety of this strategy. This trial was registered at, NCT02154178.

  11. Financial incentives and psychiatric services in Australia: an empirical analysis of three policy changes. (United States)

    Doessel, D P; Scheurer, Roman W; Chant, David C; Whiteford, Harvey


    Australia has a national, compulsory and universal health insurance scheme, called Medicare. In 1996 the Government changed the Medicare Benefit Schedule Book in such a way as to create different financial incentives for consumers or producers of out-of-hospital private psychiatric services, once an individual consumer had received 50 such services in a 12-month period. The Australian Government introduced a new Item (319) to cover some special cases that were affected by the policy change. At the same time, the Commonwealth introduced a 'fee-freeze' for all medical services. The purpose of this study is two-fold. First, it is necessary to describe the three policy interventions (the constraints on utilization, the operation of the new Item and the general 'fee-freeze'.) The new Item policy was essentially a mechanism to 'dampen' the effect of the 'constraint' policy, and these two policy changes will be consequently analysed as a single intervention. The second objective is to evaluate the policy intervention in terms of the (stated) Australian purpose of reducing utilization of psychiatric services, and thus reducing financial outlays. Thus, it is important to separate out the different effects of the three policies that were introduced at much the same time in November 1996 and January 1997. The econometric results indicate that the composite policy change (constraining services and the new 319 Item) had a statistically significant effect. The analysis of the Medicare Benefit (in constant prices) indicates that the 'fee-freeze' policy also had a statistically significant effect. This enables separate determination of the several policy changes. In fact, the empirical results indicate that the Commonwealth Government underestimated the 'savings' that would arise from the 'constraint' policy.

  12. Climate change and associated spatial heterogeneity of Pakistan: Empirical evidence using multidisciplinary approach. (United States)

    Ali, Ghaffar


    Climate change is a multidimensional phenomenon, which has various implications for the environment and socio-economic conditions of the people. Its effects are deeper in an agrarian economy which is susceptible to the vagaries of nature. Therefore, climate change directly impacts the society in different ways, and society must pay the cost. Focusing on this truth, the main objective of this research was to investigate the empirical changes and spatial heterogeneity in the climate of Pakistan in real terms using time series data. Climate change and variability in Pakistan, over time, were estimated from 1961 to 2014 using all the climate variables for the very first time. Several studies were available on climate change impacts, mitigation, and adaptation; however, it was difficult to observe exactly how much change occurred in which province and when. A multidisciplinary approach was utilized to estimate the absolute change through a combination of environmental, econometric, and remote sensing methods. Moreover, the Autoregressive Distributed Lag (ARDL) model was used to ascertain the extent of variability in climate change and information was digitalized through ground truthing. Results showed that the average temperature of Pakistan increased by 2°C between 1960 and 1987 and 4°C between 1988 and 2014, and R 2 was 0.978. The rate of temperature increased 0.09°C between 1960 and 2014. The mean annual precipitation of Pakistan increased by 478mm, and its R 2 were 0.34-0.64. The mean annual humidity of Pakistan increased by 2.94%, and the rate of humidity has been increased by 0.97% from 1988 to 2014. Notably, Sindh and Balochistan provinces have shown a significant spatial heterogeneity regarding the increase in precipitation. Statistically all variables are significant. This would serve as a baseline information for climate change-related studies in Pakistan and its application in different sectors. This would also serve the plant breeders and policymakers of

  13. Empirically derived pain-patient MMPI subgroups: prediction of treatment outcome. (United States)

    Moore, J E; Armentrout, D P; Parker, J C; Kivlahan, D R


    Fifty-seven male chronic pain patients admitted to an inpatient multimodal pain treatment program at a Midwestern Veterans Administration hospital completed the MMPI, Profile of Mood States (POMS), Tennessee Self-Concept Scale (TSCS), Rathus Assertiveness Schedule (RAS), activity diaries, and an extensive pain questionnaire. All patients were assessed both before and after treatment, and most also were assessed 2-5 months prior to treatment. No significant changes occurred during the baseline period, but significant improvements were evident at posttreatment on most variables: MMPI, POMS, TSCS, RAS, pain severity, sexual functioning, and activity diaries. MMPI subgroup membership, based on a hierarchical cluster analysis in a larger sample, was not predictive of differential treatment outcome. Possible reasons for comparable treatment gains among these subgroups, which previously have been shown to differ on many psychological and behavioral factors, are discussed.

  14. Estimating the effect of treatment rate changes when treatment benefits are heterogeneous: antibiotics and otitis media. (United States)

    Park, Tae-Ryong; Brooks, John M; Chrischilles, Elizabeth A; Bergus, George


    Contrast methods to assess the health effects of a treatment rate change when treatment benefits are heterogeneous across patients. Antibiotic prescribing for children with otitis media (OM) in Iowa Medicaid is the empirical example. Instrumental variable (IV) and linear probability model (LPM) are used to estimate the effect of antibiotic treatments on cure probabilities for children with OM in Iowa Medicaid. Local area physician supply per capita is the instrument in the IV models. Estimates are contrasted in terms of their ability to make inferences for patients whose treatment choices may be affected by a change in population treatment rates. The instrument was positively related to the probability of being prescribed an antibiotic. LPM estimates showed a positive effect of antibiotics on OM patient cure probability while IV estimates showed no relationship between antibiotics and patient cure probability. Linear probability model estimation yields the average effects of the treatment on patients that were treated. IV estimation yields the average effects for patients whose treatment choices were affected by the instrument. As antibiotic treatment effects are heterogeneous across OM patients, our estimates from these approaches are aligned with clinical evidence and theory. The average estimate for treated patients (higher severity) from the LPM model is greater than estimates for patients whose treatment choices are affected by the instrument (lower severity) from the IV models. Based on our IV estimates it appears that lowering antibiotic use in OM patients in Iowa Medicaid did not result in lost cures.

  15. Promoting Behavioral Change in Psychoanalytic Treatments. (United States)

    Busch, Fredric N


    One of the shibboleths of psychoanalysis is that treatment should not target behavioral change, focusing instead on gaining insight and the therapeutic relationship (Freud, 1917; 1923; Gabbard, 2014; Greenson, 1967). Such an approach is believed to be accompanied by disruptions of exploration or problematic distortions of the transference (Freud, 1917; 1923; Gabbard, 2014; Greenson, 1967). However, ignoring behavioral change can put patients at increased risk for stalemates in treatment and persistent problematic behaviors that interfere with improvement and impair relationships. This article suggests that rather than being at odds or disruptive, efforts at behavioral change can be part of the development and employment of a psychodynamic formulation, and can be used to enhance self-understanding and exploration of the transference. Psychoanalytic approaches provide strategies for behavioral change not included in other psychotherapeutic treatments. This article describes a variety of ways in which efforts at behavioral change can be integrated with and enhanced by psychodynamic exploration.

  16. Empirical estimation of present-day Antarctic glacial isostatic adjustment and ice mass change (United States)

    Gunter, B. C.; Didova, O.; Riva, R. E. M.; Ligtenberg, S. R. M.; Lenaerts, J. T. M.; King, M. A.; van den Broeke, M. R.; Urban, T.


    This study explores an approach that simultaneously estimates Antarctic mass balance and glacial isostatic adjustment (GIA) through the combination of satellite gravity and altimetry data sets. The results improve upon previous efforts by incorporating a firn densification model to account for firn compaction and surface processes as well as reprocessed data sets over a slightly longer period of time. A range of different Gravity Recovery and Climate Experiment (GRACE) gravity models were evaluated and a new Ice, Cloud, and Land Elevation Satellite (ICESat) surface height trend map computed using an overlapping footprint approach. When the GIA models created from the combination approach were compared to in situ GPS ground station displacements, the vertical rates estimated showed consistently better agreement than recent conventional GIA models. The new empirically derived GIA rates suggest the presence of strong uplift in the Amundsen Sea sector in West Antarctica (WA) and the Philippi/Denman sectors, as well as subsidence in large parts of East Antarctica (EA). The total GIA-related mass change estimates for the entire Antarctic ice sheet ranged from 53 to 103 Gt yr-1, depending on the GRACE solution used, with an estimated uncertainty of ±40 Gt yr-1. Over the time frame February 2003-October 2009, the corresponding ice mass change showed an average value of -100 ± 44 Gt yr-1 (EA: 5 ± 38, WA: -105 ± 22), consistent with other recent estimates in the literature, with regional mass loss mostly concentrated in WA. The refined approach presented in this study shows the contribution that such data combinations can make towards improving estimates of present-day GIA and ice mass change, particularly with respect to determining more reliable uncertainties.

  17. The economics of climate change mitigation in developing countries - methodological and empirical results

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.


    This thesis presents a methodological and empirical discussion of the costs associated with implementing greenhouse gas reduction strategies in developing countries. It presents a methodological framework for national costing studies and evaluates a number of associated valuation methods. The methodological framework has been applied in several developing countries as part of a UNEP project in which the author has participated, and reference is made to the results of these country studies. Some of the theoretical issues associated with the determination of the costs of emission reductions are discussed with reference to a number of World Bank and UN guidelines for project analysis in developing countries. The use of several accounting prices is recommended for mitigation projects, with a distinction being made between internationally and domestically traded goods. The consequences of using different accounting prices are discussed with respect to the methodology applied in the UNEP country studies. In conclusion the thesis reviews the results of some of the most important international studies of greenhouse gas emissions in developing countries. The review, which encompasses a total of 27 country studies, was undertaken by the author for the Intergovernmental Panel of Climate Change, the IPCC. Its conclusion is that the UNEP methodological framework and associated country study results are consistent with the recommendations and conclusions of the IPCC. (EG) 23 refs.

  18. Changes in Bacterial Resistance Patterns of Pediatric Urinary Tract Infections and Rationale for Empirical Antibiotic Therapy

    Directory of Open Access Journals (Sweden)

    İbrahim Gökçe


    Full Text Available Background: The causative agent spectrum and resistance patterns of urinary tract infections in children are affected by many factors. Aims: To demonstrate antibiotic resistance in urinary tract infections and changing ratio in antibiotic resistance by years. Study Design: Retrospective cross-sectional study. Methods: We analysed antibiotic resistance patterns of isolated Gram (- bacteria during the years 2011-2014 (study period 2 in children with urinary tract infections. We compared these findings with data collected in the same centre in 2001-2003 (study period 1. Results: Four hundred and sixty-five uncomplicated community-acquired Gram (- urinary tract infections were analysed from 2001-2003 and 400 from 2011-2014. Sixty-one percent of patients were female (1.5 girls : 1 boy. The mean age of children included in the study was 3 years and 9 months. Escherichia coli was the predominant bacteria isolated during both periods of the study (60% in study period 1 and 73% in study period 2. Bacteria other than E. coli demonstrated a higher level of resistance to all of the antimicrobials except trimethoprim-sulfamethoxazole than E. coli bacteria during the years 2011-2014. In our study, we found increasing resistance trends of urinary pathogens for cefixime (from 1% to 15%, p0.05. Conclusion: In childhood urinary tract infections, antibiotic resistance should be evaluated periodically and empiric antimicrobial therapy should be decided according to antibiotic sensitivity results

  19. The economics of climate change mitigation in developing countries -methodological and empirical results

    International Nuclear Information System (INIS)

    Halsnaes, K.


    This thesis presents a methodological and empirical discussion of the costs associated with implementing greenhouse gas reduction strategies in developing countries. It presents a methodological framework for national costing studies and evaluates a number of associated valuation methods. The methodological framework has been applied in several developing countries as part of a UNEP project in which the author has participated, and reference is made to the results of these country studies. Some of the theoretical issues associated with the determination of the costs of emission reductions are discussed with reference to a number of World Bank and UN guidelines for project analysis in developing countries. The use of several accounting prices is recommended for mitigation projects, with a distinction being made between internationally and domestically traded goods. The consequences of using different accounting prices are discussed with respect to the methodology applied in the UNEP country studies. In conclusion the thesis reviews the results of some of the most important international studies of greenhouse gas emissions in developing countries. The review, which encompasses a total of 27 country studies, was undertaken by the author for the Intergovernmental Panel of Climate Change, the IPCC. Its conclusion is that the UNEP methodological framework and associated country study results are consistent with the recommendations and conclusions of the IPCC. (EG) 23 refs

  20. Use of Evidence-Based Practice Resources and Empirically Supported Treatments for Posttraumatic Stress Disorder among University Counseling Center Psychologists (United States)

    Juel, Morgen Joray


    In the present study, an attempt was made to determine the degree to which psychologists at college and university counseling centers (UCCs) utilized empirically supported treatments with their posttraumatic stress disorder (PTSD) clients. In addition, an attempt was made to determine how frequently UCC psychologists utilized a number of…

  1. A Model of Therapist Competencies for the Empirically Supported Cognitive Behavioral Treatment of Child and Adolescent Anxiety and Depressive Disorders (United States)

    Sburlati, Elizabeth S.; Schniering, Carolyn A.; Lyneham, Heidi J.; Rapee, Ronald M.


    While a plethora of cognitive behavioral empirically supported treatments (ESTs) are available for treating child and adolescent anxiety and depressive disorders, research has shown that these are not as effective when implemented in routine practice settings. Research is now indicating that is partly due to ineffective EST training methods,…

  2. The changing trend in marketing of financial services: an empirical study on bank performance in Nigeria

    Directory of Open Access Journals (Sweden)

    Abiodun Eniola Alao


    Full Text Available The long years of marketing practices in the Nigerian banking industry has recorded low level standards relative to global standard practice. The effect on the overall industry performance measurable basically in terms of customer satisfaction, customer loyalty and brand equity has been on the negativity. In some cases, banks overall performance level was never assessed based on customer orientation, value and other customer related measures rather on some quick financial indicators. This poor orientation towards marketing has rather become a forgone especially in the banking area of financial services in Nigeria. This study was therefore conducted to examine the changing trend towards embracing marketing philosophy and the extent of the banks’ performance level in response to changing expectations of customers. Theoretical issues relating marketing, customer philosophy, financial marketing, customer loyalty, satisfaction, and brand equity were explored to establish the key performance variables and the existing relationships amongst them. Empirical study was equally carried out with the use of questionnaire, administered on randomly selected banks’ customers and management staff. Data collected were analyzed on the basis of critical measures which include customer awareness, market sensitivity to financial delivery, customer profile and sophistication through the use of Spearman Rank Correlation Coefficient. The result among other things shows that there is a significant relationship between the new trend towards marketing orientation, financial services in the banking industry and performance level. Based on this study, we recommend improved marketing performance and training to enhance service delivery, customer satisfaction, and customer loyalty across all banks in the geographical places of the Nigerian financial markets.

  3. When complexity science meets implementation science: a theoretical and empirical analysis of systems change. (United States)

    Braithwaite, Jeffrey; Churruca, Kate; Long, Janet C; Ellis, Louise A; Herkes, Jessica


    Implementation science has a core aim - to get evidence into practice. Early in the evidence-based medicine movement, this task was construed in linear terms, wherein the knowledge pipeline moved from evidence created in the laboratory through to clinical trials and, finally, via new tests, drugs, equipment, or procedures, into clinical practice. We now know that this straight-line thinking was naïve at best, and little more than an idealization, with multiple fractures appearing in the pipeline. The knowledge pipeline derives from a mechanistic and linear approach to science, which, while delivering huge advances in medicine over the last two centuries, is limited in its application to complex social systems such as healthcare. Instead, complexity science, a theoretical approach to understanding interconnections among agents and how they give rise to emergent, dynamic, systems-level behaviors, represents an increasingly useful conceptual framework for change. Herein, we discuss what implementation science can learn from complexity science, and tease out some of the properties of healthcare systems that enable or constrain the goals we have for better, more effective, more evidence-based care. Two Australian examples, one largely top-down, predicated on applying new standards across the country, and the other largely bottom-up, adopting medical emergency teams in over 200 hospitals, provide empirical support for a complexity-informed approach to implementation. The key lessons are that change can be stimulated in many ways, but a triggering mechanism is needed, such as legislation or widespread stakeholder agreement; that feedback loops are crucial to continue change momentum; that extended sweeps of time are involved, typically much longer than believed at the outset; and that taking a systems-informed, complexity approach, having regard for existing networks and socio-technical characteristics, is beneficial. Construing healthcare as a complex adaptive system

  4. Colonialism, Education and Social Change in the British Empire: The Cases of Australia, Papua New Guinea and Ireland (United States)

    O'Donoghue, Tom


    This paper focuses on the history of relations between colonialism, schooling and social change in Australia, Papua New Guinea and Ireland, countries that were once part of the British Empire. It indicates that responses to schooling ranged from acceptance and tolerance, to modification and rejection, depending on the country, the issue, and the…

  5. Appropriability, Technological Opportunity, Market Demand, and Technical Change - Empirical Evidence from Switzerland


    Harabi, Najib


    The purpose of this paper is to analyze both theoretically and empirically those factors which underlay the - empirically observable - inter-industry differences in technical progress. At the theoretical level economists agree more and more that technical progress can be explained at the industry level by the following three factors: (1) the technological opportunities, (2) the appropriability conditions, meaning the ability to capture and protect the results of technical innovations and (3) ...

  6. Changes in Bacterial Resistance Patterns of Pediatric Urinary Tract Infections and Rationale for Empirical Antibiotic Therapy. (United States)

    Gökçe, İbrahim; Çiçek, Neslihan; Güven, Serçin; Altuntaş, Ülger; Bıyıklı, Neşe; Yıldız, Nurdan; Alpay, Harika


    The causative agent spectrum and resistance patterns of urinary tract infections in children are affected by many factors. To demonstrate antibiotic resistance in urinary tract infections and changing ratio in antibiotic resistance by years. Retrospective cross-sectional study. We analysed antibiotic resistance patterns of isolated Gram (-) bacteria during the years 2011-2014 (study period 2) in children with urinary tract infections. We compared these findings with data collected in the same centre in 2001-2003 (study period 1). Four hundred and sixty-five uncomplicated community-acquired Gram (-) urinary tract infections were analysed from 2001-2003 and 400 from 2011-2014. Sixty-one percent of patients were female (1.5 girls : 1 boy). The mean age of children included in the study was 3 years and 9 months. Escherichia coli was the predominant bacteria isolated during both periods of the study (60% in study period 1 and 73% in study period 2). Bacteria other than E. coli demonstrated a higher level of resistance to all of the antimicrobials except trimethoprim-sulfamethoxazole than E. coli bacteria during the years 2011-2014. In our study, we found increasing resistance trends of urinary pathogens for cefixime (from 1% to 15%, pUrinary pathogens showed a decreasing trend for nitrofurantoin (from 17% to 7%, p=0.0001). No significant trends were detected for ampicillin (from 69% to 71%), amoxicillin-clavulanate (from 44% to 43%), cefazolin (from 39% to 32%), trimethoprim-sulfamethoxazole (from 32% to 31%), cefuroxime (from 21% to 18%) and ceftriaxone (from 10% to 14%) between the two periods (p>0.05). In childhood urinary tract infections, antibiotic resistance should be evaluated periodically and empiric antimicrobial therapy should be decided according to antibiotic sensitivity results.

  7. Stories of change in drug treatment

    DEFF Research Database (Denmark)

    Andersen, Ditte


    ’ (story content) and ‘the hows’ (storying process) the article presents four findings: (1) stories of change function locally as an institutional requirement; (2) professional drug treatment providers edit young people's storytelling through different techniques; (3) the narrative environment of the drug...... treatment. Building on the sociology of storytelling and ethnographic fieldwork conducted at two drug treatment institutions for young people in Denmark, this article argues that studying stories in the context of their telling brings forth novel insights. Through a narrative analysis of both ‘the whats...... treatment institution shapes how particular stories make sense of the past, present and future; and (4) storytelling in drug treatment is an interactive achievement. A fine-grained analysis illuminates in particular how some stories on gender and drug use are silenced, while others are encouraged...

  8. Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions (United States)

    Mitchell, John T.; Zylowska, Lidia; Kollins, Scott H.


    Research examining nonpharmacological interventions for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) has expanded in recent years and provides patients with more treatment options. Mindfulness-based training is an example of an intervention that is gaining promising preliminary empirical support and is increasingly administered in clinical settings. The aim of this review is to provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, describe the current state of the empirical basis for mindfulness training in ADHD, and summarize a treatment approach specific to adults diagnosed with ADHD: the Mindful Awareness Practices (MAPs) for ADHD Program. Two case study examples are provided to demonstrate relevant clinical issues for practitioners interested in this approach. Directions for future research, including mindfulness meditation as a standalone treatment and as a complementary approach to cognitive-behavioral therapy, are provided. PMID:25908900

  9. Treatments for Autism: Parental Choices and Perceptions of Change (United States)

    Bowker, Anne; D'Angelo, Nadia M.; Hicks, Robin; Wells, Kerry


    Empirically conducted studies of the efficacy of various treatments for autism are limited, which leaves parents with little evidence on which to base their treatment decisions (Kasari, "Journal of Autism and Developmental Disorders," 32: 447-461, 2002). The purpose of this study was to examine the types of treatments in current use by families of…

  10. Upscaling Empirically Based Conceptualisations to Model Tropical Dominant Hydrological Processes for Historical Land Use Change (United States)

    Toohey, R.; Boll, J.; Brooks, E.; Jones, J.


    Surface runoff and percolation to ground water are two hydrological processes of concern to the Atlantic slope of Costa Rica because of their impacts on flooding and drinking water contamination. As per legislation, the Costa Rican Government funds land use management from the farm to the regional scale to improve or conserve hydrological ecosystem services. In this study, we examined how land use (e.g., forest, coffee, sugar cane, and pasture) affects hydrological response at the point, plot (1 m2), and the field scale (1-6ha) to empirically conceptualize the dominant hydrological processes in each land use. Using our field data, we upscaled these conceptual processes into a physically-based distributed hydrological model at the field, watershed (130 km2), and regional (1500 km2) scales. At the point and plot scales, the presence of macropores and large roots promoted greater vertical percolation and subsurface connectivity in the forest and coffee field sites. The lack of macropores and large roots, plus the addition of management artifacts (e.g., surface compaction and a plough layer), altered the dominant hydrological processes by increasing lateral flow and surface runoff in the pasture and sugar cane field sites. Macropores and topography were major influences on runoff generation at the field scale. Also at the field scale, antecedent moisture conditions suggest a threshold behavior as a temporal control on surface runoff generation. However, in this tropical climate with very intense rainstorms, annual surface runoff was less than 10% of annual precipitation at the field scale. Significant differences in soil and hydrological characteristics observed at the point and plot scales appear to have less significance when upscaled to the field scale. At the point and plot scales, percolation acted as the dominant hydrological process in this tropical environment. However, at the field scale for sugar cane and pasture sites, saturation-excess runoff increased as

  11. SPACE AND MEANING CHANGE IN URBANIZATION AND MODERNIZATION PROCESS: An Urban Park in the First Capital of the Ottoman Empire

    Directory of Open Access Journals (Sweden)

    Gul ATANUR


    Full Text Available The foundations of Westernization Movement in Turkey were laid in late Ottoman Empire. Following the fall of the Ottoman Empire and the proclamation of the republic, urban space became highly important and modernist architects from the west planned a large number of Turkish cities. The concept of urban park was introduced and parks became significant components of modern life in this period. Bursa, too, was influenced by this movement; it was planned by western planners and an urban park was built. However, the meaning of urban parks within the ideal of modern life in Turkey and in Bursa has changed over time.  This study is based on urban development periods in Turkey and it presents the change Bursa Kültürpark in Bursa, the early modern city of Turkey, underwent during the process from modernization to globalization.

  12. Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder (United States)

    Schreibman, Laura; Dawson, Geraldine; Stahmer, Aubyn C.; Landa, Rebecca; Rogers, Sally J.; McGee, Gail G.; Kasari, Connie; Ingersoll, Brooke; Kaiser, Ann P.; Bruinsma, Yvonne; McNerney, Erin; Wetherby, Amy; Halladay, Alycia


    Earlier autism diagnosis, the importance of early intervention, and development of specific interventions for young children have contributed to the emergence of similar, empirically supported, autism interventions that represent the merging of applied behavioral and developmental sciences. "Naturalistic Developmental Behavioral Interventions…

  13. Empirical likelihood

    CERN Document Server

    Owen, Art B


    Empirical likelihood provides inferences whose validity does not depend on specifying a parametric model for the data. Because it uses a likelihood, the method has certain inherent advantages over resampling methods: it uses the data to determine the shape of the confidence regions, and it makes it easy to combined data from multiple sources. It also facilitates incorporating side information, and it simplifies accounting for censored, truncated, or biased sampling.One of the first books published on the subject, Empirical Likelihood offers an in-depth treatment of this method for constructing confidence regions and testing hypotheses. The author applies empirical likelihood to a range of problems, from those as simple as setting a confidence region for a univariate mean under IID sampling, to problems defined through smooth functions of means, regression models, generalized linear models, estimating equations, or kernel smooths, and to sampling with non-identically distributed data. Abundant figures offer vi...

  14. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections. (United States)

    Linsenmeyer, Katherine; Strymish, Judith; Gupta, Kalpana


    The emergence of multidrug-resistant (MDR) uropathogens is making the treatment of urinary tract infections (UTIs) more challenging. We sought to evaluate the accuracy of empiric therapy for MDR UTIs and the utility of prior culture data in improving the accuracy of the therapy chosen. The electronic health records from three U.S. Department of Veterans Affairs facilities were retrospectively reviewed for the treatments used for MDR UTIs over 4 years. An MDR UTI was defined as an infection caused by a uropathogen resistant to three or more classes of drugs and identified by a clinician to require therapy. Previous data on culture results, antimicrobial use, and outcomes were captured from records from inpatient and outpatient settings. Among 126 patient episodes of MDR UTIs, the choices of empiric therapy against the index pathogen were accurate in 66 (52%) episodes. For the 95 patient episodes for which prior microbiologic data were available, when empiric therapy was concordant with the prior microbiologic data, the rate of accuracy of the treatment against the uropathogen improved from 32% to 76% (odds ratio, 6.9; 95% confidence interval, 2.7 to 17.1; P tract (GU)-directed agents (nitrofurantoin or sulfa agents) were equally as likely as broad-spectrum agents to be accurate (P = 0.3). Choosing an agent concordant with previous microbiologic data significantly increased the chance of accuracy of therapy for MDR UTIs, even if the previous uropathogen was a different species. Also, GU-directed or broad-spectrum therapy choices were equally likely to be accurate. The accuracy of empiric therapy could be improved by the use of these simple rules. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  15. Identification of sudden stiffness changes in the acceleration response of a bridge to moving loads using ensemble empirical mode decomposition (United States)

    Aied, H.; González, A.; Cantero, D.


    The growth of heavy traffic together with aggressive environmental loads poses a threat to the safety of an aging bridge stock. Often, damage is only detected via visual inspection at a point when repairing costs can be quite significant. Ideally, bridge managers would want to identify a stiffness change as soon as possible, i.e., as it is occurring, to plan for prompt measures before reaching a prohibitive cost. Recent developments in signal processing techniques such as wavelet analysis and empirical mode decomposition (EMD) have aimed to address this need by identifying a stiffness change from a localised feature in the structural response to traffic. However, the effectiveness of these techniques is limited by the roughness of the road profile, the vehicle speed and the noise level. In this paper, ensemble empirical mode decomposition (EEMD) is applied by the first time to the acceleration response of a bridge model to a moving load with the purpose of capturing sudden stiffness changes. EEMD is more adaptive and appears to be better suited to non-linear signals than wavelets, and it reduces the mode mixing problem present in EMD. EEMD is tested in a variety of theoretical 3D vehicle-bridge interaction scenarios. Stiffness changes are successfully identified, even for small affected regions, relatively poor profiles, high vehicle speeds and significant noise. The latter is due to the ability of EEMD to separate high frequency components associated to sudden stiffness changes from other frequency components associated to the vehicle-bridge interaction system.

  16. An Empirical Analysis of the Changing Role of the German Bundesbank after 1983

    DEFF Research Database (Denmark)

    Juselius, Katarina

    and expansion or contraction of money supply had the expected effect on prices, income, and interest rates. After 1983, the conventional mechanisms no longer seemed to work. The empirical analysis pointed to the crucial role of the bond rate in the system, particularly for the more recent period......A cointegrated VAR model describing a small macroeconomic system consisting of money, income, prices, and interest rates is estimated on split sample data before and after 1983. The monetary mechanisms were found to be significantly different. Before 1983, the money supply seemed controlable...

  17. Psychodynamic therapy from the perspective of self-organization. a concept of change and a methodological approach for empirical examination. (United States)

    Gumz, Antje; Geyer, Michael; Brähler, Elmar


    Observations from therapeutic practice and a series of empirical findings, for example, those on discontinuous change in psychotherapeutic processes, suggest modelling the therapeutic process as a self-organizing system with stable and critical instable phases and abrupt transitions. Here, a concept of psychotherapeutic change is presented that applies self-organization theory to psychodynamic principles. The authors explain the observations and considerations that form the basis of the concept and present some connections with existing findings and concepts. On the basis of this model, they generated two hypotheses regarding the co-occurrence of instability and discontinuous change and the degree of synchrony between the therapist and patient. A study design to test these hypotheses was developed and applied to a single case (psychodynamic therapy). After each session, patient and therapist rated their interaction. A measure of instability was calculated across the resulting time series. Sequences of destabilization were observed. On the basis of points of extreme instability, the process was divided into phases. Local instability maxima were accompanied by significant discontinuous change. Destabilization was highly synchronous in therapist and patient ratings. The authors discussed the concept and the methodological procedure. The approach enables the operationalization of crises and to empirically assess the significance of critical phases and developments within the therapeutic relationship. We present a concept of change that applies self-organization theory to psychodynamic therapy. We empirically tested the hypotheses formulated in the concept based on an extract of 125 long-term psychodynamic therapy sessions. We continuously monitored the therapeutic interaction and calculated a measure of the instability of the assessments. We identified several sequences of stable and unstable episodes. Episodes of high instability were accompanied by discontinuous

  18. Routine Treatment of Cervical Cytological Cell Changes (United States)

    Huber, J.; Pötsch, B.; Gantschacher, M.; Templ, M.


    Introduction: Diagnosis and treatment of vaginal and cervical cytological cell changes are described in European and national guidelines. The aim of this data collection was to evaluate the remission rates of PAP III and PAP III D cytological findings in patients over a period of 3–4 months. Method: The current state of affairs in managing suspicious and cytological findings (PAP III, and III D) in gynecological practice was assessed in the context of a data collection survey. An evaluation over a period of 24 months was conducted on preventative measures, the occurrence and changes to normal/suspect/pathological findings and therapy management (for suspicious or pathological findings). Results: 307 female patients were included in the analysis. At the time of the survey 186 patients (60.6 %) had PAP III and 119 (38.8 %) had PAP III D findings. The spontaneous remission rate of untreated PAP III patients was 6 % and that of untreated PAP III D patients was 11 %. The remission rates of patients treated with a vaginal gel were 77 % for PAP III and 71 % for PAP III D. Conclusion: A new treatment option was used in gynecological practice on patients with PAP III and PAP III D findings between confirmation and the next follow-up with excellent success. PMID:27761030

  19. Treating Pediatric Obesity Using an Empirically Supported Treatment: A Case Report (United States)

    Cunningham, Phillippe B.; Ellis, Deborah A.; Naar-King, Sylvie


    Overweight and obesity are increasing dramatically in the United States of America, especially among children. Effective treatment of the multiple risk factors that promote youth obesity requires treatment approaches that are flexible and comprehensive enough to address each of these factors. One such treatment approach is Multisystemic Therapy…

  20. An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities. (United States)

    Kurtz, Patricia F; Boelter, Eric W; Jarmolowicz, David P; Chin, Michelle D; Hagopian, Louis P


    This paper examines the literature on the use of functional communication training (FCT) as a treatment for problem behavior displayed by individuals with intellectual disabilities (ID). Criteria for empirically supported treatments developed by Divisions 12 and 16 of the American Psychological Association (Kratochwill & Stoiber, 2002; Task Force, 1995) and adapted by Jennett and Hagopian (2008) for evaluation of single-case research studies were used to examine the support for FCT. Results indicated that FCT far exceeds criteria to be designated as a well-established treatment for problem behavior exhibited by children with ID and children with autism spectrum disorder, and can be characterized as probably efficacious with adults. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Empirically observed learning rates for concentrating solar power and their responses to regime change (United States)

    Lilliestam, Johan; Labordena, Mercè; Patt, Anthony; Pfenninger, Stefan


    Concentrating solar power (CSP) capacity has expanded slower than other renewable technologies and its costs are still high. Until now, there have been too few CSP projects to derive robust conclusions about its cost development. Here we present an empirical study of the cost development of all operating CSP stations and those under construction, examining the roles of capacity growth, industry continuity, and policy support design. We identify distinct CSP expansion phases, each characterized by different cost pressure in the policy regime and different industry continuity. In 2008-2011, with low cost pressure and following industry discontinuity, costs increased. In the current phase, with high cost pressure and continuous industry development, costs decreased rapidly, with learning rates exceeding 20%. Data for projects under construction suggest that this trend is continuing and accelerating. If support policies and industrial structure are sustained, we see no near-term factors that would hinder further cost decreases.

  2. Quantifying the number of lane changes in traffic : An empirical analysis

    NARCIS (Netherlands)

    Knoop, V.L.; Hoogendoorn, S.P.; Shiomi, Y.; Buisson, C.


    Lane changes are an important aspect of freeway flow. Most lane change models are microscopic, describing whether individual vehicles/drives will change lanes, and hence are calibrated microscopically. Macroscopic validation often is restricted to the distribution of vehicles across lanes. To the

  3. An Empirical Study on the Role of Context Factors in Employees' Commitment to Change (United States)

    Soumyaja, Devi; Kamlanabhan, T. J.; Bhattacharyya, Sanghamitra


    The study attempts to address the gap of exploring the possible antecedents of employees' commitment to change and its three dimensions. The role of context factors--participation in decision making, quality of communication, trust in management and history of change--are tested on overall commitment to change and also on its three…

  4. Empirical measures vs. perceived gambling severity among youth: why adolescent problem gamblers fail to seek treatment. (United States)

    Hardoon, Karen; Derevensky, Jeffrey L; Gupta, Rina


    A comparison of empirical measures and perceived gambling severity among youth was conducted. Participants (N=980), mean age of 18.6 years, completed several widely accepted measures of pathological gambling [Diagnostic and Statistical Manual of Mental Disorders-IV-Juveniles (DSM-IV-J), South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), and Gambler's Anonymous 20 Questions (GA 20)] and a questionnaire assessing gambling behavior. Findings revealed that while the DSM-IV-J, SOGS-RA, and GA 20 identified between 3.4% and 5.8% of participants as probable pathological gamblers, only 1.1% of individuals classified themselves as such. Further, 3.3% of the population reported that they considered themselves problem gamblers and 66% reported being social gamblers. It appears as though either youth are grossly underestimating the severity of their gambling problems or the gambling screens are overestimating prevalence rates. The clinical implications and future directions for research are considered.

  5. The Current State of Empirical Support for the Pharmacological Treatment of Selective Mutism (United States)

    Carlson, John S.; Mitchell, Angela D.; Segool, Natasha


    This article reviews the current state of evidence for the psychopharmacological treatment of children diagnosed with selective mutism within the context of its link to social anxiety disorder. An increased focus on potential medication treatment for this disorder has resulted from significant monetary and resource limitations in typical practice,…

  6. Empirically Supported Family-Based Treatments for Conduct Disorder and Delinquency in Adolescents (United States)

    Henggeler, Scott W.; Sheidow, Ashli J.


    Several family-based treatments of conduct disorder and delinquency in adolescents have emerged as evidence-based and, in recent years, have been transported to more than 800 community practice settings. These models include multisystemic therapy, functional family therapy, multidimensional treatment foster care, and, to a lesser extent, brief…

  7. Language Change in the Wake of Empire: Syriac in Its Greco-Roman Context (United States)

    Butts, Aaron Michael


    Greek-Aramaic bilingualism was wide-spread throughout Late Antique Syria and Mesopotamia. Among the various Aramaic dialects, Syriac underwent a particularly intense and prolonged period of contact with Greek. This contact led to changes in both languages. The present study provides a new analysis of contact-induced changes in Syriac due to Greek,…

  8. The Serengeti food web : Empirical quantification and analysis of topological changes under increasing human impact

    NARCIS (Netherlands)

    de Visser, Sara N.; Freymann, Bernd P.; Olff, Han

    P>1. To address effects of land use and human overexploitation on wildlife populations, it is essential to better understand how human activities have changed species composition, diversity and functioning. Theoretical studies modelled how network properties change under human-induced, non-random

  9. Melting empires? Climate change and politics in Antarctica since the International Geophysical Year. (United States)

    Howkins, Adrian


    This article examines the relationship between climate change and politics in Antarctica since the International Geophysical Year of 1957-8, paying particular attention to the work of the British Antarctic Survey. Research conducted in Antarctica has played an important role in the understanding of climate change on a global scale. In turn, fears about the consequences of global climate change have radically changed perceptions of Antarctica and profoundly shaped scientific research agendas: a continent that until fifty years ago was perceived largely as an inhospitable wilderness has come to be seen as a dangerously vulnerable environment. This radical shift in perception contrasts with a fundamental continuity in the political power structures of the continent. This article argues that the severity of the threat of climate change has reinforced the privileged political position of the "insider" nations within the Antarctic Treaty System.

  10. Preferences for trauma treatment: A systematic review of the empirical literature. (United States)

    Simiola, Vanessa; Neilson, Elizabeth C; Thompson, Richard; Cook, Joan M


    The prevalence of trauma histories and related psychological problems is high in general clinical settings, but little is known about trauma patient preferences for mental health treatment. The purpose of this article is to systematically review and synthesize the literature on treatment preferences in survivors of traumatic events. Studies were identified using comprehensive searches of PsycINFO, Medline, PubMed, Published International Literature on Traumatic Stress, and Cumulative Index to Nursing and Allied Health Literature databases. Included in the review were articles published between January 1980 and September 2014, in English that reported patient preference of treatment for trauma related disorders in either clinical or nonclinical (e.g., analog) samples. The total number of individual participants was 6,091. Of the identified studies, 35 were quantitative and 6 were qualitative. Methodological concerns included the use of analog samples, small sample sizes, and the assessment of a limited number of treatment options (e.g., asking about only 1 type of psychotherapy or medication). Overall, participants expressed a preference for psychotherapy over medication and for talking about their trauma. Understanding and addressing trauma patient preferences may assist in improving treatment initiation as well as facilitate engagement, retention and outcome. (c) 2015 APA, all rights reserved).

  11. Economic valuation of environmental benefits from wastewater treatment processes: an empirical approach for Spain. (United States)

    Hernández-Sancho, Francesc; Molinos-Senante, María; Sala-Garrido, Ramón


    Economic research into the design and implementation of policies for the efficient management of water resources has been emphasized by the European Water Framework Directive (Directive 2000/60/EC). The efficient implementation of policies to prevent the degradation and depletion of water resources requires determining their value in social and economic terms and incorporating this information into the decision-making process. A process of wastewater treatment has many associated environmental benefits. However, these benefits are often not calculated because they are not set by the market, due to inadequate property rights, the presence of externalities, and the lack of perfect information. Nevertheless, the valuation of these benefits is necessary to justify a suitable investment policy and a limited number of studies exist on the subject of the economic valuation of environmental benefits. In this paper, we propose a methodology based on the estimation of shadow prices for the pollutants removed in a treatment process. This value represents the environmental benefit (avoided cost) associated with undischarged pollution. This is a pioneering approach to the economic valuation of wastewater treatment. The comparison of these benefits with the internal costs of the treatment process will provide a useful indicator for the feasibility of wastewater treatment projects. Copyright 2009 Elsevier B.V. All rights reserved.

  12. Early Medical Treatment of Children and Adolescents With Gender Dysphoria: An Empirical Ethical Study

    NARCIS (Netherlands)

    Vrouenraets, L.J.J.J.; Fredriks, A.M.; Hannema, S.E.; Cohen-Kettenis, P.T.; de Vries, M.C.


    Purpose The Endocrine Society and the World Professional Association for Transgender Health published guidelines for the treatment of adolescents with gender dysphoria (GD). The guidelines recommend the use of gonadotropin-releasing hormone agonists in adolescence to suppress puberty. However, in

  13. The Differential Treatment Model: Empirical Evidence from a Personality Typology of Adult Offenders. (United States)

    Annis, Helen M.; Chan, David


    Interaction of offender type by treatment program was examined for 100 adult offenders with alcohol and drug problems assigned to a group therapy program and 50 to routine care. Offenders who were classified high in self-image showed greater improvement in the group therapy program. (Author/HLM)

  14. Why Do Firms Train? Empirical Evidence on the Relationship between Training and Technological and Organizational Change (United States)

    Neirotti, Paolo; Paolucci, Emilio


    We explore the relationship between training and innovation using key insights from the resource-based approach, organizational learning and labour studies. By using data from 304 large enterprises in Italy, the study highlights a twofold role of training in favouring technological and organizational changes. First, training plays a role in…

  15. Adaptability: Conceptual and Empirical Perspectives on Responses to Change, Novelty and Uncertainty (United States)

    Martin, Andrew J.; Nejad, Harry; Colmar, Susan; Liem, Gregory Arief D.


    Adaptability is proposed as individuals' capacity to constructively regulate psycho-behavioral functions in response to new, changing, and/or uncertain circumstances, conditions and situations. The present investigation explored the internal and external validity of an hypothesised adaptability scale. The sample comprised 2,731 high school…

  16. Do changes in environmental and fishing pressures impact marine communities? An empirical assessment

    NARCIS (Netherlands)

    Rochet, M.J.; Trenkel, V.M.; Carpentier, A.; Coppin, F.; Sola, L.G.; Leaute, J.P.; Mahe, J.C.; Maiorano, P.; Mannini, A.; Murenu, M.; Piet, G.J.; Politou, C.Y.; Reale, B.; Spedicato, M.T.; Tserpes, G.; Bertrand, J.A.


    1. The development of ecosystem approaches to environmental management implies the need to account for multiple pressures on ecosystems. Trends in multiple metrics that respond differently to changes in major environmental pressures need to be combined to evaluate the impacts of fishing and

  17. Mechanisms of change in psychotherapy for depression: An empirical update and evaluation of research aimed at identifying psychological mediators. (United States)

    Lemmens, Lotte H J M; Müller, Viola N L S; Arntz, Arnoud; Huibers, Marcus J H


    We present a systematic empirical update and critical evaluation of the current status of research aimed at identifying a variety of psychological mediators in various forms of psychotherapy for depression. We summarize study characteristics and results of 35 relevant studies, and discuss the extent to which these studies meet several important requirements for mechanism research. Our review indicates that in spite of increased attention for the topic, advances in theoretical consensus about necessities for mechanism research, and sophistication of study designs, research in this field is still heterogeneous and unsatisfactory in methodological respect. Probably the biggest challenge in the field is demonstrating the causal relation between change in the mediator and change in depressive symptoms. The field would benefit from a further refinement of research methods to identify processes of therapeutic change. Recommendations for future research are discussed. However, even in the most optimal research designs, explaining psychotherapeutic change remains a challenge. Psychotherapy is a multi-dimensional phenomenon that might work through interplay of multiple mechanisms at several levels. As a result, it might be too complex to be explained in relatively simple causal models of psychological change. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Electricity markets evolution with the changing generation mix: An empirical analysis based on China 2050 High Renewable Energy Penetration Roadmap

    International Nuclear Information System (INIS)

    Zou, Peng; Chen, Qixin; Yu, Yang; Xia, Qing; Kang, Chongqing


    Highlights: • How electricity markets are evolving with the changing generation mix is studied. • China 2050 High Renewable Energy Penetration Roadmap are empirically analysed. • A multi-period Nash-Cournot model is established to study the market equilibrium. • Energy storages are analysed and compared to reveal their impacts on the equilibrium. - Abstract: The power generation mix are significantly changing due to the growth of stricter energy policies. The renewables are increasingly penetrating the power systems and leading to more clean energy and lower energy prices. However, they also require much more flexibilities and ancillary services to handle their uncertainties and variabilities. Thus, the requirements for regulation and reserve services may dramatically increase while the supplies of these services, which are mainly from the traditional thermal plants, remain almost invariant. This changing situation will cause higher regulation and reserve prices and impact the profit models and revenue structures of the traditional plants. How electricity markets are actually evolving with the changing generation mix? Can enough backup power plants be given adequate economic incentives and thus remained with the increasing renewables and the decreasing energy prices and productions? Can de-carbonization be fully performed in power systems? To explicitly answer the question, this paper uses a multi-period Nash-Cournot equilibrium model to formulate the evolution of power markets incorporating different types of generators, including thermal units, hydro units, wind farms, solar stations and energy storage systems. The price changes in the co-optimized energy, regulation and reserve markets, and the profit changes of various generators are studied. And the variabilities and uncertainties of renewable generation sources are considered in dynamically determining the requirements of regulation and reserve services. Based on the China 2050 High Renewable Energy

  19. Transformational leadership and change readiness and a moderating role of perceived bureaucratic structure: an empirical investigation


    Badri Abbasi


    The purpose of this study was to examine the relationship between transformational leadership and change readiness through perceived bureaucratic structure among government employees in Rasht. As a methodology, descriptive method was applied using questionnaire to collect data. The studied population consisted of 600 employees from three state organizations including Municipality, Gilan Tax Department and Gilan Justice Court. According to Morgan table, the sample size was estimated at 234. Th...

  20. Changes in Bacterial Resistance Patterns of Pediatric Urinary Tract Infections and Rationale for Empirical Antibiotic Therapy


    İbrahim Gökçe; Neslihan Çiçek; Serçin Güven; Ülger Altuntaş; Neşe Bıyıklı; Nurdan Yıldız; Harika Alpay


    Background: The causative agent spectrum and resistance patterns of urinary tract infections in children are affected by many factors. Aims: To demonstrate antibiotic resistance in urinary tract infections and changing ratio in antibiotic resistance by years. Study Design: Retrospective cross-sectional study. Methods: We analysed antibiotic resistance patterns of isolated Gram (-) bacteria during the years 2011-2014 (study period 2) in children with urinary tract infections. We...

  1. Three empirical essays on consumer behavior related to climate change and energy (United States)

    Jacobsen, Grant Douglas

    This dissertation consists of three essays. All of the chapters address a topic in the area of household and consumer behavior related to climate change or energy. The first chapter is titled "The Al Gore Effect: An Inconvenient Truth and Voluntary Carbon Offsets". This chapter examines the relationship between climate change awareness and household behavior by testing whether Al Gore's documentary An Inconvenient Truth caused an increase in the purchase of voluntary carbon offsets. The analysis shows that in the two months following the film's release, zip codes within a 10-mile radius of a zip code where the film was shown experienced a 50 percent relative increase in the purchase of voluntary carbon offsets. The second chapter is titled "Are Building Codes Effective at Saving Energy? Evidence from Residential Billing Data in Florida". The analysis shows that Florida's energy-code change that took effect in 2002 is associated with a 4-percent decrease in electricity consumption and a 6-percent decrease in natural-gas consumption in Gainesville, FL. The estimated private payback period for the average residence is 6.4 years and the social payback period ranges between 3.5 and 5.3 years. The third chapter in this dissertation is titled "Do Environmental Offsets Increase Demand for Dirty Goods? Evidence from Residential Electricity Demand". This study evaluates the relationship between green products and existing patterns of consumer behavior by examining the relationship between household enrollment in a green electricity program and consumption of residential electricity. The results suggest there are two different types of green consumers. One type makes a small monthly donation and partially views the donation as a substitute for a previously existing pattern of green behavior, in this case, energy conservation. The other type makes a larger monthly donation and views the donation as a way to make strictly additional improvements in environmental quality.

  2. Changes of energy-related GHG emissions in China: An empirical analysis from sectoral perspective

    International Nuclear Information System (INIS)

    Xu, Xianshuo; Zhao, Tao; Liu, Nan; Kang, Jidong


    Highlights: • We analyzed the factors impacting China’s emissions from a sectoral perspective. • Sector-specific policies and measures for emissions mitigation were evaluated. • Economic growth dominantly increased the emissions in the economic sectors. • Energy intensity decrease primarily reduced the emissions in the economic sectors. • Residential emissions growth was mainly driven by increase in per-capita energy use. - Abstract: In order to better understand sectoral greenhouse gas (GHG) emissions in China, this study utilized a logarithmic mean Divisia index (LMDI) decomposition analysis to study emission changes from a sectoral perspective. Based on the decomposition results, recently implemented policies and measures for emissions mitigation in China were evaluated. The results show that for the economic sectors, economic growth was the dominant factor in increasing emissions from 1996 to 2011, whereas the decline in energy intensity was primarily responsible for the emission decrease. As a result of the expansion of industrial development, economic structure change also contributed to growth in emissions. For the residential sector, increased emissions were primarily driven by an increase in per-capita energy use, which is partially confirmed by population migration. For all sectors, the shift in energy mix and variation in emission coefficient only contributed marginally to the emissions changes. The decomposition results imply that energy efficiency policy in China has been successful during the past decade, i.e., Top 1000 Priorities, Ten-Key Projects programs, the establishment of fuel consumption limits and vehicle emission standards, and encouragement of efficient appliances. Moreover, the results also indicate that readjusting economic structure and promoting clean and renewable energy is urgently required in order to further mitigate emissions in China

  3. Fiscal Sustainability: Does EU Membership Change Policy Behavior? Empirical Evidence from Central and Eastern Europe

    Directory of Open Access Journals (Sweden)

    Bettina Bökemeier


    Full Text Available This paper studies fiscal policy behavior with regard to sustainability for the group of the eight eastern new member states which joined the European Union in 2004. Using the approach of Bohn (1995, 998 the fiscal reaction function is estimated for the years 1996 until 2013. Further, separating the response in periods before and after accession studies potential changes in fiscal sustainability. The results of the panel regressions reveal a positive statistically significant reaction coefficient, indicating sustainable behavior. Moreover, once the responses are split in 2004 the reaction coefficient is somewhat larger in size ahead of the accession. Accounting for the crisis reveals that these years challenge fiscal sustainability.

  4. The Influence of Globalization on the Change and Convergence of Social Security Transfer: An Empirical Analysis for OECD Counties

    Directory of Open Access Journals (Sweden)

    Jinyoung Hwang


    Full Text Available Using a cross-section of OECD countries, this paper examines the relationship between globalization and the change and convergence of social security transfer. Globalization has arguably had a profound impact on the use of social protection in states, since it is normally accompanied with increases in income inequality, polarization, and unemployment. In addition, globalization may lead to socio- economic policy harmonization across countries. The empirical results show that there exists a significant and positive relationship between social security transfer in GDP and the globalization index based on political, economic, and social integrations. Also, we found the convergence phenomenon of social security transfer in OECD countries, applying the traditional methodology of convergence and convergence. Therefore, there is evidence in OECD countries that globalization indirectly affects the convergence of social security transfer in addition to direct relation to social security transfer in GDP.

  5. Climate change and hailstorm damage: Empirical evidence and implications for agriculture and insurance

    International Nuclear Information System (INIS)

    Botzen, W.J.W.; Bouwer, L.M.; van den Bergh, J.C.J.M.


    There is much uncertainty about the effects of anthropogenic climate change on the frequency and severity of extreme weather events like hailstorms, and subsequent economic losses, while this is also relevant information for the design of climate policy. Few studies conducted indicate that a strong positive relation exists between hailstorm activity and hailstorm damage, as predicted by minimum temperatures using simple correlations. This relation suggests that hailstorm damage may increase in the future if global warming leads to further temperature increase. This study estimates a range of Tobit models of relations between normalized insured hailstorm damage to agriculture and several temperature and precipitation indicators for the Netherlands. Temporal dynamics are explicitly modelled. A distinction is made between damage costs for greenhouse horticulture and outdoor farming, which appear to be differently affected by variability in weather. 'Out of sample' forecast tests show that a combination of maximum temperatures and precipitation predicts hailstorm damage best. Extrapolations of the historical relations between hailstorm damage and weather indicators under climate change scenarios project a considerable increase in future hailstorm damage. Our estimates show that by 2050 annual hailstorm damage to outdoor farming could increase by between 25% and 50%, with considerably larger impacts on greenhouse horticulture in summer of more than 200%. The economic implications of more hailstorm damage for, and adaptation by, the agricultural and insurance sectors are discussed. (author)

  6. Voltammetric Thin-Layer Ionophore-Based Films: Part 2. Semi-Empirical Treatment. (United States)

    Yuan, Dajing; Cuartero, Maria; Crespo, Gaston A; Bakker, Eric


    This work reports on a semiempirical treatment that allows one to rationalize and predict experimental conditions for thin-layer ionophore-based films with cation-exchange capacity read out with cyclic voltammetry. The transition between diffusional mass transport and thin-layer regime is described with a parameter (α), which depends on membrane composition, diffusion coefficient, scan rate, and electrode rotating speed. Once the thin-layer regime is fulfilled (α = 1), the membrane behaves in some analogy to a potentiometric sensor with a second discrimination variable (the applied potential) that allows one to operate such electrodes in a multianalyte detection mode owing to the variable applied ion-transfer potentials. The limit of detection of this regime is defined with a second parameter (β = 2) and is chosen in analogy to the definition of the detection limit for potentiometric sensors provided by the IUPAC. The analytical equations were validated through the simulation of the respective cyclic voltammograms under the same experimental conditions. While simulations of high complexity and better accuracy satisfactorily reproduced the experimental voltammograms during the forward and backward potential sweeps (companion paper 1), the semiempirical treatment here, while less accurate, is of low complexity and allows one to quite easily predict relevant experimental conditions for this emergent methodology.

  7. Empirical study on impact of demographic and economic changes on pension cost (United States)

    Yusof, Shaira; Ibrahim, Rose Irnawaty


    A continuation of the same financial standard of living after retirement as before is very importance to retired person. The pension provider has a responsibility to ensure their employees receive the sufficient benefit after retirement and regularly monitor the factors that cause insufficient funds to pay benefit to retirees. Insufficient funds may be due to increased in pension cost. Some of the factors that increase the cost of pensions are changes in mortality rates and interest rates. This study will used these two factors to determine their sensitivity to pension cost. Two methods which are Accrued Benefit Cost Method and Projected Benefit Cost Method will be used to estimate pension cost. Interest rates has a inversely related to pension cost while mortality rates has a directly related to pension cost.

  8. Empirical Records of Environmental Change across the Archean-Proterozoic Transition (United States)

    Kaufman, A. J.


    Time-series geochemical analyses of scientific drill cores intersecting the Archean-Proterozoic transition suggest a coupling of environmental and biological change that culminated in the pervasive oxygenation of Earth's atmosphere and oceans. Elemental and multiple isotope measurements of sedimentary archives, including carbonate, shale, and banded iron-formation from Western Australia, South Africa, Brazil, and southern Canada, indicate important changes in the carbon, sulfur, and nitrogen cycles that monitor the redox state of the oceans and the cyanobacterial buildup of atmospheric oxygen and ozone. In response, continental weathering would have increased, resulting in the enhanced delivery of sulfate and nutrients to seawater, further stimulating photoautotrophic fluxes of oxygen to surface environments. The positive feedback may additionally be responsible for the decline of atmospheric methane and surface refrigeration, represented by a series of discrete ice ages beginning around 2.4 billion years ago, due to the loss of greenhouse capacity during a time of lower solar luminosity. While speculative, the linkage of surface oxidation with enhanced nutrient supply and development of stratospheric sunscreen soon after the Archean-Proterozoic boundary suggests that the earliest perturbation in the carbon cycle may be associated with the rapid expansion of single-celled eukaryotes. Both sterol synthesis in eukaryotes and aerobic respiration require significant levels of oxygen in the ambient environment. Hence, Earth's earliest ice age(s) and onset of a modern and far more energetic carbon cycle may have been directly related to the global expansion of cyanobacteria that released oxygen to the environment, and of eukaryotes that respired it.

  9. Empirical Accounting of Adaptation to Environmental Change: Organizational Competencies and Biodiversity in Finnish Forest Management

    Directory of Open Access Journals (Sweden)

    Eeva Primmer


    Full Text Available Integration of biodiversity conservation into economic utilization of natural resources has become a central response to the challenges of sustainable development. However, the resources and competencies required to implement such an integrated strategy at the level of the individual, the organization, and the sector are not known. To address this knowledge gap, we have developed an approach to analyze responses of organizations to environmental change and evolving social demands for biodiversity conservation. We analyze the scale, scope, and distribution of the resources and competencies that support the delineation of ecologically significant habitats in intensively managed nonindustrial private forests in Finland, an important international actor in the sector. Based on a national survey of 311 foresters working in public agencies, private firms, and cooperative organizations, we investigate the division of labor in the sector and the patterns of investment in human capital, organizational resources, and information networks that support delineation. We find that communicating frequently with the actors who are directly engaged in field operations is consistently the most productive resource in conserving habitats. Our analysis identifies differences in competencies among different types of organizations, as well as distinct roles for public and private-sector organizations. Beyond identification of differences in conservation behavior and competencies among organizations, our analysis points to substantial uniformity in the sector. We attribute similarities in patterns of investment in conservation resources to historically structured central coordination mechanisms within the sector that include education, training, and broadly shared professional norms. These institutional structures and the resulting uniformity can be potential impediments to radical innovation. Our approach to analyzing adaptation to environmental change highlights the

  10. The influence of causal knowledge on the willingness to change attitude towards climate change: results from an empirical study (United States)

    Tasquier, Giulia; Pongiglione, Francesca


    Climate change is one of the significant global challenges currently facing humanity. Even though its seriousness seems to be common knowledge among the public, the reaction of individuals to it has been slow and uncertain. Many studies assert that simply knowing about climate change is not enough to generate people's behavioural response. They claim, indeed, that in some cases scientific literacy can even obstruct behavioural response instead. However, recent surveys show a rather poor understanding of climate dynamics and argue that lack of knowledge about causal relationships within climate dynamics can hinder behavioural response, since the individual is not able to understand his/her role as causal agent and therefore doesn't know how to take proper action. This study starts from the hypothesis that scientific knowledge focused on clarifying climate dynamics can make people understand not only dynamics themselves, but also their interactive relationship with the environment. Teaching materials on climate change based on such considerations were designed and implemented in a course for secondary-school students with the aim of investigating whether this kind of knowledge had an influence on students' willingness to adopt pro-environmental behaviours. Questionnaires were delivered for testing the effect of the teaching experience on knowledge and behaviour.

  11. Impact of appropriate empirical antibiotic treatment on recurrence and mortality in patients with bacteraemia

    DEFF Research Database (Denmark)

    Gradel, Kim O.; Jensen, Ulrich S; Schønheyder, Henrik C.


    of bacteraemia patients. Methods: A cohort study including all patients hospitalized with incident bacteraemia during 2007-2008 in the Copenhagen City and County areas and the North Denmark Region. EAT was defined as the antibiotic treatment given at the 1st notification of a positive blood culture...... models. Results: In 6483 eligible patients, 712 (11%) had a recurrent episode. A total of 3778 (58%) patients received appropriate EAT, 1290 (20%) received inappropriate EAT, while EAT status was unrecorded for 1415 (22%) patients. The 2-30 day mortality was 15.1%, 17.4% and 19.2% in patients receiving...... appropriate EAT, inappropriate EAT, and unknown EAT, respectively. Among patients alive on day 30, the 31-365 day mortality was 22.3% in patients given appropriate EAT compared to 30.7% in those given inappropriate EAT. Inappropriate EAT was independently associated with recurrence (HR 1.25; 95% CI = 1...

  12. Changes in carbon intensity in China. Empirical findings from 1980-2003

    International Nuclear Information System (INIS)

    Fan, Ying; Wei, Yi-Ming; Liu, Lan-Cui; Wu, Gang; Tsai, Hsien-Tang


    China experienced sustainable, rapid economic growth over the period 1980-2003 but, at the same time, energy-related carbon intensity showed a downward trend. It begs the question, therefore, what factors were driving this decline in carbon intensity and will this decline be maintained in future? Moreover, what measures can be adopted to ensure a continual decline in carbon intensity? These questions led to increased research in the factors governing CO 2 emission in China. This paper quantifies the driving force behind China's primary energy-related carbon intensity and measures the material production sectors' final energy-related carbon intensity. Our results show that the overwhelming contributor to the decline of energy-related carbon intensity was the reduction in real energy intensity. However, policies that focus only on the decline in energy intensity are insufficient to further decrease carbon intensity. The change of primary energy mix can improve the decline of carbon intensity. This should focus on the material production sectors' development strategies and final energy use. Greater emphasis should be given to secondary industry, which needs national and regional governments' policy support. (author)

  13. Simulated vs. empirical weather responsiveness of crop yields: US evidence and implications for the agricultural impacts of climate change (United States)

    Mistry, Malcolm N.; Wing, Ian Sue; De Cian, Enrica


    Global gridded crop models (GGCMs) are the workhorse of assessments of the agricultural impacts of climate change. Yet the changes in crop yields projected by different models in response to the same meteorological forcing can differ substantially. Through an inter-method comparison, we provide a first glimpse into the origins and implications of this divergence—both among GGCMs and between GGCMs and historical observations. We examine yields of rainfed maize, wheat, and soybeans simulated by six GGCMs as part of the Inter-Sectoral Impact Model Intercomparison Project-Fast Track (ISIMIP-FT) exercise, comparing 1981-2004 hindcast yields over the coterminous United States (US) against US Department of Agriculture (USDA) time series for about 1000 counties. Leveraging the empirical climate change impacts literature, we estimate reduced-form econometric models of crop yield responses to temperature and precipitation exposures for both GGCMs and observations. We find that up to 60% of the variance in both simulated and observed yields is attributable to weather variation. A majority of the GGCMs have difficulty reproducing the observed distribution of percentage yield anomalies, and exhibit aggregate responses that show yields to be more weather-sensitive than in the observational record over the predominant range of temperature and precipitation conditions. This disparity is largely attributable to heterogeneity in GGCMs’ responses, as opposed to uncertainty in historical weather forcings, and is responsible for widely divergent impacts of climate on future crop yields.

  14. Changes in US HIV Treatment Guidelines

    Centers for Disease Control (CDC) Podcasts


    Following the 2012 HIV Treatment Guidelines, which include early diagnosis and treatment with ART, can increase longevity and improve the quality of life for patients living with HIV.  Created: 10/3/2012 by National Center for HIV/AIDS, Hepatitis, STD and TB Prevention (NCHHSTP).   Date Released: 10/3/2012.

  15. Empirical Study on the Indicators of Sustainable Performance – the Sustainability Balanced Scorecard, Effect of Strategic Organizational Change

    Directory of Open Access Journals (Sweden)

    Maria Radu


    Full Text Available The sustainable organizational change has an ever increasing importance, leading to the rethinking of the management and systems of performance measurement and monitoring within the companies. As a reaction to current economic phenomena, in the first section of this work we tried to bring out the need for using the couple Balanced Scorecard - Corporate Social Responsibility by companies. Thus, companies involved in sustainable actions must grant a great importance to the impact of environmental, social and economic factors in providing added value, informing the interested parties and reflecting the reporting of sustainable performance. As a consequence, in the second part of the work we present the Sustainability Balanced Scorecard for the implementation of efficient strategies which cumulate the economic, social and environmental aspects as integrating system for sustainable performance and as a new challenge for organizational change. The key performance indicators included in the Sustainability Balanced Scorecard are quantified by the indicators of sustainable development, based on which the empirical research described in the third section of the work was achieved. Through the quantitative analysis of the economic and ecological indicators (Gross Domestic Product per capita, respective, Environmental Performance Index in correlation with the social indicator (Global Competitive Index, we conclude that the implementation of green strategies by companies leads to sustainable economic growth.

  16. Changing treatment of pediatric splenic trauma

    International Nuclear Information System (INIS)

    Kakkasseril, J.S.; Stewart, D.; Cox, J.A.; Gelfand, M.


    A review of splenic injuries at Cincinnati Children's Hospital Medical Center from July 1978 to June 1980 revealed this form of injury in 29 patients. Treatment without surgery was successful in 21 patients. Seven patients required operation. One patient died shortly after admission of severe associated injuries. All patients admitted with blunt abdominal trauma were initially treated conservatively. If the clinical state improved, after transfusions if necessary, or remained stable and there were no objective signs of further blood loss, conservative therapy was continued. Liver-spleen scans were obtained on an urgent basis to confirm the diagnosis of splenic injury in patients who did not undergo surgery. No complications of treatment without surgery were recognized. The satisfactory outcome in these patients suggests that there is a place for treatment without surgery in some children with splenic injury

  17. Changing treatment of pediatric splenic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Kakkasseril, J.S.; Stewart, D.; Cox, J.A.; Gelfand, M.


    A review of splenic injuries at Cincinnati Children's Hospital Medical Center from July 1978 to June 1980 revealed this form of injury in 29 patients. Treatment without surgery was successful in 21 patients. Seven patients required operation. One patient died shortly after admission of severe associated injuries. All patients admitted with blunt abdominal trauma were initially treated conservatively. If the clinical state improved, after transfusions if necessary, or remained stable and there were no objective signs of further blood loss, conservative therapy was continued. Liver-spleen scans were obtained on an urgent basis to confirm the diagnosis of splenic injury in patients who did not undergo surgery. No complications of treatment without surgery were recognized. The satisfactory outcome in these patients suggests that there is a place for treatment without surgery in some children with splenic injury.

  18. Functional changes after pancreatoduodenectomy: Diagnosis and treatment

    NARCIS (Netherlands)

    T.C. Tran; J.J.B. van Lanschot (Jan); M.J. Bruno (Marco); C.H.J. van Eijck (Casper)


    textabstractRelatively little is known about the gastrointestinal function after recovery of a pancreatoduodenectomy. This review focuses on the functional changes of the stomach, duodenum and pancreas that occur after pancreatoduodenectomy. Although the mortality in relation to

  19. The treatment of adolescent transsexuals: changing insights

    NARCIS (Netherlands)

    Cohen-Kettenis, P.T.; Delemarre-van d Waal, H.A.; Gooren, L.J.G.


    Introduction. Treatment of individuals with gender identity disorder (GID) has in medicine nearly always met with a great deal of skepticism. Professionals largely follow the Standards of Care of the World Professional Association for Transgender Health. For adolescents, specific guidelines have

  20. Carbapenem resistance, inappropriate empiric treatment and outcomes among patients hospitalized with Enterobacteriaceae urinary tract infection, pneumonia and sepsis. (United States)

    Zilberberg, Marya D; Nathanson, Brian H; Sulham, Kate; Fan, Weihong; Shorr, Andrew F


    Drug resistance among gram-negative pathogens is a risk factor for inappropriate empiric treatment (IET), which in turn increases the risk for mortality. We explored the impact of carbapenem-resistant Enterobacteriaceae (CRE) on the risk of IET and of IET on outcomes in patients with Enterobacteriaceae infections. We conducted a retrospective cohort study in Premier Perspective database (2009-2013) of 175 US hospitals. We included all adult patients with community-onset culture-positive urinary tract infection (UTI), pneumonia, or sepsis as a principal diagnosis, or as a secondary diagnosis in the setting of respiratory failure, treated with antibiotics within 2 days of admission. We employed regression modeling to compute adjusted association of presence of CRE with risk of receiving IET, and of IET on hospital mortality, length of stay (LOS) and costs. Among 40,137 patients presenting to the hospital with an Enterobacteriaceae UTI, pneumonia or sepsis, 1227 (3.1%) were CRE. In both groups, the majority of the cases were UTI (51.4% CRE and 54.3% non-CRE). Those with CRE were younger (66.6+/-15.3 vs. 69.1+/-15.9 years, p pneumonia or sepsis was comparable to other national estimates. Infection with CRE was associated with a four-fold increased risk of receiving IET, which in turn increased mortality, LOS and costs.

  1. Comparative Case Study of Diffusion of Eye Movement Desensitization and Reprocessing in Two Clinical Settings: Empirically Supported Treatment Status Is Not Enough

    NARCIS (Netherlands)

    Cook, Joan M.; Biyanova, Tatyana; Coyne, James C.


    An in-depth comparative case study was conducted of two attempts at diffusion of an empirically supported, but controversial, psychotherapy: eye movement desensitization and reprocessing (EMDR). One Department of Veterans Affairs (VA) treatment setting in which there was substantial uptake was

  2. Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study

    Directory of Open Access Journals (Sweden)

    Peralta Galo


    Full Text Available Abstract Background The objective of this study is to analyze the factors that are associated with the adequacy of empirical antibiotic therapy and its impact in mortality in a large cohort of patients with extended-spectrum β-lactamase (ESBL - producing Escherichia coli and Klebsiella spp. bacteremia. Methods Cases of ESBL producing Enterobacteriaceae (ESBL-E bacteremia collected from 2003 through 2008 in 19 hospitals in Spain. Statistical analysis was performed using multivariate logistic regression. Results We analyzed 387 cases ESBL-E bloodstream infections. The main sources of bacteremia were urinary tract (55.3%, biliary tract (12.7%, intra-abdominal (8.8% and unknown origin (9.6%. Among all the 387 episodes, E. coli was isolated from blood cultures in 343 and in 45.71% the ESBL-E was multidrug resistant. Empirical antibiotic treatment was adequate in 48.8% of the cases and the in hospital mortality was 20.9%. In a multivariate analysis adequacy was a risk factor for death [adjusted OR (95% CI: 0.39 (0.31-0.97; P = 0.04], but not in patients without severe sepsis or shock. The class of antibiotic used empirically was not associated with prognosis in adequately treated patients. Conclusion ESBL-E bacteremia has a relatively high mortality that is partly related with a low adequacy of empirical antibiotic treatment. In selected subgroups the relevance of the adequacy of empirical therapy is limited.

  3. Cost Effectiveness of Candida Polymerase Chain Reaction Detection and Empirical Antifungal Treatment among Patients with Suspected Fungal Peritonitis in the Intensive Care Unit. (United States)

    Pagès, Arnaud; Iriart, Xavier; Molinier, Laurent; Georges, Bernard; Berry, Antoine; Massip, Patrice; Juillard-Condat, Blandine


    Mortality from intra-abdominal candidiasis in intensive care units (ICUs) is high. It takes many days for peritoneal-fluid fungal culture to become positive, and the recommended empirical antifungal therapy involves excessive costs. Polymerase chain reaction (PCR) should produce results more rapidly than fungal culture. To perform a cost-effectiveness analysis of the combination of several diagnostic and therapeutic strategies to manage Candida peritonitis in non-neutropenic adult patients in ICUs. We constructed a decision tree model to evaluate the cost effectiveness. Cost and effectiveness were taken into account in a 1-year time horizon and from the French National Health Insurance perspective. Six strategies were compared: fluconazole or echinocandin as an empirical therapy, plus diagnosis by fungal culture or detection by PCR of all Candida species, or use of PCR to detect most fluconazole-resistant Candida species (i.e., Candida krusei and Candida glabrata). The use of fluconazole empirical treatment and PCR to detect all Candida species is more cost effective than using fluconazole empirical treatment without PCR (incremental cost-effectiveness ratio of €40,055/quality-adjusted life-year). Empirical treatment with echinocandin plus PCR to detect C. krusei and C. glabrata is the most effective strategy, but has an incremental cost-effectiveness ratio of €93,776/quality-adjusted life-year. If the cost of echinocandin decreases, then strategies involving PCR plus empirical echinocandin become more cost-effective. Detection by PCR of all Candida species and of most fluconazole-resistant Candida species could improve the cost-effectiveness of fluconazole and echinocandin given to non-neutropenic patients with suspected peritoneal candidiasis in ICUs. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  4. Empirical Comparison of Two Psychological Therapies: Self Psychology and Cognitive Orientation in the Treatment of Anorexia and Bulimia (United States)

    Bachar, Eytan; Latzer, Yael; Kreitler, Shulamit; Berry, Elliot M.


    The authors investigated the applicability of self psychological treatment (SPT) and cognitive orientation treatment (COT) to the treatment of anorexia and bulimia. Thirty-three patients participated in this study. The bulimic patients (n = 25) were randomly assigned either to SPT, COT, or control/nutritional counseling only (C/NC). The anorexic patients (n = 8) were randomly assigned to either SPT or COT. Patients were administered a battery of outcome measures assessing eating disorders symptomatology, attitudes toward food, self structure, and general psychiatric symptoms. After SPT, significant improvement was observed. After COT, slight but nonsignificant improvement was observed. After C/NC, almost no changes could be detected.(The Journal of Psychotherapy Practice and Research 1999; 8:115–128) PMID:10079459

  5. Time to Guideline-Based Empiric Antibiotic Therapy in the Treatment of Pneumonia in a Community Hospital: A Retrospective Review. (United States)

    Erwin, Beth L; Kyle, Jeffrey A; Allen, Leland N


    The 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines for hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and health care-associated pneumonia (HCAP) stress the importance of initiating prompt appropriate empiric antibiotic therapy. This study's purpose was to determine the percentage of patients with HAP, VAP, and HCAP who received guideline-based empiric antibiotic therapy and to determine the average time to receipt of an appropriate empiric regimen. A retrospective chart review of adults with HAP, VAP, or HCAP was conducted at a community hospital in suburban Birmingham, Alabama. The hospital's electronic medical record system utilized International Classification of Diseases, Ninth Revision (ICD-9) codes to identify patients diagnosed with pneumonia. The percentage of patients who received guideline-based empiric antibiotic therapy was calculated. The mean time from suspected diagnosis of pneumonia to initial administration of the final antibiotic within the empiric regimen was calculated for patients who received guideline-based therapy. Ninety-three patients met the inclusion criteria. The overall guideline adherence rate for empiric antibiotic therapy was 31.2%. The mean time to guideline-based therapy in hours:minutes was 7:47 for HAP and 28:16 for HCAP. For HAP and HCAP combined, the mean time to appropriate therapy was 21:55. Guideline adherence rates were lower and time to appropriate empiric therapy was greater for patients with HCAP compared to patients with HAP. © The Author(s) 2015.

  6. An empirical test of the relative and combined effects of land-cover and climate change on local colonization and extinction. (United States)

    Yalcin, Semra; Leroux, Shawn James


    Land-cover and climate change are two main drivers of changes in species ranges. Yet, the majority of studies investigating the impacts of global change on biodiversity focus on one global change driver and usually use simulations to project biodiversity responses to future conditions. We conduct an empirical test of the relative and combined effects of land-cover and climate change on species occurrence changes. Specifically, we examine whether observed local colonization and extinctions of North American birds between 1981-85 and 2001-05 are correlated with land-cover and climate change and whether bird life history and ecological traits explain interspecific variation in observed occurrence changes. We fit logistic regression models to test the impact of physical land-cover change, changes in net primary productivity, winter precipitation, mean summer temperature, and mean winter temperature on the probability of Ontario breeding bird local colonization and extinction. Models with climate change, land-cover change, and the combination of these two drivers were the top ranked models of local colonization for 30%, 27%, and 29% of species, respectively. Conversely, models with climate change, land-cover change, and the combination of these two drivers were the top ranked models of local extinction for 61%, 7%, and 9% of species, respectively. The quantitative impacts of land-cover and climate change variables also vary among bird species. We then fit linear regression models to test whether the variation in regional colonization and extinction rate could be explained by mean body mass, migratory strategy, and habitat preference of birds. Overall, species traits were weakly correlated to heterogeneity in species occurrence changes. We provide empirical evidence showing that land-cover change, climate change, and the combination of multiple global change drivers can differentially explain observed species local colonization and extinction. This article is protected

  7. Inglorious Empire

    DEFF Research Database (Denmark)

    Khair, Tabish


    Review of 'Inglorious Empire: What the British did to India' by Shashi Tharoor, London, Hurst Publishers, 2017, 296 pp., £20.00......Review of 'Inglorious Empire: What the British did to India' by Shashi Tharoor, London, Hurst Publishers, 2017, 296 pp., £20.00...

  8. Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care (United States)

    Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart


    Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

  9. Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Faber, J; Petersen, L; Wiinberg, N


    by LT(4) (p treatment in SH results in changes in hemodynamic parameters of potentially beneficial character. SH and overt hypothyroidism should......In hypothyroidism, lack of thyroid hormones results in reduced cardiac function (cardiac output [CO]), and an increase of systemic vascular resistance (SVR). We speculated whether hemodynamic regulation in subjects with subclinical hypothyroidism (SH) (defined as mildly elevated thyrotropin [TSH......) and T(3) estimates) LT(4) treatment resulted in 6% reduction in supine MAP (p treatment (p

  10. Mechanisms of change in psychotherapy for depression : An empirical update and evaluation of research aimed at identifying psychological mediators

    NARCIS (Netherlands)

    Lemmens, L.H.J.M.; Müller, V.N.L.S.; Arntz, A.; Huibers, M.J.H.


    We present a systematic empirical update and critical evaluation of the current status of research aimed at identifying a variety of psychological mediators in various forms of psychotherapy for depression. We summarize study characteristics and results of 35 relevant studies, and discuss the extent

  11. Empirical Philosophy of Science

    DEFF Research Database (Denmark)

    Mansnerus, Erika; Wagenknecht, Susann


    knowledge takes place through the integration of the empirical or historical research into the philosophical studies, as Chang, Nersessian, Thagard and Schickore argue in their work. Building upon their contributions we will develop a blueprint for an Empirical Philosophy of Science that draws upon...... qualitative methods from the social sciences in order to advance our philosophical understanding of science in practice. We will regard the relationship between philosophical conceptualization and empirical data as an iterative dialogue between theory and data, which is guided by a particular ‘feeling with......Empirical insights are proven fruitful for the advancement of Philosophy of Science, but the integration of philosophical concepts and empirical data poses considerable methodological challenges. Debates in Integrated History and Philosophy of Science suggest that the advancement of philosophical...

  12. Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study

    NARCIS (Netherlands)

    van der Eerden, M. M.; Vlaspolder, F.; de Graaff, C. S.; Groot, T.; Bronsveld, W.; Jansen, H. M.; Boersma, W. G.


    Background: There is much controversy about the ideal approach to the management of community acquired pneumonia ( CAP). Recommendations differ from a pathogen directed approach to an empirical strategy with broad spectrum antibiotics. Methods: In a prospective randomised open study performed

  13. Shape of the self-concept clarity change during group psychotherapy predicts the outcome: an empirical validation of the theoretical model of the self-concept change (United States)

    Styła, Rafał


    Background: Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and “V” shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a “V” shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and “V” shape of SCC change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis. PMID:26579001

  14. Life Writing After Empire

    DEFF Research Database (Denmark)

    A watershed moment of the twentieth century, the end of empire saw upheavals to global power structures and national identities. However, decolonisation profoundly affected individual subjectivities too. Life Writing After Empire examines how people around the globe have made sense of the post...... in order to understand how individual life writing reflects broader societal changes. From far-flung corners of the former British Empire, people have turned to life writing to manage painful or nostalgic memories, as well as to think about the past and future of the nation anew through the personal...

  15. Some features and applications of an empirical approach to the treatment of measurement data (DoD-method)

    International Nuclear Information System (INIS)

    Beyrich, W.; Golly, W.; Spannagel, G.


    An empirical method of data evaluation is described which allows the derivation of meaningful estimates of the variances of data groups even if they comprise extreme values (outliers). It can be applied to problems usually treated by variance analysis and seems to be suitable to investigate and describe the state of the art of the various analytical methods applied in international safeguards. Some examples are given to illustrate this procedure; they are based on data of the SALE program

  16. Angulation change of the third molar tooth in orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Ardiansyah S. Pawinru


    Full Text Available Objective : Impaction of the third molar tooth mandibular is often found in patients with orthodontic treatment. In orthodontic treatment, extraction cases of impaction of the third molar tooth are usually performed, but the patients often refuse this extraction. Extraction of premolar has a good effect on the third molar mandibular angulation during treatment. Material and Methods : This study is a retrospective clinical study with descriptive analytic to find out the effect of the first mandibular premolar tooth extraction to angulation change of the third molar mandibular in orthodontic treatment with a standard edgewise method. Angulation change was performed by comparing the third molar mandibular angulation before and after orthodontic treatment with panoramic radiographs. Angulation of the third molar tooth mandibular was calculated from the angle formed between the long axis of the tooth with the reference line infraorbita. Results : The sample comprised 60 of impacted mandibular third molar region of the left and right regions of 30 patients who had been treated declared cured in clinic of orthodontic specialist of Dentistry Faculty Padjadjaran University. The sample was divided into three (3 groups of patients before treatment angulation of the third molar tooth mandibular under 300, 300 to 600 and above 60o, then measured change of angulation and observed whether it increased, fixed or decreased. Results were analyzed by T- test and Wilcoxon test showed that there was a significant change in angulation of the third molar mandibular in orthodontic treatment with the first premolar tooth mandibular extraction. Conclusion : This study is that the first premolar tooth mandibular extraction affects the angulation of the third molar tooth mandibular after orthodontic treatment.

  17. Shape of the self-concept clarity change during group psychotherapy predicts the outcome: An empirical validation of the theoretical model of the self-concept change

    Directory of Open Access Journals (Sweden)

    Rafał eStyła


    Full Text Available Background: Self-concept clarity describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of self-concept clarity change (especially stable increase and V shape observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable self-concept clarity increase is needed for the participants with a rather healthy personality structure, while self-concept clarity change characterized by a V shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M=5.8 was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale, Symptoms’ Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The Self-Concept Clarity Scale was also administered every two weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable self-concept clarity increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and V shape of self-concept clarity change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of self-concept clarity is a sign of a good treatment prognosis.

  18. Improving Substance Abuse Treatment: The National Treatment Plan Initiative. Changing the Conversation. (United States)

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

    This report is the result of five expert panels and six regional public hearings around the country that focused on key persistent issues that have characterized discussions of substance abuse over the years: closing the treatment gap; reducing stigma and changing attitudes; improving and strengthening treatment systems; connecting services and…

  19. An improved empirical dynamic control system model of global mean sea level rise and surface temperature change (United States)

    Wu, Qing; Luu, Quang-Hung; Tkalich, Pavel; Chen, Ge


    Having great impacts on human lives, global warming and associated sea level rise are believed to be strongly linked to anthropogenic causes. Statistical approach offers a simple and yet conceptually verifiable combination of remotely connected climate variables and indices, including sea level and surface temperature. We propose an improved statistical reconstruction model based on the empirical dynamic control system by taking into account the climate variability and deriving parameters from Monte Carlo cross-validation random experiments. For the historic data from 1880 to 2001, we yielded higher correlation results compared to those from other dynamic empirical models. The averaged root mean square errors are reduced in both reconstructed fields, namely, the global mean surface temperature (by 24-37%) and the global mean sea level (by 5-25%). Our model is also more robust as it notably diminished the unstable problem associated with varying initial values. Such results suggest that the model not only enhances significantly the global mean reconstructions of temperature and sea level but also may have a potential to improve future projections.

  20. Facial soft tissue changes after orthodontic treatment | Aksakalli ...

    African Journals Online (AJOL)

    Objectives: To successfully meet expectations on facial esthetics, it is important to understand normal craniofacial growth and the impact of orthodontic treatment thereon. To date, there have been few studies documenting changes in facial esthetics through photography. The objective of this study was to compare facial soft ...

  1. Changing the course of schizophrenia - predictors of treatment ...

    African Journals Online (AJOL)

    Changing the course of schizophrenia - predictors of treatment outcome revisited. R Emsley, P Oosthuizen, D Niehaus, L Koen, B chiliza. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT ·

  2. Treatment changes in patients with psoriasis on etanercept or adalimumab

    DEFF Research Database (Denmark)

    Lee, Erica B; Amin, Mina; Egeberg, Alexander


    PURPOSE: To determine the frequency of and reasons for treatment changes in patients with psoriasis. MATERIALS AND METHODS: A retrospective chart review of 140 patients with psoriasis treated with adalimumab or etanercept seen at Kaiser Permanente Los Angeles Medical Center between September 20, ...

  3. Psychological treatment and therapeutic change in incarcerated rapists

    Directory of Open Access Journals (Sweden)

    Ana Martínez-Catena


    Full Text Available Abstract Most Spanish prisons provide specialised treatment for incarcerated sex offenders, both rapists and child molesters. This treatment is a cognitive-behavioural intervention that has shown relative effectiveness in previous research. With regard to offenders’ rehabilitation, recidivism assessments are necessary as a final measure of treatment effectiveness. However, the evaluation of recidivism by itself does not provide sufficient information on the treatment process and the specific effects that treated subjects could undergo. This paper aims to analyse the therapeutic effectiveness of psychological treatment provided to rapists (in general, males sentenced for committing a sexual offence against women. To this aim, a group of treated rapists (N=153 serving a sentence in prison was analysed. Using a specially designed scale (PASSO, the global therapeutic change and ten specific variables (including assertiveness, readiness to change, cognitive distortions, impulsivity, etc. were assessed. The within-subjects comparison showed that treated sex offenders improved, in therapeutic terms, globally as well as in most of the specific variables assessed (improvements not experimented by the control group. Also, different therapeutic subscales showed relevant associations between them. The findings regarding treatment effectiveness are discussed.

  4. Linezolid Versus Vancomycin in the Empiric Treatment of Nosocomial Pneumonia: A Cost-Utility Analysis Incorporating Results from the ZEPHyR Trial. (United States)

    Collins, Curtis D; Schwemm, Ann K


    To examine the cost-effectiveness of vancomycin versus linezolid in the empiric treatment of nosocomial pneumonias incorporating results from a recent prospective, double-blind, multicenter, controlled trial in adults with suspected methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia. A decision-analytic model examining the cost-effectiveness of linezolid versus vancomycin for the empiric treatment of nosocomial pneumonia was created. Publicly available cost, efficacy, and utility data populated relevant model variables. A probabilistic sensitivity analysis varied parameters in 10,000 Monte-Carlo simulations, and univariate sensitivity analyses assessed the impact of model uncertainties and the robustness of our conclusions. Results indicated that the cost per quality-adjusted life-year (QALY) increased 6% ($22,594 vs. $23,860) by using linezolid versus vancomycin for nosocomial pneumonia. The incremental cost per QALY gained by using linezolid over vancomycin was $6,089, and the incremental cost per life saved was $68,615 with the use of linezolid. Vancomycin dominated linezolid in the subset of patients with documented MRSA. The incremental cost per QALY gained using linezolid if no mortality benefit exists between agents or a 60-day time horizon was analyzed was $19,608,688 and $443,662, respectively. Linezolid may be a cost-effective alternative to vancomycin in the empiric treatment of patients with suspected MRSA nosocomial pneumonia; however, results of our model were highly variable on a number of important variables and assumptions including mortality differences and time frame analyzed. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. An empirical evaluation of competency requirements for first-line managers to deal with resistance to change.



    The point of departure of this study is that first-line managers play a pivotal role in the facilitation of change initiatives in organisations world-wide. Resistance to change is one of the primary reasons why change interventions fail or why success is not achieved in the change process. More specific, the inability of first-line managers to deal with resistance to change has been cited as a primary cause for change projects to fail. There is no evidence that any research has been conducted...

  6. Oil production responses to price changes. An empirical application of the competitive model to OPEC and non-OPEC countries

    International Nuclear Information System (INIS)

    Ramcharran, Harri


    Falling oil prices over the last decade, accompanied by over-production by some OPEC members and the growth of non-OPEC supply, warrant further empirical investigation of the competitive model to ascertain production behavior. A supply function, based on a modification of Griffin's model, is estimated using data from 1973-1997. The sample period, unlike Griffin's, however, includes phases of price increase (1970s) and price decrease (1980s-1990s), thus providing a better framework for examining production behavior using the competitive model. The OPEC results do not support the competitive hypothesis; instead, a negative and significant price elasticity of supply is obtained. This result offers partial support for the target revenue theory. For most of the non-OPEC members, the estimates support the competitive model. OPEC's loss of market share and the drop in the share of oil-based energy should signal adjustments in price and quantity based on a competitive world market for crude oil

  7. Rapid treatment-induced brain changes in pediatric CRPS. (United States)

    Erpelding, Nathalie; Simons, Laura; Lebel, Alyssa; Serrano, Paul; Pielech, Melissa; Prabhu, Sanjay; Becerra, Lino; Borsook, David


    To date, brain structure and function changes in children with complex regional pain syndrome (CRPS) as a result of disease and treatment remain unknown. Here, we investigated (a) gray matter (GM) differences between patients with CRPS and healthy controls and (b) GM and functional connectivity (FC) changes in patients following intensive interdisciplinary psychophysical pain treatment. Twenty-three patients (13 females, 9 males; average age ± SD = 13.3 ± 2.5 years) and 21 healthy sex- and age-matched controls underwent magnetic resonance imaging. Compared to controls, patients had reduced GM in the primary motor cortex, premotor cortex, supplementary motor area, midcingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex (dlPFC), posterior cingulate cortex, precuneus, basal ganglia, thalamus, and hippocampus. Following treatment, patients had increased GM in the dlPFC, thalamus, basal ganglia, amygdala, and hippocampus, and enhanced FC between the dlPFC and the periaqueductal gray, two regions involved in descending pain modulation. Accordingly, our results provide novel evidence for GM abnormalities in sensory, motor, emotional, cognitive, and pain modulatory regions in children with CRPS. Furthermore, this is the first study to demonstrate rapid treatment-induced GM and FC changes in areas implicated in sensation, emotion, cognition, and pain modulation.

  8. Subtypes of batterers in treatment: empirical support for a distinction between type I, type II and type III.

    Directory of Open Access Journals (Sweden)

    José Luis Graña

    Full Text Available This study explores the existence of different types of batterers in a sample of 266 men who had been court referred for intimate partner violence. The data collected in the assessment that have been used to perform a hierarchical and a two-step cluster analysis fall into three areas: aggression towards the partner, general aggression and presence of psychopathology and personality traits, more specifically, alcohol use, borderline and antisocial personality traits, psychopathy traits, state anger and trait anger, anger expression and control, anger, hostility, and, finally, impulsivity. The results show a typology consisting of 3 types of batterers on the basis of violence level and psychopathology: low (65%, moderate (27.8% and high (7.1%. This study provides empirical support for the development of batterer typologies. These typologies will help achieve early detection of different types of batterers, allowing us to tailor interventions on the basis of the needs of each of the types.

  9. Color changes in pork in relation to high pressure treatment

    DEFF Research Database (Denmark)

    Bak, Kathrine Holmgaard

    treatment and during a six-day storage period was investigated via surface reflectance. Spectroscopic studies (in the form of surface reflectance, UV-vis, and circular dichroism) on the effect of HP treatment on the soluble protein fraction of porcine LD were conducted attempting to explain the color......-denatured ferric myoglobin species was not similar to the heat-denatured pigment, ferrihemochrome, but instead a closely related species sharing features of denatured gobin, ferric iron, and brown color. The reversibility of the pressure-induced changes often observed for various myoglobin forms in solution were...

  10. Coping with side effects from cancer treatment in daily life from the perspective of cancer patients: A qualitative empirical study

    DEFF Research Database (Denmark)

    Pedersen, Birgith; Koktved, Dorte Pallesen; Nielsen, Lene Lyngø

    Aim The aim of this paper is to deepen our understanding of how patients cope with side effects from cancer treatment in daily life. Background Patients receiving cancer treatment experience acute side effects and need individualized information and guidance in order to manage treatment......-related adverse events in everyday life. However development in cancer treatment and the societal demands for efficiency may limit the possibility for individualized support. Methods Nine patients were interviewed from March to July 2009 to explore the patients’ experience of coping with side effects in daily...

  11. Multidisciplinary approach to the treatment of invasive fungal infections in adult patients. Prophylaxis, empirical, preemptive or targeted therapy, which is the best in the different hosts?

    Directory of Open Access Journals (Sweden)

    Rafael Zaragoza


    Full Text Available Rafael Zaragoza1, Javier Pemán2, Miguel Salavert3, Ángel Viudes2, Amparo Solé4, Isidro Jarque5, Emilio Monte6, Eva Romá6, Emilia Cantón71Servicio de Medicina Intensiva, Hospital Universitario Dr Peset, Valencia, Spain; 2Servicio de Microbiología; 3Unidad de Enfermedades Infecciosas; 4Unidad de Trasplante Pulmonar; 5Servicio de Hematología; 6Servicio de Farmacia; 7Unidad de Microbiología Experimental, Centro de Investigación, Hospital Universitario La Fe Valencia, SpainAbstract: The high morbidity, mortality, and health care costs associated with invasive fungal infections, especially in the critical care setting and immunocompromised host, have made it an excellent target for prophylactic, empiric, and preemptive therapy interventions principally based on early identification of risk factors. Early diagnosis and treatment are associated with a better prognosis. In the last years there have been important developments in antifungal pharmacotherapy. An approach to the new diagnosis tools in the clinical mycology laboratory and an analysis of the use new antifungal agents and its application in different clinical situations has been made. Furthermore, an attempt of developing a state of the art in each clinical scenario (critically ill, hematological, and solid organ transplant patients has been performed, trying to choose the best strategy for each clinical situation (prophylaxis, pre-emptive, empirical, or targeted therapy. The high mortality rates in these settings make mandatory the application of early de-escalation therapy in critically ill patients with fungal infection. In addition, the possibility of antifungal combination therapy might be considered in solid organ transplant and hematological patients.Keywords: invasive fungal infections, prophylaxis, empirical therapy, preemptive treatment, targeted therapy

  12. Changes in the uterus after maternal treatment with diethylstilbestrol

    International Nuclear Information System (INIS)

    Sanders, F.B.M.; Dony, J.M.J.; Rosenbusch, G.; Katholieke Univ. Nijmegen


    In the fifties and sixties pregnant women with a history of habitual abortions or premature deliveries were treated with DES (diethylstilboestrol). This treatment can lead to certain pathognomonic uterine changes in the daughters, that are recognizable on hysterosalpingographs. Because of the obstetric consequences, it is important to interpret these changes correctly. The findings in 7 patients are described. As most of the DES-daughters are now coming into reproductive age, gynecologists and radiologists will be confronted more frequently with their specific problems. (orig.) [de


    Directory of Open Access Journals (Sweden)

    Rodrigo Arnold Tisot


    Full Text Available ABSTRACT Objective: To evaluate the correlation between structural changes in burst fractures of thoracic and lumbar spine with clinical outcome of the treatment. Methods: A retrospective study in 25 patients with fractures of thoracic and lumbar spine burst fractures without neurological deficit. Eleven patients underwent conservative treatment and for the remaining the treatment was surgical. All patients were followed up for at least 24 months. The cases were evaluated by a protocol that included: posttraumatic measurement of kyphosis, vertebral body collapse and narrowing of the spinal canal, the visual analog scale of pain, and the quality of life questionnaire SF-36 at the follow-up. For statistical analysis, the significance level was 5% and the software SPSS 18.0 was used. Results: No statistically significant difference was observed when comparing the clinical outcomes of one treatment over another. Similarly, there was no statistically significant correlation between kyphosis and post-traumatic narrowing of the spinal canal with clinical worsening in the follow-up, regardless of the treatment used. We found a positive correlation (p<0.05 between initial collapse and SF-36 domains in both groups (operated and non-operated. Conclusion: There was no significant superiority of one treatment over the other, and no correlation was found between kyphosis and spinal canal narrowing in burst fractures of the thoracic and lumbar spine without neurological deficit. However, there was correlation between initial collapse and clinical outcome in some domains of the SF-36 questionnaire.

  14. Knowledge-driven institutional change: an empirical study on combating desertification in northern China from 1949 to 2004. (United States)

    Yang, Lihua; Wu, Jianguo


    Understanding institutional changes is crucial for environmental management. Here we investigated how institutional changes influenced the process and result of desertification control in northern China between 1949 and 2004. Our analysis was based on a case study of 21 field sites and a meta-analysis of additional 29 sites reported in the literature. Our results show that imposed knowledge-driven institutional change was often perceived as a more progressive, scientific, and rational type of institutional change by entrepreneurs, scholars, experts, and technicians, while voluntary, knowledge-driven institutional change based on indigenous knowledge and experiences of local populations was discouraged. Our findings also demonstrate that eight working rules of imposed knowledge-driven institutional change can be applied to control desertification effectively. These rules address the issues of perception of potential gains, entrepreneurs' appeals and support, coordination of multiple goals, collaboration among multiple organizations, interest distribution and conflict resolution, incremental institutional change, external intervention, and coordination among the myriad institutions involved. Imposed knowledge-driven institutional change tended to be more successful when these rules were thoroughly implemented. These findings provide an outline for implementing future institutional changes and policy making to combat desertification and other types of ecological and environmental management. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Empirical Hamiltonians

    International Nuclear Information System (INIS)

    Peggs, S.; Talman, R.


    As proton accelerators get larger, and include more magnets, the conventional tracking programs which simulate them run slower. The purpose of this paper is to describe a method, still under development, in which element-by-element tracking around one turn is replaced by a single man, which can be processed far faster. It is assumed for this method that a conventional program exists which can perform faithful tracking in the lattice under study for some hundreds of turns, with all lattice parameters held constant. An empirical map is then generated by comparison with the tracking program. A procedure has been outlined for determining an empirical Hamiltonian, which can represent motion through many nonlinear kicks, by taking data from a conventional tracking program. Though derived by an approximate method this Hamiltonian is analytic in form and can be subjected to further analysis of varying degrees of mathematical rigor. Even though the empirical procedure has only been described in one transverse dimension, there is good reason to hope that it can be extended to include two transverse dimensions, so that it can become a more practical tool in realistic cases

  16. Late mental health changes in tortured refugees in multidisciplinary treatment

    DEFF Research Database (Denmark)

    Carlsson, Jessica Mariana; Olsen, Dorte Reff; Kastrup, Marianne


    to the Rehabilitation and Research Centre for Torture Victims in 2001 to 2002. Data on background, trauma, present social situation, mental symptoms (Hopkins Symptom Checklist-25, Hamilton Depression Scale, Harvard Trauma Questionnaire), and on health-related quality of life (World Health Organization Quality of Life......-Bref) were collected before treatment and after 9 and 23 months. No substantial changes in mental health were observed at the 9-month follow-up, and the minor decrease in some symptoms observed between the 9 and 23 months may reflect regression toward the mean or the natural course of symptoms in this cohort......The aim of this study was to examine long-term changes in symptoms of post-traumatic stress disorder, depression, anxiety, and in health-related quality of life in traumatized refugees 23 months after admission to multidisciplinary treatment. The study group comprised 45 persons admitted...

  17. Myelodysplastic changes mimicking MDS following treatment for osteosarcoma

    DEFF Research Database (Denmark)

    Løhmann, Ditte

    -MDS/AML) is a feared long-term complication of paediatric cancer including osteosarcoma. Few develop t-MDS/AML, but it is not known how many have significant haematological changes after finishing treatment for osteosarcoma. In this study we reviewed biochemistry from a consecutive series of children for up to two...... years after finishing treatment. We included all children (n=14) who where diagnosed from October 2006 to January 2011 at our department and treated according to the EURAMOS-1 protocol. Four patients relapsed and died before the end of the study period. We found noteworthy changes in MCV, platelets...... for osteosarcoma developed haematological abnormalities similar to early MDS but few developed t-MDS/AML. Close monitoring of patients recovering from osteosarcoma is essential. Keywords: Osteosarcoma, t-MDS/AML, Haematological abnormalities, Children...

  18. Paclitaxel/carboplatin with or without belinostat as empiric first-line treatment for patients with carcinoma of unknown primary site

    DEFF Research Database (Denmark)

    Hainsworth, John D; Daugaard, Gedske; Lesimple, Thierry


    : The addition of belinostat to paclitaxel/carboplatin did not improve the PFS of patients with CUP who were receiving first-line therapy, although the patients who received belinostat had a higher investigator-assessed response rate. Future trials in CUP should focus on specific subsets, defined either......BACKGROUND: The objective of this study was to evaluate the efficacy of belinostat, a histone deacetylase inhibitor, when added to paclitaxel/carboplatin in the empiric first-line treatment of patients with carcinoma of unknown primary site (CUP). METHODS: In this randomized phase 2 trial......, previously untreated patients with CUP were randomized to receive belinostat plus paclitaxel/carboplatin (group A) or paclitaxel/carboplatin alone (group B) repeated every 21 days. Patients were re-evaluated every 2 cycles, and those without disease progression continued treatment for 6 cycles. Patients...

  19. Sleep disturbances in treatment-seeking OCD-patients: Changes after concentrated exposure treatment. (United States)

    Nordahl, Håkon; Havnen, Audun; Hansen, Bjarne; Öst, Lars-Göran; Kvale, Gerd


    Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD-treatment. Thirty-six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow-up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre-treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD-symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow-up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre-treatment had better outcome on OCD-symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  20. Orthodontic treatment plan changed by 3D images

    International Nuclear Information System (INIS)

    Yordanova, G.; Stanimirov, P.


    Clinical application of CBCT is most often enforced in dental phenomenon of impacted teeth, hyperodontia, transposition, ankyloses or root resorption and other pathologies in the maxillofacial area. The goal, we put ourselves, is to show how the information from 3D images changes the protocol of the orthodontic treatment. The material, we presented six our clinical cases and the change in the plan of the treatment, which has used after analyzing the information carried on the three planes of CBCT. These cases are casuistic in the orthodontic practice and require individual approach to each of them during their analysis and decision taken. The discussion made by us is in line with reveal of the impacted teeth, where we need to evaluate their vertical depth and mediodistal ratios with the bond structures. At patients with hyperodontia, the assessment is of outmost importance to decide which of the teeth to be extracted and which one to be arranged into the dental arch. The conclusion we make is that diagnostic information is essential for decisions about treatment plan. The exact graphs will lead to better treatment plan and more predictable results. (authors) Key words: CBCT. IMPACTED CANINES. HYPERODONTIA. TRANSPOSITION

  1. The Effects of Source Water Quality on Drinking Water Treatment Costs: A Review and Synthesis of Empirical Literature - Ecological Economics (United States)

    Watershed protection, and associated in situ water quality improvements, has received considerable attention as a means of mitigating health risks and avoiding expenditures at drinking water treatment plants (DWTPs). This study reviews the extant cost function literature linking ...

  2. The Effects of Source Water Quality on Drinking Water Treatment Costs: A Review and Synthesis of Empirical Literature - slides (United States)

    Watershed protection, and associated in situ water quality improvements, has received considerable attention as a means of mitigating health risks and avoiding expenditures at drinking water treatment plants (DWTPs). In this presentation, we review the literature linking raw wate...

  3. Coping with side effects from cancer treatment in daily life from the perspective of cancer patients: A qualitative empirical study

    DEFF Research Database (Denmark)

    Pedersen, Birgith; Koktved, Dorte Pallesen; Nielsen, Lene Lyngø

    Aim The aim of this paper is to deepen our understanding of how patients cope with side effects from cancer treatment in daily life. Background Patients receiving cancer treatment experience acute side effects and need individualized information and guidance in order to manage treatment......-related adverse events in everyday life. However development in cancer treatment and the societal demands for efficiency may limit the possibility for individualized support. Methods Nine patients were interviewed from March to July 2009 to explore the patients’ experience of coping with side effects in daily...... their identity but the side effects can control the daily life. Patients do not always possess the knowledge of how to handle the side effects and adaptation to the institutional efficiency can lead to lack of confidence and feelings of responsibility and guilt concerning coping with these side effects...

  4. Malaria treatment policy change and implementation: the case of Uganda. (United States)

    Nanyunja, Miriam; Nabyonga Orem, Juliet; Kato, Frederick; Kaggwa, Mugagga; Katureebe, Charles; Saweka, Joaquim


    Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ) was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.

  5. Malaria Treatment Policy Change and Implementation: The Case of Uganda

    Directory of Open Access Journals (Sweden)

    Miriam Nanyunja


    Full Text Available Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.

  6. Does political change affect senior management turnover? An empirical analysis of top-tier local authorities in England


    Boyne, George A.; James, Oliver; John, Peter; Petrovsky, Nicolai


    In many political systems the political neutrality of senior managers' tenure is often cherished as a key part of the politics-administration dichotomy and is subject to formal safeguards. We test hypotheses about the impact of political change on senior management turnover drawn from political science, public administration and private sector management theory. Using panel data to control for unobserved heterogeneity between authorities, we find that changes in political party control and lo...

  7. Is Change Required? An Economic Case Study of the Rise and Fall of Empires, and Why a National Strategic Narrative Could Change the Fate of the United States Empire (United States)


    Thanks to Ann Jacobson, the Business School Librarian , for your help with Refworks, and help with references and citations . Thanks to Professor Brook...For those who may be confused by this citation , it was not until 2004 that the GAO’s name changed from General Accounting Office to Government...defense, preparation of fields, use of a common water supply, manufacture of one style of pottery and basketry, etc,”303 the Indians functioned well

  8. Improve projections of changes in southern African summer rainfall through comprehensive multi-timescale empirical statistical downscaling (United States)

    Dieppois, B.; Pohl, B.; Eden, J.; Crétat, J.; Rouault, M.; Keenlyside, N.; New, M. G.


    The water management community has hitherto neglected or underestimated many of the uncertainties in climate impact scenarios, in particular, uncertainties associated with decadal climate variability. Uncertainty in the state-of-the-art global climate models (GCMs) is time-scale-dependant, e.g. stronger at decadal than at interannual timescales, in response to the different parameterizations and to internal climate variability. In addition, non-stationarity in statistical downscaling is widely recognized as a key problem, in which time-scale dependency of predictors plays an important role. As with global climate modelling, therefore, the selection of downscaling methods must proceed with caution to avoid unintended consequences of over-correcting the noise in GCMs (e.g. interpreting internal climate variability as a model bias). GCM outputs from the Coupled Model Intercomparison Project 5 (CMIP5) have therefore first been selected based on their ability to reproduce southern African summer rainfall variability and their teleconnections with Pacific sea-surface temperature across the dominant timescales. In observations, southern African summer rainfall has recently been shown to exhibit significant periodicities at the interannual timescale (2-8 years), quasi-decadal (8-13 years) and inter-decadal (15-28 years) timescales, which can be interpret as the signature of ENSO, the IPO, and the PDO over the region. Most of CMIP5 GCMs underestimate southern African summer rainfall variability and their teleconnections with Pacific SSTs at these three timescales. In addition, according to a more in-depth analysis of historical and pi-control runs, this bias is might result from internal climate variability in some of the CMIP5 GCMs, suggesting potential for bias-corrected prediction based empirical statistical downscaling. A multi-timescale regression based downscaling procedure, which determines the predictors across the different timescales, has thus been used to

  9. Enhancing motivation for change in treatment-resistant eating disorders. (United States)

    Vitousek, K; Watson, S; Wilson, G T


    Denial and resistance to change are prominent features in most patients with anorexia nervosa. The egosyntonic quality of symptoms can contribute to inaccuracy in self-report, avoidance of treatment, difficulties in establishing a therapeutic relationship, and high rates of attrition and relapse. Individuals with bulimia nervosa are typically more motivated to recover, but often ambivalent about forfeiting the ideal of slenderness and the protective functions of binge-purge behavior. Few attempts have been made to assess denial and resistance in the eating disorders, or to examine alternative strategies for enhancing motivation to change. Review of the clinical literature indicates a striking convergence of recommendations across conceptually distinct treatment approaches. Clinicians are encouraged to acquire a frame of reference that can help them understand the private experience of individuals with eating disorders, empathize with their distress at the prospect of weight gain, and acknowledge the difficulty of change. The Socratic method seems particularly well-suited to work with this population because of its emphasis on collaboration, openness, curiosity, patience, focused and systematic inquiry, and individual discovery. Four themes are crucial in engaging reluctant eating-disordered clients in therapy: the provision of psychoeducational material, an examination of the advantages and disadvantages of symptoms, the explicit use of experimental strategies, and an exploration of personal values.

  10. How Does Cultural Change Affect Indigenous Peoples' Hunting Activity? An Empirical Study among the Tsimane' in the Bolivian Amazon

    NARCIS (Netherlands)

    A. Luz (Ana); M. Guèze (Maximilien); J. Paneque-Gálvez (Jaime); J. Pino (Joan); M. MacIá (Manuel); M. Orta-Martínez (Martí); V. Reyes-Garciá (Victoria)


    textabstractWildlife hunting is an important economic activity that contributes to the subsistence of indigenous peoples and the maintenance of their cultural identity. Changes in indigenous peoples' ways of life affect the way they manage the ecosystems and resources around them, including wildlife

  11. How Does Cultural Change Affect Indigenous Peoples' Hunting Activity? An Empirical Study Among the Tsimane' in the Bolivian Amazon

    Directory of Open Access Journals (Sweden)

    Ana Catarina Luz


    Full Text Available Wildlife hunting is an important economic activity that contributes to the subsistence of indigenous peoples and the maintenance of their cultural identity. Changes in indigenous peoples' ways of life affect the way they manage the ecosystems and resources around them, including wildlife populations. This paper explores the relationship between cultural change, or detachment from traditional culture, and hunting behaviour among the Tsimane', an indigenous group in the Bolivian Amazon. We interviewed 344 hunters in 39 villages to estimate their hunting activity and the degree of cultural change among them. We used multilevel analyses to assess the relationships between three different proxies for cultural change at the individual level (schooling, visits to a market town, and detachment from tradition, and the following two independent variables: 1 probability of engaging in hunting (i.e., hunting activity and 2 hunting efficiency with catch per unit effort (CPUE. We found a statistically significant negative association between schooling and hunting activity. Hunting efficiency (CPUE biomass/km was positively associated with visits to a market town, when holding other co-variates in the model constant. Other than biophysical factors, such as game abundance, hunting is also conditioned by social factors (e.g., schooling that shape the hunters' cultural system and impel them to engage in hunting or deter them from doing so.

  12. Changes in different organic matter fractions during conventional treatment and advanced treatment

    Institute of Scientific and Technical Information of China (English)

    Chao Chen; Xiaojian Zhang; Lingxia Zhu; Wenjie He; Hongda Han


    XAD-8 resin isolation of organic matter in water was used to divide organic matter into the hydrophobic and hydrophilic fractions.A pilot plant was used to investigate the change in both fractions during conventional and advanced treatment processes.The treatment of hydrophobic organics (HPO), rather than hydrophilic organicas (HPI), should carry greater emphasis due to HPO's higher trihalomethane formation potential (THMFP) and haloacetic acid formation potential (HAAFP).The removal of hydrophobic matter and its transmission into hydrophilic matter reduced ultimate DBP yield during the disinfection process.The results showed that sand filtration, ozonation, and biological activated carbon (BAC) filtration had distinct influences on the removal of both organic fractions.Additionally, the combination of processes changed the organic fraction proportions present during treatment.The use of ozonation and BAC maximized organic matter removal efficiency, especially for the hydrophobic fraction.In sum, the combination of pre-ozonation,conventional treatment, and O3-BAC removed 48% of dissolved organic carbon (DOC), 60% of HPO, 30% of HPI, 63% of THMFP,and 85% of HAAFP.The use of conventional treatment and O3-BAC without pre-ozonation had a comparable performance, removing 51% of DOC, 56% of HPO, 45% of HPI, 61% of THMFP, and 72% of HAAFP.The effectiveness of this analysis method indicated that resin isolation and fractionation should be standardized as an applicable test to help assess water treatment process efficiency.

  13. Economic evaluation of test-and-treat and empirical treatment strategies in the eradication of Helicobacter pylori infection; A Markov model in an Iranian adult population. (United States)

    Mazdaki, Alireza; Ghiasvand, Hesam; Sarabi Asiabar, Ali; Naghdi, Seyran; Aryankhesal, Aidin


    Helicobacter pylori may cause many gastrointestinal problems in developing countries such as Iran. We aimed to analyze the cost- effectiveness and cost- utility of the test-and-treat and empirical treatment strategies in managing Helicobacter pylori infection. This was a Markov based economic evaluation. Effectiveness was defined as the symptoms free numbers and QALYs in 100,000 hypothetical adults. The sensitivity analysis was based on Monte Carlo approach. In the test- and- treat strategy, if the serology is the first diagnostic test vs. histology, the cost per symptoms free number would be 291,736.1 Rials while the cost per QALYs would be 339,226.1 Rials. The cost per symptoms free number and cost per QALYs when the 13 C-UBT was used as the first diagnostic test vs. serology was 1,283,200 and 1,492,103 Rials, respectively. In the empirical strategy, if histology is used as the first diagnostic test vs. 13 CUBT, the cost per symptoms free numbers and cost per QALYs would be 793,234 and 955,698 Rials, respectively. If serology were used as the first diagnostic test vs. histology, the cost per symptoms free and QALYs would be 793,234 and 368941 Rials, respectively. There was no significant and considerable dominancy between the alternatives and the diagnostic tests.

  14. The Changing Treatment Landscape for Metastatic Urothelial Carcinoma. (United States)

    Flaig, Thomas W


    Urothelial carcinoma is the predominant histologic type of bladder cancer. After 30 years of minimal progress in the treatment of advanced-stage disease, recent advances in the genomic characterization of urothelial cancer and breakthroughs in bladder cancer therapeutics have rejuvenated the field. Nivolumab, pembrolizumab, atezolizumab, durvalumab, and avelumab are among the exciting recent novel therapeutic advances gaining approvals by the FDA for treatment of advanced-stage urothelial carcinoma. Yet the challenge for clinicians is to determine the optimal choice of agents as first-line or second-line therapy and which offers the best chance for overall survival for the individual patient in this rapidly changing field. Copyright © 2018 by the National Comprehensive Cancer Network.

  15. Changes in Transformational Leadership and Empirical Quality Outcomes in a Finnish Hospital over a Two-Year Period: A Longitudinal Study (United States)

    Mäntynen, Raija; Vehviläinen-Julkunen, Katri; Partanen, Pirjo; Turunen, Hannele; Miettinen, Merja; Kvist, Tarja


    This paper describes the changes in transformational leadership and quality outcomes that occurred between 2008 and 2011 in a Finnish university hospital that is aiming to meet the Magnet standards. Measurements were conducted in 2008-2009 and subsequently in 2010-2011 by surveying nursing staff and patients. Nursing staff were surveyed using web-based surveys to collect data on transformational leadership (n 1 = 499, n 2 = 498) and patient safety culture (n 1 = 234, n 2 = 512) and using both postal and web-based surveys to gather information on job satisfaction (n 1 = 1176, n 2 = 779). Questionnaires were used to collect data on care satisfaction from patients (n 1 = 678, n 2 = 867). Transformational leadership was measured using the 54-item TLS, job satisfaction with the 37-item KUHJSS, patient safety culture with the 42-item HSPSC, and patient satisfaction using the 42-item RHCS questionnaire. Transformational leadership, which was the weakest area, was at the same level between the two measurement occasions. Job satisfaction scores increased between 2008 and 2010, although they were generally excellent in 2008. The scores for nonpunitive responses to errors and events reported were also higher in the 2010-2011 surveys. The highest empirical outcome scores related to patient satisfaction. The project and the development initiatives undertaken since 2008 seem to have had positive effects on empirical quality outcomes. PMID:25009744

  16. Should the patients colonized with extended-spectrum beta-lactamase-producing Gram-negative bacilli (E-GNB) coming to hospital from the community with pneumonia get anti-E-GNB active empirical treatment? (United States)

    Peterlin, Lara; Žagar, Mateja; Lejko Zupanc, Tatjana; Paladin, Marija; Beović, Bojana


    Extended-spectrum beta-lactamases are responsible for resistance of Gram-negative bacilli to several beta-lactam antibiotics, including those prescribed for treatment pneumonia. To evaluate the importance of colonization with E-GNB for the choice of empirical treatment we performed a retrospective case-control study including 156 patients, hospitalized for treatment of pneumonia from 2009 through 2013. Empirical treatment success and in-hospital survival were significantly lower in patients colonized with E-GNB compared to non-colonized (p = 0.002, p = 0.035). When comparing subgroups of colonized patients, treatment success was significantly lower in patients who were colonized with E-GNB resistant to empirical antibiotic (p = 0.010), but not in those colonized by E-GNB susceptible to empirically given antibiotic (p = 0.104). Difference in in-hospital mortality was insignificant in both subgroups (p = 0.056, p = 0.331). The results of study suggest that an anti-E-GNB active antibiotic should be used for empirical treatment of pneumonia in E-GNB colonized patients.

  17. Decomposition of toxicity emission changes on the demand and supply sides: empirical study of the US industrial sector (United States)

    Fujii, Hidemichi; Okamoto, Shunsuke; Kagawa, Shigemi; Managi, Shunsuke


    This study investigated the changes in the toxicity of chemical emissions from the US industrial sector over the 1998-2009 period. Specifically, we employed a multiregional input-output analysis framework and integrated a supply-side index decomposition analysis (IDA) with a demand-side structural decomposition analysis (SDA) to clarify the main drivers of changes in the toxicity of production- and consumption-based chemical emissions. The results showed that toxic emissions from the US industrial sector decreased by 83% over the studied period because of pollution abatement efforts adopted by US industries. A variety of pollution abatement efforts were used by different industries, and cleaner production in the mining sector and the use of alternative materials in the manufacture of transportation equipment represented the most important efforts.

  18. Using LMDI method to analyze the change of China's industrial CO2 emissions from final fuel use: An empirical analysis

    International Nuclear Information System (INIS)

    Liu Lancui; Fan Ying; Wu Gang; Wei Yiming


    Based on time series decomposition of the Log-Mean Divisia Index (LMDI), this paper analyzes the change of industrial carbon emissions from 36 industrial sectors in China over the period 1998-2005. The changes of industrial CO 2 emission are decomposed into carbon emissions coefficients of heat and electricity, energy intensity, industrial structural shift, industrial activity and final fuel shift. Our results clearly show that raw chemical materials and chemical products, nonmetal mineral products and smelting and pressing of ferrous metals account for 59.31% of total increased industrial CO 2 emissions. The overwhelming contributors to the change of China's industrial sectors' carbon emissions in the period 1998-2005 were the industrial activity and energy intensity; the impact of emission coefficients of heat and electricity, fuel shift and structural shift was relatively small. Over the year 1998-2002, the energy intensity change in some energy-intensive sectors decreased industrial emissions, but increased emissions over the period 2002-2005. The impact of structural shift on emissions have varied considerably over the years without showing any clear trend, and the final fuel shift increased industrial emissions because of the increase of electricity share and higher emissions coefficient. Therefore, raw chemical materials and chemical products, nonmetal mineral products and smelting and pressing of ferrous metals should be among the top priorities for enhancing energy efficiency and driving their energy intensity close to the international advanced level. To some degree, we should reduce the products waste of these sectors, mitigate the growth of demand for their products through avoiding the excessive investment highly related to these sectors, increasing imports or decreasing the export in order to avoid expanding their share in total industrial value added. However, all these should integrate economic growth to harmonize industrial development and CO 2

  19. Reasons for Treatment Changes in Patients With Moderate to Severe Psoriasis. (United States)

    Anderson, Kathryn L; Feldman, Steven R


    Psoriasis treatment involves multiple treatment arms. Treatment choice depends on many factors and may change, due to the chronicity of psoriasis. The purpose of our study is to explore reasons for treatment changes in patients with moderate to severe psoriasis. Ten charts of patients with moderate to severe psoriasis were reviewed. The medication changes and reasons for change were extracted. A "treatment change" was defined as switching between medication classes, adding or removing a medication class, or switching medications within the oral or biologic medication class. Seventy-seven treatment changes were identified. On average, 1 treatment change occurred per year of follow-up. The most common reason for treatment change was inadequate disease control. Inadequate disease control with current therapy is the most common reason a physician changes treatment for moderate to severe psoriasis. More efficacious treatments or ways to improve efficacy may help improve the long-term outcomes of psoriasis. © The Author(s) 2015.

  20. Clarithromycin vs. Gemifloxacin in Quadruple Therapy Regimens for Empiric Primary Treatment of Helicobacter pylori Infection: A Randomized Clinical Trial (United States)

    Masoodi, Mohsen; Talebi-Taher, Mahshid; Tabatabaie, Khadijeh; Khaleghi, Siamak; Faghihi, Amir-Hossein; Agah, Shahram; Asadi, Reyhaneh


    BACKGROUND Eradication of Helicobacter pylori infection plays a crucial role in the treatment of peptic ulcer. Clarithromycin resistance is a major cause of treatment failure. This randomized clinical trial aimed at evaluating the efficacy of a clarithromycin versus gemifloxacin containing quadruple therapy regimen in eradication of H.pylori infection. METHODS In this randomized double blind clinical trial (RCT 2012102011054N2), a total of 120 patients were randomized to two groups of 60 patients each. Patients with proven H.pylori infection were consecutively assigned into two groups to receive OBAG or OBAC in gastroenterology clinic in Rasoul-e- Akram General Hospital in Tehran, Iran. The patients in the OBAG group received omeprazole (20 mg) twice daily, bismuth subcitrate (240 mg) twice daily, amoxicillin (1 gr) twice daily, and gemifloxacin (320 mg) once daily, and those in the OBAC group received omeprazole (20 mg) twice daily, 240 mg of bismuth subcitrate twice daily, amoxicillin (1 gr) twice daily, and clarithromycin (500 mg) twice daily for 10 days. RESULTS Five patients from each group were excluded from the study because of poor compliance, so 110 patients completed the study. The intention-to-treat eradication rate was 61.6% and 66.6% for the OBAC and OBAG groups, respectively. According to the per protocol analysis, the success rates of eradication of H.pylori infection were 67.2% and 72.7% for OBAC and OBAG groups, respectively (p=0.568). CONCLUSION The results of this study suggest that gemifloxacin containing regimen is at least as effective as clarithromycin regimen; hence, this new treatment could be considered as an alternative for the patients who cannot tolerate clarithromycin. PMID:26106468

  1. An Empirical Study on Key Indicators of Environmental Quality: Green Budgeting - a Catalyst for Sustainable Economy and a Factor for Institutional Change

    Directory of Open Access Journals (Sweden)

    Violeta – Maria Cimpoeru


    Full Text Available This paper presents the phenomenon of institutional change through the implementation of sustainable strategies of medium-term budgeting, having as an effect the growth of opportunity to attract proper resources for social and environmental programs. The study analyzes green budget practices and suggests several ways to use them in order to ensure consistency in implementing key elements of sustainable economy. Thus, we conducted an empirical study to explain the decisive factors impact (greenhouse gas emissions and national income on health expenditure and we obtained statistically significant positive relationship, suggesting that green budgeting is an important factor for sustainable economy. The reasons behind the introduction of a sustainable perspective for budgeting in any country are important since they will dictate, to a large extent, the way the medium term budgeting will be institutionalized

  2. An empirical investigation into the changing visual identity of full service and low cost carriers, 2000 vs. 2012

    Directory of Open Access Journals (Sweden)

    Adam Taylor


    Full Text Available This paper reports on the findings of a semiotic content analysis of the visual branding of over 630 airline tail fins as they appeared in 2000 and 2012. Unlike existing studies of airlines’ visual identities that rely on a snap shot in time and examine all airlines, this paper focuses on changes that have occurred in the visual branding of full-service carriers (FSCs and low cost carriers (LCCs between 2000 and 2012. The results confirm that there have been significant changes in the visual content of FSC and LCC tail fins and the way in which these airlines portray non-price competitive characteristics. The research shows that while an increasing number of LCCs now use aircraft tail fins to display their corporate name, FSCs are increasingly employing icons of nationhood. This suggests that while LCCs are trying to appeal to a wide passenger demographic who value low fares over service, FSCs are responding to the competitive threat by explicitly drawing on the cultural rhetoric of symbols of sovereign national identity to differentiate themselves in an increasingly competitive market.

  3. Changes in sexual function after radiotherapy treatment of prostate cancer

    International Nuclear Information System (INIS)

    Beckendorf, V.; Hay, M.; Rozan, R.; Lagrange, J.L.; N'Guyen, T.; Giraud, B.


    The objective was to assess sexual function before and after definitive irradiation for the treatment of cancer of the prostate. The study comprised 67 patients (mean age 68 years) treated in five radiotherapy departments and assessed with repeated questionnaires about their libido, arousal, frequency and quality of intercourse, and sexual satisfaction. Interviews were obtained before radiotherapy and at the end of the first year after treatment. Sixty-three patients were married and 50 had a sexually effective partner. Forty-six patients presented with another pathology or medical treatment capable of inducing sexual dysfunction. Before radiotherapy, 40 patients were sexually active, with good to acceptable intercourse. Between 10 and 24 months after the end of radiotherapy, no disease progression was observed and prostate-specific antigen levels remained high in only two patients. Sexual function was preserved in 67% of patients but only 50% observed no change. The functional prognosis seemed to be related to the initial frequency and quality of intercourse; more than three times per month, the prognosis remained good, under three per month, it was poor. The patient's age was a predictive factor for the frequency of intercourse. (author)

  4. Typology of Couples Entering Alcohol Behavioral Couple Therapy: An Empirical Approach and Test of Predictive Validity on Treatment Response. (United States)

    Ladd, Benjamin O; McCrady, Barbara S


    This study aimed to examine whether classification of couples in which one partner has an alcohol problem is similar to that reported in the general couples literature. Typologies of couples seeking alcohol behavioral couple therapy (ABCT) were developed via hierarchical cluster analysis using behavioral codes of couple interactions during their first ABCT session. Four couples types based on in-session behavior were established reliably, labeled avoider, validator, hostile, and ambivalent-detached. These couple types resembled couples types found in previous research. Couple type was associated with baseline relationship satisfaction, but not alcohol use. Results suggest heterogeneity in couples with alcohol problems presenting to treatment; further study is needed to investigate the function of alcohol within these different types. © 2015 American Association for Marriage and Family Therapy.

  5. Art and artistic processes bridge knowledge systems about social-ecological change: An empirical examination with Inuit artists from Nunavut, Canada

    Directory of Open Access Journals (Sweden)

    Kaitlyn J. Rathwell


    Full Text Available The role of art and artistic processes is one fruitful yet underexplored area of social-ecological resilience. Art and art making can nurture Indigenous knowledge and at the same time bridge knowledge across generations and cultures (e.g., Inuit and scientific. Experiences in two Inuit communities in northern Canada (Cape Dorset and Pangnirtung, Nunavut provide the context in which we empirically examine the mechanisms through which art and art making may bridge knowledge systems about social-ecological change. Art making and artworks create continuity between generations via symbols and skill development (e.g., seal skin stretching for a modern artistic mural and by creating mobile and adaptive boundary objects that function as a shared reference point to connect different social worlds. Our results indicate how art and artistic processes may bridge knowledge systems through six mechanisms, and in so doing contribute to social-ecological resilience during change and uncertainty. These mechanisms are (1 embedding knowledge, practice and belief into art objects; (2 sharing knowledge using the language of art; (3 sharing of art making skills; (4 art as a contributor to monitoring social-ecological change; (5 the role of art in fostering continuity through time; and (6 art as a site of knowledge coproduction.

  6. Empirical Hamiltonians

    International Nuclear Information System (INIS)

    Peggs, S.; Talman, R.


    As proton accelerators get larger, and include more magnets, the conventional tracking programs which simulate them run slower. At the same time, in order to more carefully optimize the higher cost of the accelerators, they must return more accurate results, even in the presence of a longer list of realistic effects, such as magnet errors and misalignments. For these reasons conventional tracking programs continue to be computationally bound, despite the continually increasing computing power available. This limitation is especially severe for a class of problems in which some lattice parameter is slowly varying, when a faithful description is only obtained by tracking for an exceedingly large number of turns. Examples are synchrotron oscillations in which the energy varies slowly with a period of, say, hundreds of turns, or magnet ripple or noise on a comparably slow time scale. In these cases one may with to track for hundreds of periods of the slowly varying parameter. The purpose of this paper is to describe a method, still under development, in which element-by-element tracking around one turn is replaced by a single map, which can be processed far faster. Similar programs have already been written in which successive elements are ''concatenated'' with truncation to linear, sextupole, or octupole order, et cetera, using Lie algebraic techniques to preserve symplecticity. The method described here is rather more empirical than this but, in principle, contains information to all orders and is able to handle resonances in a more straightforward fashion

  7. Advanced Wastewater Treatment Engineering—Investigating Membrane Fouling in both Rotational and Static Membrane Bioreactor Systems Using Empirical Modelling

    Directory of Open Access Journals (Sweden)

    Parneet Paul


    Full Text Available Advanced wastewater treatment using membranes are popular environmental system processes since they allow reuse and recycling. However, fouling is a key limiting factor and so proprietary systems such as Avanti’s RPU-185 Flexidisks membrane bioreactor (MBR use novel rotating membranes to assist in ameliorating it. In earlier research, this rotating process was studied by creating a simulation model based on first principles and traditional fouling mechanisms. In order to directly compare the potential benefits of this rotational system, this follow-up study was carried out using Avanti’s newly developed static (non-rotating Flexidisks MBR system. The results from operating the static pilot unit were simulated and modelled using the rotational fouling model developed earlier however with rotational switching functions turned off and rotational parameters set to a static mode. The study concluded that a rotating MBR system could increase flux throughput when compared against a similar static system. It is thought that although the slowly rotating spindle induces a weak crossflow shear, it is still able to even out cake build up across the membrane surface, thus reducing the likelihood of localised critical flux being exceeded at the micro level and lessening the potential of rapid trans-membrane pressure increases at the macro level.

  8. Pathological changes in cystic craniopharyngiomas following intracavital 90Yttrium treatment

    International Nuclear Information System (INIS)

    Szeifert, G.T.; Julow, J.; Slowik, F.; Balint, K.; Lanyi, F.; Pasztor, E.


    Radiosurgery, using 90 Y injected directly into the cavity of cystic craniopharyngiomas produces remarkable reduction of tumour size and diminishes cyst fluid production. The authors have studied the histology of biopsy and autopsy material obtained from seven patients presented with cystic craniopharyngiomas. Histological examination was carried out before and after 90 Y silicate implantation. As an effect of 90 Y irradiation, histology of samples taken from the cyst wall revealed that the lining epithelial cell layer became destroyed and the cyst wall shrunk. Large amount of collagen fibres with focal hyaline degeneration was present. Proliferation of intimal cells and subendothelial connective tissue narrowing small vessel lumina also occurred. Considering that fibrotic tissue is more susceptible to shrink, the fibrosis induced by irradiation together with destruction of the squamous epithelium and vascular changes, might explain the reduction of the cyst volume and diminished fluid secretion after 90 Y treatment. (Authors)

  9. Change in consumer sensitivity to electricity prices in response to retail deregulation: A panel empirical analysis of the residential demand for electricity in the United States

    International Nuclear Information System (INIS)

    Nakajima, Tadahiro; Hamori, Shigeyuki


    About ten years have passed since the deregulation of the U.S. retail electricity market, and it is now generally accepted that the available data is adequate to quantitatively assess and compare conditions before and after deregulation. This study, therefore, estimates the changes in price elasticity in the residential electricity market to examine the changes, if any, in household sensitivity (as a result of retail electricity market deregulation policies) to residential electricity rates. Specifically, six types of panel data are prepared, based on three cross-sections-all states (except for Alaska and Hawaii) and the District of Columbia, deregulated states, and non-deregulated states-and two time series-the period before deregulation and the period after deregulation. The panel empirical analysis techniques are used to determine whether or not the variables are stationary, and to estimate price elasticity. We find that there is no substantial difference in the price elasticity between deregulated and non-deregulated states for both periods-before deregulation and after deregulation. Thus, it can be said that the deregulation of the retail electricity market has not made consumers more sensitive to electricity rates and that retail deregulation policies are not the cause of price elasticity differences between deregulated and non-deregulated states.

  10. Change in consumer sensitivity to electricity prices in response to retail deregulation. A panel empirical analysis of the residential demand for electricity in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Tadahiro [The Kansai Electric Power Company, Incorporated, 6-16, Nakanoshima 3-chome, Kita-Ku, Osaka 530-8270 (Japan); Hamori, Shigeyuki [Faculty of Economics, Kobe University 2-1, Rokkodai, Nada-Ku, Kobe 657-8501 (Japan)


    About ten years have passed since the deregulation of the U.S. retail electricity market, and it is now generally accepted that the available data is adequate to quantitatively assess and compare conditions before and after deregulation. This study, therefore, estimates the changes in price elasticity in the residential electricity market to examine the changes, if any, in household sensitivity (as a result of retail electricity market deregulation policies) to residential electricity rates. Specifically, six types of panel data are prepared, based on three cross-sections - all states (except for Alaska and Hawaii) and the District of Columbia, deregulated states, and non-deregulated states - and two time series - the period before deregulation and the period after deregulation. The panel empirical analysis techniques are used to determine whether or not the variables are stationary, and to estimate price elasticity. We find that there is no substantial difference in the price elasticity between deregulated and non-deregulated states for both periods - before deregulation and after deregulation. Thus, it can be said that the deregulation of the retail electricity market has not made consumers more sensitive to electricity rates and that retail deregulation policies are not the cause of price elasticity differences between deregulated and non-deregulated states. (author)

  11. Changing treatment paradigms for the management of inflammatory bowel disease. (United States)

    Im, Jong Pil; Ye, Byong Duk; Kim, You Sun; Kim, Joo Sung


    Inflammatory bowel disease (IBD) is a chronic and progressive inf lammatory condition of the gastrointestinal tract causing bowel damage, hospitalizations, surgeries, and disability. Although there has been much progress in the management of IBD with established and evolving therapies, most current approaches have failed to change the natural course. Therefore, the treatment approach and follow-up of patients with IBD have undergone a significant change. Usage of immunosuppressants and/or biologics early during the course of the disease, known as top-down or accelerated step-up approach, was shown to be superior to conventional management in patients who had been recently diagnosed with IBD. This approach can be applied to selected groups based on prognostic factors to control disease activity and prevent progressive disease. Therapeutic targets have been shifted from clinical remission mainly based on symptoms to objective parameters such as endoscopic healing due to the discrepancies observed between symptoms, objectively evaluated inf lammatory activity, and intestinal damage. The concept of treat-to-target in IBD has been supported by population-based cohort studies, post hoc analysis of clinical trials, and meta-analysis, but more evidence is needed to support this concept to be applied to the clinical practice. In addition, individualized approach with tight monitoring of non-invasive biomarker such as C-reactive protein and fecal calprotectin and drug concentration has shown to improve clinical and endoscopic outcomes. An appropriate de-escalation strategy is considered based on patient demographics, disease features, current disease status, and patients' preferences.

  12. Autobiography After Empire

    DEFF Research Database (Denmark)

    Rasch, Astrid

    of the collective, but insufficient attention has been paid to how individuals respond to such narrative changes. This dissertation examines the relationship between individual and collective memory at the end of empire through analysis of 13 end of empire autobiographies by public intellectuals from Australia......Decolonisation was a major event of the twentieth century, redrawing maps and impacting on identity narratives around the globe. As new nations defined their place in the world, the national and imperial past was retold in new cultural memories. These developments have been studied at the level......, the Anglophone Caribbean and Zimbabwe. I conceive of memory as reconstructive and social, with individual memory striving to make sense of the past in the present in dialogue with surrounding narratives. By examining recurring tropes in the autobiographies, like colonial education, journeys to the imperial...

  13. Treatment Changes in Patients With Moderate to Severe Psoriasis: A Retrospective Chart Review. (United States)

    Smith, Jaclyn A; Wehausen, Brooke; Richardson, Irma; Zhao, Yang; Li, Yunfeng; Herrera, Vivian; Feldman, Steven R

    Psoriasis treatment involves topical medications, oral medications, phototherapy, and/or biologics. The treatments used depend on a myriad of factors that change over time. To characterise the frequency of and reasons for treatment changes in patients with moderate to severe psoriasis. A chart review examined treatment changes at 902 visits by 116 patients seen between January 1, 2010, and June 30, 2015, for moderate to severe psoriasis and the physicians' justifications for those changes. 'Treatment change' was defined as switching between, adding, or removing medication classes or switching within the oral or biologic class. There were 221 visits with treatment changes identified, and a change occurred every 4.1 visits. On average, there were 1.2 treatment changes per year. Patients treated for at least 1 year averaged 1 treatment change every 16 months. The most common type of change was from one biologic to another biologic (24.9%), followed by adding a nonbiologic to a biologic (18.6%). The most common reason for switching was poor control or flare of psoriasis. Affordability was a more common problem for biologics than for nonbiologic treatments. Biologic treatment options provide a major improvement over older systemic treatments, but patients still undergo frequent treatment changes to help control their disease.

  14. A pilot randomised controlled trial in intensive care patients comparing 7 days' treatment with empirical antibiotics with 2 days' treatment for hospital-acquired infection of unknown origin. (United States)

    Scawn, N; Saul, D; Pathak, D; Matata, B; Kemp, I; Stables, R; Lane, S; Haycox, A; Houten, R


    Management of cardiac intensive care unit (ICU) sepsis is complicated by the high incidence of systemic inflammatory response syndrome, which mimics sepsis but without an infective cause. This pilot randomised trial investigated whether or not, in the ICU, 48 hours of broad-spectrum antibiotic treatment was adequate to safely treat suspected sepsis of unknown and unproven origin and also the predictive power of newer biomarkers of sepsis. The main objective of this pilot study was to provide preliminary data on the likely safety and efficacy of a reduced course of antibiotics for the treatment of ICU infections of unknown origin. A pilot, single-centre, open-label randomised trial. This study was carried out in the ICU of a tertiary heart and chest hospital. Patients being treated within the ICU were recruited into the trial if the intensivist was planning to commence antibiotics because of evidence of systemic inflammatory response syndrome and a strong suspicion of infection but there was no actual known source for that infection. Broad-spectrum antibiotic treatment administered for 48 hours (experimental) compared with treatment for 7 days (control). The primary outcome was a composite outcome of the rate of death or initiation of antibiotic therapy after the completion of the treatment schedule allocated at randomisation. Secondary outcomes included the duration of mechanical ventilation and ICU and hospital stay; the incidence of infection with Clostridium difficile (B. S. Weeks & E. Alcamo) Jones & Bartlett International Publishers, 2008, or methicillin-resistant Staphylococcus aureus (MRSA) (B. S. Weeks & E. Alcamo) Jones & Bartlett International Publishers, 2008; resource utilisation and costs associated with each of the two pilot arms; the ratio of patients screened to patients eligible to patients randomised; the incidence of crossover between groups; and the significance of newer biomarkers for sepsis for predicting patients' need for further antibiotics

  15. Culturally sensitive substance abuse intervention for Hispanic and African American adolescents: empirical examples from the Alcohol Treatment Targeting Adolescents in Need (ATTAIN) Project. (United States)

    Gil, Andrés G; Wagner, Eric F; Tubman, Jonathan G


    This study presents preliminary analyses examining the effects of an alcohol and other drug use (AOD) intervention with minority juvenile offenders. Furthermore, the study investigates the impact of cultural factors on baseline AOD use among Hispanic and African American youth, as well as on treatment outcome. Participants were 213 juvenile offenders referred for treatment (mean age = 15.7 years), 97 of whom have completed treatment to date. The intervention was carried out in clinics placed within the neighborhoods in which the participants resided. Intervention Alcohol Treatment Targeting Adolescents in Need (ATTAIN) is a controlled clinical trial evaluating the effectiveness of a brief motivational, cognitive behavioral intervention, guided self-change (GSC). Participants are assigned randomly to the individual format of guided self-change (I-GSC), the family involved format of guided self-Change (F-GSC), choice of one of these two, or a waiting list control condition. Only participants involved in active intervention are included in the present report. Data were collected via structured face-to-face interviews. Alcohol and marijuana use measures were collected using the Time-line Follow-back interview (TLFB). There were significant reductions in alcohol and marijuana use for all ethnic groups from baseline to post-intervention. Cultural factors (discrimination, acculturation, ethnic pride and cultural mistrust) were associated with pre-intervention levels of alcohol and marijuana use. Among Hispanics, pre-intervention level of substance use were higher among foreign-born than US-born youth. Analyses conducted with the US-born Hispanic group showed that ethnic orientation and ethnic pride were associated positively with greater reductions in alcohol use. The intervention provided through ATTAIN appears to be effective with a multi-ethnic population of juvenile delinquents. Cultural factors, such as ethnic orientation and ethnic mistrust, appear to constitute

  16. Changes in rat hippocampal CA1 synapses following imipramine treatment

    DEFF Research Database (Denmark)

    Chen, Fenghua; Madsen, Torsten M; Wegener, Gregers


    Neuronal plasticity in hippocampus is hypothesized to play an important role in both the pathophysiology of depressive disorders and the treatment. In this study, we investigated the consequences of imipramine treatment on neuroplasticity (including neurogenesis, synaptogenesis, and remodelling...... and number of neurons of hippocampal subregions following imipramine treatment were found. However, the number and percentage of CA1 asymmetric spine synapses increased significantly and, conversely, the percentage of asymmetric shaft synapses significantly decreased in the imipramine treated group. Our...

  17. Multimodality treatment strategies have changed prognosis of peritoneal metastases (United States)

    Lungoci, Corneliu; Mironiuc, Aurel Ion; Muntean, Valentin; Oniu, Traian; Leebmann, Hubert; Mayr, Max; Piso, Pompiliu


    For a long time, treatment of peritoneal metastases (PM) was mostly palliative and thus, this status was link with “terminal status/despair”. The current multimodal treatment strategy, consisting of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources (multi-center and -institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results (similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists’ perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams. PMID:26798438

  18. A scoping study to identify opportunities to advance the ethical implementation and scale-up of HIV treatment as prevention: priorities for empirical research. (United States)

    Knight, Rod; Small, Will; Pakula, Basia; Thomson, Kimberly; Shoveller, Jean


    Despite the evidence showing the promise of HIV treatment as prevention (TasP) in reducing HIV incidence, a variety of ethical questions surrounding the implementation and "scaling up" of TasP have been articulated by a variety of stakeholders including scientists, community activists and government officials. Given the high profile and potential promise of TasP in combatting the global HIV epidemic, an explicit and transparent research priority-setting process is critical to inform ongoing ethical discussions pertaining to TasP. We drew on the Arksey and O'Malley framework for conducting scoping review studies as well as systematic approaches to identifying empirical and theoretical gaps within ethical discussions pertaining to population-level intervention implementation and scale up. We searched the health science database PubMed to identify relevant peer-reviewed articles on ethical and implementation issues pertaining to TasP. We included English language articles that were published after 2009 (i.e., after the emergence of causal evidence within this field) by using search terms related to TasP. Given the tendency for much of the criticism and support of TasP to occur outside the peer-reviewed literature, we also included grey literature in order to provide a more exhaustive representation of how the ethical discussions pertaining to TasP have and are currently taking place. To identify the grey literature, we systematically searched a set of search engines, databases, and related webpages for keywords pertaining to TasP. Three dominant themes emerged in our analysis with respect to the ethical questions pertaining to TasP implementation and scale-up: (a) balancing individual- and population-level interests; (b) power relations within clinical practice and competing resource demands within health care systems; (c) effectiveness considerations and socio-structural contexts of HIV treatment experiences within broader implementation contexts. Ongoing research

  19. Long-term contracts for European gas supply - an empirical analysis of the changing nature of pipeline and LNG-contracts

    International Nuclear Information System (INIS)

    Neumann, Anne


    As the structure of the European natural gas market is evolving towards more competition and more diverse market structures than before, the nature of the long-term contracts for European natural gas supply is also undergoing change. Experience from other liberalization processes, such as in the U.S. or the UK, suggests that the importance of long-term contracts diminishes over time, but that they remain an important element of supply. In Europe long-term contracts are still considered as a firm basis for investment and financing of capital-intensive infrastructure with a high degree of asset and relationship-specificity. Literature on institutional economics also suggests that long-term contracts act as a device to overcome the ''hold-up'' problem of relationship-specific investments in infrastructure (Klein, Crawford, and Alchian, 1987; Williamson, 1975, 1985). On the other hand, Hartley and Brito (2002) show that more flexible markets also imply a lower degree of asset specificity, thus requiring less fixed contracts. This paper explores the changing nature of long-term contracts for European natural gas supply, with a particular focus on differences between contracts for pipeline gas and liquefied natural gas (LNG). Traditionally, Europe relied on very long-term contracts for pipeline gas (Russia, Norway, Algeria). More recently, increasing LNG supplies are contemplated as a more flexible source of natural gas: The international LNG market is becoming more flexible, LNG can be sourced from a variety of sellers, and the cost of LNG supplies and infrastructure is coming down rapidly (Jensen, 2004). Thus, the evaluation of investing in LNG infrastructure (and the so bought flexibility and possibility of arbitraging profits) may be higher than committing to fixed/predetermined flows of pipeline gas. We ask whether this is reflected in the observed contracts. The paper is based on standard contract theory (Bolton and Dewatripont, 2005). We apply a microeconomic

  20. Simple physical-empirical model of the precipitation distribution based on a tropical sea surface temperature threshold and the effects of climate change (United States)

    Jauregui, Yakelyn R.; Takahashi, Ken


    The observed nonlinear relationship between tropical sea surface temperature (T_s) and precipitation ( P) on climate timescales, by which a threshold (T_c) must be exceeded by T_s in order for deep convection to occur, is the basis of a physical-empirical model (PEM) that we fitted to observational data and CMIP5 climate model output and used to show that, with essentially only two constant parameters (T_c and the sensitivity a_1 of P to T_s>T_c), it provides a useful first-order description of the climatological and interannual variability of the large-scale distribution of tropical P given T_s, as well as of the biases of the Global Climate Models (GCMs). A substantial limitation is its underestimation of the peak P in the convergence zones, as the necessary processes associated with the atmospheric circulation are not considered. The pattern of the intermodel correlation between the mean T_s-T_c for each GCM and the average P distribution is in agreement with the double ITCZ bias, featuring roughly zonally-symmetric off-equatorial maxima, rather than being regionally or hemispherically restricted. The inter-comparison of GCMs indicates a relationship between T_c with the near-equatorial low-level (850 hPa) tropospheric temperature, consistent with the interpretation that it is a measure of the convective inhibition (CIN). The underestimation of T_c is linked to the cold free tropospheric bias in the GCMs. However, the discrepancy among the observational datasets is a limitation for assessing the GCM biases from the PEM framework quantitatively. Under the RCP4.5 climate change scenario, T_c increases slightly more than the mean tropical T_s, implying a stabilizing trend consistent with the amplified free tropospheric warming relative to the surface. However, since a_1 increases by 10-50%/°C with the surface warming, its effect dominates and results in generally positive precipitation change (Δ P) in the equatorial regions. In the equatorial eastern

  1. Changes in lipidemia during chronic care treatment of childhood obesity

    DEFF Research Database (Denmark)

    Nielsen, Tenna Ruest Haarmark; Gamborg, Michael; Fonvig, Cilius Esmann


    Childhood obesity and related co-morbidities are increasing. This intervention study assessed the associations between weight changes and lipidemia in obese children and adolescents.......Childhood obesity and related co-morbidities are increasing. This intervention study assessed the associations between weight changes and lipidemia in obese children and adolescents....

  2. Gender representation of cancer patients in medical treatment and psychosocial survivorship research: changes over three decades. (United States)

    Hoyt, Michael A; Rubin, Lisa R


    Prior studies raise concern about gender bias in cancer research, including insufficient inclusion of women or men, or studying women and men differently. The 1993 National Institutes of Health Revitalization Act aimed to eliminate gender bias in medicine. To examine changes in medical and psychological literature, this study reviews gender representation in biomedical treatment studies and psychosocial survivorship studies published in a single year. Research published in Cancer in 2007, and all empirical psychological studies about cancer published that year, provided a 15-year update to findings reported by Meyerowitz and Hart. The gender distribution and context of included articles were coded and compared with findings from 1983 and 1992. Across biomedical studies, 34.3% of subjects were women (vs 47% of new cancers and 48% of cancer deaths). Among men, 41.3% had sex-specific cancers (vs 12.5% [1983] and 12.3% [1992]). Among women, 46.1% had sex-specific cancers (vs 69.1% [1983] and 64.6% [1992]). Fewer women (36.8%) were represented in sex-nonspecific cancer studies (vs 41.4% [1983] and 42.5% [1992]); however, fewer studies had a significant (>20%) gender disparity. Across psychosocial studies, representation of men increased to 47.9% (vs 30.4% [1983] and 29.9% [1992]). The proportion of men in studies of feelings/relationships increased to 47% (vs 22.9% [1992]); the proportion of women in studies assessing physical/functional ability increased to 58.3% (vs 45.4%). Women remain under-represented in sex-nonspecific biomedical research, whereas men's representation in sex-specific research increased substantially. Psychosocial research trends suggest movement from research questions supporting traditional stereotypes that women feel and men act. Copyright © 2012 American Cancer Society.

  3. Empiric Piperacillin-Tazobactam versus Carbapenems in the Treatment of Bacteraemia Due to Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae. (United States)

    Ng, Tat Ming; Khong, Wendy X; Harris, Patrick N A; De, Partha P; Chow, Angela; Tambyah, Paul A; Lye, David C


    Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a common cause of bacteraemia in endemic countries and may be associated with high mortality; carbapenems are considered the drug of choice. Limited data suggest piperacillin-tazobactam could be equally effective. We aimed to compare 30-day mortality of patients treated empirically with piperacillin-tazobactam versus a carbapenem in a multi-centre retrospective cohort study in Singapore. Only patients with active empiric monotherapy with piperacillin-tazobactam or a carbapenem were included. A propensity score for empiric carbapenem therapy was derived and an adjusted multivariate analysis of mortality was conducted. A total of 394 patients had ESBL-Escherichia.coli and ESBL-Klebsiella pneumoniae bacteraemia of which 23.1% were community acquired cases. One hundred and fifty-one received initial active monotherapy comprising piperacillin-tazobactam (n = 94) or a carbapenem (n = 57). Patients who received carbapenems were less likely to have health-care associated risk factors and have an unknown source of bacteraemia, but were more likely to have a urinary source. Thirty-day mortality was comparable between those who received empiric piperacillin-tazobactam and a carbapenem (29 [30.9%] vs. 17 [29.8%]), P = 0.89). Those who received empiric piperacillin-tazobactam had a lower 30-day acquisition of multi-drug resistant and fungal infections (7 [7.4%] vs. 14 [24.6%]), Pcarbapenem.

  4. The assessment and treatment of wound pain at dressing change.

    LENUS (Irish Health Repository)

    Bell, Cassandra


    Pain is a common reason for patients with acute or chronic wounds seeking hospital admission, but it appears to be under-treated by health professionals. A quantitative descriptive study was conducted to investigate nurses\\' knowledge with regard to dressing change and wound pain. Data were collected from registered nurses (n=94). Analysis indicated a low level of knowledge with regard to pain assessment and strategies to overcome pain at dressing change, but a good knowledge of factors that contribute to pain at dressing change.

  5. Using dreams to assess clinical change during treatment. (United States)

    Glucksman, Myron L; Kramer, Milton


    This article describes several studies that examine the relationship between the manifest content of selected dreams reported by patients and their clinical progress during psychoanalytic and psychodynamically oriented treatment. There are a number of elements that dreaming and psychotherapy have in common: affect regulation; conflict resolution; problem-solving; self-awareness; mastery and adaptation. Four different studies examined the relationship between the manifest content of selected dreams and clinical progress during treatment. In each study, the ratings of manifest content and clinical progress by independent observers were rank-ordered and compared. In three of the four studies there was a significant correlation between the rankings of manifest content and the rankings of clinical progress. This finding suggests that the manifest content of dreams can be used as an independent variable to assess clinical progress during psychoanalytic and psychodynamically oriented treatment.

  6. [Perinatal clomiphene citrate treatment changes sexual orientations of male mice]. (United States)

    He, Feng-Qin; Zhang, Heng-Rui


    Perinatal period and adolescence are critical for brain development, which is the biological basis of an individual's sexual orientation and sexual behavior. In this study, animals were divided into two groups and their sexual orientations were observed: one group experienced drug treatments during the perinatal period, and the other group was castrated at puberty. The results showed that estradiol treatment had no effect on mature male offspring's sexual orientations, but 9 days and 14 days of clomiphene citrate treatment significantly increased the chance of homosexuality and effeminized behavior. In addition, the sexual orientation of mature normal male offspring, which were castrated when they were 21 days old,was not significant different from the control animals. These findings suggest that the inhibition of perinatal estrogen activities could suppress individual male-typical responses, enhance female-typical responses and induce homosexual orientations. Moreover, the masculinizing effects of estrogen were more obvious during perinatal period than adolescence.

  7. Classification and pharmacological treatment of preschool wheezing: changes since 2008

    DEFF Research Database (Denmark)

    Brand, P. L. P.; Caudri, D.; Eber, E.


    Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some......, with scheduled close follow-up to monitor treatment effect. The group recommends discontinuing treatment if there is no benefit and taking favourable natural history into account when making decisions about long-term therapy. Oral corticosteroids are not indicated in mild-to-moderate acute wheeze episodes...

  8. Social skills training for juvenile delinquents : post-treatment changes

    NARCIS (Netherlands)

    van der Stouwe, Trudy; Asscher, Jessica J.; Hoeve, Machteld; van der Laan, Peter H.; Stams, Geert Jan J M


    Objectives: To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods: The sample consisted of juveniles who received Tools4U,

  9. Social Skills Training for Juvenile Delinquents: Post-Treatment Changes

    NARCIS (Netherlands)

    van der Stouwe, Trudy; Asscher, J.J.; Stams, G.J.J.M.; Hoeve, M.; van der Laan, Peter H.


    Objectives: To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods: The sample consisted of juveniles who received Tools4U,

  10. Social skills training for juvenile delinquents : Post-treatment changes

    NARCIS (Netherlands)

    van der Stouwe, T.; Asscher, J.J.; Hoeve, M.; van der Laan, P.H.; Stams, G.J.J.M.


    Objectives To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods The sample consisted of juveniles who received Tools4U, a

  11. Water Supply and Treatment Equipment. Change Notice 1 (United States)


    Coagulation Filtration Total Dissolved Solids Water Quality Conductivity Potable water Turbidity Water Treatment/Purification Disinfection ...microorganisms (pathogenic) found in the raw water . The preferred Army field method of water disinfection is chlorination. Filtration Filtration...senses. It looks, tastes, and smells good and is neither too hot nor too cold. Potable water Water that is safe for drinking . Reverse osmosis

  12. Corrected QT changes during antipsychotic treatment of children and adolescents

    DEFF Research Database (Denmark)

    Jensen, Karsten Gjessing; Juul, Klaus; Fink-Jensen, Anders


    covering 9 antipsychotics and including 5,423 patients with QTc data (mean age = 12.8 ± 3.6 years, female = 32.1%). Treatments included aripiprazole: studies = 14; n = 814; haloperidol: studies = 1; n = 15; molindone: studies = 3; n = 125; olanzapine: studies = 5; n = 212; paliperidone: studies = 3; n...

  13. Changes in bone metabolism during treatment of acromegaly

    NARCIS (Netherlands)

    Bijlsma, J. W.; Nortier, J. W.; Duursma, S. A.; Croughs, R. J.; Bosch, R.; Thijssen, J. H.


    Bone metabolism was studied in 17 acromegalic patients, who responded to either medical treatment with bromocriptine (12 patients), or to transsphenoidal surgery (5 patients). Parameters of bone turnover decreased, e.g. serum acid phosphatase (9.2 +/- 0.7 vs 8.1 +/- 0.6 U/l, P less than 0.05) and

  14. Recent advances in behavioral addiction treatments: focusing on mechanisms of change. (United States)

    Longabaugh, Richard; Magill, Molly


    In the latter half of the 20th century, research on behavioral treatments for addictions aimed to develop and test effective treatments. Among the treatments found to be at least moderately effective, direct comparisons failed to reveal consistent superiority of one approach over another. This ubiquitous finding held true despite underlying theories that differed markedly in their proposed causal processes related to patient change. In the 21st century, the focus of treatment research is increasingly on how treatment works for whom rather than whether it works. Studies of active treatment ingredients and mechanisms of behavioral change, while promising, have yielded inconsistent results. Simple mediation analysis may need to be expanded via inclusion of models testing for moderated mediation, mediated moderation, and conditional indirect effects. Examples are offered as to how these more complex models can lead to increased understanding of the conditions under which specific treatment interventions will be effective and mechanisms of change operative in improving behavioral treatments for addictions.

  15. Body composition changes in essential hypertension before and after treatment

    International Nuclear Information System (INIS)

    Fueloep, T. Jr.; Worum, I.; Csongor, J.; Ujhelyi, L.; Foeris, G.


    The body composition of 30 elderly (22 females: 78,2+7,6; 8 males: 80,4+5,4 yrs) and 38 middle-aged (27 females: 45,5+10.3; 11 males: 42,3+8,7 yrs) people suffering of essential hypertension determined by complex clinical and biological examinations (BP: 160-180/100-200 Hgmm), was determined before and after treatment. Most of them (78%) could be reassessed after 3 month of treatment (beta-blocking drugs or diuretics). The authors also investigated a few numbers (n=10) of patients presenting a hypertensive crisis treated with vasodilatant drugs and diuretics during 1 week of period. The hormonal status of all of them was assessed at the same time. The body composition was determined by multiple-isotope method

  16. Pharmacokinetics of imipenem in critically ill patients during empirical treatment of nosocomial pneumonia: a comparison of 0.5-h and 3-h infusions. (United States)

    Lipš, Michal; Siller, Michal; Strojil, Jan; Urbánek, Karel; Balík, Martin; Suchánková, Hana


    In critically ill patients, pathophysiological changes alter the pharmacokinetics of antibiotics. Imipenem exhibits primarily time-dependent killing. Its administration by prolonged infusion may increase the time for which its plasma concentration exceeds the minimum inhibitory concentrations (MICs) of suspected pathogens. The objectives of this study were to compare the pharmacokinetic parameters of imipenem administered by standard short infusion (1g imipenem/1g cilastatin over 30min three times daily) and by extended infusion with a reduced total dose (0.5g imipenem/0.5g cilastatin over 3h four times daily) and to compare the target pharmacokinetic/pharmacodynamic indices, namely percentage of the dosing interval for which the free plasma concentration of imipenem exceeds the MIC and 4× MIC (%fT>MIC and %fT>4×MIC) of 0.5, 1, 2 and 4mg/L, for these two regimens in critically ill adult patients with nosocomial pneumonia on Day 2 of empirical antibiotic therapy. The study included 22 patients. Whilst no significant differences were found between both groups for %fT>MIC, %fT>4×MIC was 87.4±12.19%, 68.6±15.08%, 47.31±6.64% and 27.81±9.52% of the 8-h interval in the short infusion group for MICs of 0.5, 1, 2 and 4mg/L, respectively, and 85.15±17.57%, 53.14±27.27%, 13.55±24.47% and 0±0% of the 6-h interval for the extended infusion group. In conclusion, administration of 0.5g of imipenem by a 3-h infusion every 6h does not provide sufficient drug concentrations to treat infections caused by pathogens with a MIC of ≥2mg/L. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  17. Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

    DEFF Research Database (Denmark)

    Faber, J; Wiinberg, N; Schifter, S


    rate. Subclinical hyperthyroidism is characterised by reduced serum TSH levels despite free thyroxine (T4) and tri-iodothyronine (T3) estimates within the reference range, in subjects with no obvious symptoms of hyperthyroidism. We measured haemodynamic changes (using impedance cardiography...

  18. Changes in hydroxyapatite powder properties via heat treatment

    Indian Academy of Sciences (India)

    1807–1819. c Indian Academy of Sciences. Changes in hydroxyapatite .... pension was conditioned for 30 h during which the pH was adjusted. After shaking ... ment between the experimental data (for all samples) and the standard hexagonal ...

  19. Changes in functional status after treatment of critical limb ischemia

    NARCIS (Netherlands)

    Frans, Franceline Alkine; Met, Rosemarie; Koelemay, Mark J. W.; Bipat, Shandra; Dijkgraaf, Marcel G. W.; Legemate, Dink A.; Reekers, Jim A.


    This study evaluated changes in functional status with the Academic Medical Center Linear Disability Score (ALDS) and in quality of life with the Vascular Quality of Life Questionnaire (VascuQol) in patients treated for critical limb ischemia (CLI). We conducted a prospective observational cohort

  20. Regulation management in the power industry. Results of an empirical analysis with particular consideration of institutional change; Regulierungsmanagement in der Energiewirtschaft. Ergebnisse einer empirischen Analyse unter besonderer Beruecksichtigung des institutionellen Wandels

    Energy Technology Data Exchange (ETDEWEB)

    Schuchardt, Lukas D.


    With the introduction of regulation by incentives in 2009, German grid operators were faced with a new challenge, i.e. economic efficiency instead of technical excellence became the determining factor on which decisions for actions were based. To these new requirements, grid operators reacted by introducing a central regulation management department. The book presents an empirical investigation of the tasks, organisational structure and goals of the new department and analyses the institutional changes in the structure of grid operating utilities.

  1. The changing face of complicated infantile hemangioma treatment

    Energy Technology Data Exchange (ETDEWEB)

    Menapace, Deanna [Creighton University School of Medicine, Phoenix Regional Campus, Phoenix, AZ (United States); Mayo School of Graduate Medical Education-MN, Department of Otorhinolaryngology, Rochester, MN (United States); Mitkov, Mario [Creighton University School of Medicine, Phoenix Regional Campus, Phoenix, AZ (United States); Towbin, Richard [Phoenix Children' s Hospital, Department of Radiology, Phoenix, AZ (United States); Hogeling, Marcia [University of California, Los Angeles, Division of Dermatology, Santa Monica, CA (United States)


    Infantile hemangiomas are the most common vascular tumors of infancy. A multidisciplinary approach including dermatologists, otolaryngologists, plastic surgeons, hematologists/oncologists and interventional/diagnostic radiologists is crucial for appropriate management of children with complicated infantile hemangiomas. Since its unforeseen discovery in 2008, propranolol has become the first-line treatment for infantile hemangiomas, eclipsing systemic corticosteroids and radiologic intervention. There are still, however, uncommon indications for more aggressive interventional management. We review the 2014-updated International Society for the Study of Vascular Anomalies (ISSVA) classification for vascular anomalies. Additionally, we suggest management algorithms for complicated lesions, including recommendations for radiologic and surgical intervention. (orig.)

  2. Empirical Productivity Indices and Indicators

    NARCIS (Netherlands)

    B.M. Balk (Bert)


    textabstractThe empirical measurement of productivity change (or difference) by means of indices and indicators starts with the ex post profit/loss accounts of a production unit. Key concepts are profit, leading to indicators, and profitability, leading to indices. The main task for the productivity

  3. [C-reactive protein changes with antihypertensive and statin treatment]. (United States)

    Rodilla, Enrique; Gómez-Belda, Ana; Costa, José A; Aragó, Miriam; Miralles, Amparo; González, Carmen; Pascual, José M


    The aim of this study was to evaluate the modifications of high sensitivity C-reactive protein (CRP) with antihypertensive and statin treatment in a hypertensive population with a wide range of coronary risks (CR). Retrospective follow-up study in 665 hypertensive patients: 556 (52% male) without dyslipidemia and CR (Framingham at 10 years) of 8.3 (7.6) as a control group (C) and 109 (61% male) with dyslipidemia and CR of 13.1 (8.8) who were treated with statins (T). Statins treatment was established according to NCEP-ATP-III. In both groups, the antihypertensive treatment was optimized in order to achieve blood pressure (BP) control (< 140/90 mmHg). A lipid profile and high sensitivity CRP (analyzed by nephelometry) was performed at the beginning and at the end of follow up [14.3 (3.6) months]. CRP levels were reduced in the T group -0.17 (0.2) mg/L vs. 0.14 (0.09) mg/L (p = 0.003, Mann-Whitney) in C. The lessening of CRP was not related to the reduction of lipids levels: total cholesterol (r = 0.06; p = 0.49), LDL-C (r = 0.11; p = 0.24), triglycerides (r = -0.02; p = 0.81) (Spearman), or to the reduction of systolic BP (r = -0.07; p = 0.44) and diastolic BP (r = -0.121; p = 0.21). The T group was treated with more antihypertensive drugs than C (2.2 [2.3] vs. 2.5 [1.2]; p = 0.02). Patients treated with ECA inhibitors or angiotensin II antagonist showed a tendency to decreasing the CRP levels more (p = 0.08). In hypertensive populations, statins induce a reduction of CRP levels. The reduction is not related to the lowering of lipids levels or BP values. The effect of statins on the reduction of CRP in hypertensive patients is not related to the lowering of lipids or BP.

  4. The changing treatment landscape in idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Ulrich Costabel


    Full Text Available Idiopathic pulmonary fibrosis (IPF is a chronic, progressive and irreversible fibrotic disease of the lung that has greatly frustrated clinicians for a long time. The prognosis of IPF (median survival 2–5 years following diagnosis is poorer than that of some cancers and for many years no significant advances were made in its management. However, between 2011 and 2014 a number of pivotal developments were made that have improved the outlook for patients with IPF. Herein, we review this rapidly changing landscape, discussing key events whilst still acknowledging that IPF remains a challenging disease to diagnose and manage.

  5. Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

    DEFF Research Database (Denmark)

    Faber, J; Wiinberg, N; Schifter, S


    Hyperthyroidism has profound effects on the cardiovascular system, including reduced systemic vascular resistance (SVR) due to relaxation of vascular smooth muscle cells, enhanced heart rate (HR) and cardiac output (CO) due to an increase in cardiac diastolic relaxation, contractility and heart...... rate. Subclinical hyperthyroidism is characterised by reduced serum TSH levels despite free thyroxine (T4) and tri-iodothyronine (T3) estimates within the reference range, in subjects with no obvious symptoms of hyperthyroidism. We measured haemodynamic changes (using impedance cardiography......) in subjects with endogenous subclinical hyperthyroidism in order to elucidate whether these patients had signs of excess thyroid hormone at the tissue level....

  6. Treatment of Radiation Induced Biological Changes by Bone Marrow Transplantation

    International Nuclear Information System (INIS)

    El-Missiry, M.A.; Shehata, G.; Roushdy, H.M; Fayed, Th.A.


    Preventing the propagation of radiation induced oxidative damage has been a subject of considerable investigations. The ultimate goal of the present study is to use bone marrow cells to ameliorate or to treat the radiation sickness. Transplantation of bone marrow cell has shown promising results in the present experimental radiation treatment. In this report, suspension of bone marrow cells was injected into rats 12 h. after exposure to 4.5 Gy whole body gamma irradiation. Significant results were recorded on the successful control of the radiation induced disorders in a number of biochemical parameters including certain enzymatic and nonenzymatic antioxidants (superoxide dismutase and glutathione) and certain parameters related to kidney function including creatinine, urea as well as Atpase Activity in blood serum, urine and kidney tissue

  7. Forecasting land cover change impacts on drinking water treatment costs in Minneapolis, Minnesota (United States)

    Woznicki, S. A.; Wickham, J.


    Source protection is a critical aspect of drinking water treatment. The benefits of protecting source water quality in reducing drinking water treatment costs are clear. However, forecasting the impacts of environmental change on source water quality and its potential to influence future treatment processes is lacking. The drinking water treatment plant in Minneapolis, MN has recognized that land cover change threatens water quality in their source watershed, the Upper Mississippi River Basin (UMRB). Over 1,000 km2 of forests, wetlands, and grasslands in the UMRB were lost to agriculture from 2008-2013. This trend, coupled with a projected population increase of one million people in Minnesota by 2030, concerns drinking water treatment plant operators in Minneapolis with respect to meeting future demand for clean water in the UMRB. The objective of this study is to relate land cover change (forest and wetland loss, agricultural expansion, urbanization) to changes in treatment costs for the Minneapolis, MN drinking water utility. To do this, we first developed a framework to determine the relationship between land cover change and water quality in the context of recent historical changes and projected future changes in land cover. Next we coupled a watershed model, the Soil and Water Assessment Tool (SWAT) to projections of land cover change from the FOREcasting SCEnarios of Land-use Change (FORE-SCE) model for the mid-21st century. Using historical Minneapolis drinking water treatment data (chemical usage and costs), source water quality in the UMRB was linked to changes in treatment requirements as a function of projected future land cover change. These analyses will quantify the value of natural landscapes in protecting drinking water quality and future treatment processes requirements. In addition, our study provides the Minneapolis drinking water utility with information critical to their planning and capital improvement process.

  8. The family in Italy: cultural changes and implications for treatment. (United States)

    Luciano, Mario; Sampogna, Gaia; del Vecchio, Valeria; Giacco, Domenico; Mulè, Alice; de Rosa, Corrado; Fiorillo, Andrea; Maj, Mario


    In Italy family is characterized by strong ties and is based on mutual aid of all its members. In the last 20 years, the structure of families has been significantly influenced by demographic, economic and professional changes, determining a transition from a patriarchal to a nuclear family model, with a higher number of single-parent families, single-person households, childless couples, same-sex couples. However, this transition has been slower than that occurring in other countries, probably as an ongoing impact of prevalent Catholic ideology. Major demographic changes in Italian families include, 1) a decrease in the number of marriages, delays in getting married and an high number of civil ceremonies, 2) a reduced birth rate; Italy is becoming one of the European countries with lowest growth rate, and with an increasing number of births out of wedlock, 3) an increased marital instability, with a constantly growing number of legal separations. Like many countries, relatives in Italy are highly involved in the care of patients with physical and mental disorders. There are a number of psychosocial interventions used in Italy including the 'Milan Systemic Approach' and family psycho-educational interventions. However, there are difficulties in implementing these interventions which are highlighted in this paper. We recommend research strategies to identify the best options to involve families in the care of mentally ill patients and to adequately support them.

  9. Change of mechanical properties of molybdenum after chemical heat treatment

    International Nuclear Information System (INIS)

    Skuratov, L.P.; Yatsimirskij, V.K.; Kirillova, N.V.


    Gaseous media (argon, ammonia, nitrogen-hydrogen-ammonia mixture) are studied for their effect on mechanical characteristics of molybdenum at temperatures up to 1000 deg C. It is established that the highest hardening occurs when molybdenum is esposed in the nitrogen-hydrogen medium, while the highest lost of strength takes place in the ammonia medium. An increase of the ammonia concentration in nitrogen-hydrogen-ammonia mixture promotes regular increasing of the deformation rate. With ammonia concentration of 33.3% the gaseous mixture acts the same as pure ammonia. Change of physical-and-mechanical properties of molybdenum under the action of nitrogen-containing gaseous media is associated with formation of molybdenum compounds with nitrogen. During nitriding in ammonia an internal (volume) nitriding proceeds while in the medium of nitrogen-hydrogen mixture surface nitride layers form

  10. Changing low income smokers' beliefs about tobacco dependence treatment. (United States)

    Christiansen, Bruce; Reeder, Kevin; Fiore, Michael C; Baker, Timothy B


    This field study tested an intervention that challenged beliefs about the effectiveness of various quit methods held by Salvation Army client smokers from two urban locations (N = 245). Data (surveys administered immediately after and one month post-intervention) were collected 2009-2010 and analyzed using primarily χ(2) and t-tests. The intervention changed client perceptions about the effectiveness of quitting methods. Compared to no-intervention controls, intervention participants reported significantly greater smoking reduction and greater likelihood of contacting the Wisconsin Tobacco Quit Line. Study implications/limitations are discussed and future research directions noted. This research was supported by grant UL1TR000427 from the Clinical and Translational Science Award (CTSA) program of the National Center for Advancing Translational Sciences, NIH.

  11. Recent Advances in Behavioral Addiction Treatments: Focusing on Mechanisms of Change


    Longabaugh, Richard; Magill, Molly


    In the latter half of the 20th century, research on behavioral treatments for addictions aimed to develop and test effective treatments. Among treatments found to be at least moderately effective, direct comparisons failed to reveal consistent superiority of one approach over another. This ubiquitous finding held true despite underlying theories that differed markedly in their proposed causal processes related to patient change. In the 21st century the focus of treatment research is increasin...

  12. [Relationship between cocaine dependence treatment and personal values of openness to change and conservation]. (United States)

    Galdós, Jesús Saiz; Sánchez, Isabel Martínez


    To analyze the relationship between participation in a drug addiction treatment program and Schwartz's values of Openness to change (Self-direction, Stimulation and Hedonism) and Conservation (Tradition, Conformity and Security) in cocaine users. The present quasi-experimental study was carried out on a sample of 411 adult cocaine users, grouped according to whether they had begun treatment more than three months earlier or less than three months earlier or they were not receiving any treatment. Using Schwartz's Personal Values Questionnaire (PVQ), we measured the priority given by each of these groups to the values of Conservation and Openness to change. Participants who had initiated the treatment more than three months earlier tended to score lower in the values of Openness to change than those who were not in treatment, though there were no significant differences in these values between those who were not in treatment and those who had been in treatment for less than three months. On the other hand, it was observed that participants in treatment, regardless of the time spent in treatment, scored higher in values of Conservation than the cocaine users who were not in treatment. These results reveal the relationship between attendance on a cocaine-dependence treatment program and personal values, together with their potential importance in treatment and rehabilitation programs for cocaine users.

  13. Associations between change in sedentary behavior and outcome in standard behavioral weight loss treatment. (United States)

    Kerrigan, Stephanie G; Call, Christine; Schaumberg, Katherine; Forman, Evan; Butryn, Meghan L


    Sedentary behavior, particularly in prolonged periods, is an important determinant of health. Little research exploring changes in sedentary behavior during behavioral weight loss programs exists. This study evaluated the magnitude of changes in total and prolonged sedentary behavior and how these changes related to changes in weight and cardiovascular outcomes during a behavioral weight loss program. Participants (n = 450) in two lifestyle modification programs underwent assessments of sedentary behavior (by accelerometry), weight, waist circumference, blood pressure, and resting heart rate at baseline and after 6 months of treatment. Sedentary behavior was defined as both total and prolonged (≥30 continuous minutes) sedentary minutes/day. Reductions in total and prolonged sedentary time were significant and were accounted for by increases in moderate-to-vigorous physical activity (MVPA). Only changes in MVPA significantly predicted change in weight when entered into a model simultaneously with changes in sedentary behavior. Changes in total and prolonged sedentary time were not associated with changes in waist circumference, heart rate, or blood pressure. Change in sedentary time was not independently associated with change in health outcomes during a behavioral weight loss treatment. High variability in changes in sedentary time indicate that individual differences may be important to examine. Reducing sedentary time may not be powerful enough to impact these health outcomes above the effects of other changes made during these programs; alternatively, it may be that increasing focus in treatment on reducing sedentary time may engender greater decreases in sedentariness, which could lead to better health outcomes.

  14. Estimating evapotranspiration change due to forest treatment and fire at the basin scale in the Sierra Nevada, California (United States)

    Roche, J. W.; Goulden, M.; Bales, R. C.


    Increased forest evapotranspiration (ET) coupled with snowpack decreases in a warming climate is likely to decrease runoff and increase forest drought stress. Field experiments and modeling suggest that forest thinning can reduce ET and thus increase potential runoff relative to untreated areas. We investigated the potential magnitude and duration of ET decreases resulting from forest-thinning treatments and fire using a robust empirical relation between Landsat-derived mean-annual normalized difference vegetation index (NDVI) and annual ET measured at flux towers. Among forest treatments, the minimum observed NDVI change required to produce a significant departure from control plots with NDVI of about 0.70 was -0.07 units, corresponding to a basal-area reduction of 3.1 m2 ha-1, and equivalent to an estimated ET reduction of -102 mm yr-1. Intensive thinning in highly productive forests that approached pre-fire-exclusion densities reduced basal area by 40-50%, generating estimated ET reductions of 152-216 mm yr-1 over five years following treatment. Between 1990 and 2008, fires in the American River basin generated more than twice the ET reduction per unit area than those in the Kings River basin, corresponding to greater water and energy limitations in the latter and greater fire severity in the former. A rough extrapolation of these results to the entire American River watershed, much of which would have burned naturally during this 19-year period, could result in ET reductions that approach 10% of full natural flows for drought years and 5% averaged over all years. This work demonstrates the potential utility to estimate forest ET change at the patch scale, which in turn may allow managers to estimate thinning benefits in areas lacking detailed hydrologic measurements.

  15. Effectiveness of the Treatment Readiness and Induction Program for increasing adolescent motivation for change. (United States)

    Becan, Jennifer E; Knight, Danica K; Crawley, Rachel D; Joe, George W; Flynn, Patrick M


    Success in substance abuse treatment is improved by problem recognition, desire to seek help, and readiness to engage in treatment, all of which are important aspects of motivation. Interventions that facilitate these at treatment induction for adolescents are especially needed. The purpose of this study is to assess the effectiveness of TRIP (Treatment Readiness and Induction Program) in promoting treatment motivation. Data represent 519 adolescents from 6 residential programs who completed assessments at treatment intake (time 1) and 35 days after admission (time 2). The design consisted of a comparison sample (n=281) that had enrolled in treatment prior to implementation of TRIP (standard operating practice) and a sample of clients that had entered treatment after TRIP began and received standard operating practice enhanced by TRIP (n=238). Repeated measures ANCOVAs were conducted using each time 2 motivation scale as a dependent measure. Motivation scales were conceptualized as representing sequential stages of change. LISREL was used to test a structural model involving TRIP participation, gender, drug use severity, juvenile justice involvement, age, race-ethnicity, prior treatment, and urgency as predictors of the stages of treatment motivation. Compared to standard practice, adolescents receiving TRIP demonstrated greater gains in problem recognition, even after controlling for the other variables in the model. The model fit was adequate, with TRIP directly affecting problem recognition and indirectly affecting later stages of change (desire for help and treatment readiness). Future studies should examine which specific components of TRIP affect change in motivation. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Neural and behavioural changes in male periadolescent mice after prolonged nicotine-MDMA treatment. (United States)

    Adeniyi, Philip A; Ishola, Azeez O; Laoye, Babafemi J; Olatunji, Babawale P; Bankole, Oluwamolakun O; Shallie, Philemon D; Ogundele, Olalekan M


    The interaction between MDMA and Nicotine affects multiple brain centres and neurotransmitter systems (serotonin, dopamine and glutamate) involved in motor coordination and cognition. In this study, we have elucidated the effect of prolonged (10 days) MDMA, Nicotine and a combined Nicotine-MDMA treatment on motor-cognitive neural functions. In addition, we have shown the correlation between the observed behavioural change and neural structural changes induced by these treatments in BALB/c mice. We observed that MDMA (2 mg/Kg body weight; subcutaneous) induced a decline in motor function, while Nicotine (2 mg/Kg body weight; subcutaneous) improved motor function in male periadolescent mice. In combined treatment, Nicotine reduced the motor function decline observed in MDMA treatment, thus no significant change in motor function for the combined treatment versus the control. Nicotine or MDMA treatment reduced memory function and altered hippocampal structure. Similarly, a combined Nicotine-MDMA treatment reduced memory function when compared with the control. Ultimately, the metabolic and structural changes in these neural systems were seen to vary for the various forms of treatment. It is noteworthy to mention that a combined treatment increased the rate of lipid peroxidation in brain tissue.

  17. Calcitonin treatment in osteoectasia with hyperphosphatasia (juvenile Paget's disease): radiographic changes after treatment

    Energy Technology Data Exchange (ETDEWEB)

    Tueysuez, B. [Div. of Genetics and Teratology, Univ. of Istanbul (Turkey); Serencebey, Istanbul (Turkey); Mercimek, S.; Uenguer, S. [Dept. of Paediatrics, Univ. of Istanbul (Turkey); Deniz, M. [Dept. of Paediatrics, Haseki Hospital, Istanbul (Turkey)


    Osteoectasia with hyperphosphatasia is a rare skeletal disorder, characterised by demineralisation and expansion of tubular bones and elevated serum alkaline phosphatase. We present a girl diagnosed as having osteoectasia with hyperphosphatasia who had swelling of phalanges of both hands and motor retardation. She was treated with synthetic human calcitonin. Clinical and radiological findings showed remarkable improvement after 2 years' treatment. (orig.)

  18. Can pharmacological and psychological treatment change brain structure and function in PTSD? A systematic review

    NARCIS (Netherlands)

    Thomaes, Kathleen; Dorrepaal, Ethy; Draijer, Nel; Jansma, Elise P.; Veltman, Dick J.; van Balkom, Anton J.


    While there is evidence of clinical improvement of posttraumatic stress disorder (PTSD) with treatment, its neural underpinnings are insufficiently clear. Moreover, it is unknown whether similar neurophysiological changes occur in PTSD specifically after child abuse, given its enduring nature and

  19. Empirical Test Case Specification

    DEFF Research Database (Denmark)

    Kalyanova, Olena; Heiselberg, Per

    This document includes the empirical specification on the IEA task of evaluation building energy simulation computer programs for the Double Skin Facades (DSF) constructions. There are two approaches involved into this procedure, one is the comparative approach and another is the empirical one. I....... In the comparative approach the outcomes of different software tools are compared, while in the empirical approach the modelling results are compared with the results of experimental test cases....

  20. Cognitive Remediation Therapy for Adolescents with Anorexia Nervosa—Treatment Satisfaction and the Perception of Change

    Directory of Open Access Journals (Sweden)

    Camilla Lindvall Dahlgren


    Full Text Available Cognitive remediation therapy (CRT has recently been developed for children and adolescents with anorexia nervosa (AN. It focuses on decreasing rigid cognitions and behaviors, as well as increasing central coherence. Overall, CRT has been proven feasible for young individuals with AN, but little is known regarding the specifics of its feasibility, and the perception of change associated with the intervention. Consequently, the aim of the current study was to explore service users’ perspective on CRT with a specific focus on treatment delivery, treatment content, and perceived change. Twenty adolescents (age 13–18 with AN participated in a 10-session course of CRT. A 20-item treatment evaluation questionnaire was administered at the end of treatment, focusing on four aspects of the intervention: (1 general attitudes towards treatment, (2 treatment specifics, (3 the perception of change and (4 the patient-therapist relation. The main findings suggest high levels of treatment satisfaction, but somewhat limited perceptions of change. The current study is one of the most detailed accounts of adolescents’ perspective on CRT published on eating disorders, and highlights several important aspects of the treatment viewed through the eye of the receiver.

  1. Change in Depressive Symptoms among Treatment-Seeking College Students Who Are Sexual Minorities (United States)

    Effrig, Jessica C.; Maloch, Janelle K.; McAleavey, Andrew; Locke, Benjamin D.; Bieschke, Kathleen J.


    Changes in students' depressive symptoms during the course of treatment at college counseling centers were examined by sexual orientation. In Study 1, results showed that depressive symptoms decreased similarly across sexual orientation groups during the course of treatment. In Study 2, family support did not moderate the relationship between…

  2. Predicting Change in Emotional and Behavioural Problems during Inpatient Treatment in Clients with Mild Intellectual Disability (United States)

    Tenneij, Nienke; Didden, Robert; Koot, Hans M.


    Background: Little is known about client characteristics that are related to outcome during inpatient treatment of adults with mild intellectual disability (ID) and severe behavioural problems. Method: We explored variables that were related to a change in behavioural problems in 87 individuals with mild ID during inpatient treatment in facilities…

  3. 76 FR 17617 - Changes to Treatments for Citrus Fruit From Australia (United States)


    ... Inspection Service [Docket No. APHIS-2008-0140] Changes to Treatments for Citrus Fruit From Australia AGENCY... Australia into the United States. These new treatments will continue to prevent the introduction or... from Australia into the United States. We also proposed to establish an approved irradiation dose for...

  4. Changes in canopy fuels and fire behavior after ponderosa pine restoration treatments: A landscape perspective (United States)

    J. P. Roccaforte; P. Z. Fule


    (Please note, this is an abstract only) We modeled crown fire behavior and assessed changes in canopy fuels before and after the implementation of restoration treatments in a ponderosa pine landscape at Mt. Trumbull, Arizona. We measured 117 permanent plots before (1996/1997) and after (2003) thinning and burning treatments. The plots are evenly distributed across the...

  5. Fuel accumulation and forest structure change following hazardous fuel reduction treatments throughout California (United States)

    Nicole M. Vaillant; Erin K. Noonan-Wright; Alicia L. Reiner; Carol M. Ewell; Benjamin M. Rau; Josephine A. Fites-Kaufman; Scott N. Dailey


    Altered fuel conditions coupled with changing climate have disrupted fire regimes of forests historically characterised by high-frequency and low-to-moderate-severity fire. Managers use fuel treatments to abate undesirable fire behaviour and effects. Short-term effectiveness of fuel treatments to alter fire behaviour and effects is well documented; however, long-term...

  6. Soil erosion risk assessment using interviews, empirical soil erosion modeling (RUSLE) and fallout radionuclides in a volcanic crater lake watershed subjected to land use change, western Uganda (United States)

    De Crop, Wannes; Ryken, Nick; Tomma Okuonzia, Judith; Van Ranst, Eric; Baert, Geert; Boeckx, Pascal; Verschuren, Dirk; Verdoodt, Ann


    Population pressure results in conversion of natural vegetation to cropland within the western Ugandan crater lake watersheds. These watersheds however are particularly prone to soil degradation and erosion because of the high rainfall intensity and steep topography. Increased soil erosion losses expose the aquatic ecosystems to excessive nutrient loading. In this study, the Katinda crater lake watershed, which is already heavily impacted by agricultural land use, was selected for an explorative study on its (top)soil characteristics - given the general lack of data on soils within these watersheds - as well as an assessment of soil erosion risks. Using group discussions and structured interviews, the local land users' perceptions on land use, soil quality, soil erosion and lake ecology were compiled. Datasets on rainfall, topsoil characteristics, slope gradient and length, and land use were collected. Subsequently a RUSLE erosion model was run. Results from this empirical erosion modeling approach were validated against soil erosion estimates based on 137Cs measurements.

  7. Changes in Neurocognitive Functioning After 6 Months of Mentalization-Based Treatment for Borderline Personality Disorder

    DEFF Research Database (Denmark)

    Thomsen, Marianne S; Ruocco, Anthony C; Uliaszek, Amanda A


    working memory. After 6 months of treatment, patients showed significantly greater increases in sustained attention and perceptual reasoning than controls, with initial deficits in sustained attention among patients resolving after treatment. Improved emotion regulation over the follow-up period...... was associated with increased auditory-verbal working memory capacity, whereas interpersonal functioning improved in parallel with perceptual reasoning. These findings suggest that changes in neurocognitive functioning may track improvements in clinical symptoms in mentalization-based treatment for BPD....

  8. Cognitive Changes After Adjuvant Treatment in Older Adults with Early-Stage Breast Cancer. (United States)

    Lange, Marie; Heutte, Natacha; Noal, Sabine; Rigal, Olivier; Kurtz, Jean-Emmanuel; Lévy, Christelle; Allouache, Djelila; Rieux, Chantal; Lefel, Johan; Clarisse, Bénédicte; Leconte, Alexandra; Veyret, Corinne; Barthélémy, Philippe; Longato, Nadine; Tron, Laure; Castel, Hélène; Eustache, Francis; Giffard, Bénédicte; Joly, Florence


    Group-based trajectory modeling is particularly important to identify subgroups of patients with pathological cognitive changes after cancer treatment. To date, only one study has explored cognitive trajectories in older patients with cancer. The present article describes objective cognitive changes before to after adjuvant treatment in older adults with early-stage breast cancer (EBC) after adjuvant treatment compared with healthy controls. Participants were patients ≥65 years of age with newly diagnosed EBC and healthy controls (age-, sex-, and education-matched). The pretreatment assessment was conducted before adjuvant therapy, and the post-treatment assessment after the end of the first adjuvant treatment. Objective cognitive changes before to after treatment were evaluated based on the Reliable Change Index for cognitive decline accounting for cognitive impairment status. The sample consisted of women newly diagnosed with EBC ( n  = 118) and healthy controls ( n  = 62). Five patterns of changes before to after treatment were identified based on the presence of cognitive decline and cognitive impairment. The distribution of these five change patterns was statistically significant ( p  = .0001). Thirty-six percent of patients had phase shift changes, 31% without initial objective cognitive impairment developed impairment, 15% had a normal aging, 12% had a nonpathological decline, and 6% experienced accelerated cognitive decline. This study described for the first time objective cognitive changes before to after treatment of older adults with EBC immediately after the end of adjuvant treatment. A longer-term remote follow-up of adjuvant treatment is needed to better understand the cognitive trajectories of older patients with EBC. The Oncologist IMPLICATIONS FOR PRACTICE: After the end of adjuvant treatment, 31% of older adults with early-stage breast cancer without initial objective cognitive impairment developed impairment, and 6% experienced

  9. An Empirical Analysis on Labor Unions and Occupational Safety and Health Committees' Activity, and Their Relation to the Changes in Occupational Injury and Illness Rate (United States)

    Cho, Hm Hak; Kim, Jiyun


    Objectives To find out from an analysis of empirical data the levels of influence, which a labor union (LU) and Occupational Safety and Health Committee (OSHC) have in reducing the occupational injury and illness rate (OIIR) through their accident prevention activities in manufacturing industries with five or more employees. Methods The empirical data used in this study are the Occupational Safety and Health Tendency survey data, Occupational Accident Compensation data and labor productivity and sales data for the years 2003 to 2007. By matching these three sources of data, a final data set (n = 280) was developed and analyzed using SPSS version 18 (SPSS Inc., Chicago, IL, USA). Results It was found that a workplace with a LU has a lower OIIR than one without a LU. In manufacturing industries with five or more employees in 2007, the OIIR of the workplaces without a LU was 0.87%, while that of workplaces with a LU was much lower at 0.45%. In addition, workplaces with an established OSHC had a lower OIIR than those without an OSHC. Conclusion It was found that the OIIR of workplaces with a LU is lower than those without a LU. Moreover, those with the OSHC usually had a lower OIIR than those without. The workplace OIIR may have an impact on management performance because the rate is negatively correlated with labor productivity and sales. In the long run, the OIIR of workplaces will be reduced when workers and employers join forces and recognize that the safety and health activities of the workplace are necessary, not only for securing the health rights of the workers, but also for raising labor productivity. PMID:22953216

  10. [Chronic pain patients' readiness to change after multimodal treatment. Short- and long-term effects]. (United States)

    Küchler, A; Sabatowski, R; Kaiser, U


    Patients' readiness to behavioural changes according to the transtheoretical model (TTM) and criteria of treatment outcome are positively associated and have in part already been confirmed. For a stable effect of therapeutic treatment, patients' readiness to change seems indispensable for an independent and active pain management. Thus, in addition to an enhanced quality of life, increasing patients' motivation is a declared objective of the treatment at Dresden's Comprehensive Pain Center. In this study, it was examined how the readiness to change develops in the course of and during the 2 years following the multimodal treatment program. Furthermore, associations between outcome criteria of the treatment and patients' readiness to change were explored. The database constitutes 169 patients who took part in a 4-week interdisciplinary, partially residential pain treatment. Beside the Freiburg Pain Stages questionnaire ("Frieburger Fragebogen - Stadien der Bewältigung chronischer Schmerzen", FF-STABS), a comprehensive pain diagnostic inventory including the Pain Disability Index (PDI), the SF-36 questionnaire, and the Hospital Anxiety and Depression Scale (HADS) was completed at six different time points (beginning of treatment, end of treatment, booster session after 10 weeks, after 6, 12, and 24 months). The statistical analyses were performed with SPSS 16.0 including nonparametric analyses and variance analyses. Significant differences in the level of readiness to change between the beginning of treatment and all follow-up measures were observed. The average patients' readiness to change was still higher after 2 years than at the first measurement. However, a differentiated consideration revealed a small portion of patients who showed no change or even a reduction of motivation. After an additional week (booster session), the stages of readiness to change remained stable, irrespective of the direction of the previous change. Regarding therapeutic outcome

  11. Changes in sleep polygraphic variables and clinical state in depressed patients during treatment with citalopram

    NARCIS (Netherlands)

    Bemmel, Alex L. van; Hoofdakker, Rutger H. van den; Beersma, Domien G.M.; Bouhuys, Antoinette L.


    Drug-induced improvement of depression may be mediated by changes in sleep physiology. The aim of this study was to relate changes in sleep polygraphic variables to clinical state during treatment with citalopram, a highly specific serotonin uptake inhibitor. Sixteen patients took part. The study

  12. 78 FR 69694 - Changing Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Obesity... (United States)


    ...] Changing Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Obesity and... Administration (FDA) is announcing a public workshop entitled ``Changing Regulatory and Reimbursement Paradigms... information on the AGA Web site. If you need special accommodations due to a disability, please contact...

  13. Translucency changes of direct esthetic restorative materials after curing, aging and treatment

    Directory of Open Access Journals (Sweden)

    Yong-Keun Lee


    Full Text Available The purpose of this article was to review the changes in translucency of direct esthetic restorative materials after curing, aging and treatment. As a criterion for the evaluation of clinical translucency changes, visual perceptibility threshold in translucency parameter difference (ΔTP of 2 was used. Translucency changes after curing were perceivable depending on experimental methods and products (largest ΔTP in resin composites = 15.9. Translucency changes after aging were reported as either relatively stable or showed perceivable changes by aging protocols (largest ΔTP in resin composites = -3.8. Translucency changes after curing, aging and treatment were perceivable in several products and experimental methods. Therefore, shade matching of direct esthetic materials should be performed considering these instabilities of translucency in direct esthetic materials.

  14. Empirical research on Waldorf education


    Randoll, Dirk; Peters, Jürgen


    Waldorf education began in 1919 with the first Waldorf School in Stuttgart and nowadays is widespread in many countries all over the world. Empirical research, however, has been rare until the early nineties and Waldorf education has not been discussed within educational science so far. This has changed during the last decades. This article reviews the results of surveys during the last 20 years and is mainly focused on German Waldorf Schools, because most investigations have been done in thi...

  15. A Review and Empirical Comparison of Three Treatments for Adolescent Males with Conduct and Personality Disorder: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training (United States)

    Apsche, Jack A.; Bass, Christopher K.


    This research study compared the efficacy of three treatment methodologies for adolescent males in residential treatment with conduct disorders and/or personality dysfunctions and documented problems with physical and sexual aggression. The results showed that Mode Deactivation Therapy, an advanced form of cognitive behavioral therapy based on…

  16. A Review and Empirical Comparison of Two Treatments for Adolescent Males with Conduct and Personality Disorder: Mode Deactivation Therapy and Cognitive Behavior Therapy (United States)

    Apsche, Jack A.; Bass, Christopher K.; Jennings, Jerry L.; Siv, Alexander M.


    This research study compared the efficacy of two treatment methodologies for adolescent males in residential treatment with conduct disorders and/or personality dysfunctions and documented problems with physical and sexual aggression. The results showed that Mode Deactivation Therapy, an advanced form of cognitive behavioral therapy based on…

  17. Empirical Comparison of Three Treatments for Adolescent Males with Physical and Sexual Aggression: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training (United States)

    Apsche, Jack A.; Bass, Christopher K.; Jennings, Jerry L.; Murphy, Christopher J.; Hunter, Linda A.; Siv, Alexander M.


    This research study compared the efficacy of three treatment methodologies for adolescent males in residential treatment with conduct disorders and/or personality dysfunctions and documented problems with physical and sexual aggression. The results showed that Mode Deactivation Therapy, an advanced form of cognitive behavioral therapy based on…

  18. Motivation for change as a predictor of treatment response for dysthymia. (United States)

    Frías Ibáñez, Álvaro; González Vallespí, Laura; Palma Sevillano, Carol; Farriols Hernando, Núria


    Dysthymia constitutes a chronic, mild affective disorder characterized by heterogeneous treatment effects. Several predictors of clinical response and attendance have been postulated, although research on the role of the psychological variables involved in this mental disorder is still scarce. Fifty-four adult patients, who met criteria for dysthymia completed an ongoing naturalistic treatment based on the brief interpersonal psychotherapy (IPT-B), which was delivered bimonthly over 16 months. As potential predictor variables, the therapeutic alliance, coping strategies, perceived self-efficacy, and motivation for change were measured at baseline. Outcome variables were response to treatment (Clinical Global Impression and Beck’s Depression Inventory) and treatment attendance. Stepwise multiple linear regression analyses revealed that higher motivation for change predicted better response to treatment. Moreover, higher motivation for change also predicted treatment attendance. Therapeutic alliance was not a predictor variable of neither clinical response nor treatment attendance. These preliminary findings support the adjunctive use of motivational interviewing (MI) techniques in the treatment of dysthymia. Further research with larger sample size and follow-up assessment is warranted.

  19. The response of substance use disorder treatment providers to changes in macroeconomic conditions. (United States)

    Cantor, Jonathan; Stoller, Kenneth B; Saloner, Brendan


    To study how substance use disorder (SUD) treatment providers respond to changes in economic conditions. 2000-2012 National Survey of Substance Abuse Treatment Services (N-SSATS) which contains detailed information on specialty SUD facilities in the United States. We use fixed-effects regression to study how changes in economic conditions, proxied by state unemployment rates, impact treatment setting, accepted payment forms, charity care, offered services, special programs, and use of pharmacotherapies by specialty SUD treatment providers. Secondary data analysis in the N-SSATS. Our findings suggest a one percentage point increase in the state unemployment rate is associated with a 2.5% reduction in outpatient clients by non-profit providers and a 1.8% increase in the acceptance of private insurance as a form of payment overall. We find no evidence that inpatient treatment, the provision of charity care, offered services, or special programs are impacted by changes in the state unemployment rate. However, a one percentage point increase in the state unemployment rate leads to a 2.5% increase in the probability that a provider uses pharmacotherapies to treat addiction. Deteriorating economic conditions may increase financial pressures on treatment providers, prompting them to seek new sources of revenue or to change their care delivery models. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Dietary changes and food intake in the first year after breast cancer treatment. (United States)

    Vance, Vivienne; Campbell, Sharon; McCargar, Linda; Mourtzakis, Marina; Hanning, Rhona


    Understanding dietary habits of women after breast cancer is a critical first step in developing nutrition guidelines that will support weight management and optimal health in survivorship; however, limited data are available. The objective of this study was to describe changes in diet among breast cancer survivors in the first year after treatment, and to evaluate these changes in the context of current dietary intake. Changes in diet were assessed in 28 early stage breast cancer survivors, using a self-reported survey in which women identified changes in food intake since their diagnosis. Current dietary intake was estimated from 3-day food records and described relative to current recommendations. The majority of women reported changes in diet after diagnosis, most common being an increase in vegetables/fruit and fish, lower intake of red meat, and reduced alcohol. Many women reported that these changes were initiated during active treatment. Dietary changes were largely consistent with current recommendations for cancer prevention; however, some women were still above the guidelines for total and saturated fat, and many were below recommendations for vegetables/fruit, milk/alternatives, calcium, and vitamin D. Evidence that some women are willing and able to initiate positive changes in diet early in the treatment trajectory suggests that early intervention may be effective in promoting dietary habits that will assist with weight management and overall health. Data on current dietary intake highlights several possible targets for dietary intervention in this population.

  1. In search of patient characteristics that may guide empirically based treatment selection for personality disorder patients-a concept map approach. (United States)

    van Manen, J G; Kamphuis, J H; Goossensen, A; Timman, R; Busschbach, J J V; Verheul, R


    Using the concept map method, this study aimed to summarize and describe patient characteristics pertinent to treatment selection for patients with personality disorders (PDs). Initial patient characteristics were derived from the research literature and a survey among Dutch expert clinicians. Concept mapping is a formalized conceptualization procedure that describes the underlying cognitive structures people use in complex tasks, such as treatment allocation. Based on expert opinions of 29 Dutch clinicians, a concept map was generated that yielded eight domains of patient characteristics, i.e., Severity of symptoms, Severity of personality pathology, Ego-adaptive capacities, Motivation and working alliance, Social context, Social demographic characteristics, Trauma, and Treatment history and medical condition. These domains can be ordered along two bipolar axes, running from internal to external concepts and from vulnerability to strength concepts, respectively. Our findings may serve as input for the delineation of algorithms for patient-treatment matching research in PD.

  2. Changes of wood cell walls in response to hygro-mechanical steam treatment. (United States)

    Guo, Juan; Song, Kunlin; Salmén, Lennart; Yin, Yafang


    The effects of compression combined with steam treatment (CS-treatment), i.e. a hygro-mechanical steam treatment on Spruce wood were studied on a cell-structure level to understand the chemical and physical changes of the secondary cell wall occurring under such conditions. Specially, imaging FT-IR microscopy, nanoindentation and dynamic vapour absorption were used to track changes in the chemical structure, in micromechanical and hygroscopic properties. It was shown that CS-treatment resulted in different changes in morphological, chemical and physical properties of the cell wall, in comparison with those under pure steam treatment. After CS-treatment, the cellular structure displayed significant deformations, and the biopolymer components, e.g. hemicellulose and lignin, were degraded, resulting in decreased hygroscopicity and increased mechanical properties of the wood compared to both untreated and steam treated wood. Moreover, CS-treatment resulted in a higher degree of degradation especially in earlywood compared to a more uniform behaviour of wood treated only by steam. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Theological reflections on empire

    Directory of Open Access Journals (Sweden)

    Allan A. Boesak


    Full Text Available Since the meeting of the World Alliance of Reformed Churches in Accra, Ghana (2004, and the adoption of the Accra Declaration, a debate has been raging in the churches about globalisation, socio-economic justice, ecological responsibility, political and cultural domination and globalised war. Central to this debate is the concept of empire and the way the United States is increasingly becoming its embodiment. Is the United States a global empire? This article argues that the United States has indeed become the expression of a modern empire and that this reality has considerable consequences, not just for global economics and politics but for theological refl ection as well.

  4. Orthodontic treatment effects on inflammatory marker profiles in saliva before and after 2 archwire changes (United States)

    Yamamoto, Zulham; Jaafar, Ikmal Mohamad; Rohaya, M. A. W.; Abidin, Intan Zarina Zainol; Senafi, Sahidan; Ariffin, Zaidah Zainal; Ariffin, Shahrul Hisham Zainal


    Periodontal tissue changes exerted by external forces in orthodontic treatment allow tooth movement. The changes in periodontal tissues i.e. inflammation can be monitored using gingival crevicular fluid (GCF). GCF is a component of saliva. Saliva could be used to monitor periodontal disease progression. The use of saliva to monitor periodontal tissues changes during orthodontic treatment is still unknown. Therefore, we observed the profiles of inflammatory markers namely creatine kinase ('CK), nitric oxide (NO), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) in saliva of orthodontic patients to evaluate their importance in orthodontic treatment. A total of 21 subjects (13 female and 8 male) participated in this study. Samples were collected from gingival crevicular fluid at three period of archwire changes: baseline (M0), 2 weeks after 0.014" NiTi archwire (M1), and 2 weeks after 0.018" NiTi archwire (M2). All enzyme activities i.e. CK, LDH and AST were measured spectrophotometrically at 340 nm. Griess assay was used to measure nitric oxide level. CK activity, NO level, LDH activity and AST activity in saliva samples did not show significant differences among period of archwire changes. The use of inflammatory marker profiles in saliva may not represent the changes in periodontal tissues during orthodontic treatment.

  5. Hematological and histopathological changes in female albino rats after gamma irradiation and /or piper nigrum treatment

    International Nuclear Information System (INIS)

    Ali, S.E.; Hanna, L.S.; Khattab, H.M.


    This study was carried out to investigate the effect of whole body gamma irradiation, at dose level of 6.0 Gy (single dose), and or daily treatment with P. nigrum (black pepper) at doses of 160 and 320 mg/kg body weight up to 36, 71 and 99 days on some hematological aspects as well as histopathological changes in lung, kidney and brain tissues of female albino rats. The results revealed that whole body gamma irradiation significantly elevated the values of red blood cells (RBCs), white blood cells (WBCs) and hematocrit percentage (HC %) but hemoglobin level was significantly decreased. These changes were ameliorated after treatment with P. nigrum. Non-significant changes were obtained regarding the effect of both doses of P. nigrum on red and white blood cell counts throughout the three time intervals. However, a dose of 160 mg/kg body weight of P. nigrum significantly reduced the hemoglobin contents throughput the experimental period. Histopathological examination revealed that lung, kidney and brain tissues showed marked to moderate pathological changes after irradiation and/or P.nigrum treatments. However, treatment with P. nigrum showed positive effect against the harmful effects of gamma irradiation, concerning kidney and brain. Although no malignant transformation could be detected, the resultant marked alveolar inflammation, bronchial wall hyperplasia and reactive astrocytic proliferation are important pathological changes that should be considered as pre-neoplastic changes

  6. The Role of Empirical Research in Bioethics (United States)

    Kon, Alexander A.


    There has long been tension between bioethicists whose work focuses on classical philosophical inquiry and those who perform empirical studies on bioethical issues. While many have argued that empirical research merely illuminates current practices and cannot inform normative ethics, others assert that research-based work has significant implications for refining our ethical norms. In this essay, I present a novel construct for classifying empirical research in bioethics into four hierarchical categories: Lay of the Land, Ideal Versus Reality, Improving Care, and Changing Ethical Norms. Through explaining these four categories and providing examples of publications in each stratum, I define how empirical research informs normative ethics. I conclude by demonstrating how philosophical inquiry and empirical research can work cooperatively to further normative ethics. PMID:19998120

  7. The integration of empirical, remote sensing and modelling approaches enhances insight in the role of biodiversity in climate change mitigation by tropical forests

    NARCIS (Netherlands)

    Sande, van der Masha T.; Poorter, Lourens; Balvanera, Patricia; Kooistra, Lammert; Thonicke, Kirsten; Boit, Alice; Dutrieux, Loic; Equihua, Julian; Gerard, France; Herold, Martin; Kolb, Melanie; Simões, Margareth; Peña-Claros, Marielos


    Tropical forests store and sequester high amounts of carbon and are the most diverse terrestrial ecosystem. A complete understanding of the relationship between biodiversity and carbon storage and sequestration across spatiotemporal scales relevant for climate change mitigation needs three

  8. Feasibility of coupled empirical and dynamic modeling to assess climate change and air pollution impacts on temperate forest vegetation of the eastern United States. (United States)

    McDonnell, T C; Reinds, G J; Sullivan, T J; Clark, C M; Bonten, L T C; Mol-Dijkstra, J P; Wamelink, G W W; Dovciak, M


    Changes in climate and atmospheric nitrogen (N) deposition caused pronounced changes in soil conditions and habitat suitability for many plant species over the latter half of the previous century. Such changes are expected to continue in the future with anticipated further changing air temperature and precipitation that will likely influence the effects of N deposition. To investigate the potential long-term impacts of atmospheric N deposition on hardwood forest ecosystems in the eastern United States in the context of climate change, application of the coupled biogeochemical and vegetation community model VSD+PROPS was explored at three sites in New Hampshire, Virginia, and Tennessee. This represents the first application of VSD+PROPS to forest ecosystems in the United States. Climate change and elevated (above mid-19th century) N deposition were simulated to be important factors for determining habitat suitability. Although simulation results suggested that the suitability of these forests to support the continued presence of their characteristic understory plant species might decline by the year 2100, low data availability for building vegetation response models with PROPS resulted in uncertain results at the extremes of simulated N deposition. Future PROPS model development in the United States should focus on inclusion of additional foundational data or alternate candidate predictor variables to reduce these uncertainties. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. The Challenge of Fostering Healthy Organizations: An Empirical Study on the Role of Workplace Relational Civility in Acceptance of Change and Well-Being (United States)

    Di Fabio, Annamaria; Giannini, Marco; Loscalzo, Yura; Palazzeschi, Letizia; Bucci, Ornella; Guazzini, Andrea; Gori, Alessio


    The world of work in the twenty-first century is characterized by globalization, instability, and unavoidable change. Organizations need to develop a positive relational environment in the workplace thereby enabling workers to enhance their personal resources in order to face with on-going changes in the sphere of work for promoting their well-being. Against this background, the aim of this research was to examine the relationship between workplace relational civility and both acceptance of change and well-being (hedonic well-being as well as eudaimonic well-being) beyond the effect of personality traits. The following instruments were administered to 261 Italian workers: the Ten Item Personality Inventory (TIPI), the Acceptance of Change Scale (ACS), the Satisfaction With Life Scale (SWLS), and the Meaningful Life Measure (MLM). The results of hierarchical regression analyses revealed that workplace relational civility explained a percentage of incremental variance beyond personality traits in relation to acceptance of change, life satisfaction, and meaning in life. These results underscore the positive relationship between workplace relational civility and acceptance of change, hedonic well-being, and eudaimonic well-being, offering new research and intervention opportunities to meet the challenge of fostering healthy organizations. PMID:27917131

  10. The challenge of fostering healthy organizations: An empirical study on the role of workplace relational civility in acceptance of change and well-being

    Directory of Open Access Journals (Sweden)

    Annamaria Di Fabio


    Full Text Available The world of work in the 21st century is characterized by globalization, instability, and unavoidable change. Organizations need to develop a positive relational environment in the workplace thereby enabling workers to enhance their personal resources in order to face with ongoing changes in the sphere of work for promoting their well-being. Against this background, the aim of this research was to examine the relationship between workplace relational civility and both acceptance of change and well-being (hedonic well-being as well as eudaimonic well-being beyond the effect of personality traits. The following instruments were administered to 261 Italian workers: the Ten Item Personality Inventory (TIPI, the Acceptance of Change Scale (ACS, the Satisfaction With Life Scale (SWLS, and the Meaningful Life Measure (MLM. The results of hierarchical regression analyses revealed that workplace relational civility explained a percentage of incremental variance beyond personality traits in relation to acceptance of change, life satisfaction, and meaning in life. These results underscore the positive relationship between workplace relational civility and acceptance of change, hedonic well-being, and eudaimonic well-being, offering new research and intervention opportunities to meet the challenge of fostering healthy organizations.

  11. Changes in spatiotemporal gait parameters following intravenous immunoglobulin treatment for chronic inflammatory demyelinating polyneuropathy. (United States)

    Vo, Mary L; Chin, Russell L; Miranda, Caroline; Latov, Norman


    Gait impairment is a common presenting symptom in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). However, gait parameters have not previously been evaluated in detail as potential independent outcome measures. We prospectively measured changes in spatiotemporal gait parameters of 20 patients with CIDP at baseline and following treatment with intravenous immunoglobulin (IVIG), using GAITRite® a computerized walkway system with embedded sensors. Overall, study patients showed significant improvements in gait velocity, cadence, stride length, double support time, stance phase, and swing phase following IVIG treatment. Mean changes in velocity, stance phase, and swing phase, exhibited the greatest statistical significance among the subgroup that exhibited clinically meaningful improvement in Inflammatory Neuropathy Cause and Treatment disability score, Medical Research Council sum score, and grip strength. Assessment of gait parameters, in particular velocity, step phase and swing phase, is a potentially sensitive outcome measure for evaluating treatment response in CIDP. Muscle Nerve 56: 732-736, 2017. © 2017 Wiley Periodicals, Inc.

  12. Empirical Evidence from Kenya

    African Journals Online (AJOL)



    Jan 18, 2011 ... Empirical results reveal that consumption of sugar in. Kenya varies ... experiences in trade in different regions of the world. Some studies ... To assess the relationship between domestic sugar retail prices and sugar sales in ...

  13. Changes in body water distribution during treatment with inhaled steroid in pre-school children

    DEFF Research Database (Denmark)

    Heitmann, B L; Anhøj, Jacob; Bisgaard, A M


    .i.d. delivered via Babyhaler, budesonide pressurized metered dose inhaler (pMDI) 200 microg b.i.d. delivered via Nebuchamber and placebo. Spacers were primed before use. In total, 40 children aged 1-3 years, with mild intermittent asthma were included. Twenty-five of the children completed all three treatments...... overall this effect was not statistically significant (0.1 growth during inhaled steroid treatment seems to partly reflect generalized changes...

  14. Outcomes of changing immunosuppressive therapy after treatment failure in patients with noninfectious uveitis. (United States)

    Joshi, Lavnish; Talat, Lazha; Yaganti, Satish; Sandhu, Sartaj; Taylor, Simon R J; Wakefield, Denis; McCluskey, Peter; Lightman, Susan


    To evaluate the outcomes of changing immunosuppressive therapy for noninfectious uveitis after failure. Retrospective cohort study. Patients with noninfectious uveitis managed at 2 tertiary uveitis clinics in the United Kingdom and Australia. Participants with a history of using immunosuppressive therapy were identified in clinics, and notes were reviewed by doctors trained in uveitis therapy. Each treatment episode/course (starting or changing a therapy) was identified, and demographic details, clinical characteristics, drug used (second-line immunosuppressive agent [ISA] or biologicals), and drug doses were obtained. For each treatment episode, the reasons for changing therapy, corticosteroid-sparing effects, and control of inflammation were determined. A total of 147 patients were identified who underwent 309 different treatment episodes. Fifty-five percent of patients eventually required a change in treatment after their first treatment episode/course. Forty-five episodes involved switching from one ISA to another, with 50% to 100% of these patients achieving "success" (prednisolone ≤10 mg and sustained control) with the new ISA. A combination of ISAs were used in 53 episodes, with "success" being achieved in 50% to 71% of these patients. Biological agents were used in 45 episodes, the most common one being infliximab, which achieved success in 80% of patients. Our data suggest that control of inflammation can be achieved after switching or combining ISAs. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  15. Treatment Outcome and Metacognitive Change in CBT and GET for Chronic Fatigue Syndrome. (United States)

    Fernie, Bruce A; Murphy, Gabrielle; Wells, Adrian; Nikčević, Ana V; Spada, Marcantonio M


    Studies have reported that Cognitive Behavioural Therapy (CBT) and Graded Exercise Therapy (GET) are effective treatments for Chronic Fatigue Syndrome (CFS). One hundred and seventy-one patients undertook a course of either CBT (n = 116) or GET (n = 55) and were assessed on a variety of self-report measures at pre- and posttreatment and follow-up. In this paper we present analyses on treatment outcomes for CBT and GET in routine clinical practice and evaluate whether changes on subscales of the Metacognitions Questionnaire-30 (MCQ-30) predict fatigue severity independently of changes in other covariates, and across the two treatment modalities. Both CBT and GET were equally effective at decreasing fatigue, anxiety, and depression, and at increasing physical functioning. Changes on the subscales of the MCQ-30 were also found to have a significant effect on fatigue severity independently of changes in other covariates and across treatment modalities. The findings from the current study suggest that CFS treatment protocols for CBT and GET, based on those from the PACE trial, achieve similar to poorer outcomes in routine clinical practice as in a RCT.

  16. Analysis of physiological responses associated with emotional changes induced by viewing video images of dental treatments. (United States)

    Sekiya, Taki; Miwa, Zenzo; Tsuchihashi, Natsumi; Uehara, Naoko; Sugimoto, Kumiko


    Since the understanding of emotional changes induced by dental treatments is important for dentists to provide a safe and comfortable dental treatment, we analyzed physiological responses during watching video images of dental treatments to search for the appropriate objective indices reflecting emotional changes. Fifteen healthy young adult subjects voluntarily participated in the present study. Electrocardiogram (ECG), electroencephalogram (EEG) and corrugator muscle electromyogram (EMG) were recorded and changes of them by viewing videos of dental treatments were analyzed. The subjective discomfort level was acquired by Visual Analog Scale method. Analyses of autonomic nervous activities from ECG and four emotional factors (anger/stress, joy/satisfaction, sadness/depression and relaxation) from EEG demonstrated that increases in sympathetic nervous activity reflecting stress increase and decreases in relaxation level were induced by the videos of infiltration anesthesia and cavity excavation, but not intraoral examination. The corrugator muscle activity was increased by all three images regardless of video contents. The subjective discomfort during watching infiltration anesthesia and cavity excavation was higher than intraoral examination, showing that sympathetic activities and relaxation factor of emotion changed in a manner consistent with subjective emotional changes. These results suggest that measurement of autonomic nervous activities estimated from ECG and emotional factors analyzed from EEG is useful for objective evaluation of subjective emotion.

  17. On the importance of prompt oxygen changes for hypofractionated radiation treatments

    International Nuclear Information System (INIS)

    Kissick, Michael; Campos, David; Van der Kogel, Albert; Kimple, Randall


    This discussion is motivated by observations of prompt oxygen changes occurring prior to a significant number of cancer cells dying (permanently stopping their metabolic activity) from therapeutic agents like large doses of ionizing radiation. Such changes must be from changes in the vasculature that supplies the tissue or from the metabolic changes in the tissue itself. An adapted linear–quadratic treatment is used to estimate the cell survival variation magnitudes from repair and reoxygenation from a two-fraction treatment in which the second fraction would happen prior to significant cell death from the first fraction, in the large fraction limit. It is clear the effects of oxygen changes are likely to be the most significant factor for hypofractionation because of large radiation doses. It is a larger effect than repair. Optimal dose timing should be determined by the peak oxygen timing. A call is made to prioritize near real time measurements of oxygen dynamics in tumors undergoing hypofractionated treatments in order to make these treatments adaptable and patient-specific. (note)

  18. A retrospective analysis of the change in anti-malarial treatment policy: Peru

    Directory of Open Access Journals (Sweden)

    Vincent-Mark Arlene


    Full Text Available Abstract Background National malaria control programmes must deal with the complex process of changing national malaria treatment guidelines, often without guidance on the process of change. Selecting a replacement drug is only one issue in this process. There is a paucity of literature describing successful malaria treatment policy changes to help guide control programs through this process. Objectives To understand the wider context in which national malaria treatment guidelines were formulated in a specific country (Peru. Methods Using qualitative methods (individual and focus group interviews, stakeholder analysis and a review of documents, a retrospective analysis of the process of change in Peru's anti-malarial treatment policy from the early 1990's to 2003 was completed. Results The decision to change Peru's policies resulted from increasing levels of anti-malarial drug resistance, as well as complaints from providers that the drugs were no longer working. The context of the change occurred in a time in which Peru was changing national governments, which created extreme challenges in moving the change process forward. Peru utilized a number of key strategies successfully to ensure that policy change would occur. This included a having the process directed by a group who shared a common interest in malaria and who had long-established social and professional networks among themselves, b engaging in collaborative teamwork among nationals and between nationals and international collaborators, c respect for and inclusion of district-level staff in all phases of the process, d reliance on high levels of technical and scientific knowledge, e use of standardized protocols to collect data, and f transparency. Conclusion Although not perfectly or fully implemented by 2003, the change in malaria treatment policy in Peru occurred very quickly, as compared to other countries. They identified a problem, collected the data necessary to justify the

  19. Changes induced in spice paprika powder by treatment with ionizing radiation and saturated steam

    International Nuclear Information System (INIS)

    Kispeter, J.; Bajusz-Kabok, K.; Fekete, M.; Szabo, G.; Fodor, E.; Pali, T.


    The changes in spice paprika powder induced by ionizing radiation, saturated steam (SS) and their combination were studied as a function of the absorbed radiation dose and the storage time. The SS treatment lead to a decrease in color content (lightening) after 12 weeks of storage, together with the persistence of free radicals and viscosity changes for a longer period. The results suggest that ionizing radiation is a more advantageous method as concerns preservation of the quality of spice paprika

  20. Assertiveness training: Effects of treatment, maintenance of change and therapists' contribution in therapy outcome

    Directory of Open Access Journals (Sweden)

    Tovilović Snežana


    Full Text Available In this research is shown part of results concerning evaluation study of group assertiveness training. Treatment, which has been organized as structured program of assertiveness training, has been applied on 18 groups of subjects during 9 group sessions. This treatment has been adjusted to non-psychiatric clients from our country. Groups were lead by two therapists. During 20 months of our research 215 voluntary participants of full age have joined training groups. Final sample consisted of 158 subjects who had finished treatment and who had fulfilled criteria for taking repeated measurement. Subjects had taken battery of questionnaires before the treatment and eight weeks after they had completed treatment. Subsample, which included 35 subjects from one therapist’s groups, took retest after twice longer time period. Results of conducted research have confirmed the hypothesis concerning the potentiality of assertiveness training to produce expected and significant improvements of treated subjects. Therapy effect is found on symptomatic level through reduction of symptoms of non-assertive behaviors, which were target of the treatment. Contrary to expectation interactive effect of treatment and therapist to reduction of symptoms of non-assertive behavior has been found, which implies need for further investigation of variables that are related to therapists. Through the medium of treatment therapeutic changes in structural level, in domain of general assertiveness, social anxiety and treated subjects' self-concept are produced. The effect of therapy we might consider stabled and maintained after 16 weeks of finishing the treatment.

  1. Motivational stage of change in young patients undergoing day treatment for eating disorders. (United States)

    Bustin, Lisa A; Lane-Loney, Susan E; Hollenbeak, Christopher S; Ornstein, Rollyn M


    The objective was to determine whether motivation to change is significantly altered over the course of partial hospitalization in children and adolescents with eating disorders (EDs). This study was a retrospective chart review of 30 sets of adolescents and their parents who completed the Motivational Stage of Change for Adolescents Recovering from an Eating Disorder (MSCARED) at both intake and discharge from partial hospitalization. The main outcome variables included change in stage of change (SOC) for patients and their parents. Secondary outcomes included correlations between SOC and other baseline variables, as well as changes in SOC and psychological test scores. The SOC was significantly higher at discharge than at intake in both the patients and parents, but the two groups were not in agreement at discharge. The change in the SOC was correlated with change in Children's Eating Attitudes Test scores. Assessment of decisional balance showed correlations with SOC. Age, change in weight, and psychiatric diagnoses did not correlate with initial SOC. The MSCARED may be a useful tool for monitoring young ED patients' psychological improvements with day treatment. Initial SOC is not predictive of treatment outcomes.

  2. Predicting treatment related imaging changes (TRICs) after radiosurgery for brain metastases using treatment dose and conformality metrics. (United States)

    Taylor, B Frazier; Knisely, Jonathan P; Qian, Jack M; Yu, James B; Chiang, Veronica L


    Treatment-related imaging changes (TRICs) after stereotactic radiosurgery (SRS) involves the benign transient enlargement of radiographic lesions after treatment. Identifying the radiation dose volumes and conformality metrics associated with TRICs for different post-treatment periods would be helpful and improve clinical decision making. 367 metastases in 113 patients were treated using Gamma Knife SRS between 1/1/2007-12/31/2009. Each metastasis was measured at each imaging follow-up to detect TRICs (defined as ≥ 20% increase in volume). Fluctuations in small volume lesions (less than 108 mm 3 ) were ignored given widely variable conformity indices (CI) for small volumes. The Karolinska Adverse Radiation Effect (KARE) factor, Paddick's CI, Shaw's CI, tumor volume (TV), 10 Gy (V10) and 12 Gy (V12) volumes, and prescription isodose volume (PIV) were calculated. From 0-6 months, all measures correlated with the incidence of TRICs (p<.001), except KARE, which was inversely correlated. During the 6-12 month period all measures except KARE were still correlated. Beyond 12 months, no correlation was found between any of the measures and the development of TRICs. All metrics except KARE were associated with TRICs from 0-12 months only. Additional patient and treatment factors may become dominant at greater times after SRS.

  3. Change in Identity Diffusion and Psychopathology in a Specialized Inpatient Treatment for Borderline Personality Disorder. (United States)

    Sollberger, Daniel; Gremaud-Heitz, Daniela; Riemenschneider, Anke; Agarwalla, Puspa; Benecke, Cord; Schwald, Oliver; Küchenhoff, Joachim; Walter, Marc; Dammann, Gerhard


    Patients with borderline personality disorder (BPD) show various psychopathological symptoms and suffer especially from disturbance in their identity. The purpose of the study was to investigate changes-particularly in affective BPD symptoms and identity diffusion-during a structured, disorder-specific inpatient treatment (DST) that combined a psychodynamic transference-focused psychotherapy approach with modules of dialectical behavioural skills training. In a prospective, two-group comparison trial, 44 patients with BPD were assessed with questionnaires addressing identity diffusion and state, as well as trait affective psychopathology, before and after 12 weeks of inpatient treatment. Thirty-two patients received DST, whereas 12 patients were given inpatient treatment-as-usual (TAU). The patients were allocated in a non-random procedure for two groups, in order of admission and availability of treatment options in the DST unit. In the pre-post-comparison, the DST group showed a significant decrease in identity diffusion (p borderline symptomatology and in the personality structure feature of identity diffusion. This highlights the significance of a short-term specific inpatient therapy for BPD. A structured, disorder-specific inpatient treatment of patients diagnosed with borderline personality disorder (BPD) combined a psychodynamic transference-focused psychotherapy treatment approach (focusing on pathological features in personality organization, particularly on non-integrated images of self and others) with modules of dialectical behavioural skills training. This treatment is associated with a decrease in identity diffusion of these patients after 12 weeks of treatment. The treatment is also related to a significant decrease in borderline typical psychopathological symptoms such as depressive symptoms, as well as an improvement in state anger. The outcomes of this structured, disorder-specific inpatient treatment of severely ill BPD patients indicated

  4. Changes in levels of cytokines in the treatment of infected wounds and festering in children

    Directory of Open Access Journals (Sweden)

    O. V. Spakhi


    Full Text Available Informative and prognostic significance of cytokines in assessing the effectiveness of treatment tactics no doubt. The aim was to study the levels of pro- and anti-inflammatory cytokines in the dynamics of the treatment of infected wounds and purulent (IWP in children using the proposed optimized local treatment compared with standard procedure. Materials and methods. 45 children with IWP who were treated in the department of purulent surgery of Zaporozhye Regional Children's Hospital during the period of 2015-2016 years were divided into main (n = 26 and control groups (n = 19 depending on the tactics of treatment. The therapy of the main group patients were added by optimized integrated local treatment, which included a combination of magnetic therapy, antibacterial drug liposomal solutions and hirudotherapy. Efficacy of treatment was assessed by clinical characteristics and serum levels of IL-1β and IL-10 on the 1st and the 7th day of treatment. Results. The highest levels of pro-inflammatory IL-1β were defined in children with lymphadenitis on the first day of treatment. Common trends in the dynamics of cytokines content changes on the 7th day were in the line with generally accepted: decreased in IL-1β and increased in IL-10 levels. The level of IL-1β was not statistically different on the 7th day only in children with phlegmon. The most significant changes in IL-10 were observed in children with abscesses and lymphadenitis than in children with infected wound and phlegmon. Changes in markers of inflammation conform to positive changes in the clinical course of wound healing in children at the study. Generally, there was a lag dynamics of cytokines changes in the children who received standard therapy compared with the children who received the proposed optimized local treatment. Conclusions. The use of proposed IWP complex treatment in children showed the most significant effect on the anti-inflammatory IL-10 level in children with

  5. In vitro early changes in intercellular junctions by treatment with a chemical carcinogen. (United States)

    Tachikawa, T; Kohno, Y; Matsui, Y; Yoshiki, S


    To examine early intercellular junction changes caused by treatment with 9,10-dimethyl-1,2-benzanthracene (DMBA), rat lingual epithelium was cultivated in isolation and observed by electrophysiological, freeze-fracture and whole-mount electron microscopy. Electrophysiological measurements showed a transient decrease in membrane potential of -10.2 mV 6 h after the treatment. It returned to almost the same level as that of the control group 1 day later. Six hours after treatment, input resistance decreased rapidly to 5.3 M omega but increased to 18.0 M omega 12 h after treatment. Transient reduction of input resistance and membrane potential occurred prior to the decrease in the coupling ratio 6 h after treatment with DMBA. In freeze-fracture replicas, the number of gap junctions decreased by approximately 45% of the control value 6 h after treatment with DMBA. At 12 h and thereafter, the number and area of gap junctions subsequently decreased by 60-80% of the control value. Alterations in the number and area of desmosomes were similar to those of the gap junctions. The formation of epithelial cytoskeletons, partially devoid of the 2-4 and 5-8 nm filaments was also observed. A decrease in the density of filament networks beneath the plasma membranes was especially apparent. Treatment with a carcinogen brought about morphological cellular changes as early as 6 h after treatment, and such early changes might trigger metabolic cellular abnormalities. Affected cells appear to move away from normal cells in a process of repeated destruction and revision of intercellular junctions, and cytoskeletons.

  6. Self-Directed Gambling Changes: Trajectory of Problem Gambling Severity in Absence of Treatment. (United States)

    Kushnir, Vladyslav; Godinho, Alexandra; Hodgins, David C; Hendershot, Christian S; Cunningham, John A


    Most problem gamblers do not seek formal treatment, recovering on their own through cognitive re-appraisal or self-help strategies. Although barriers to treatment have been extensively studied, there is a paucity of research on self-directed changes in problem gambling and very few studies have examined these changes prospectively. The aim of this study was to examine the trajectory of gambling severity and behavior change over an 18-month period, among a sample of non-treatment seeking/attending problem gamblers recruited from the community (N = 204) interested in quitting or reducing gambling. Separate mixed effects models revealed that in absence of formal treatment, significant reductions in gambling severity, frequency, and amount gambled could be observed over the course of a 6 to 9-month period and that changes experienced within the first 12 months were maintained for an extended 6 months. Problem gambling severity at baseline was significantly associated with changes in severity over time, such that participants with more severe gambling problems demonstrated greater reductions in their gambling severity over time. A total of 11.1% of participants gambled within a low-risk threshold at 18 months, although 28.7% of the sample reported consecutive gambling severity scores below problem levels for the duration of 1 year or longer. The findings suggest that among problem gamblers motivated to quit or reduce their gambling, significant self-directed changes in gambling severity can occur over a relatively short time. Additional prospective studies are needed to document the role of specific self-help tools or thought processes in exacting gambling changes.

  7. Changes in Body Compositions and Basal Metabolic Rates during Treatment of Graves’ Disease

    Directory of Open Access Journals (Sweden)

    Min Joo Kim


    Full Text Available Objectives. Because thyroid hormone is an important determinant of body weight and basal metabolic rate, we investigated the changes in the basal metabolic rate and body composition sequentially after treatment for Graves’ disease. Methods. A prospective cohort study was performed with six women newly diagnosed with Graves’ disease. During a 52-week treatment of methimazole, body composition, resting respiratory expenditure (REE, and handgrip strength were measured consecutively. Results. After methimazole treatment, body weight was initially increased (0–8 weeks, subsequently plateaued (8–24 weeks, and gradually decreased in the later period (24–52 weeks despite the decreased food intake. The measured REE was 40% higher than the predicted REE at baseline, and it gradually decreased after treatment. REE positively correlated with thyroid hormone levels, peripheral deiodinase activity, and thyroid’s secretory capacity. Body compositional analyses showed that the fat mass increased during an earlier period (4–12 weeks, while the lean mass increased significantly during the later period (26–52 weeks. Consistent with the lean mass changes, muscle strength also significantly increased during the later period. Conclusions. Treatment of Graves’ disease increased body weight and fat mass transiently with decreased REE. However, long-term compositional changes moved in a beneficial direction increasing lean mass and reinforcing muscle strength, following decreasing fat percentages.

  8. Oral cavity changes following treatment of oncologic patients with tumors of the head and neck

    International Nuclear Information System (INIS)

    Lyubenov, T.; Vasilev, V.; Boneva, I.


    Changes mainly in the soft tissue structures of the oral cavity (salivary glands and mucosa, following ionizing radiation treatment of tumors of the head and neck), were studied. The relationship between the morphologic characteristics of the lesions and the dose and, on the other hand, the correlation with the clinical symptoms are discussed. (authors)

  9. Factors correlated with developing caries during orthodontic treatment: Changes in saliva and behavioral risks

    Directory of Open Access Journals (Sweden)

    Edith Lara-Carrillo


    Conclusion: The multiple caries-related factors examined in this study changed during orthodontic treatment, but many of these stayed within normal values. Saliva is an important protector of oral mucosal tissues and teeth, and its constant role is supported even in adverse conditions, such as the presence of orthodontic appliances in the mouth.

  10. Changes in the Position of Mandibular Third Molars Following Extraction and Non-Extraction Orthodontic Treatments

    Directory of Open Access Journals (Sweden)

    Maryam Poosti


    Full Text Available Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction.

  11. Changes in the Position of Mandibular Third Molars Following Extraction and Non-Extraction Orthodontic Treatments

    Directory of Open Access Journals (Sweden)

    Maryam Poosti


    Full Text Available Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction

  12. Metabolic changes during treatment with valproate in humans: Implication for untoward weight gain

    DEFF Research Database (Denmark)

    Breum, L.; Astrup, A.; Gram, L.


    of carnitine in humans, it is hypothesized that a possible VPA-induced deficiency of the beta-oxidation of fatty acids is important for the development of obesity in epileptic patients in long-term treatment with VPA, but changes in catecholamines or other hormones might also be of importance....

  13. Therapeutic Responses of Psychopathic Sexual Offenders: Treatment Attrition, Therapeutic Change, and Long-Term Recidivism (United States)

    Olver, Mark E.; Wong, Stephen C. P.


    The authors examined the therapeutic responses of psychopathic sex offenders (greater than or equal to 25 Psychopathy Checklist-Revised; PCL-R) in terms of treatment dropout and therapeutic change, as well as sexual and violent recidivism over a 10-year follow-up among 156 federally incarcerated sex offenders treated in a high-intensity inpatient…

  14. Tumor microvascular changes in antiangiogenic treatment : Assessment by magnetic resonance contrast media of different molecular weights

    NARCIS (Netherlands)

    Turetschek, K; Preda, A; Novikov, [No Value; Brasch, RC; Weinmann, HJ; Wunderbaldinger, P; Roberts, TPL

    Purpose: To test magnetic resonance (MR) contrast media of different molecular weights (MWs) for their potential to characterize noninvasively microvascular changes in an experimental tumor treatment model. Materials and Methods: MD-MBA-435, a poorly differentiated human breast cancer cell line, was

  15. Changes in blood flow by local hypothermia and its application to cancer treatment

    International Nuclear Information System (INIS)

    Hong, Seong-Su; Higano, Shuichi; Ogawa, Yoshihiro; Nakamura, Mamoru; Hoshino, Humihiko


    Protective effects of local hypothermia on radiation dermatitis and mucositis were shown. It was considered that the main factor influencing radioprotection was decrease of local blood flow. Our examinations showed that blood flow of the skin and oral mucosa decreased while that of the tumors did not so change. Adequate results were obtained in the combined treatment of radiation and chemotherapy. (author)

  16. Changes in mutational status during third-line treatment for metastatic colorectal cancer

    DEFF Research Database (Denmark)

    Spindler, Karen-Lise Garm; Pallisgaard, Niels; Andersen, Rikke Fredslund


    and BRAF in plasma and report the changes during third line treatment with cetuximab and irinotecan. One-hundred-and-eight patients received irinotecan 350 mg/m2 q3w and weekly cetuximab (250 mg/m2) until progression (RECIST) or unacceptable toxicity. cfDNA and number of mutated KRAS/BRAF alleles in plasma...

  17. Multi-dimensional self-esteem and magnitude of change in the treatment of anorexia nervosa. (United States)

    Collin, Paula; Karatzias, Thanos; Power, Kevin; Howard, Ruth; Grierson, David; Yellowlees, Alex


    Self-esteem improvement is one of the main targets of inpatient eating disorder programmes. The present study sought to examine multi-dimensional self-esteem and magnitude of change in eating psychopathology among adults participating in a specialist inpatient treatment programme for anorexia nervosa. A standardised assessment battery, including multi-dimensional measures of eating psychopathology and self-esteem, was completed pre- and post-treatment for 60 participants (all white Scottish female, mean age=25.63 years). Statistical analyses indicated that self-esteem improved with eating psychopathology and weight over the course of treatment, but that improvements were domain-specific and small in size. Global self-esteem was not predictive of treatment outcome. Dimensions of self-esteem at baseline (Lovability and Moral Self-approval), however, were predictive of magnitude of change in dimensions of eating psychopathology (Shape and Weight Concern). Magnitude of change in Self-Control and Lovability dimensions were predictive of magnitude of change in eating psychopathology (Global, Dietary Restraint, and Shape Concern). The results of this study demonstrate that the relationship between self-esteem and eating disorder is far from straightforward, and suggest that future research and interventions should focus less exclusively on self-esteem as a uni-dimensional psychological construct. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Changes in Perception of Selected Concepts That Accompany Differing Leadership Treatments. (United States)

    Callan, Laurence Brian

    A study was made of effects of two different leadership treatments on perception of nonverbal stimuli relating to concepts of leaders, authority, and cohesion as measured by changes in the Semantic Differential Scale. Subjects (28 Yaqui Indian and Mexican-American members of the Neighborhood Youth Corps) were randomly assigned to an autocratic…

  19. Evaluation of Climate Change Impact on Drinking Water Treatment Plant Operation (United States)

    It is anticipated that global climate change will adversely impact source water quality in many areas of the United States and, therefore, will influence the design and operation of current and future drinking water treatment systems. Some of these impacts may lead to violations ...

  20. Mediation of Changes in Anxiety and Depression During Treatment of Social Phobia (United States)

    Moscovitch, David A.; Stefan G. Hofmann, Michael K.; Suvak, Michael K.; In-Albon, Tina


    To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive- behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated…

  1. Local changes in bone marrow at MRI after treatment of extremity soft tissue sarcoma

    International Nuclear Information System (INIS)

    Hwang, Sinchun; Lefkowitz, Robert; Landa, Jonathan; Akin, Oguz; Schwartz, Lawrence H.; Cassie, Conrad; Panicek, David M.; Healey, John H.; Alektiar, Kaled M.


    To determine the prevalence and appearance of magnetic resonance imaging (MRI) signal changes that occur in local bone marrow after radiation therapy (RT) and/or chemotherapy for extremity soft tissue sarcoma (STS). Seventy patients with primary STS at the level of a long bone who also had undergone pretreatment MRI and at least one post-treatment MRI of the tumor bed were identified. MRIs of each patient were retrospectively reviewed for new changes in marrow signal in the region of the tumor bed and for the morphology, relative signal intensities, heterogeneity, and progression or regression of changes over time. Focal signal changes in marrow were observed in 26/70 patients (37%) at a median of 9.5 months after RT and/or chemotherapy and diffuse changes in seven (10%) at a median of 8 months. Patients who received neither RT nor chemotherapy did not develop marrow changes. Mean RT doses in patients with changes and those without were 5,867 and 6,076 cGy, respectively. In most patients with focal changes, changes were seen in all sequences and were linear-curvilinear, patchy, or mixed at the level of the tumor bed. Predominant signal intensity of changes was between muscle and fat at T1WI and between muscle and fluid at fat-saturated T2WI or short tau inversion recovery. Most focal changes enhanced heterogeneously and increased or fluctuated in size over time. Changes in MRI appearance of long bone marrow frequently are evident after combined RT and chemotherapy for STS and most commonly increase or fluctuate in size over time. These changes have various non-mass-like configurations and often show signal intensities similar to those of red marrow and thus should not be mistaken for metastases. The marrow changes might represent an early stage of gelatinous transformation of marrow. (orig.)

  2. Changes in nail keratin observed by Raman spectroscopy after Nd:YAG laser treatment. (United States)

    Shin, Min Kyung; Kim, Tae In; Kim, Wan Sun; Park, Hun-Kuk; Kim, Kyung Sook


    Lasers and photodynamic therapy have been considered a convergence treatment for onychomycosis, which is a fungal infection on the nail bed and nail plate. Laser therapies have shown satisfactory results without significant complications for onychomycosis; however, the mechanism of clearing remains unknown. In this work, we investigated changes in the chemical structure of nail keratin induced by Nd:YAG laser using Raman spectroscopy. Toe nails with onychomycosis were treated with 1064 nm Nd:YAG laser. After laser treatment, the disulfide band (490-590 cm -1 ) of nail keratin was rarely observed or was reduced in intensity. The amide I band (1500-1700 cm -1 ) also showed changes induced by the laser. The α-helical (1652 cm -1 ) structures dominated the β-sheet (1673 cm -1 ) in nontreated nail, but the opposite phenomenon was observed after laser treatment. © 2016 Wiley Periodicals, Inc.

  3. Striatal Reward Activity and Antipsychotic-Associated Weight Change in Patients With Schizophrenia Undergoing Initial Treatment

    DEFF Research Database (Denmark)

    Nielsen, Mette Ødegaard; Rostrup, Egill; Wulff, Sanne


    -nine antipsychotic-naive inpatients and outpatients with schizophrenia were included in a multimodal longitudinal cohort study from December 16, 2008, to December 11, 2013. Fifty-eight patients underwent functional magnetic resonance imaging (fMRI) while performing a monetary reward task. After 6 weeks of treatment...... with amisulpride, a relatively selective dopamine D2 antagonist, 39 patients underwent a second fMRI scan and measurement of change in body weight. Final follow-up was completed on January 14, 2014, and data were analyzed from October 25, 2014, to June 15, 2015 and August 31 to September 19, 2015. Exposures: Six...... weeks of individually dosed amisulpride treatment. Main Outcomes and Measures: Reward-anticipation activity in the striatum before and after treatment and weight change. Results: Of the 69 patients who consented to the study, 39 underwent the follow-up fMRI and weight measurement (age range, 18-45 years...

  4. Breast Cancer Treatment: Experiences of Changes and Social Stigma Among Thai Women in Southern Thailand. (United States)

    Suwankhong, Dusanee; Liamputtong, Pranee


    Women with breast cancer receive different forms of treatment. Although treatment can save the lives of women, they can result in adverse physical, psychological, and social effects that can impact the women's quality of life. The objective of this study was to describe the experiences of breast cancer treatment among Thai women in southern Thailand. This study used qualitative methods (in-depth interviewing and drawings) with 20 Thai women who had been diagnosed with breast cancer. Data were analyzed using thematic analysis methods. Three themes emerged: (a) being a breast cancer patient: visible signs and adverse effects of therapy, (b) experiencing emotional chaos, and (c) experiencing social dysfunction. The women had to deal with physical body changes, emotional burden, treatment-related social stigma, and being marginalized within their own social context. Women experienced changes including social stigma after receiving breast cancer treatments. They had to manage stigma and difficulties themselves without sufficient professional support. It is important for nurses to understand such experiences so that they may support appropriate coping strategies suited to each woman. Community health nurses need to view each woman with breast cancer as a unique person and appreciate how to provide appropriate care and support based on each woman's experience with her illness and treatment.

  5. Skeletal and dental changes induced by bionator in early treatment of class II

    Directory of Open Access Journals (Sweden)

    Dirceu Barnabé Raveli


    Full Text Available The purpose was to investigate the amount of skeletal and dentoalveolar changes after early treatment of Class II, Division 1 malocclusion with bionator appliance in prepubertal growing patients. Forty Class II patients were divided in two groups. Treated group consisted of 20 subjects treated consecutively with bionator. Mean age at the start of treatment (T0 was 9.1 years, while it was 10.6 years at the end of treatment (T1. Mean treatment time was 17.7 months. Pretreatment and post-treatment cephalometric records of treated group were evaluated and compared with a control group consisted of 20 patients with untreated Class II malocclusion. Intergroup comparisons were performed using Student’s t-tests and chi-square test with Yates’ correction at a significance level of 5 per cent. Bionator appliance was effective in generating differential growth between the jaws. Cephalometric skeletal measurements ANB, WITS, Lafh, Co-A and dental L6-Mp, U1.Pp, IsIi, OB, OJ showed statistically significantly different from the control. Bionator induced more dentoalveolar changes than skeletal during treatment in prepubertal stage.

  6. Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program. (United States)

    Pratt, Keeley J; Lazorick, Suzanne; Lamson, Angela L; Ivanescu, Andrada; Collier, David N


    Changes in Quality of Life (QOL) measures over time with treatment of obesity have not previously been described for youth. We describe the changes from baseline through two follow up visits in youth QOL (assessed by the Pediatric Quality Life Inventory, PedsQL4.0), teen depression (assessed by the Patient Health Questionnaire, PHQ9A), Body Mass Index (BMI) and BMI z-score. We also report caregiver proxy ratings of youth QOL. A sample of 267 pairs of youth and caregiver participants were recruited at their first visit to an outpatient weight-treatment clinic that provides care integrated between a physician, dietician, and mental health provider; of the 267, 113 attended a visit two (V2) follow-up appointment, and 48 attended visit three (V3). We investigated multiple factors longitudinally experienced by youth who are overweight and their caregivers across up to three different integrated care visits. We determined relationships at baseline in QOL, PHQ9A, and BMI z-score, as well as changes in variables over time using linear mixed models with time as a covariate. Overall across three visits the results indicate that youth had slight declines in relative BMI, significant increases in their QOL and improvements in depression. We encourage clinicians and researchers to track youth longitudinally throughout treatment to investigate not only youth's BMI changes, but also psychosocial changes including QOL.

  7. Dimensional Changes of Nb$_{3}$Sn Rutherford Cables During Heat Treatment

    CERN Document Server

    Rochepault, E; Ambrosio, G; Anerella, M; Ballarino, A; Bonasia, A; Bordini, B; Cheng, D; Dietderich, D R; Felice, H; Garcia Fajardo, L; Ghosh, A; Holik, E F; Izquierdo Bermudez, S; Perez, J C; Pong, I; Schmalzle, J; Yu, M


    In high field magnet applications, Nb$_{3}$Sn coils undergo a heat treatment step after winding. During this stage, coils radially expand and longitudinally contract due to the Nb$_{3}$Sn phase change. In order to prevent residual strain from altering superconducting performances, the tooling must provide the adequate space for these dimensional changes. The aim of this paper is to understand the behavior of cable dimensions during heat treatment and to provide estimates of the space to be accommodated in the tooling for coil expansion and contraction. This paper summarizes measurements of dimensional changes on strands, single Rutherford cables, cable stacks, and coils performed between 2013 and 2015. These samples and coils have been performed within a collaboration between CERN and the U.S. LHC Accelerator Research Program to develop Nb$_{3}$Sn quadrupole magnets for the HiLumi LHC. The results are also compared with other high field magnet projects.

  8. Empirical study of the ability of Canadian oil and gas companies' reserves disclosures to account for relative changes in common stock prices

    Energy Technology Data Exchange (ETDEWEB)

    Teall, H D


    The purpose of this study is to determine which of these alternative annual report disclosures of oil and gas reserves, namely historic capitalized costs, quantities, and discounted cash flows contributes the most information content. Information content is defined as the ability of a reserves disclosure to account for relative changes in common stock prices. Multiple correlation/regression analysis was used to evaluate the extent that each of the three alternative reserves disclosures account for common stock returns after first recognizing the information provided by an industry variable and by an earnings per share or cash flow per share variable. The results indicated that the earnings per share provides significant information content while the cash flow per share consistently provides no significant evidence of information content. The capitalized costs reserves disclosure did not provide consistent evidence of information content, while the quantities disclosure and the discounted cash flows disclosure do provide significant incremental information content. The study concludes that the alternative reserves disclosures of quantities and discounted cash flows are more informative to users when accounting for changes in a corporation's common stock prices than the disclosure of reserves in historic capitalized costs.

  9. Beware: The empire striking back: An update of regulatory changes in Ontario`s gas and electricity business as at February 1998

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, K. [Gowling, Strathy and Henderson, Toronto, ON (Canada)


    A review of what is happening with regard to deregulation of the gas and electricity industry in Ontario was presented. Recently, a series of government actions in Ontario have recommended fundamental changes in the gas and electric power sector. Prior to the October 31, 1985 agreement, no competitive market existed within local distribution franchises in Ontario or elsewhere in Canada. The Agreement created gas on gas competition and enabled consumers to purchase natural gas from producers at negotiated prices. The Ontario government`s proposed legislation and implementation schedule forecasts even more fundamental changes for the province`s electric power industry. Essentially, the legislation proposes to break up Ontario Hydro into several different entities and transfer regulatory authority to the Ontario Energy Board. The pending legislation also envisages the structural separation of local distribution companies into natural monopolies which will compete in the marketplace. The possibility of privatizing part or all of Ontario`s nuclear assets is also part of the ongoing debate. It was the author`s view that unless there is immediate and complete structural separation of all monopoly services within the gas and electric utilities, the market will not be truly competitive. Instead, regulated monopoly pricing would be replaced by unregulated oligopoly pricing. 1 tab.

  10. Empirical philosophy of science

    DEFF Research Database (Denmark)

    Wagenknecht, Susann; Nersessian, Nancy J.; Andersen, Hanne


    A growing number of philosophers of science make use of qualitative empirical data, a development that may reconfigure the relations between philosophy and sociology of science and that is reminiscent of efforts to integrate history and philosophy of science. Therefore, the first part...... of this introduction to the volume Empirical Philosophy of Science outlines the history of relations between philosophy and sociology of science on the one hand, and philosophy and history of science on the other. The second part of this introduction offers an overview of the papers in the volume, each of which...... is giving its own answer to questions such as: Why does the use of qualitative empirical methods benefit philosophical accounts of science? And how should these methods be used by the philosopher?...

  11. Early change in coping strategies in responsive treatments for borderline personality disorder: A mediation analysis. (United States)

    Kramer, Ueli; Keller, Sabine; Caspar, Franz; de Roten, Yves; Despland, Jean-Nicolas; Kolly, Stéphane


    Difficulty in emotion regulation is a hallmark feature of patients with borderline personality disorder (BPD). Therefore, change in the frequency of certain patients' coping strategies-aiming at emotion regulation-are among the most promising mechanisms of change in treatments for BPD. In parallel, it was highlighted that therapist responsiveness significantly contributed to outcome across treatment approaches (Stiles, 2009). Based on a randomized controlled trial (Kramer et al., 2014), the present process-outcome mediation analysis aims at examining the patient's early change in frequency of coping strategies-in particular the decrease in behavioral forms of coping-as potential mechanism of change in responsive treatments for BPD. A total of 57 patients with BPD were included in the present analysis, out of whom 27 were randomly assigned to a 10-session psychiatric treatment and 30 to a 10-session psychiatric treatment augmented with the responsive intervention of the motive-oriented therapeutic relationship (Caspar, 2007). The 1st, 5th, and 9th session of each therapy were transcribed and analyzed using the Coping Action Pattern Rating Scale (Perry et al., 2005; 171 sessions analyzed in total), a validated observer-rated method for assessing coping strategies in the therapy process. Psychological distress was assessed using the OQ-45 at intake, after Session 5, and after Session 10. The results confirmed a responsiveness effect associated with the motive-oriented therapeutic relationship and showed a significant decrease in frequency of behavioral forms of coping, F(1, 54) = 3.09, p = .05, d = .56, which was not different between the 2 conditions. In addition, we demonstrated that the early decrease in behavioral forms of coping between Sessions 1 and 5 partially mediated the link between the group assignment and the change in psychological distress between Sessions 5 and 10. These results shed light on the centrality of therapist responsiveness in treatments for

  12. Predicting Retrograde Autobiographical Memory Changes Following Electroconvulsive Therapy: Relationships between Individual, Treatment, and Early Clinical Factors. (United States)

    Martin, Donel M; Gálvez, Verònica; Loo, Colleen K


    Loss of personal memories experienced prior to receiving electroconvulsive therapy is common and distressing and in some patients can persist for many months following treatment. Improved understanding of the relationships between individual patient factors, electroconvulsive therapy treatment factors, and clinical indicators measured early in the electroconvulsive therapy course may help clinicians minimize these side effects through better management of the electroconvulsive therapy treatment approach. In this study we examined the associations between the above factors for predicting retrograde autobiographical memory changes following electroconvulsive therapy. Seventy-four depressed participants with major depressive disorder were administered electroconvulsive therapy 3 times per week using either a right unilateral or bitemporal electrode placement and brief or ultrabrief pulse width. Verbal fluency and retrograde autobiographical memory (assessed using the Columbia Autobiographical Memory Interview - Short Form) were tested at baseline and after the last electroconvulsive therapy treatment. Time to reorientation was measured immediately following the third and sixth electroconvulsive therapy treatments. Results confirmed the utility of measuring time to reorientation early during the electroconvulsive therapy treatment course as a predictor of greater retrograde amnesia and the importance of assessing baseline cognitive status for identifying patients at greater risk for developing later side effects. With increased number of electroconvulsive therapy treatments, older age was associated with increased time to reorientation. Consistency of verbal fluency performance was moderately correlated with change in Columbia Autobiographical Memory Interview - Short Form scores following right unilateral electroconvulsive therapy. Electroconvulsive therapy treatment techniques associated with lesser cognitive side effects should be particularly considered for

  13. The medical treatment of Maria, Dowager Empress of the Russian Empire: an analysis of her prescription book from 1807 and 1808. (United States)

    Gudienè, V


    This study analyzes the medicines that were used to treat the Dowager Russian Empress Maria, widow of Tsar Paul I, and describes the doctors who cared for her health in 1807 and 1808. The source for this research was the imperial court pharmacy prescription book 1807-1811. Hypotheses about the diseases and medical problems of the Empress and how treatment for her differed according to circumstances, particularly after the loss of her granddaughter Princess Elizabeth, have been made based on the prescriptions recorded in the book. The content of the prescriptions suggests that the Empress suffered from gastrointestinal tract disorders, skin and eye diseases, neuralgic pains and insomnia. Foreign physicians educated in European universities worked at the imperial court and implemented European medical traditions. They took high positions in the administration and the medical education system, and gradually spread their experience and modern knowledge to Tsarist Russian society.

  14. Empire vs. Federation

    DEFF Research Database (Denmark)

    Gravier, Magali


    The article discusses the concepts of federation and empire in the context of the European Union (EU). Even if these two concepts are not usually contrasted to one another, the article shows that they refer to related type of polities. Furthermore, they can be used at a time because they shed light...... on different and complementary aspects of the European integration process. The article concludes that the EU is at the crossroads between federation and empire and may remain an ‘imperial federation’ for several decades. This could mean that the EU is on the verge of transforming itself to another type...

  15. Empirical comparison of theories

    International Nuclear Information System (INIS)

    Opp, K.D.; Wippler, R.


    The book represents the first, comprehensive attempt to take an empirical approach for comparative assessment of theories in sociology. The aims, problems, and advantages of the empirical approach are discussed in detail, and the three theories selected for the purpose of this work are explained. Their comparative assessment is performed within the framework of several research projects, which among other subjects also investigate the social aspects of the protest against nuclear power plants. The theories analysed in this context are the theory of mental incongruities and that of the benefit, and their efficiency in explaining protest behaviour is compared. (orig./HSCH) [de

  16. Empirical Music Aesthetics

    DEFF Research Database (Denmark)

    Grund, Cynthia M.

    The toolbox for empirically exploring the ways that artistic endeavors convey and activate meaning on the part of performers and audiences continues to expand. Current work employing methods at the intersection of performance studies, philosophy, motion capture and neuroscience to better understand...... musical performance and reception is inspired by traditional approaches within aesthetics, but it also challenges some of the presuppositions inherent in them. As an example of such work I present a research project in empirical music aesthetics begun last year and of which I am a team member....

  17. Changes in sick leave among Swedish dental patients after treatment for dental fear. (United States)

    Hakeberg, M; Berggren, U


    The most obvious consequence of a genuine dental phobic reaction is the avoidance of necessary dental care. Previous research has indicated that such avoidance results in deterioration of the oral status, which subsequently worsens patients' well-being and quality of life. The authors' previous investigations have shown overt behavioural and social effects by an increased time spent on sick leave compared with the public experience. Self-reports by patients also indicated that the time spent on sick leave was reduced after successful treatment for dental fear. The present investigation assessed the frequency of sick leave days among patients with dental fear and avoidance with regard to successful or unsuccessful treatment for dental fear (subsequent regular dental visit habits). A sub-sample of the fear group was compared with a group of matched controls. Data were collected from the official register of the National Health Insurance Board. It was revealed that the number of sick leave days was significantly reduced after treatment for dental fear among treated patients. This effect was also confirmed by a significant post-treatment difference between treated patients and those who discontinued or never started treatment. When compared with a matched control group, the positive change was further supported by a significant pre-treatment difference and a non-significant post-treatment difference.

  18. Dentoalveolar and skeletal changes associated with the pendulum appliance followed by fixed orthodontic treatment. (United States)

    Angelieri, Fernanda; Almeida, Renato Rodrigues de; Almeida, Marcio Rodrigues de; Fuziy, Acácio


    This prospective clinical study analyzed the distalization of maxillary molars achieved by the pendulum appliance and its effect on the anchorage teeth during and after fixed orthodontic treatment. Lateral cephalograms of 22 adolescents (15 girls, 7 boys) taken pretreatment, after distalization, after leveling and aligning, and after fixed orthodontic treatment were evaluated. The initial mean age was 14.5 years (SD = 1.80). The mean time for distalization of the maxillary molars was 5.85 months (SD = 1.82), and the total treatment time was 3.61 years (SD = 1.83). The pendulum appliance moved the maxillary molars distally, but with significant distal inclination, protrusion of the anterior teeth, and increase in lower anterior facial height (LAFH) due to the clockwise mandibular rotation. After fixed orthodontic treatment, the maxillary incisors and the maxillary first premolars and first molars were returned to their pretreatment anteroposterior positions. Thus, at postdistalization, there was 2.1 mm of protrusion of the maxillary first molars, despite the anchorage reinforcement (Nance button and cervical headgear worn at night during fixed appliance therapy). However, at the end of treatment, all patients had Class I molar relationships. The pendulum appliance followed by fixed orthodontic treatment corrected the Class II sagittal relationship, especially due to the dentoalveolar changes secondary to the spontaneous mandibular growth in the anterior direction during fixed appliance treatment.

  19. Pre-treatment predictors and in-treatment factors associated with change in avoidant and dependent personality disorder traits among patients with social phobia. (United States)

    Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold; Martinsen, Egil; Gude, Tore; Hedley, Liv Margaret; Abrahamsen, Gun


    We examined changes in avoidant and dependent personality disorder dimensions, and pre-treatment and in-treatment factors associated with such changes in 77 patients, randomized to medication-free residential cognitive (CT) or residential interpersonal therapy for social phobia. Personality disorders and personality dimensions according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were assessed at pre-treatment and at one-year post-treatment. Both treatments were associated with a decrease in avoidant and dependent personality dimensions; dependent dimension decreased more in CT. Changes in cognitive factors predicted changes in both personality dimensions, whereas changes in symptoms or interpersonal factors did not. Change in the cognitive factor estimated cost was the most powerful predictor in the avoidant dimension, as it was the only predictor that remained significant in the forward regression analyses. Change in the cognitive factor estimated cost, and treatment were the most powerful predictors of change in the dependent dimension. Pre-treatment use of anxiolytics predicted larger changes in both PD dimensions.

  20. Growth hormone (GH) and atherosclerosis: changes in morphology and function of major arteries during GH treatment. (United States)

    Pfeifer, M; Verhovec, R; Zizek, B


    Patients with hypopituitarism have increased carotid artery intima-media thickness and reduced arterial distensibility. The effect of 2 years of growth hormone (GH) replacement therapy on these parameters was studied in 11 GH-deficient men (age range, 24-49 years) with hypopituitarism and compared with 12 healthy, age-matched men with no evidence of pituitary or vascular disease. Before treatment the intima-media of the common carotid arteries and the carotid bifurcations were significantly thicker in patients (P < 0.001) than in the control group. Treatment with GH normalized the intima-media thickness of the common carotid artery within 6 months and of the carotid bifurcation within 3 months. The changes in intima-media thickness of the carotid artery were negatively correlated with changes in serum levels of insulin-like growth factor I during treatment. There was a significant improvement in flow-mediated, endothelium-dependent dilation of the brachial artery at 3 months, which was sustained at 6, 18 and 24 months of GH treatment (P < 0.05). Thus, GH replacement therapy in GH-deficient men reverses early morphological and functional atherosclerotic changes in major arteries, and may reduce rates of vascular morbidity and mortality.

  1. Treatment of obesity in children: Parent's perceived emotional barriers as predictor of change in body fat. (United States)

    Steinsbekk, Silje; Odegård, Rønnaug; Wichstrøm, Lars


    Research supports the use of family-based interventions in the treatment of obesity in children, but there is a lack of knowledge about what factors affect parents' ability to carry out the lifestyle changes necessary to reduce their child's obesity. The aim of the present study was to examine whether parents' self-efficacy, perceived emotional barriers, subjective norms, and attitudes could predict change in their children's body fat at 6 month and 2 year follow-ups after a family-based treatment of obesity. Body Mass Index Standard Deviation Scores (BMI SDS) were calculated and body fat (dual-energy X-ray absorptiometry) were measured in 99 treatment-seeking children with obesity (ages 7-12; 48 girls, 51 boys; mean BMI SDS = 2.99) at baseline, after 6 month and after 2 year follow-up. Parental cognitions regarding diet and physical activity were examined by parent-completed questionnaires. Structural equation modeling (SEM) was used to test whether the selected health cognitions could predict treatment outcome. Parental perceived emotional barriers was a significant predictor of change in body fat at 6 month (β = -.32, p = .001) and 2 year (β = -.38, p = .002) follow-up when the initial body fat values were controlled. Self-efficacy, subjective norms and attitudes did not improve the amount of variance explained. Parents' perceived emotional barriers significantly predict change in total body fat in children treated for obesity. In order to increase treatment-efficacy, perceived emotional barriers should be addressed. © 2011 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

  2. Benzo[a]pyrene treatment leads to changes in nuclear protein expression and alternative splicing

    Energy Technology Data Exchange (ETDEWEB)

    Yan Chunlan; Wu Wei [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Li Haiyan [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Huzhou Maternity and Child Care Hospital, Huzhou, Zhejiang 313000 (China); Zhang Guanglin [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Duerksen-Hughes, Penelope J. [Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92354 (United States); Zhu Xinqiang, E-mail: [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Yang Jun, E-mail: [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Zhejiang-California International Nanosystems Institute, Hangzhou, Zhejiang 310029 (China)


    Benzo[a]pyrene (BaP) is a potent pro-carcinogen generated from the combustion of fossil fuel and cigarette smoke. Previously, using a proteomic approach, we have shown that BaP can induce changes in the expression of many cellular proteins, including transcription regulators. In the present study, using a similar approach, we examined the nuclear protein response to BaP in HeLa cells and found that BaP treatment caused expression changes in many nuclear proteins. Twenty-four of these proteins were successfully identified, several of which are involved in the alternative splicing of mRNA, DNA replication, recombination, and repair. The changed expression levels were further confirmed by immunoblot analysis using specific antibodies for two proteins, Lamin A and mitotic checkpoint protein Bub3. The nuclear localization of these two proteins was also confirmed by confocal microscopy. To determine whether alternative splicing was activated following BaP treatment, we examined Fas and CD44, two genes previously shown to be targets of alternative splicing in respond to DNA damage. While no significant activation of alternative splicing was observed for Fas, CD44 splicing variants were found after BaP treatment. Together, these data show that DNA damage induces dramatic changes in nuclear protein expression, and that alternative splicing might be involved in the cellular response to DNA damage.

  3. Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments. (United States)

    Naqvi, Nasir H; Morgenstern, Jon


    Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of subcortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms.

  4. CADrx for GBM Brain Tumors: Predicting Treatment Response from Changes in Diffusion-Weighted MRI

    Directory of Open Access Journals (Sweden)

    Matthew S. Brown


    Full Text Available The goal of this study was to develop a computer-aided therapeutic response (CADrx system for early prediction of drug treatment response for glioblastoma multiforme (GBM brain tumors with diffusion weighted (DW MR images. In conventional Macdonald assessment, tumor response is assessed nine weeks or more post-treatment. However, we will investigate the ability of DW-MRI to assess response earlier, at five weeks post treatment. The apparent diffusion coefficient (ADC map, calculated from DW images, has been shown to reveal changes in the tumor’s microenvironment preceding morphologic tumor changes. ADC values in treated brain tumors could theoretically both increase due to the cell kill (and thus reduced cell density and decrease due to inhibition of edema. In this study, we investigated the effectiveness of features that quantify changes from pre- and post-treatment tumor ADC histograms to detect treatment response. There are three parts to this study: first, tumor regions were segmented on T1w contrast enhanced images by Otsu’s thresholding method, and mapped from T1w images onto ADC images by a 3D region of interest (ROI mapping tool using DICOM header information; second, ADC histograms of the tumor region were extracted from both pre- and five weeks post-treatment scans, and fitted by a two-component Gaussian mixture model (GMM. The GMM features as well as standard histogram-based features were extracted. Finally, supervised machine learning techniques were applied for classification of responders or non-responders. The approach was evaluated with a dataset of 85 patients with GBM under chemotherapy, in which 39 responded and 46 did not, based on tumor volume reduction. We compared adaBoost, random forest and support vector machine classification algorithms, using ten-fold cross validation, resulting in the best accuracy of 69.41% and the corresponding area under the curve (Az of 0.70.

  5. Age- and treatment-related associations with health behavior change among breast cancer survivors. (United States)

    Anderson, Chelsea; Sandler, Dale P; Weinberg, Clarice R; Houck, Kevin; Chunduri, Minal; Hodgson, M Elizabeth; Sabatino, Susan A; White, Mary C; Rodriguez, Juan L; Nichols, Hazel B


    The aim of this study was to identify demographic and treatment-related factors associated with health-promoting behavior changes after a breast cancer diagnosis. Changes in health behaviors were also evaluated according to weight, exercise, diet and alcohol consumption patterns before breast cancer diagnosis. We examined self-reported behavior changes among 1415 women diagnosed with breast cancer in the NIEHS Sister Study cohort. Women reported changes in exercising, eating healthy foods, maintaining a healthy body weight, drinking alcohol, smoking, getting enough sleep, spending time with family and friends, and participating in breast cancer awareness events. On average, women were 3.7 years from their breast cancer diagnosis. Overall, 20-36% reported positive changes in exercise, eating healthy foods, maintaining a healthy weight, or alcohol consumption. However, 17% exercised less. With each 5-year increase in diagnosis age, women were 11-16% less likely to report positive change in each of these behaviors (OR = 0.84-0.89; p exercise, eating healthy foods, efforts to maintain a healthy weight, alcohol consumption, sleep patterns, or time spent with family or friends. Many women reported no change in cancer survivorship guideline-supported behaviors after diagnosis. Positive changes were more common among younger women or those who underwent chemotherapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Study of the changes in the magnetic properties of stainless steels under mechanical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Iankov, R.; Rusanov, V., E-mail: [Magna Powertrain Ltd., Industrial Zone Rakowski (Bulgaria); Paneva, D.; Mitov, I. [Institute of Catalysis, Bulgarian Academy of Sciences (Bulgaria); Trautwein, A. X. [Institut für Physik, Universität zu Lübeck (Germany)


    Six types of stainless steels (SS) were studied for changes in its structure and magnetic properties under mechanical treatment. Depending on intensity and duration of the process of plastic deformation and the SS type the paramagnetic austenite structure transforms partially to completely into ferrite structure with ferromagnetic behaviour. Some of the SS tested were found slightly modified yet in the process of its manufacturing. Only one SS type with high Ni content preserved its structure and paramagnetic properties even after very intense mechanical treatment.

  7. Role of the preliminary heat treatment in anisothermic eutectoid change of the cast iron

    Directory of Open Access Journals (Sweden)

    T. Szykowny


    Full Text Available Preliminary heat treatment, preceding continuous cooling of the iron casting, assumed in the research, complies with the applied in prac- tice single normalization, double normalization or normalization with slow cooling. In each of these cases continuous cast iron cooling has been begun from the same temperature 925°C. CCT diagrams have been made with use of metallographic method. The mechanism, kinet- ics and the final structure of eutectoid change of the cast iron after such treatment have been traced.

  8. Clinical significance of changes of plasma ET and NPY levels after treatment in patients with AMI

    International Nuclear Information System (INIS)

    Zhou Jinbao


    Objective: To investigate the changes of plasma ET and NPY levels in patients with AMI. Methods: Plasma ET and NPY levels were dynamically determined in 36 patients with AMI right after establishment of diagnosis and 8h, 24h, 4ph, 72h, 7d, 14d later. Levels in 35 healthy individuals were taken as control. Results: Before treatment was initiated, the levels of Et and Np in patients with AMI were significantly higher than those in controls (P <0.01). After one week of treatment, the levels dropped toward normal. Conclusion: Dynamic measurement of plasma ET and NPY levels in patients with AMI is of clinical importance. (authors)

  9. Late effects of tumour treatment. Structural changes in the spinal column seen on X-ray

    Energy Technology Data Exchange (ETDEWEB)

    Gutyahr, P; Greinacher, I; Kutzner, J [Mainz Univ. (Germany, F.R.). Kinderklinik; Mainz Univ. (Germany, F.R.). Inst. fuer Klinische Strahlenkunde)


    Cure rates are increasing in pediatric oncology; simultaneously the numbers of late effects of therapy are also increasing. 64 children with malignant neoplastic disease in whom the spine had been partially or totally exposed during X-ray treatment were re-investigated for radiographically visible irradiation effects on the vertebral column. 140 different abnormalities were found in 56 children of which scolioses were the most important. Irradiation for Wilms' tumour produced more numerous changes than direct irradiation of the vertebral column. In spite of the unexpectedly high number of growth defects rigorous X-ray treatment is indicated in certain circumstances. The growth abnormalities were of only minor clinical significance.

  10. Empirical research through design

    NARCIS (Netherlands)

    Keyson, D.V.; Bruns, M.


    This paper describes the empirical research through design method (ERDM), which differs from current approaches to research through design by enforcing the need for the designer, after a series of pilot prototype based studies, to a-priori develop a number of testable interaction design hypothesis

  11. Essays in empirical microeconomics

    NARCIS (Netherlands)

    Péter, A.N.


    The empirical studies in this thesis investigate various factors that could affect individuals' labor market, family formation and educational outcomes. Chapter 2 focuses on scheduling as a potential determinant of individuals' productivity. Chapter 3 looks at the role of a family factor on

  12. Worship, Reflection, Empirical Research


    Ding Dong,


    In my youth, I was a worshipper of Mao Zedong. From the latter stage of the Mao Era to the early years of Reform and Opening, I began to reflect on Mao and the Communist Revolution he launched. In recent years I’ve devoted myself to empirical historical research on Mao, seeking the truth about Mao and China’s modern history.

  13. Trade and Empire

    DEFF Research Database (Denmark)

    Bang, Peter Fibiger


    This articles seeks to establish a new set of organizing concepts for the analysis of the Roman imperial economy from Republic to late antiquity: tributary empire, port-folio capitalism and protection costs. Together these concepts explain better economic developments in the Roman world than the...

  14. Empirically sampling Universal Dependencies

    DEFF Research Database (Denmark)

    Schluter, Natalie; Agic, Zeljko


    Universal Dependencies incur a high cost in computation for unbiased system development. We propose a 100% empirically chosen small subset of UD languages for efficient parsing system development. The technique used is based on measurements of model capacity globally. We show that the diversity o...

  15. Changes in brain activity following intensive voice treatment in children with cerebral palsy. (United States)

    Bakhtiari, Reyhaneh; Cummine, Jacqueline; Reed, Alesha; Fox, Cynthia M; Chouinard, Brea; Cribben, Ivor; Boliek, Carol A


    Eight children (3 females; 8-16 years) with motor speech disorders secondary to cerebral palsy underwent 4 weeks of an intensive neuroplasticity-principled voice treatment protocol, LSVT LOUD ® , followed by a structured 12-week maintenance program. Children were asked to overtly produce phonation (ah) at conversational loudness, cued-phonation at perceived twice-conversational loudness, a series of single words, and a prosodic imitation task while being scanned using fMRI, immediately pre- and post-treatment and 12 weeks following a maintenance program. Eight age- and sex-matched controls were scanned at each of the same three time points. Based on the speech and language literature, 16 bilateral regions of interest were selected a priori to detect potential neural changes following treatment. Reduced neural activity in the motor areas (decreased motor system effort) before and immediately after treatment, and increased activity in the anterior cingulate gyrus after treatment (increased contribution of decision making processes) were observed in the group with cerebral palsy compared to the control group. Using graphical models, post-treatment changes in connectivity were observed between the left supramarginal gyrus and the right supramarginal gyrus and the left precentral gyrus for the children with cerebral palsy, suggesting LSVT LOUD enhanced contributions of the feedback system in the speech production network instead of high reliance on feedforward control system and the somatosensory target map for regulating vocal effort. Network pruning indicates greater processing efficiency and the recruitment of the auditory and somatosensory feedback control systems following intensive treatment. Hum Brain Mapp 38:4413-4429, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. Changes in Neuropsychiatric Inventory Associated with Semagacestat Treatment of Alzheimer's Disease. (United States)

    Rosenberg, Paul B; Lanctôt, Krista L; Herrmann, Nathan; Mintzer, Jacobo E; Porsteinsson, Anton P; Sun, Xiaoying; Raman, Rema


    In a recent report, 76 weeks' treatment with a gamma-secretase inhibitor (semagacestat) was associated with poorer cognitive outcomes in Alzheimer's disease (AD). We sought to examine the effect of semagacestat treatment on neuropsychiatric symptoms (NPS). 1,537 participants with mild to moderate AD were randomized to 76 weeks' treatment with placebo versus two doses of semagacestat. NPS were assessed with the Neuropsychiatric Inventory (NPI-Total and subdomains). Cognition was assessed with the Alzheimer's Disease Assessment Scale-Cognitive (first 11 items, ADAS11). Mixed-Model Repeated Measures was used to compare the effects of treatment assignment on change in NPI-total and subdomains over time. Survival analysis was used to assess the treatment effect on time to first worsening of NPS (NPI-Total ≥10 or NPI subdomain ≥4) for subjects with no or minor NPS at baseline. Participants on high dose semagecestat (140 mg) had greater increase in NPI-Total and greater risk of incident first worsening in NPI-Total and in subdomains of aberrant motor behavior, appetite, depression/dysphoria, and sleep. ADAS11 increased more in participants whose NPI-Total increased. In participants with mild to moderate AD, high dose semagacestat treatment was associated with greater severity and faster worsening of NPS in a pattern resembling an agitated depression. Increased NPS was associated with cognitive decline regardless of treatment assignment. These findings suggest that greater NPS may be the result of gamma-secretase treatment and emphasize the importance of monitoring NPS as potential adverse events in trials of novel treatments for AD.

  17. An update on the "empirical turn" in bioethics: analysis of empirical research in nine bioethics journals. (United States)

    Wangmo, Tenzin; Hauri, Sirin; Gennet, Eloise; Anane-Sarpong, Evelyn; Provoost, Veerle; Elger, Bernice S


    A review of literature published a decade ago noted a significant increase in empirical papers across nine bioethics journals. This study provides an update on the presence of empirical papers in the same nine journals. It first evaluates whether the empirical trend is continuing as noted in the previous study, and second, how it is changing, that is, what are the characteristics of the empirical works published in these nine bioethics journals. A review of the same nine journals (Bioethics; Journal of Medical Ethics; Journal of Clinical Ethics; Nursing Ethics; Cambridge Quarterly of Healthcare Ethics; Hastings Center Report; Theoretical Medicine and Bioethics; Christian Bioethics; and Kennedy Institute of Ethics Journal) was conducted for a 12-year period from 2004 to 2015. Data obtained was analysed descriptively and using a non-parametric Chi-square test. Of the total number of original papers (N = 5567) published in the nine bioethics journals, 18.1% (n = 1007) collected and analysed empirical data. Journal of Medical Ethics and Nursing Ethics led the empirical publications, accounting for 89.4% of all empirical papers. The former published significantly more quantitative papers than qualitative, whereas the latter published more qualitative papers. Our analysis reveals no significant difference (χ2 = 2.857; p = 0.091) between the proportion of empirical papers published in 2004-2009 and 2010-2015. However, the increasing empirical trend has continued in these journals with the proportion of empirical papers increasing from 14.9% in 2004 to 17.8% in 2015. This study presents the current state of affairs regarding empirical research published nine bioethics journals. In the quarter century of data that is available about the nine bioethics journals studied in two reviews, the proportion of empirical publications continues to increase, signifying a trend towards empirical research in bioethics. The growing volume is mainly attributable to two

  18. The implications of starvation induced psychological changes for the ethical treatment of hunger strikers. (United States)

    Fessler, D M T


    To evaluate existing ethical guidelines for the treatment of hunger strikers in light of findings on psychological changes that accompany the cessation of food intake. Electronic databases were searched for (a) editorials and ethical proclamations on hunger strikers and their treatment; (b) studies of voluntary and involuntary starvation, and (c) legal cases pertaining to hunger striking. Additional studies were gathered in a snowball fashion from the published material cited in these databases. Material was included if it (a) provided ethical or legal guidelines; (b) shed light on psychological changes accompanying starvation, or (c) illustrated the practice of hunger striking. Authors' observations, opinions, and conclusions were noted. Although the heterogeneous nature of the sources precluded statistical analysis, starvation appears to be accompanied by marked psychological changes. Some changes clearly impair competence, in which case physicians are advised to follow advance directives obtained early in the hunger strike. More problematic are increases in impulsivity and aggressivity, changes which, while not impairing competence, enhance the likelihood that patients will starve themselves to death.

  19. Alternative approaches used to assess structural changes of natural zircon caused by heat treatment (United States)

    Huong, L. T. T.; Thuyet, N. T. M.; Phan, T. L.; Tran, N.; Toan, D. N.; Thang, P. D.; Huy, B. T.


    It is known that large changes in the crystal structure of zircon (ZrSiO4) can be assessed through the linewidth of the characteristic Raman mode (Δν3) at 1008 cm-1. However, the use of Δν3 to assess small changes caused by heat treatment at temperatures below its decomposition temperature of 1670 °C is difficult. The present work points out that the combination of X-ray diffraction (XRD) analyses, and photoluminescence (PL) and Raman (RS) measurements with different excitation wavelengths is an effective approach to solve the above problem. In this context, we have selected natural zircon containing some rare-earth (RE) impurities, and then studied the changes in its crystal structure caused by heat treatment at temperatures Tan=400-1600 °C. XRD analyses reveal that small modifications of the unit-cell parameters occur as Tan>600 °C. Taking the intensity ratios of the ν3 mode to RE-related emissions (Iν3/IRE) or the PL intensity ratios between RE-related emissions into consideration, the similar results in good agreement with the XRD analyses are also found. We believe that the small structural changes are related to the migration and redistribution of defects and impurities, and re-crystallization of zircon. This could be further confirmed though the relation between paramagnetic and ferromagnetic signals when Tan changes.

  20. Estimation of wildfire size and risk changes due to fuels treatments (United States)

    Cochrane, M.A.; Moran, C.J.; Wimberly, M.C.; Baer, A.D.; Finney, M.A.; Beckendorf, K.L.; Eidenshink, J.; Zhu, Z.


    Human land use practices, altered climates, and shifting forest and fire management policies have increased the frequency of large wildfires several-fold. Mitigation of potential fire behaviour and fire severity have increasingly been attempted through pre-fire alteration of wildland fuels using mechanical treatments and prescribed fires. Despite annual treatment of more than a million hectares of land, quantitative assessments of the effectiveness of existing fuel treatments at reducing the size of actual wildfires or how they might alter the risk of burning across landscapes are currently lacking. Here, we present a method for estimating spatial probabilities of burning as a function of extant fuels treatments for any wildland fire-affected landscape. We examined the landscape effects of more than 72 000 ha of wildland fuel treatments involved in 14 large wildfires that burned 314 000 ha of forests in nine US states between 2002 and 2010. Fuels treatments altered the probability of fire occurrence both positively and negatively across landscapes, effectively redistributing fire risk by changing surface fire spread rates and reducing the likelihood of crowning behaviour. Trade offs are created between formation of large areas with low probabilities of increased burning and smaller, well-defined regions with reduced fire risk.

  1. Stories of change in drug treatment: a narrative analysis of 'whats' and 'hows' in institutional storytelling. (United States)

    Andersen, Ditte


    Addiction research has demonstrated how recovering individuals need narratives that make sense of past drug use and enable constructions of future, non-addict identities. However, there has not been much investigation into how these recovery narratives actually develop moment-to-moment in drug treatment. Building on the sociology of storytelling and ethnographic fieldwork conducted at two drug treatment institutions for young people in Denmark, this article argues that studying stories in the context of their telling brings forth novel insights. Through a narrative analysis of both 'the whats' (story content) and 'the hows' (storying process) the article presents four findings: (1) stories of change function locally as an institutional requirement; (2) professional drug treatment providers edit young people's storytelling through different techniques; (3) the narrative environment of the drug treatment institution shapes how particular stories make sense of the past, present and future; and (4) storytelling in drug treatment is an interactive achievement. A fine-grained analysis illuminates in particular how some stories on gender and drug use are silenced, while others are encouraged. The demonstration of how local narrative environments shape stories contributes to the general understanding of interactive storytelling in encounters between professionals and clients in treatment settings. © 2015 The Author. Sociology of Health & Illness published by John Wiley & Sons Ltd. on behalf of Foundation for Sociology of Health & Illness.

  2. Changes in urinary excretion of water and sodium transporters during amiloride and bendroflumethiazide treatment

    DEFF Research Database (Denmark)

    Jensen, Janni M; Mose, Frank H; Kulik, Anna-Ewa O


    AIM: To quantify changes in urinary excretion of aquaporin2 water channels (u-AQP2), the sodium-potassium-chloride co-transporter (u-NKCC2) and the epithelial sodium channels (u-ENaC) during treatment with bendroflumethiazide (BFTZ), amiloride and placebo. METHODS: In a randomized, double....... General linear model with repeated measures or related samples Friedman's two-way analysis was used to compare differences. Post hoc Bonferroni correction was used for multiple comparisons of post infusion periods to baseline within each treatment group. RESULTS: At baseline there were no differences in u...... by the constant infusion clearance technique with (51)Cr-EDTA as reference substance. To estimate the changes in water transport via AQP2 and sodium transport via NKCC2 and ENaC, u-NKCC2, the gamma fraction of ENaC (u-ENaCγ), and u-AQP2 were measured at baseline and after infusion with 3% hypertonic saline. U...

  3. Effects of heat treatment to the sound velocity and microstructural changes of ASTM A516 steels

    International Nuclear Information System (INIS)

    Norasiah Abdul Kasim; Azali Muhammad; Amry Amin Abas; Zaiton Selamat


    Full-text: The used of ultrasonic testing as a thickness measurement for structural components (pipeline and pressure vessel) is among the popular inspection tool widely use in the industrial power plant such as at petrochemical and nuclear power plant. Currently, there are cases where the thickness grows and the result will affect the reliability of the test. There are many factors that can affect the reliability of measurement. One of it is the material under test itself. In the Malaysian Nuclear Agency, initial efforts are underway to study the understanding on the effects of heat treatment to the sound velocity and microstructure changes of ASTM A516 steel. Few samples of thin square shaped prepared were heat treated under the following conditions: austenitization at 9800 degree Celsius - 2 hours, quenching; tempering at various temperature 4000, 5000, 6000 and 7000 degree Celsius. The results show that the microstructure changes and samples exhibit different sound velocity at different heat treatment. (author)

  4. Life cycle cost analysis changes mixed waste treatment program at the Savannah River Site

    International Nuclear Information System (INIS)

    Pickett, J.B.; England, J.L.; Martin, H.L.


    A direct result of the reduced need for weapons production has been a re-evaluation of the treatment projects for mixed (hazardous/radioactive) wastes generated from metal finishing and plating operations and from a mixed waste incinerator at the Savannah River Site (SRS). A Life Cycle Cost (LCC) analysis was conducted for two waste treatment projects to determine the most cost effective approach in response to SRS mission changes. A key parameter included in the LCC analysis was the cost of the disposal vaults required for the final stabilized wasteform(s) . The analysis indicated that volume reduction of the final stabilized wasteform(s) can provide significant cost savings. The LCC analysis demonstrated that one SRS project could be eliminated, and a second project could be totally ''rescoped and downsized.'' The changes resulted in an estimated Life Cycle Cost saving (over a 20 year period) of $270,000,000

  5. Changes in the treatment of abused children: a retrospective review of a practice. (United States)

    Tsaltas, M O


    Using the population of sexually abused children from three periods of my practice, I have described changes in my practice of play therapy over the past 30 years. These changes have come about in part due to the pioneering work of psychiatrists specializing in studies of development in children not designated as emotionally disturbed or mentally ill (Chess and Thomas, 1986; Greenspan, 1981; Winnicott, 1953, 1965, 1971) as well those who have described treatment techniques and theoretical constructs of the experience of traumatized children (Finkelhor and Browne, 1985; Terr, 1991). Because of these convincing works, I have been able to shorten treatment, and shift my goals from direct efforts at unconscious conflict resolution to the more indirect but more effective method of re-establishing maturational tracks through involvement of families, dialogue with children in multiple play techniques as well as words, and to plan ahead for these traumatized children. It remains to be seen what the eventual outcome of this change in treatment will be. Although I always ask families and children to keep in touch even by postcard, only about 20% of them do. Naturally, these are families that are doing well. I am not sure that this necessarily means the other 80% are not doing well but I simply do not know. Because all of these patients are known to one authority or another (police, Rape Centers, courts and Department of Welfare) it should be possible to plan long-term studies of treatment outcome at the time of the initial contact. It seems important enough to me to do this because betrayed trust has a very long lag time before its full effects may be seen in the adults these children become. Because there are so many cases of child abuse, defining the relative effectiveness and efficacy of different kinds of treatment could be useful in managing what is, in effect, a public health problem.

  6. Changes in bacterial profiles after periodontal treatment associated with respiratory quality of asthmatic children


    Wiyarni Pambudi; Imelda Fabiola; Retno Indrawati; Haryono Utomo; Anang Endaryanto; Ariyanto Harsono


    Background Despite the reduction phenomenon of asthma exacerbation after dental plaque control, no scientific report has been found to describe the link between bacterial profiles and respiratory quality in children with asthma. Objective To investigate association between bacterial profiles changes and improvement in respiratory quality after periodontal treatment. Methods Asthmatic children with FEV1 reversibility ~ 12% and dental plaque index ~ 2 who qualified for incl...

  7. Changes of Corneal Wavefront Aberrations in Dry Eye Patients after Treatment with Artificial Lubricant Drops

    Directory of Open Access Journals (Sweden)

    Ning Lu


    Full Text Available Purpose. To evaluate the corneal aberration changes in dry eye patients after treatment with artificial eye drops. Methods. Thirty mild to moderate dry eye patients treated with artificial eye drops and twenty comparable dry eye patients were recruited as controls. Anterior corneal aberrations over 3 mm and 5 mm analytical zones including total, 3rd to 5th high order aberrations (HOAs, spherical aberration (SA, and vertical (V-coma and horizontal coma (H-coma obtained from corneal topography data at baseline and 2 weeks after treatment were evaluated. Results. For 3 mm zone, trefoils, V-coma, H-coma terms, and 3rd and 5th HOAs were significantly decreased (p0.05. Conclusions. Treatment with artificial eye drops can effectively improve the corneal optical quality of dry eye patients by ameliorating the HOAs of anterior corneal surface.

  8. Mechanisms of Change in Treatments of Personality Disorders: Commentary on the Special Section. (United States)

    Kealy, David; Ogrodniczuk, John S


    Considerable progress has been made in the psychotherapeutic treatment of patients with personality disorders (PDs). Once engendering a pervasive therapeutic nihilism, PDs are starting to be viewed as treatable with a much better prognosis than previously thought. Evidence from several randomized controlled trials demonstrating the effectiveness of various forms of psychotherapy, coupled with findings from several longitudinal studies, suggests that such increased clinical optimism is warranted. However, the persistent focus on treatment brands obscures our understanding of the mechanisms through which benefits are actually realized. This article considers emerging trends in PD treatment research, exemplified by the series of articles contained within this special section, that attempt to identify more precisely the mechanisms of therapeutic change. It is only through such work that we will be able to accomplish further refinement of effective strategies, create possibilities for true integration of therapies, and achieve real progress in the field for the betterment of our patients.

  9. The Key to Individualized Addiction Treatment is Comprehensive Assessment and Monitoring of Symptoms and Behavioral Change

    Directory of Open Access Journals (Sweden)

    Thomas F. Hilton


    Full Text Available Modern health services now strive for individualized treatment. This approach has been enabled by the increase in knowledge derived from neuroscience and genomics. Substance use disorders are no exception to individualized treatment even though there are no gene-specific medications yet available. What is available is the ability to quickly and precisely assess and monitor biopsychosocial variables known to vary during addiction recovery and which place addicts at increased risk of relapse. Monitoring a broad spectrum of biopsychosocial health enables providers to address diverse genome-specific changes that might trigger withdrawal from treatment or recovery relapse in time to prevent that from occurring. This paper describes modern measurement tools contained in the NIH Patient-Reported Outcomes Measurement Information System (PROMIS and the NIH Toolbox and suggests how they might be applied to support recovery from alcohol and other substance use disorders in both pharmacological and abstinence-oriented modalities of care.

  10. Parenting as a Mechanism of Change in Psychosocial Treatment for Youth with ADHD, Predominantly Inattentive Presentation. (United States)

    Haack, Lauren M; Villodas, Miguel; McBurnett, Keith; Hinshaw, Stephen; Pfiffner, Linda J


    We investigated whether parenting and child behavior improve following psychosocial treatment for Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation (ADHD-I) and whether parenting improvements mediate child outcomes. We analyzed data from a randomized clinical trial investigating the efficacy of a multicomponent psychosocial intervention (Child Life and Attention Skills, CLAS, n = 74) in comparison to Parent-Focused Treatment (PFT, n = 74) and treatment as usual (TAU, n = 51) for youth with ADHD-I (average child age = 8.6 years, range 7-11 years, 58 % boys). Child and parent/family functioning were assessed prior to treatment, immediately following treatment, and at follow-up into the subsequent school year using parent and teacher reports of inattention, organization, social skills, academic competency (teachers only), parenting daily hassles, and positive and negative parenting behaviors (parents only). Both treatment groups improved on negative parenting and home impairment, but only CLAS families also improved on positive parenting as well as academic impairment. Improvements in positive and negative parenting mediated treatment effects on child impairment independent of improvements in child inattention, implicating parenting as an important mechanism of change in psychosocial treatment for ADHD-I. Further, whereas parent-focused training produces improvements in negative parenting and impairment at home for children with ADHD-I, a multicomponent approach (incorporating child skills training and teacher consultation) more consistently produces improvements at school and in positive parenting, which may contribute to improvements in social skills into the next school year.

  11. Tongue motion variability with changes of upper airway stimulation electrode configuration and effects on treatment outcomes. (United States)

    Steffen, Armin; Kilic, Ayse; König, Inke R; Suurna, Maria V; Hofauer, Benedikt; Heiser, Clemens


    Upper airway stimulation (UAS) is an effective treatment for obstructive sleep apnea (OSA). Previous data have demonstrated a correlation between the phenotype of tongue motion and therapy response. Closed loop hypoglossal nerve stimulation implant offers five different electrode configuration settings which may result in different tongue motion. Two-center, prospective consecutive trial in a university hospital setting. Clinical outcomes of 35 patients were analyzed after at least 12 months of device use. Tongue motion was assessed at various electrode configuration settings. Correlation between the tongue motion and treatment response was evaluated. OSA severity was significantly reduced with the use of UAS therapy (P < .001). Changes in tongue motion patterns were frequently observed (58.8%) with different electrode configuration settings. Most of the patients alternated between right and bilateral protrusion (73.5%), which are considered to be the optimal phenotypes for selective UAS responses. Different voltage settings were required to achieve functional stimulation levels when changing between the electrode settings. UAS is highly effective for OSA treatment in selected patients with an apnea-hypopnea index between 15 and 65 events per hour and higher body mass index. Attention should be given to patients with shifting tongue movement in response to change of electrode configuration. The intraoperative cuff placement should be reassessed when tongue movement shifting is observed. 4 Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  12. [Morphological changes of the intestine in experimental acute intestinal infection in the treatment of colloidal silver]. (United States)

    Polov'ian, E S; Chemich, N D; Moskalenko, R A; Romaniuk, A N


    At the present stage of infectionist practice in the treatment of acute intestinal infections caused by opportunistic microorganisms, colloidal silver is used with a particle size of 25 nm as an alternative to conventional causal therapy. In 32 rats, distributed in 4 groups of 8 animals each (intact; healthy, got colloidal silver; with a modeled acute intestinal infection in the basic treatment and with the addition of colloidal silver), histological examination was performed of small and large intestine of rats. Oral administration of colloidal silver at a dose of 0.02 mg/day to intact rats did not lead to changes in morphometric parameters compared to the norm, and during early convalescence in rats with acute intestinal infections were observed destructive and compensatory changes in the intestine, which depended on the treatment regimen. With the introduction of colloidal silver decreased activity of the inflammatory process and the severity of morphological changes in tissues of small and large intestine, indicating that the positive effect of study drug compared with baseline therapy.

  13. Changes in the radiation sensitivity of mouse skin during fractionated and prolonged treatments

    International Nuclear Information System (INIS)

    Ruifrok, A.C.C.; Mason, K.A.; Hunter, N.; Thames, H.D.


    Reactions of the skin of the right thigh of mice were used as an experimental model to test possible changes in the radiosensitivity of mouse skin, as represented by changes in the linear-quadratic (LQ) model parameters α and β, as a function of fractionation interval and overall treatment time. In the first series of experiments, variable numbers of 3-Gy fractions with intervals of 6, 24 or 48 h were applied, followed by top-up doses to increase the skin damage to a level that could be scored. The results showed that mouse skin is more sensitive to 3-Gy fractions applied with 48-h intervals than to 3-Gy fractions applied with 6- or 24-h intervals. In the second series of experiments we used single-dose or fractonated test treatments for previously unirradiated mice and mice treated with priming doses of 10, 20 or 30 Gy given 1-18 days before the test treatment. The sensitivity appeared to be higher after intervals of 14-18 days than after 1-10 days after priming treatments of 20 and 30 Gy. The increased sensitivity 18 days after 20 Gy was mainly the result of an increase in the β component of the LQ model; higher values of α were also determined. We conclude that the radiosensitivity of mouse skin is higher during a radiation-induced proliferative response. 28 refs., 3 figs., 7 tabs

  14. Intensive inpatient treatment for bulimia nervosa: Statistical and clinical significance of symptom changes. (United States)

    Diedrich, Alice; Schlegl, Sandra; Greetfeld, Martin; Fumi, Markus; Voderholzer, Ulrich


    This study examines the statistical and clinical significance of symptom changes during an intensive inpatient treatment program with a strong psychotherapeutic focus for individuals with severe bulimia nervosa. 295 consecutively admitted bulimic patients were administered the Structured Interview for Anorexic and Bulimic Syndromes-Self-Rating (SIAB-S), the Eating Disorder Inventory-2 (EDI-2), the Brief Symptom Inventory (BSI), and the Beck Depression Inventory-II (BDI-II) at treatment intake and discharge. Results indicated statistically significant symptom reductions with large effect sizes regarding severity of binge eating and compensatory behavior (SIAB-S), overall eating disorder symptom severity (EDI-2), overall psychopathology (BSI), and depressive symptom severity (BDI-II) even when controlling for antidepressant medication. The majority of patients showed either reliable (EDI-2: 33.7%, BSI: 34.8%, BDI-II: 18.1%) or even clinically significant symptom changes (EDI-2: 43.2%, BSI: 33.9%, BDI-II: 56.9%). Patients with clinically significant improvement were less distressed at intake and less likely to suffer from a comorbid borderline personality disorder when compared with those who did not improve to a clinically significant extent. Findings indicate that intensive psychotherapeutic inpatient treatment may be effective in about 75% of severely affected bulimic patients. For the remaining non-responding patients, inpatient treatment might be improved through an even stronger focus on the reduction of comorbid borderline personality traits.

  15. Changes in blood lead levels associated with use of chloramines in water treatment systems. (United States)

    Miranda, Marie Lynn; Kim, Dohyeong; Hull, Andrew P; Paul, Christopher J; Galeano, M Alicia Overstreet


    More municipal water treatment plants are using chloramines as a disinfectant in order to reduce carcinogenic by-products. In some instances, this has coincided with an increase in lead levels in drinking water in those systems. Lead in drinking water can be a significant health risk. We sought to test the potential effect of switching to chloramines for disinfection in water treatment systems on childhood blood lead levels using data from Wayne County, located in the central Coastal Plain of North Carolina. We constructed a unified geographic information system (GIS) that links blood lead screening data with age of housing, drinking water source, and census data for 7,270 records. The data were analyzed using both exploratory methods and more formal multivariate techniques. The analysis indicates that the change to chloramine disinfection may lead to an increase in blood lead levels, the impact of which is progressively mitigated in newer housing. Introducing chloramines to reduce carcinogenic by-products may increase exposure to lead in drinking water. Our research provides guidance on adjustments in the local childhood lead poisoning prevention program that should accompany changes in water treatment. As similar research is conducted in other areas, and the underlying environmental chemistry is clarified, water treatment strategies can be optimized across the multiple objectives that municipalities face in providing high quality drinking water to local residents.

  16. Therapeutic assessment promotes treatment readiness but does not affect symptom change in patients with personality disorders: Findings from a randomized clinical trial

    NARCIS (Netherlands)

    de Saeger, H.; Kamphuis, J.H.; Finn, S.E.; Smith, J.D.; Verheul, R.; van Busschbach, J.J.; Feenstra, D.J.; Dine, J.; Horn, E.K.


    The field of clinical personality assessment is lacking in published empirical evidence regarding its treatment and clinical utility. This article reports on a randomized controlled clinical trial (N = 74) allocating patients awaiting treatment in a specialized clinic for personality disorders to

  17. Catastrophic misinterpretations as a predictor of symptom change during treatment for panic disorder. (United States)

    Teachman, Bethany A; Marker, Craig D; Clerkin, Elise M


    Cognitive models of panic disorder suggest that change in catastrophic misinterpretations of bodily sensations will predict symptom reduction. To examine change processes, we used a repeated measures design to evaluate whether the trajectory of change in misinterpretations over the course of 12-week cognitive behavior therapy is related to the trajectory of change in a variety of panic-relevant outcomes. Participants had a primary diagnosis of panic disorder (N = 43; 70% female; mean age = 40.14 years). Race or ethnicity was reported as 91% Caucasian, 5% African American, 2.3% biracial, and 2.3% "other." Change in catastrophic misinterpretations (assessed with the Brief Body Sensations Interpretation Questionnaire; Clark et al., 1997) was used to predict a variety of treatment outcomes, including overall panic symptom severity (assessed with the Panic Disorder Severity Scale [PDSS]; Shear et al., 1997), panic attack frequency (assessed with the relevant PDSS item), panic-related distress/apprehension (assessed by a latent factor, including peak anxiety in response to a panic-relevant stressor-a straw breathing task), and avoidance (assessed by a latent factor, which included the Fear Questionnaire-Agoraphobic Avoidance subscale; Marks & Mathews, 1979). Bivariate latent difference score modeling indicated that, as expected, change in catastrophic misinterpretations predicted subsequent reductions in overall symptom severity, panic attack frequency, distress/apprehension, and avoidance behavior. However, change in the various symptom domains was not typically a significant predictor of later interpretation change (except for the distress/apprehension factor). These results provide considerable support for the cognitive model of panic and speak to the temporal sequence of change processes during therapy. (c) 2010 APA, all rights reserved.

  18. Changes in rat parotid saliva protein composition following chronic reserpine treatment and their relation to inanition. (United States)

    Johnson, D A


    Chronic administration of the catecholamine-depleting agent, reserpine (0.5 mg/kg), resulted in a reduction in food intake after 3 days. To differentiate effects of the drug from those of reduced food intake a pair-fed group, whose daily caloric intake was restricted to the amount consumed by the reserpine-treated rats, was included. After 7 days, both the reserpine-treated and pair-fed control exhibited a marked reduction in the volume of saliva collected in a 30 min interval following a secretory stimulus compared to untreated ad libitum-fed controls, and the proportion of salivary proteins attributable to acidic and basic proline-rich proteins and to minor 1b protein were decreased whereas deoxyribonuclease was increased. For two of the salivary proteins (fractions I and V) changes for the reserpine-treated and pair-fed groups were different. Fraction I was reduced in both groups, but exhibited a greater decrease in the pair-fed than in the reserpine-treated, whereas fraction V was significantly increased only in the pair-fed group. Thus many of the salivary changes associated with reserpine treatment may have resulted from the change in feeding habits and not from reserpine treatment per se. The study demonstrates the importance of controlling for food intake under experimental circumstances which may lead to a marked change in daily feeding habits.

  19. Proteome changes in banana fruit peel tissue in response to ethylene and high-temperature treatments. (United States)

    Du, Lina; Song, Jun; Forney, Charles; Palmer, Leslie Campbell; Fillmore, Sherry; Zhang, ZhaoQi


    Banana (Musa AAA group) is one of the most consumed fruits in the world due to its flavor and nutritional value. As a typical climacteric fruit, banana responds to ethylene treatment, which induces rapid changes of color, flavor (aroma and taste), sweetness and nutritional composition. It has also been reported that ripening bananas at temperatures above 24 °C inhibits chlorophyll breakdown and color formation but increases the rate of senescence. To gain fundamental knowledge about the effects of high temperature and ethylene on banana ripening, a quantitative proteomic study employing multiplex peptide stable isotope dimethyl labeling was conducted. In this study, green (immature) untreated banana fruit were subjected to treatment with 10 μL L(-1) of ethylene for 24 h. After ethylene treatment, treated and untreated fruit were stored at 20 or 30 °C for 24 h. Fruit peel tissues were then sampled after 0 and 1 day of storage, and peel color and chlorophyll fluorescence were evaluated. Quantitative proteomic analysis was conducted on the fruit peels after 1 day of storage. In total, 413 common proteins were identified and quantified from two biological replicates. Among these proteins, 91 changed significantly in response to ethylene and high-temperature treatments. Cluster analysis on these 91 proteins identified 7 groups of changed proteins. Ethylene treatment and storage at 20 °C induced 40 proteins that are correlated with pathogen resistance, cell wall metabolism, ethylene biosynthesis, allergens and ribosomal proteins, and it repressed 36 proteins that are associated with fatty acid and lipid metabolism, redox-oxidative responses, and protein biosynthesis and modification. Ethylene treatment and storage at 30 °C induced 32 proteins, which were mainly similar to those in group 1 but also included 8 proteins in group 3 (identified as chitinase, cinnamyl alcohol dehydrogenase 1, cysteine synthase, villin-2, leucine-transfer RNA ligase, CP47

  20. Do symptom-specific stages of change predict eating disorder treatment outcome? (United States)

    Ackard, Diann M; Cronemeyer, Catherine L; Richter, Sara; Egan, Amber


    Interview methods to assess stages of change (SOC) in eating disorders (ED) indicate that SOC are positively correlated with symptom improvement over time. However, interviews require significant time and staff training and global measures of SOC do not capture varying levels of motivation across ED symptoms. This study used a self-report, ED symptom-specific SOC measure to determine prevalence of stages across symptoms and identify if SOC predict treatment outcome. Participants [N = 182; age 13-58 years; 92% Caucasian; 96% female; average BMI 21.7 (SD = 5.9); 50% ED not otherwise specified (EDNOS), 30.8% bulimia nervosa (BN), 19.2% anorexia nervosa (AN)] seeking ED treatment at a diverse-milieu multi-disciplinary facility in the United States completed stages of change, behavioral (ED symptom use and frequency) and psychological (ED concerns, anxiety, depression) measures at intake assessment and at 3, 6 and 12 months thereafter. Descriptive summaries were generated using ANOVA or Kruskal-Wallis (continuous) and χ (2) (categorical) tests. Repeated measures linear regression models with autoregressive correlation structure predicted treatment outcome. At intake assessment, 53.3% of AN, 34.0% of BN and 18.1% of EDNOS patients were in Preparation/Action. Readiness to change specific symptoms was highest for binge-eating (57.8%) and vomiting (56.5%). Frequency of fasting and restricting behaviors, and scores on all eating disorder and psychological measures improved over time regardless of SOC at intake assessment. Symptom-specific SOC did not predict reductions in ED symptom frequency. Overall SOC predicted neither improvement in Eating Disorder Examination Questionnaire (EDE-Q) scores nor reduction in depression or trait anxiety; however, higher overall SOC predicted lower state anxiety across follow-up. Readiness to change ED behaviors varies considerably. Most patients reduced eating disorder behaviors and increased psychological functioning regardless of stages

  1. Structure and strength of carbide-steel cermet and their changes during heat treatment

    International Nuclear Information System (INIS)

    Dariel, M.P.; Frage, N.R.; Kaputkina, L.M.; Kaputkin, D.M.; Sverdlova, N.R.


    Both homogeneous and 'graded' materials were produced by pressing and sintering of titanium carbide TiC x (0.7 x takes place during the joining. If the titanium carbide is carbon deficient that the carbon goes from the steel binder to TiC x , and this redistribution intensity with the x decreases. So-named graded cermets were produced on controlled distribution of TiC x with different x. An additional flow of carbon from C-rich to C-poor TiC x layers was obtained in these cermets. These changes both in the steel and TiC x compositions result in changes in such processes as austenitization, carbide dissolution and precipitation, and martensitic transformation. Both general strength of the material and the gradient of properties in graded cermets can be increased using kinetic factors of element redistribution and structure changes resulted from the heat treatment. (author)

  2. Gazprom: the new empire

    International Nuclear Information System (INIS)

    Guillemoles, A.; Lazareva, A.


    Gazprom is conquering the world. The Russian industrial giant owns the hugest gas reserves and enjoys the privilege of a considerable power. Gazprom edits journals, owns hospitals, airplanes and has even built cities where most of the habitants work for him. With 400000 workers, Gazprom represents 8% of Russia's GDP. This inquiry describes the history and operation of this empire and show how its has become a masterpiece of the government's strategy of russian influence reconquest at the world scale. Is it going to be a winning game? Are the corruption affairs and the expected depletion of resources going to weaken the empire? The authors shade light on the political and diplomatic strategies that are played around the crucial dossier of the energy supply. (J.S.)

  3. Growth hormone (GH) treatment reverses early atherosclerotic changes in GH-deficient adults. (United States)

    Pfeifer, M; Verhovec, R; Zizek, B; Prezelj, J; Poredos, P; Clayton, R N


    Hypopituitary patients have increased mortality from vascular disease, and in these patients, early markers of atherosclerosis [increased carotid artery intima-media thickness (IMT) and reduced distensibility] are more prevalent. As GH replacement can reverse some risk factors of atherosclerosis, the present study examined the effect of GH treatment on morphological and functional changes in the carotid and brachial arteries of GH-deficient (GHD) adults. Eleven GHD hypopituitary men (24-49 yr old) were treated with recombinant human GH (0.018 U/kg BW x day) for 18 months. IMT of the common carotid artery (CCA) and the carotid bifurcation (CB), and flow-mediated endothelium-dependent dilation (EDD) of the brachial artery were measured by B mode ultrasound before and at 3, 6, 12, and 18 months of treatment, and values were compared with those in 12 age-matched control men. Serum concentrations of lipids, lipoprotein(a), insulin-like growth factor I (IGF-I), and IGF-binding protein-3 (IGFBP-3) were also measured. In GHD men before treatment the IMTs of the CCA [mean(SD), 0.67(0.05) mm] and CB [0.75(0.04) mm] were significantly greater (P < 0.001) than those in control men [0.52(0.07) and 0.65(0.07) mm, respectively]. GH treatment normalized the IMT of the CCA by 6 months [0.53(0.04) mm] and that of the CB by 3 months [0.68(0.05) mm]. The IMT of the carotid artery (CCA and CB) was negatively correlated with serum IGF-I (r = -0.53; P < 0.0001). There was a significant improvement in flow-mediated EDD of the brachial artery at 3 months, which was sustained at 6 and 18 months of GH treatment (P < 0.05). GH treatment increased high density lipoprotein cholesterol at 3 and 6 months, but did not reduce total or low density lipoprotein cholesterol and was without effect on lipoprotein(a). There was no correlation between plasma lipids and changes in IMT or EDD of the arteries examined. In conclusion, GH treatment of hypopituitary GHD men reverses early morphological and

  4. Changes in microbial diversity of brined green asparagus upon treatment with high hydrostatic pressure. (United States)

    Toledo Del Árbol, Julia; Pérez Pulido, Rubén; La Storia, Antonietta; Grande Burgos, Maria José; Lucas, Rosario; Ercolini, Danilo; Gálvez, Antonio


    The application of high hydrostatic pressure (HHP, 600MPa, 8 min) on brined green asparagus and the changes in bacterial diversity after treatments and during storage at 4 °C (30 days) or 22 °C (10 days) were studied. HHP treatments reduced viable cell counts by 3.6 log cycles. The residual surviving population did not increase during storage at 4 °C. However, bacterial counts significantly increased at 22 °C by day 3, leading to rapid spoilage. The microbiota of green asparagus was composed mainly by Proteobacteria (mainly Pantoea and Pseudomonas), followed by Firmicutes (mainly Lactococcus and Enterococcus) and to a less extent Bacteroidetes and Actinobacteria. During chill storage of untreated asparagus, the relative abundance of Proteobacteria as well as Enterococcus and Lactococcus decreased while Lactobacillus increased. During storage of untreated asparagus at 22 °C, the abundance of Bacteroidetes decreased while Proteobacteria increased during late storage. The HHP treatment determined a reduction of the Proteobacteria both early after treatment and during chill storage. In the HHP treated samples stored at 22 °C, the relative abundance of Pseudomonas rapidly decreased at day 1, with an increase of Bacteroidetes. This was followed by a marked increase in Enterobacteriaceae (Escherichia) simultaneously with increase in viable counts and spoilage. Results from the study indicate that the effect of HHP treatments on the viability ofmicrobial populations in foods also has an impact on the dynamics of microbial populations during the storage of the treated foods.

  5. Mediastinal lymphoma: quantitative changes in gadolinium enhancement at MR imaging after treatment. (United States)

    Rahmouni, A; Divine, M; Lepage, E; Jazaerli, N; Belhadj, K; Gaulard, P; Golli, M; Reyes, F; Vasile, N


    To compare changes in gadolinium enhancement at magnetic resonance (MR) imaging with outcome in mediastinal lymphoma after treatment. Thirty-one patients with bulky mediastinal lymphoma (17 with Hodgkin disease, 14 with non-Hodgkin lymphoma) underwent serial MR imaging before and up to 50 months after treatment, with routine follow-up (including computed tomography). Signal intensity ratios between masses and muscle were calculated on T1-weighted, T2-weighted, and contrast material-enhanced T1-weighted spin-echo MR images. The percentage enhancement and signal intensity ratios of mediastinal masses on T2-weighted MR images were calculated at diagnosis and during and after treatment. Twenty-one patients with persistent complete remission had a mean percentage enhancement of residual masses (4%; range, -26% to 40%) that was significantly lower than that of initial masses (78%; range, 41%-124%). Although the mean signal intensity ratio of residual masses on T2-weighted images was significantly lower than that of initial masses, an increase in this ratio was observed in four patients after treatment. In seven patients with relapse, the percentage enhancement value of the residual mass was as high as that of the initial mass. Gadolinium enhancement of lymphomatous masses of the mediastinum decreased markedly after treatment in patients in continuous complete remission but not in patients with relapse.

  6. Biochemical changes in cuttings of Robinia pseudoacacia after treatment with naphthenate

    Directory of Open Access Journals (Sweden)



    Full Text Available Naphthenic acids were isolated from gas oil fractions (distillation interval 168–290 °C of Vojvodina crude oil “Velebit”, characterized and their biological ac­tivity evaluated by the biochemical changes in cuttings of Robinia pseudoacacia after treatment with naphthenate. The activities of IAA peroxidase, total peroxi­da­ses and amylase, as well as the contents of reducing sugars and total proteins, were determined in the basal parts of soft wood cuttings of black locust after treat­ment with sodium naphthenate or the sodium salt of 1-naphthaleneacetic acid (NAA, con­­centration 10-7 mol dm-3 for 3 or 6 h. High activities of IAA oxidase and amy­lase, together with a low activity of peroxidase (which is known as being stimula­tory for the initiation and activation of primordia were obtained after the three-hour treatment with sodium naphthenate. Six-hour treatment had an inhibitory effect on the examined biochemical markers. The effects of three- and six-hour treatments with NAA were between those of the corresponding treatment with naphthenic acids.

  7. Comparison of doses according to change of bladder volume in treatment of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Kyung Tae [Dept. of Radiologic Technology, Dongnam Health University, Suwon (Korea, Republic of); Min, Jung Whan [Dept. of Radiological Technology, Shingu University, Seongnam (Korea, Republic of)


    In the case of radiation therapy for prostate cancer, a balloon infused with a certain amount of air through the anus is used to reduce rectal dose. Because of the reason, radiation therapy for prostate cancer has acquired CBCT for daily image induction. In order to maintain the anatomical structure most similar to the first CT taken before treatment, it is pretreated, but it can not be said to be perfectly consistent. In two actual treatment regimens, the volume of the bladder was measured as 45.82 cc and 63.43 cc, and the equivalent diameter was 4.4 cm and 4.9 cm. As a result of this study, the mean volume of the bladder was estimated to be 56.2 cc, 105.6 cc by 20 CBCT. The mean dose of CBCT was 1.74% and the mean Bladder mean dose was 96.67%. In case B, PTV mean dose was 4.31%, Bladder mean Dose was estimated to be 97.35%. The changes in the volume of the bladder resulted in changes in the dose of PTV and bladder. The correlation coefficient of bladder dose according to the change of bladder volume showed linearity of mean dose R2= -0.94. The correlation coefficient of the PTV dose according to the volume change of the bladder showed linearity of mean dose R2= 0.04. It was found that the dose change of PTV was larger than that of bladder according to the change of bladder volume.

  8. Empirically Based Myths: Astrology, Biorhythms, and ATIs. (United States)

    Ragsdale, Ronald G.


    A myth may have an empirical basis through chance occurrence; perhaps Aptitude Treatment Interactions (ATIs) are in this category. While ATIs have great utility in describing, planning, and implementing instruction, few disordinal interactions have been found. Article suggests narrowing of ATI research with replications and estimates of effect…

  9. Resistance to treatment and change in anorexia nervosa [corrected]: a clinical overview. (United States)

    Abbate-Daga, Giovanni; Amianto, Federico; Delsedime, Nadia; De-Bacco, Carlotta; Fassino, Secondo


    Current literature on Eating Disorders (EDs) is devoid of evidence-based findings providing support to effective treatments, mostly for anorexia nervosa (AN). This lack of successful guidelines may play a role in making these disorders even more resistant. In fact, many individuals do not respond to the available treatments and develop an enduring and disabling illness. With this overview we aimed to highlight and discuss treatment resistance in AN--with an in-depth investigation of resistance-related psychological factors.A literature search was conducted on PubMed and PsychINFO; English-language articles published between 1990 and 2013 investigating the phenomenon of resistance to treatment in AN have been considered. The selected papers have been then grouped into four main thematic areas: denial of illness; motivation to change; maintaining factors and treatment outcome; and therapeutic relationship. Eating symptomatology was found to only partially explain resistance to treatment. The role of duration of illness has been questioned whilst some maintaining factors seemed promising in providing a useful framework for this phenomenon. Emotive and relational aspects have been investigated on their role in resistance as well as therapists' countertransference. Remarkably there has been little research done on resistance to treatment in the ED field, in spite of its clinical relevance. Motivation, insight and subjective meaning of the illness can be useful tools to manage the resistance phenomenon when coupled with a wider approach. The latter enables the therapists to be aware of their role in the therapeutic alliance through countertransference aspects and to consider the EDs as disorders of the development of both personality and self, entailing severe impairments as regards identity and relationships.

  10. Cohort differences in dementia recognition and treatment indicators among assisted living residents in Maryland: did a change in the resident assessment tool make a difference? (United States)

    Samus, Quincy M; Vavilikolanu, Amrita; Mayer, Lawrence; McNabney, Matthew; Brandt, Jason; Lyketsos, Constantine G; Rosenblatt, Adam


    There is a lack of empirical evidence about the impact of regulations on dementia care quality in assisted living (AL). We examined cohort differences in dementia recognition and treatment indicators between two cohorts of AL residents with dementia, evaluated prior to and following a dementia-related policy modification to more adequately assess memory and behavioral problems. Cross-sectional comparison of two AL resident cohorts was done (Cohort 1 [evaluated 2001-2003] and Cohort 2 [evaluated 2004-2006]) from the Maryland Assisted Living studies. Initial in-person evaluations of residents with dementia (n = 248) were performed from a random sample of 28 AL facilities in Maryland (physician examination, clinical characteristics, and staff and family recognition of dementia included). Adequacy of dementia workup and treatment was rated by an expert consensus panel. Staff recognition of dementia was better in Cohort 1 than in Cohort 2 (77% vs. 63%, p = 0.011), with no significant differences in family recognition (86% vs. 85%, p = 0.680), or complete treatment ratings (52% vs. 64%, p = 0.060). In adjusted logistic regression, cognitive impairment and neuropsychiatric symptoms correlated with staff recognition; and cognitive impairment correlated with family recognition. Increased age and cognitive impairment reduced odds of having a complete dementia workup. Odds of having complete dementia treatment was reduced by age and having more depressive symptoms. Cohort was not predictive of dementia recognition or treatment indicators in adjusted models. We noted few cohort differences in dementia care indicators after accounting for covariates, and concluded that rates of dementia recognition and treatment did not appear to change much organically following the policy modifications.

  11. Biochemical changes in full fat rice bran stabilized through microwave heating and irradiation treatment

    International Nuclear Information System (INIS)

    El-Niely, H.F.; Abaullah, M.I.


    The effect of microwave heating and irradiation treatments on proximate composition, lipoxygenase (LOX) activity, free fatty acid (FFA) and fatty acids profile of full fat rice bran were examined. Full fat raw rice bran (FRB) (82.7 g / kg moisture content) was heated in microwave oven at 850 W for up to 4 min or exposed to gamma irradiation up to 25 KGy then packed in polyethylene bags and stored at room temperature for 6 months. Water, protein, fat, ash and crude fiber contents did not change significantly in raw, microwave heated and irradiated samples before and after storage. An exception for this general observation was observed for the moisture content of FRB processed through microwave heating where heating FRB for 4 min dropped the level of moisture to 64.3 g / kg at zero time. Storage of both raw and processed samples had significant (P<0.05) effects on LOX activity. LOX activity of raw samples was significantly increased from its initial value by 43.5% after storage for six months. Microwave heat and irradiated samples showed deactivated LOX and samples exhibited significant changes in LOX activity could be due to treatment dosage. Meanwhile, significant change in LOX activity was observed in processed samples stored for six months. Minor changes were observed due to applied processing methods on FFA and fatty acids composition of full fat rice bran before and after storage. The results suggested that microwave heated or irradiated full fat rice bran packed in polyethylene bags can be stored at room temperature for six months without adverse effect on proximate, fatty acid composition quality and could prevent oxidative and hydrolytic rancidity. However, gamma irradiation treatment at 25 KGy was more effective in this respect. Therefore, it could be concluded that gamma irradiation contributed to optimal processing conditions for FRB stabilization

  12. Urinary catheter-associated microbiota change in accordance with treatment and infection status. (United States)

    Bossa, Laetitia; Kline, Kimberly; McDougald, Diane; Lee, Bonsan Bonne; Rice, Scott A


    The use of long-term catheterisation to manage insensate bladders, often associated with spinal cord injury (SCI), increases the risk of microbial colonisation and infection of the urinary tract. Urinary tract infection (UTI) is typically diagnosed and treated based on the culturing of organisms from the urine, although this approach overlooks low titer, slow growing and non-traditional pathogens. Here, we present an investigation of the urinary tract microbiome in catheterised SCI individuals, using T-RFLP and metagenomic sequencing of the microbial community. We monitored three neurogenic patients over a period of 12 months, who were part of a larger study investigating the efficacy of probiotics in controlling UTIs, to determine how their urinary tract microbial community composition changed over time and in relation to probiotic treatment regimens. Bacterial biofilms adherent to urinary catheters were examined as a proxy for bladder microbes. The microbial community composition of the urinary tract differed significantly between individuals. Probiotic therapy resulted in a significant change in the microbial community associated with the catheters. The community also changed as a consequence of UTI and this shift in community composition preceded the clinical diagnosis of infection. Changes in the microbiota due to probiotic treatment or infection were transient, resolving to microbial communities similar to their pre-treatment communities, suggesting that the native community was highly resilient. Based on these results, we propose that monitoring a patient's microbial community can be used to track the health of chronically catheterized patients and thus, can be used as part of a health-status monitoring program.

  13. Curie Temperature and Microstructural Changes Due to the Heating Treatment of Magnetic Amorphous Materials

    Directory of Open Access Journals (Sweden)

    Gondro J.


    Full Text Available Three distinct alloys: Fe86Zr7Nb1Cu1B5, Fe82Zr7Nb2Cu1B8, and Fe81Pt5Zr7Nb1Cu1B5 were characterized both magnetically and structurally. The samples, obtained with spinning roller method as a ribbons 3 mm in width and 20 μm thick, were investigated as-quenched and after each step of a multi steps heating treatment procedure. Each sample was annealed at four steps, fifteen minutes at every temperature, starting from 573K+600K up to +700K depending on type of alloy. Mössbauer spectroscopy data and transmission electron microscope (HRE M pictures confirmed that the as-quenched samples are fully amorphous. This is not changed after the first stages of treatment heating leads to a reduction of free volumes. The heating treatment has a great influence on the magnetic susceptibilities. The treatment up to 600K improves soft magnetic properties: an χ increase was observed, from about 400 to almost 1000 for the samples of alloys without Pt, and from about 200 to 450 at maximum, for the Fe81Pt5Zr7Nb1Cu1B5. Further heating, at more elevated temperatures, leads to magnetic hardening of the samples. Curie temperatures, established from the location of Hopkinson’s maxima on the χ(T curve are in very good agreement with those obtained from the data of specific magnetization, σ(T, measured in a field of 0.75T. As a critical parameter β was chosen to be equal 0.36 for these calculations, it confirmed that the alloys may be considered as ferromagnetic of Heisenberg type. Heating treatment resulted in decreasing of TC. These changes are within a range of several K.

  14. Post-treatment occlusal changes in Class II division 2 subjects treated with the Herbst appliance. (United States)

    Bock, Niko; Ruf, Sabine


    The aim of this retrospective study was to analyse and compare the post-treatment occlusal changes of Class II division 2 treatment with the Herbst appliance in early adolescent, late adolescent, and adult subjects. The subjects were 37 Class II division 2 patients (19 females and 18 males) treated at the Orthodontic Department, University of Giessen, Germany. All were in the late mixed or permanent dentition and exhibited a Class II molar relationship > or =0.5 cusp width (CW) bilaterally or > or =1.0 CW unilaterally, an overbite (OB) >3.0 mm, and two upper central incisors retroclined. The subjects were divided into three skeletal maturity groups based on evaluation of hand wrist radiographs: early adolescent (n = 10, stages MP3-E to MP3-FG at start of treatment, age range: 11.3-13.2 years), late adolescent (n = 14, stages MP3-G to MP3-I at start of treatment, age range: 14.1-16.4 years), and adult (n = 13, stages R-I to R-J at the start of treatment, age range: 16.3-25.6 years). Study casts from before treatment (T1), after Herbst-Tip-Edge-Multibracket appliance treatment (T2), and after an average retention time of 27 months (T3) were analysed. Statistical analysis was undertaken using t-tests for paired and unpaired samples. For the whole sample, the molar relationship at T3 was stable in 82.4 per cent, the canine relationship in 82.9 per cent, and OB in 75.7 per cent of the cases. In the different skeletal maturity groups, the stability of the molars, canines, and overbite was as follows: early adolescents: 95.0, 100.0, and 70.0 per cent, respectively; late adolescents: 92.9, 74.1, and 85.7 per cent, respectively; and adults 61.5, 80.8, 69.2 per cent, respectively. Occlusal correction of Class II division 2 malocclusions with Herbst treatment was relatively stable 2 years post-treatment. The outcome of treatment of adolescents was more stable than that of adults.

  15. Superimpositional assessment of treatment-associated changes in the temporomandibular joint and the mandibular symphysis. (United States)

    Baumrind, S; Korn, E L; Isaacson, R J; West, E E; Molthen, R


    This article analyzes differences in the measured displacement of the condyle and of progonion when different vectors of force are delivered to the maxilla in the course of non-full-banded, Phase 1, mixed-dentition treatment for the correction of Class II malocclusion. The 238-case sample is identical to that for which changes in other parameters of facial form have been reported previously. Relative to superimposition on anterior cranial base and measured in a Frankfort-plane-determined coordinate system, we have attempted to identify and quantitate (1) the displacement of each structure which results from local remodeling and (2) the displacement of each structure which occurs as a secondary consequence of changes in other regions of the skull. We have also attempted to isolate treatment effects from those attributable to spontaneous growth and development. At the condyle, we note that in all three treatment groups and in the control group there is a small but real downward and backward displacement of the glenoid fossa. This change is not treatment induced but, rather, is associated with spontaneous growth and development. (See Fig. 5.) Some interesting differences in pattern of "growth at the condyle" were noted between samples. In the intraoral (modified activator) sample, there were small but statistically significant increases in growth rate as compared to the untreated group of Class II controls. To our surprise, similar statistically significant increases over the growth rate of the control group were noted in the cervical sample. (See Table III, variables 17 and 18.) Small but statistically significant differences between treatments were also noted in the patterns of change at pogonion. As compared to the untreated control group, the rate of total displacement in the modified activator group was significantly greater in the forward direction, while the rate of total displacement in the cervical group was significantly greater in the downward direction

  16. Occlusal bite force change after orthodontic treatment with Andresen functional appliance. (United States)

    Al-Khateeb, Susan N; Abu Alhaija, Elham S; Majzoub, Sami


    The aim of this study was to determine the occlusal bite force (OBF) changes, at the incisal and molar regions, after orthodontic treatment with functional appliance therapy in preadolescent subjects. OBF was measured for patients (17 females and 16 males) before and after the treatment with Andresen functional appliance for an average period of 9 months (mean age was 11.8±1.1 years). Three variables were registered; maximum OBF at molar region and the average of three readings at the molar (AOBF) and incisal regions (IOBF). The same variables were measured in two occasions for a matching non-treated control group with a period of 9 months between the two measurements. No significant changes were seen in the OBF measured parameters in the control group. There was a reduction in all measured parameters. The mean reduction in maximum OBF was 76.1±12.4 N (P appliance caused a significant reduction in OBF immediately after treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email:

  17. An evaluation of the treatment of risk and uncertainties in the IPCC reports on climate change. (United States)

    Aven, Terje; Renn, Ortwin


    Few global threats rival global climate change in scale and potential consequence. The principal international authority assessing climate risk is the Intergovernmental Panel on Climate Change (IPCC). Through repeated assessments the IPCC has devoted considerable effort and interdisciplinary competence to articulating a common characterization of climate risk and uncertainties. We have reviewed the assessment and its foundation for the Fifth Assessment Reports published in 2013 and 2014, in particular the guidance note for lead authors of the fifth IPCC assessment report on consistent treatment of uncertainties. Our analysis shows that the work carried out by the ICPP is short of providing a theoretically and conceptually convincing foundation on the treatment of risk and uncertainties. The main reasons for our assessment are: (i) the concept of risk is given a too narrow definition (a function of consequences and probability/likelihood); and (ii) the reports lack precision in delineating their concepts and methods. The goal of this article is to contribute to improving the handling of uncertainty and risk in future IPCC studies, thereby obtaining a more theoretically substantiated characterization as well as enhanced scientific quality for risk analysis in this area. Several suggestions for how to improve the risk and uncertainty treatment are provided. © 2014 Society for Risk Analysis.

  18. Changes in prefrontal and amygdala activity during olanzapine treatment in schizophrenia. (United States)

    Blasi, Giuseppe; Popolizio, Teresa; Taurisano, Paolo; Caforio, Grazia; Romano, Raffaella; Di Giorgio, Annabella; Sambataro, Fabio; Rubino, Valeria; Latorre, Valeria; Lo Bianco, Luciana; Fazio, Leonardo; Nardini, Marcello; Weinberger, Daniel R; Bertolino, Alessandro


    Earlier imaging studies in schizophrenia have reported abnormal amygdala and prefrontal cortex activity during emotion processing. We investigated with functional magnetic resonance imaging (fMRI) during emotion processing changes in activity of the amygdala and of prefrontal cortex in patients with schizophrenia during 8 weeks of olanzapine treatment. Twelve previously drug-free/naive patients with schizophrenia were treated with olanzapine for 8 weeks and underwent two fMRI scans after 4 and 8 weeks of treatment during implicit and explicit emotional processing. Twelve healthy subjects were also scanned twice to control for potential repetition effects. Results showed a diagnosis by time interaction in left amygdala and a diagnosis by time by task interaction in right ventrolateral prefrontal cortex. In particular, activity in left amygdala was greater in patients than in controls at the first scan during both explicit and implicit processing, while it was lower in patients at the second relative to the first scan. Furthermore, during implicit processing, right ventrolateral prefrontal cortex activity was lower in patients than controls at the first scan, while it was greater in patients at the second relative to the first scan. These results suggest that longitudinal treatment with olanzapine may be associated with specific changes in activity of the amygdala and prefrontal cortex during emotional processing in schizophrenia.

  19. Sialic acid changes in Dalton's lymphoma-bearing mice after cyclophosphamide and cisplatin treatment

    Directory of Open Access Journals (Sweden)

    Nicol B.M.


    Full Text Available Sialic acid changes in Dalton's lymphoma cells and other tissues of 10-12-week-old Swiss albino mice were investigated in relation to tumour growth in vivo and following cyclophosphamide (ip, 200 mg/kg body weight or cisplatin (ip, 8 mg/kg body weight treatment. Three to four animals of both sexes were used in each experimental group. The sialic acid level of tumour cells (0.88 µmol/g increased with tumour progression (1.44-1.59 µmol/g; P<=0.05 in mice. Sialic acid concentration in other tissues (liver, kidney, testes and brain also increased (~40, 10, 30 and 58%, respectively in the tumour-bearing hosts as compared with that in the respective tissues of normal mice. In vivo cyclophosphamide or cisplatin treatment resulted in an overall decrease of sialic acid contents in the tissues. Cyclophosphamide was more efficient in lowering tissue sialic acid than cisplatin (P<=0.01, ANOVA. It is suggested that sialic acid residues could be an important factor contributing to the manifestation of malignant properties in cancer cells in general and Dalton's lymphoma cells in particular. A significant decrease in the sialic acid content of Dalton's lymphoma cells after cisplatin or cyclophosphamide treatment may bring about specific changes in tumour cells which could be associated with tumour regression.

  20. A Research Agenda for Appearance Changes Due to Breast Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Mia K. Markey


    Full Text Available Breast cancer is one of the most prevalent forms of cancer in the US. It is estimated that more than 180,000 American women will be diagnosed with invasive breast cancer in 2008. Fortunately, the survival rate is relatively high and continually increasing due to improved detection techniques and treatment methods. However, maintaining quality of life is a factor often under emphasized for breast cancer survivors. Breast cancer treatments are invasive and can lead to deformation of the breast. Breast reconstruction is important for restoring the survivor’s appearance. However, more work is needed to develop technologies for quantifying surgical outcomes and understanding women’s perceptions of changes in their appearance. A method for objectively measuring breast anatomy is needed in order to help both the breast cancer survivors and their surgeons take expected changes to the survivor’s appearance into account when considering various treatment options. In the future, augmented reality tools could help surgeons reconstruct a survivor’s breasts to match her preferences as much as possible.

  1. Brain functional changes in facial expression recognition in patients with major depressive disorder before and after antidepressant treatment


    Jiang, Wenyan; Yin, Zhongmin; Pang, Yixin; Wu, Feng; Kong, Lingtao; Xu, Ke


    Functional magnetic resonance imaging was used during emotion recognition to identify changes in functional brain activation in 21 first-episode, treatment-naive major depressive disorder patients before and after antidepressant treatment. Following escitalopram oxalate treatment, patients exhibited decreased activation in bilateral precentral gyrus, bilateral middle frontal gyrus, left middle temporal gyrus, bilateral postcentral gyrus, left cingulate and right parahippocampal gyrus, and inc...

  2. Gender differences in substance use, consequences, motivation to change, and treatment seeking in people with serious mental illness. (United States)

    Drapalski, Amy; Bennett, Melanie; Bellack, Alan


    Gender differences in patterns and consequences of substance use, treatment-seeking, and motivation to change were examined in two samples of people with serious mental illness (SMI) and comorbid substance use disorders (SUDs): a community sample not currently seeking substance abuse treatment (N = 175) and a treatment-seeking sample (N = 137). In both groups, women and men demonstrated more similarities in the pattern and severity of their substance use than differences. However, treatment-seeking women showed greater readiness to change their substance use. Mental health problems and traumatic experiences may prompt people with SMI and SUD to enter substance abuse treatment, regardless of gender.

  3. Cervical vertebral bone mineral density changes in adolescents during orthodontic treatment. (United States)

    Crawford, Bethany; Kim, Do-Gyoon; Moon, Eun-Sang; Johnson, Elizabeth; Fields, Henry W; Palomo, J Martin; Johnston, William M


    The cervical vertebral maturation (CVM) stages have been used to estimate facial growth status. In this study, we examined whether cone-beam computed tomography images can be used to detect changes of CVM-related parameters and bone mineral density distribution in adolescents during orthodontic treatment. Eighty-two cone-beam computed tomography images were obtained from 41 patients before (14.47 ± 1.42 years) and after (16.15 ± 1.38 years) orthodontic treatment. Two cervical vertebral bodies (C2 and C3) were digitally isolated from each image, and their volumes, means, and standard deviations of gray-level histograms were measured. The CVM stages and mandibular lengths were also estimated after converting the cone-beam computed tomography images. Significant changes for the examined variables were detected during the observation period (P ≤0.018) except for C3 vertebral body volume (P = 0.210). The changes of CVM stage had significant positive correlations with those of vertebral body volume (P ≤0.021). The change of the standard deviation of bone mineral density (variability) showed significant correlations with those of vertebral body volume and mandibular length for C2 (P ≤0.029). The means and variability of the gray levels account for bone mineral density and active remodeling, respectively. Our results indicate that bone mineral density distribution and the volume of the cervical vertebral body changed because of active bone remodeling during maturation. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  4. A New Twist on Empirically Supported Treatments

    Directory of Open Access Journals (Sweden)

    Larry E. Beutler


    Full Text Available Este artículo presenta los resultados preliminares de un estudio experimental diseñado para desarrollar y validar un modelo integrador de intervenciones psicológicas. La psicoterapia prescriptiva basa sus procedimientos en principios de cambios meta-teóricos. Este enfoque enfatiza la adecuación o correspondencia de las intervenciones psicológicas a las características del paciente, planteando que esta correspondencia incrementa el poder predictivo de las contribuciones iniciales de los factores del paciente, tipos de intervención y alianza terapéutica de cara al resultado terapéutico. Este estudio piloto, en una muestra de 40 pacientes con trastornos del estado de ánimo y consumo excesivo de sustancias, confirmó que la correspondencia entre las características del paciente y las intervenciones psicológicas beneficia sustancialmente la eficacia del tratamiento, especialmente a los seis meses de finalizar el tratamiento. Los resultados sugieren que las características del paciente influyen en su pronóstico, que las intervenciones como tal influyen de forma modesta y que la alianza terapéutica incrementa el poder predictivo. Con todo, la adecuación de las intervenciones al paciente parece tener un valor predictivo superior al resto de variables, en particular para la depresión y la sensación de bienestar.

  5. Weight changes and their associations with demographic and clinical characteristics in risperidone maintenance treatment for schizophrenia. (United States)

    Xiang, Y-T; Wang, C-Y; Ungvari, G S; Kreyenbuhl, J A; Chiu, H F K; Lai, K Y C; Lee, E H M; Bo, Q-J; Dixon, L B


    This study aimed to characterize weight changes in schizophrenia patients taking risperidone as part of a randomized, controlled, open-label clinical trial. A total of 374 patients with schizophrenia who had been clinically stabilized following an acute episode were randomly assigned to a 'no-dose-reduction' group (initial optimal therapeutic doses continued throughout the study), a '4-week group' (initial optimal therapeutic doses continued for 4 weeks followed by a half dose reduction that was maintained until the end of the study) or a '26-week group' (initial optimal therapeutic doses continued for 26 weeks followed by a half dose reduction until the end of the study). Participants were assessed monthly using standardized assessment instruments during the first 6 months, and then every 2 months until the last recruited patient completed the 1-year follow-up. Weight gain was defined as gaining at least 7% of initial body weight, weight loss as losing at least 7% of initial body weight. A BMI weight loss compared to being normal weight. No correlation was found between weight change and dose reduction. Weight change is a common, long-term, but heterogeneous side effect in risperidone maintenance treatment for stable schizophrenia patients. Special attention should be paid to fluctuations in weight that may occur throughout the course of treatment with risperidone. © Georg Thieme Verlag KG Stuttgart · New York.

  6. The process of changing national malaria treatment policy: lessons from country-level studies. (United States)

    Williams, Holly Ann; Durrheim, David; Shretta, Rima


    Widespread resistance of Plasmodium falciparum parasites to commonly used antimalarials, such as chloroquine, has resulted in many endemic countries considering changing their malaria treatment policy. Identifying and understanding the key influences that affect decision-making, and factors that facilitate or undermine policy implementation, is critical for improving the policy process and guiding resource allocation during this process. A historical review of archival documents from Malaŵi and data obtained from in-depth policy studies in four countries (Tanzania, South Africa, Kenya and Peru) that have changed malaria treatment policy provides important lessons about decision-making, the policy cycle and complex policy environment, while specifically identifying strategies successfully employed to facilitate policy-making and implementation. Findings from these country-level studies indicate that the process of malaria drug policy review should be institutionalized in endemic countries and based on systematically collected data. Key stakeholders need to be identified early and engaged in the process, while improved communication is needed on all levels. Although malaria drug policy change is often perceived to be a daunting task, using these and other proven strategies should assist endemic countries to tackle this challenge in a systematic fashion that ensures the development and implementation of the rational malaria drug policy.

  7. Relation between stages of change and motivation in the treatment of psychiatric patients1

    Directory of Open Access Journals (Sweden)

    Gavrilov-Jerković Vesna


    Full Text Available Main aim of this research was to investigate the relation between psychiatric patients’ motivation for their participation in treatment and a stage of change they were in. Hypothesis on relation quality of examined variables have been defined from the perspective of transtheoretical model created by Prochaska and associates. Decision balance, specific and general self-efficacy and inclination to relapse have been examined as indicators of motivation. One hundred and twenty-nine psychiatric patients with diagnosis of neurosis or personality disorders have been examined in this research. Results have shown that stages of changes are significantly related to inspected motivational variables. Patients in higher stages of readiness express specific motivational profile characterized by the proactive optimism, which means that they rely on their own resources and expect positive outcome of the treatment. Patients in lower stages of readiness express motivational profile characterized by passive resignation receptiveness, by inclination towards demoralization and low trust in their own strength. Results of this research are in conformity with the basic hypothesis of transtheoretical model of change. .

  8. Did our current initial treatment practice change after EAU/ESPU vesicoureteral reflux risk grouping? (United States)

    Tokat, Eda; Gurocak, Serhat; Ure, Iyimser; Acar, Cenk; Sınık, Zafer; Tan, Mustafa Ozgur


    The "European Association of Urology (EAU) Guidelines on Vesicoureteral Reflux (VUR) in Children (September 2012)" established risk classification by analyzing and defining risk factors for each patient. In this study we aimed to investigate how our initial treatment procedures were affected by EAU/ESPU guideline vesicoureteral reflux risk grouping and to compare the early clinical results of treatments performed before and after the risk classification in our patients with VUR. 334 renal units with regular clinical follow-up who were treated owing to VUR (vesicoureteral reflux) between years 2009 and 2017 were retrospectively reviewed. Preoperative clinical parameters such as grade and laterality of reflux, presence of renal scar, initial and follow-up treatments, findings of medical treatment and surgical procedures were analyzed. The initial medical and surgical methods were compared by categorizing patients according to risk groups before and after 2013. Mean age and follow-up duration were 71.4(6-216) months and 47(4-141) months, respectively. Among the preoperative parameters, only high EAU risk group (p = 0.01) and treating lower urinary tract symptoms (p age, sex, and presence of renal scar at DMSA were not affecting the success of treatment significantly. While no significant difference in medical and surgical treatment rates is observed after risk grouping system in low risk group, the percentages of patients who are treated with surgical methods initially were significantly decreased in moderate and high risk groups (p = 0.002 and p = 0.012, respectively). We determined that VUR risk grouping did not change clinical success significantly in all risk groups. Despite the fact that EAU/ESPU VUR risk classification changed our current practice in terms of initial treatment method, this different approach did not seem to affect early clinical success positively. There is still an absolute need for studies with larger sample size and long

  9. Electrogastrography associated with symptomatic changes after prokinetic drug treatment for functional dyspepsia. (United States)

    Lim, Hyun Chul; Lee, Sang In; Chen, Jiande D Z; Park, Hyojin


    To evaluate the effect of prokinetic drugs on electrogastrography (EGG) parameters according to symptomatic changes in patients with functional dyspepsia (FD). Seventy-four patients with FD were prospectively enrolled in this study between December 2006 and December 2010. We surveyed the patients using a questionnaire on dyspeptic symptoms before and after an 8-wk course of prokinetic drug treatment. We also measured cutaneous pre-prandial and post-prandial EGG recordings including percentage of gastric waves (normogastria, bradygastria, tachygastria), dominant frequency (DF), dominant power (DP), dominant frequency instability coefficient (DFIC), dominant power instability coefficient (DPIC), and the ratio of post-prandial to fasting in DP before and after the 8-wk course of prokinetic drug treatment. Fifty-two patients (70%) achieved symptomatic improvement after prokinetic drug treatment. Patients who had normal gastric slow waves showed symptom improvement group after treatment. Post-prandial DF showed a downward trend in the symptom improvement group, especially in the itopride group. Post-prandial DP was increased regardless of symptom improvement, especially in the itopride group and mosapride group. Post-prandial DFIC and DPIC in the symptom improvement group were significantly increased after the treatment. The EGG power ratio was increased after treatment in the symptom improvement group (0.50 ± 0.70 vs 0.93 ± 1.77, P = 0.002), especially in the itopride and levosulpiride groups. Prokinetics could improve the symptoms of FD by regulating gastric myoelectrical activity, and EGG could be a useful tool in evaluating the effects of various prokinetics.

  10. Change in Visual Field Progression Following Treatment Escalation in Primary Open-angle Glaucoma. (United States)

    Aptel, Florent; Bron, Alain M; Lachkar, Yves; Schweitzer, Cédric


    To evaluate the effect of treatment escalation on the rate of visual field progression in patients with primary open-angle glaucoma (POAG). Multicenter database study. We reviewed the electronic records of 171 patients with POAG under medical hypotensive treatment who underwent 5 consecutive visits 6 months apart before and after medical treatment escalation or additive laser trabeculoplasty. We calculated the rate of visual field progression (mean deviation change per year) before and after treatment escalation. The mean duration of follow-up was 5.1±0.5 years and the mean number of visual field examinations was 10.2±0.2. In 139 eyes with medical treatment escalation, the rate of progression was significantly reduced [from -0.57 to -0.29 dB/y; P=0.022; intraocular pressure (IOP) reduction 11.1%]. In detail, the rate of progression was significantly reduced after escalation from mono to dual therapy, dual to triple therapy, and from mono to triple therapy (-0.35 to -0.24 dB/y, P=0.018; -1.01 to -0.48 dB/y, P=0.038; -1.04 to -0.35 dB/y, P=0.020, respectively). In 32 eyes with additive laser trabeculoplasty, the rate of progression was significantly reduced (-0.60 to -0.24 dB/y; P=0.014; IOP reduction 9.4%). Medical treatment escalation or additive laser trabeculoplasty significantly reduced the rate of visual field progression in POAG. Larger IOP reduction has a greater probability of reducing glaucoma progression.

  11. Expert opinion vs. empirical evidence (United States)

    Herman, Rod A; Raybould, Alan


    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

  12. Empirical reality, empirical causality, and the measurement problem

    International Nuclear Information System (INIS)

    d'Espagnat, B.


    Does physics describe anything that can meaningfully be called independent reality, or is it merely operational? Most physicists implicitly favor an intermediate standpoint, which takes quantum physics into account, but which nevertheless strongly holds fast to quite strictly realistic ideas about apparently obvious facts concerning the macro-objects. Part 1 of this article, which is a survey of recent measurement theories, shows that, when made explicit, the standpoint in question cannot be upheld. Part 2 brings forward a proposal for making minimal changes to this standpoint in such a way as to remove such objections. The empirical reality thus constructed is a notion that, to some extent, does ultimately refer to the human means of apprehension and of data processing. It nevertheless cannot be said that it reduces to a mere name just labelling a set of recipes that never fail. It is shown that their usual notion of macroscopic causality must be endowed with similar features

  13. Microbial changes in patients with acute periodontal abscess after treatment detected by PadoTest. (United States)

    Eguchi, T; Koshy, G; Umeda, M; Iwanami, T; Suga, J; Nomura, Y; Kawanami, M; Ishikawa, I


    To investigate changes in bacterial counts in subgingival plaque from patients with acute periodontal abscess by IAI-PadoTest. Ninety-one patients were randomly allocated to either test or control groups. In all the patients, pockets with acute periodontal abscess were irrigated with sterilized physiological saline, and in the test group, 2% minocycline hydrochloride ointment was applied once into the pocket in addition. Subgingival plaque samples were collected by paper point before treatment and 7 days after treatment. The total bacterial count was determined and Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, were detected using IAI-PadoTest, a DNA/RNA probe method. The total bacterial count decreased in both groups, with a significant decrease in the test group. The counts and number of sites positive for P. gingivalis, T. forsythia and T. denticola significantly decreased in the test group after treatment, compared with those in the control group. Pocket depth decreased in the both groups, with a statistically significant decrease in the test group. Topical treatment with minocycline in pockets with acute periodontal abscess was effective in reducing the bacterial counts as shown by the microbiological investigation using PadoTest 4.5.

  14. [Psychosomatic basic care in the general hospital - an empirical investigation of the bio-psycho-social stress, treatment procedures and treatment outcomes from the vantage point of medical doctors]. (United States)

    Fritzsche, Kurt; Schäfer, Inna; Wirsching, Michael; Leonhart, Rainer


    The present study investigates the psycho-social stress, the treatment procedures and the treatment outcomes of stressed patients in the hospital from the perspective of the hospital doctors. Physicians from all disciplines who had completed the course "Psychosomatic Basic Care" as part of their specialist training documented selected treatment cases. 2,028 documented treatment cases of 367 physicians were evaluated. Anxiety, depression and family problems were the most common causes of psychosocial stress. In over 40 % of the cases no information was found on the medical history. Diagnostic and therapeutic conversations took place with almost half the patients (45%). From the vantage point of the physicians patients receiving diagnostic and therapeutic conversations achieved significantly more positive scores with respect to outcome variables than patients without these measures. Collegial counseling was desired for more than half of the patients and took place mainly among the ward team. There were few significant differences in the views of surgical and nonsurgical physicians. Psychosomatic basic care in general hospitals is possible, albeit with some limitations. Patients undergoing psychosocial interventions have better treatment outcomes. Therefore, extending training to 80 hours for all medical disciplines seems reasonable.

  15. Ultrastructural changes of cell walls under intense mechanical treatment of selective plant raw material

    International Nuclear Information System (INIS)

    Bychkov, Aleksey L.; Ryabchikova, E.I.; Korolev, K.G.; Lomovsky, O.I.


    Structural changes of cell walls under intense mechanical treatment of corn straw and oil-palm fibers were studied by electron and light microscopy. Differences in the character of destruction of plant biomass were revealed, and the dependence of destruction mechanisms on the structure of cell walls and lignin content was demonstrated. We suggest that the high reactivity of the particles of corn straw (about 18% of lignin) after intense mechanical treatment is related to disordering of cell walls and an increase of the surface area, while in the case of oil palm (10% of lignin) the major contribution into an increase in the reactivity is made by an increase of surface area. -- Highlights: ► Structure of cell walls determines the processes of plant materials' destruction. ► Ultrastructure of highly lignified materials strongly disordering by mechanical action. ► Ultrastructure of low-lignified materials is not disordering by mechanical action.

  16. Treatment-related changes in serum lipids and inflammation: clinical relevance remains unclear. Analyses from the Women's Interagency HIV Study (United States)

    Parrinello, Christina M; Landay, Alan L; Hodis, Howard N; Gange, Stephen J; Norris, Philip J; Young, Mary; Anastos, Kathryn; Tien, Phyllis C; Xue, Xiaonan; Lazar, Jason; Benning, Lorie; Tracy, Russell P; Kaplan, Robert C


    Summary Among 127 HIV-infected women, the magnitude of HDLc increases after HAART initiation predicted the magnitude of concurrent decreases in inflammation biomarkers. After HAART initiation, changes in LDLc and inflammation were unrelated. In the same population, predicted risk of coronary heart disease based upon levels of standard clinical risk factors was similar before and after HAART treatment. Thus, it remains unknown whether short-term treatment-related changes in standard risk factors may appreciably change risk of CVD. PMID:23435295

  17. Ultrastructural changes of human esophageal carcinoma induced by preoperative treatments with bleomycin and/or radiation

    Energy Technology Data Exchange (ETDEWEB)

    Kohro, T. (Niigata Univ. (Japan). School of Medicine)


    In the present study, 44 cases of esophageal carcinoma were electron-microscopically examined. Nuclear bodies of various types observed in carcinoma cells or in normal mucosa of the esophagus treated by bleomycin and radiation, single or combined (BLM/R), were classified into seven types. Types A and B were observed in carcinoma cells of both conditions of untreated or treated with BLM/R. Types C, D and E were specific findings in squamous carcinoma cells after BLM/R treatment. Types F and G were considered to be far advanced in terms of other nuclear bodies and were observed in strongly affected carcinoma cells. These nucleolar changes were considered to be specific alterations induced by BLM in esophageal carcinoma cells. The appearance of various nuclear bodies and a series of nucleolar segregation after BLM/R treatments were confirmed as well in metastatic lesions of abdominal lymph nodes that may be affected only with minimal or disregardable scattered radiation, if any, giving no sifnificant influence to cell activity. This fact has suggested that types C, D and E nuclear bodies and nucleolar segregation are changes specific to BLM/R treatments, some solely to BLM. Other nuclear changes consisted in the appearance of fibrillar structures of three different types that were considered to have been produced by disturbed ribosomal activity in the nuclei. On the basis of results in the present study, BLM apparently showed serious evidence of remarkable influences or effects, although not constantly and generally available, on certain squamous carcinoma cells of the esophagus. Some of the evidence was represented by nucleolar segregation and characteristic nuclear bodies of different types, particularly of types C, D and E.

  18. Development and empirical review of determinants for lowering the probability of the willingness to change IT systems in the German energy sector; Entwicklung und empirische Ueberpruefung von Determinanten zur Senkung der Wechselbereitschaftswahrscheinlichkeit von IT-Systemen in der deutschen Energiewirtschaft

    Energy Technology Data Exchange (ETDEWEB)

    Wiedmann, Klaus-Peter; Varelmann, Dieter


    As this publication shows, recent changes in the energy sector have been so momentous that its development over the past years can hardly be compared with that of any other branch of industry. The need to meet a continuously growing body of regulatory requirements, technical innovations such as smart metering infrastructures and the complex tasks associated with an efficient decentralised energy supply all place high demands on the energy sector and its IT infrastructure. Especially the technologies surrounding smart metering confront companies of the energy sector with great challenges. Optimisation of process costs along the entire value chain will in future be an important ingredient to successful business in the sector. Thus, selecting the right accounting and billing solutions and putting them to their best possible use is a prerequisite for successful market cultivation. Based on an empirical study the present publication undertakes to determine what factors are relevant in selecting and operating IT solutions in the energy sector and what marketing design concepts software producers should opt for in order to ensure long-term customer satisfaction and hence loyalty.

  19. Impact of adverse events of antiretroviral treatment on regimen change and mortality in Ugandan children

    Directory of Open Access Journals (Sweden)

    Ntambwe Malangu


    Objectives: The purpose of this study was to determine the prevalence of the adverse events of antiretroviral treatment, their impact on mortality and the change in regimens prescribed to children treated at Mildway Centre in Uganda. Method: A retrospective chart review was performed for children younger than 6 years, treated since the Mildway Centre was opened in 1999. In order to achieve a larger sample, the records of children treated from January 2000 to July 2005 were included in the study. A pre-tested data collection form was used to collate socio-demographic and clinical data of the patients. These included the documented adverse events, causes of death, stage of infection, duration of treatment, regimen prescribed, year of enrolment into the treatment program, as well as whether or not they were still alive. Descriptive statistics were used in the analysis of data. Results: Of the 179 children, the majority were males and had a median age of 4 years. The majority (58.8% of children had suffered from severe immune depression since they met the WHO clinical stage III and IV, 73.8% had a baseline CD4T of less than 15%. Four regimens were prescribed to the children. The most common was a regimen containing zidovudine, lamivudine, and nevirapine (34.6%, followed by a regimen containing stavudine, lamivudine, and nevirapine (27.9%. Eleven children (6.1% had their regimen changed, of which six (54.5% were due to adverse events. The prevalence of adverse events was 8%; of the 14 documented adverse events, the most common were severe anaemia (3, vomiting (3, and skin rashes (3. After 12 months on treatment, 8% of the patients had died. The most common causes of death were infectious diseases (28.6%, severe anaemia (21.4%, and severe dehydration (21.4%. Conclusion: The prevalence of adverse events was 8%; they were responsible for 54.5% of regimen changes and 21.4% of deaths in children treated at the study site. These findings suggest the need for incorporating

  20. Model of mechanical properties change of steel during rolling with use of hightemperature thermomechanical treatment

    International Nuclear Information System (INIS)

    Zhadan, V.T.; Gubenko, V.T.; Bernshtejn, M.L.; Binarskij, M.S.


    A mathematical model is proposed of changes in the mechanical properties of the steel-50KHGA in the process of rolling with application of a high-temperature thermomechanical treatment (HTTMT). The model accounts for all the main particularities of the structure formation processes during a high temperature deformation of metals and alloys. The nonmonotonic dependence of the steel mechanical properties on the deformation velocity can be presented as a result of a summary effect of three parallel processes on the formation of these properties: hot working, softening and substructural hardening. The mathematical model has been constructed by the iteration method

  1. Presynaptic muscarinic receptors: Change of sensitivity during long-term drug treatment

    International Nuclear Information System (INIS)

    Marchi, M.; Raiteri, M.


    The authors investigate some of the characteristics of auto- and heteroreceptors from different brain areas in male rats; their alteration in sensitivity following chronic drug treatment is monitored. The synaptosomes were prelabeled with tritium-choline or tritium-dopamine and the release of tritium-acetylcholine and tritium-DA was studied in superfusion. It is shown that the difference in susceptibility between auto- and heteroreceptors with respect to changes of sensitivity may represent a further criterion to discriminate between muscarinic receptor subtypes

  2. Alliance-focused therapy for anorexia nervosa: integrative relational and behavioral change treatments in a single-case experimental design. (United States)

    Satir, Dana A; Goodman, David M; Shingleton, Rebecca M; Porcerelli, John H; Gorman, Bernard S; Pratt, Elizabeth M; Barlow, David H; Thompson-Brenner, Heather


    Evidence supporting outpatient treatments for anorexia nervosa (AN) is severely lacking, due to low retention and poor outcome. One explanation for drop-out is weak treatment alliances. A single-case experimental analysis accompanied by in-depth qualitative description is presented for Ms. O, who received a novel treatment for AN called Alliance Focused Treatment (AFT) that attends to ruptures in the alliance, interpersonal difficulties and emotional avoidance. At intake Ms. O met diagnostic criteria for AN, Major Depressive Disorder, and Social Phobia. She was characterized as having symptoms of Obsessive Compulsive, Avoidant, and Depressive personality disorders. Treatment began with a Baseline followed by the experimental (AFT) and comparison treatments (Behavioral Change Treatment [BCT]) using a replicated experimental single-case phase change design. Graphs of slopes of kilocalorie and alliance change facilitated observation of treatment effects. Ms. O participated in 16 sessions of AFT and 8 sessions of BCT with specific benefits. Ratings of the treatment alliance were consistently high and she evidenced significant changes in weight, quality of life, and personality pathology. Associations between rupture/repair episodes and kilocalorie increases were observed. The utility of the treatment relationship in facilitating emotional expression was evident. At posttreatment, Ms. O endorsed cognitive AN symptoms, although these were not explicitly treated. This study provides preliminary support for the feasibility and effect of AFT and BCT, and highlights the importance of the alliance in treating adults with AN. Further research on emotion regulation in AN and its effect on the treatment relationship are needed.

  3. Drinking-water treatment, climate change, and childhood gastrointestinal illness projections for northern Wisconsin (USA) communities drinking untreated groundwater (United States)

    Uejio, Christopher K.; Christenson, Megan; Moran, Colleen; Gorelick, Mark


    This study examined the relative importance of climate change and drinking-water treatment for gastrointestinal illness incidence in children (age first quantified the observed (1991-2010) precipitation and gastrointestinal illness associations after controlling for seasonality and temporal trends. Precipitation likely transported pathogens into drinking-water sources or into leaking water-distribution networks. Building on observed relationships, the second analysis projected how climate change and drinking-water treatment installation may alter gastrointestinal illness incidence. Future precipitation values were modeled by 13 global climate models and three greenhouse-gas emissions levels. The second analysis was rerun using three pathways: (1) only climate change, (2) climate change and the same slow pace of treatment installation observed over 1991-2010, and (3) climate change and the rapid rate of installation observed over 2011-2016. The results illustrate the risks that climate change presents to small rural groundwater municipalities without drinking water treatment. Climate-change-related seasonal precipitation changes will marginally increase the gastrointestinal illness incidence rate (mean: ˜1.5%, range: -3.6-4.3%). A slow pace of treatment installation somewhat decreased precipitation-associated gastrointestinal illness incidence (mean: ˜3.0%, range: 0.2-7.8%) in spite of climate change. The rapid treatment installation rate largely decreases the gastrointestinal illness incidence (mean: ˜82.0%, range: 82.0-83.0%).

  4. Epistemology and Empirical Investigation

    DEFF Research Database (Denmark)

    Ahlström, Kristoffer


    Recently, Hilary Kornblith has argued that epistemological investigation is substantially empirical. In the present paper, I will ¿rst show that his claim is not contingent upon the further and, admittedly, controversial assumption that all objects of epistemological investigation are natural kinds....... Then, I will argue that, contrary to what Kornblith seems to assume, this methodological contention does not imply that there is no need for attending to our epistemic concepts in epistemology. Understanding the make-up of our concepts and, in particular, the purposes they ¿ll, is necessary...

  5. Changes in the skeleton after long-term treatment with retinoids

    Energy Technology Data Exchange (ETDEWEB)

    Montag, M.; Reiser, M.; Hamm, H.; Traupe, H.; Vogt, H.J.


    The synthetic retinoids, the vitamin-A-derivatives ethretinate and isotretinoin, have substantially enlarged the therapeutic arsenal in dermatology. They are primarily used in severe cases of acne and cornification disorders. In the majority of cases, long-term treatment is necessary. Certain side effects in the skeletal system can occur, e.g., osteoporosis, premature epiphyseal closure, and changes similar to DISH (diffuse idiopathic skeletal hyperostosis). We discuss the reports in the literature and our own observations in 31 patients treated at the Westphalian Wilhelms University in Muenster, as well as at the Technical University in Munich. In 3 out of 31 patients treated by retinoids on a long-term basis, skeletal changes were found radiologically as a result of the retinoid medication.

  6. Instrumental evaluation of colour changes in broiler breast and thigh muscles after irradiation treatment

    International Nuclear Information System (INIS)

    Zabielski, J.; Jaworska-Piasecka, A.; Stangierski, J.


    Colour changes in Biceps femoris, Rectus femoris and Pectoralis major broiler chicken muscles were determined with a reflectance colorimeter after irradiation with gamma 60Co rays. The muscles were irradiated with doses of 2, 3, 5, 7 and 10 kGy. The colour parameters L*, a* and b* were measured after 2, 5, 7 and 9 days of refrigerated storage of muscles at 1 deg C using a MINOLTA CR-200b reflectance colorimeter. The saturation of colour C* was also calculated and the significance of redness and yellowness effect on saturation was estimated by a linear regression analysis. Only in the Biceps femoris muscle were all the examined colour parameters found to be dependent both on storage time and irradiation treatment, however, the relationship between the dose and the measured effect demonstrated no linear characteristics. It was noted that the difference between the irradiated and control Biceps femoris muscles resulted from different trends of L*, b* and C* changes during storage

  7. Peripheral blood picture changes induced by chronic radone and silicon dioxide treatment (in combination or separately)

    International Nuclear Information System (INIS)

    Ivanov, Z.; Dermendzhiev, Kh.; Nikolova, M.


    Peripheral blood changes have been studied in rats after the following treatments: 4 hours daily for six months with a radon concentration of 1.10 -10 Ci/1 (group I), 1.10 -12 Ci/1 (group II) 50 mg pure silicon dioxide in 1 ml physiological solution (group III), and intratracheal incorporation of radon concentration in air of 1.10 -10 Ci/1 and silicon dioxide (group IV). Examinations during the third and sixth month after the start of experiment showed development of leukopenia in groups I, III and IV; lymphopenia was established in groups I and IV, and lymphocytosis in group III. Atypical morphological changes were observed in red blood cells. (A.B.)

  8. RNA-SEQ reveals transcriptional level changes of poplar roots in different forms of nitrogen treatments

    Directory of Open Access Journals (Sweden)

    Chunpu eQu


    Full Text Available Poplar has emerged as a model plant for understanding molecular mechanisms of tree growth, development and response to environment. Long-term application of different forms of nitrogen (such as NO3--N and NH4+-N may cause morphological changes of poplar roots; however, the molecular level changes are still not well known. In this study, we analyzed the expression profiling of poplar roots treated by three forms of nitrogen: S1 (NH4+, S2 (NH4NO3 and S3 (NO3- by using RNA-SEQ technique. We found 463 genes significantly differentially expressed in roots by different N treatments, of which a total of 116 genes were found to differentially express between S1 and S2, 173 genes between S2 and S3, and 327 genes between S1 and S3. A cluster analysis shows significant difference in many transcription factor families and functional genes family under different N forms. Through an analysis of Mapman metabolic pathway, we found that the significantly differentially expressed genes are associated with fermentation, glycolysis and tricarboxylic acid cycle (TCA, secondary metabolism, hormone metabolism, and transport processing. Interestingly, we did not find significantly differentially expressed genes in N metabolism pathway, mitochondrial electron transport / ATP synthesis and mineral nutrition. We also found abundant candidate genes (20 transcription factors and 30 functional genes regulating morphology changes of poplar roots under the three N forms. The results obtained are beneficial to a better understanding of the potential molecular and cellular mechanisms regulating root morphology changes under different N treatments.

  9. Medium-long term soil resilience against different disturbances: wildfires, silvicultural treatments and climate change (United States)

    Hedo de Santiago, Javier; Borja, Manuel Esteban Lucas; de las Heras, Jorge


    Soils of semiarid Mediterranean forest ecosystems are very fragile and sensitive to changes due to different anthropogenic and natural disturbances. The increasing vulnerability of semiarid lands within this world framework has generated growing awareness in the field of research, with highly intensified study into soils properties. One of the main problems of Mediterranean forests is wildfire disturbance. Fire should be considered more an ecological factor but, in contrast to the role of fire, it is now a closely related factor to human action. On the other hand, to improve the recovery of forest communities after fire, silvicultural treatments are needed and, for that matter, another disturbance is added to the ecosystem. By last, climate change is also affecting the fire regime increasing fire frequency and burned area, enhancing the destructiveness to Mediterranean ecosystems. After all of these three disturbances, changes in vegetation dynamics and soil properties are expected to occur due to the plant-soil feedback. Soil plays an essential role in the forest ecosystem's fertility and stability and specifically soil microorganisms, which accomplish reactions to release soil nutrients for vegetation development, for that is essential to enlarge knowledge about soil properties resilience in semiarid forest ecosystems. Physico-chemical and microbiological soil properties, and enzyme activities have been studied in two Aleppo pine forest stands that have suffered three disturbances: 1) a wildfire event, 2) silvicultural treatments (thinning) and 3) an artificial drought (simulating climate change) and results showed that soil recovered after 15 years. Final results showed that soils have been recovered from the three disturbances at the medium-long term.

  10. Predictors of Staff Turnover and Turnover Intentions within Addiction Treatment Settings: Change Over Time Matters. (United States)

    Garner, Bryan R; Hunter, Brooke D


    This study examined the extent to which changes over time in clinicians' responses to measures of work attitude (eg, job satisfaction) and psychological climate (eg, supervisor support) could predict actual turnover and turnover intentions above and beyond absolute levels of these respective measures. Longitudinal data for this study were collected from a sample of clinicians (N = 96) being trained to implement an evidence-based treatment for adolescent substance use disorders. Supporting findings from a recent staff turnover study, we found job satisfaction change was able to predict actual turnover above and beyond average levels of job satisfaction. Representing new contributions to the staff turnover literature, we also found that change over time in several other key measures (eg, job satisfaction, role manageability, role clarity) explained a significant amount of variance in turnover intentions above and beyond the absolute level of each respective measure. A key implication of the current study is that organizations seeking to improve their ability to assess risk for staff turnover may want to consider assessing staff at multiple points in time in order to identify systematic changes in key employee attitudes like turnover intentions and job satisfaction.

  11. Predictors of Staff Turnover and Turnover Intentions within Addiction Treatment Settings: Change over Time Matters

    Directory of Open Access Journals (Sweden)

    Bryan R. Garner


    Full Text Available This study examined the extent to which changes over time in clinicians’ responses to measures of work attitude (eg, job satisfaction and psychological climate (eg, supervisor support could predict actual turnover and turnover intentions above and beyond absolute levels of these respective measures. Longitudinal data for this study were collected from a sample of clinicians ( N = 96 being trained to implement an evidence-based treatment for adolescent substance use disorders. Supporting findings from a recent staff turnover study, we found job satisfaction change was able to predict actual turnover above and beyond average levels of job satisfaction. Representing new contributions to the staff turnover literature, we also found that change over time in several other key measures (eg, job satisfaction, role manageability, role clarity explained a significant amount of variance in turnover intentions above and beyond the absolute level of each respective measure. A key implication of the current study is that organizations seeking to improve their ability to assess risk for staff turnover may want to consider assessing staff at multiple points in time in order to identify systematic changes in key employee attitudes like turnover intentions and job satisfaction.

  12. Empirical microeconomics action functionals (United States)

    Baaquie, Belal E.; Du, Xin; Tanputraman, Winson


    A statistical generalization of microeconomics has been made in Baaquie (2013), where the market price of every traded commodity, at each instant of time, is considered to be an independent random variable. The dynamics of commodity market prices is modeled by an action functional-and the focus of this paper is to empirically determine the action functionals for different commodities. The correlation functions of the model are defined using a Feynman path integral. The model is calibrated using the unequal time correlation of the market commodity prices as well as their cubic and quartic moments using a perturbation expansion. The consistency of the perturbation expansion is verified by a numerical evaluation of the path integral. Nine commodities drawn from the energy, metal and grain sectors are studied and their market behavior is described by the model to an accuracy of over 90% using only six parameters. The paper empirically establishes the existence of the action functional for commodity prices that was postulated to exist in Baaquie (2013).

  13. Stress-induced changes of hippocampal NMDA receptors: modulation by duloxetine treatment.

    Directory of Open Access Journals (Sweden)

    Francesca Calabrese

    Full Text Available It is now well established that the glutamatergic system contributes to the pathophysiology of depression. Exposure to stress, a major precipitating factor for depression, enhances glutamate release that can contribute to structural abnormalities observed in the brain of depressed subjects. On the other hand, it has been demonstrated that NMDA antagonists, like ketamine, exert an antidepressant effect at preclinical and clinical levels. On these bases, the purpose of our study was to investigate whether chronic mild stress is associated with specific alterations of the NMDA receptor complex, in adult rats, and to establish whether concomitant antidepressant treatment could normalize such deficits. We found that chronic stress increases the expression of the obligatory GluN1 subunit, as well as of the accessory subunits GluN2A and GluN2B at transcriptional and translational levels, particularly in the ventral hippocampus. Concomitant treatment with the antidepressant duloxetine was able to normalize the increase of glutamatergic receptor subunit expression, and correct the changes in receptor phosphorylation produced by stress exposure. Our data suggest that prolonged stress, a condition that has etiologic relevance for depression, may enhance glutamate activity through post-synaptic mechanisms, by regulating NMDA receptors, and that antidepressants may in part normalize such changes. Our results provide support to the notion that antidepressants may exert their activity in the long-term also via modulation of the glutamatergic synapse.

  14. Change of Pore-Fracture Structure of Anthracite Modified by Electrochemical Treatment Using Micro-CT

    Directory of Open Access Journals (Sweden)

    Xianfa Kong


    Full Text Available The electrochemical method can strengthen gas desorption and seepage from coal. The study on change of the pore-fracture structure of coal after electrochemical modification can help to reveal the mechanism. Anthracite was modified by the electrochemical method using our own self-developed experiment apparatus. The pore-fracture structure of modified samples was measured by micro-CT. Combined with the Matlab software, its characteristics such as pore number, porosity, and average pore diameter were analyzed. The results show that (1 the number of fractures in modified coal samples increases. The shape of new fractures in samples in the anodic and cathodic zones was irregular voids and striola, respectively. The effect of electrochemical treatment on the section of samples close to the electrode is relatively obvious. (2 With increasing pore size, the number of pores in samples changes according to negative exponential rules. After electrochemical modification, the porosity of modified samples in the anodic zone increases from 11.88% to 31.65%, and the porosity of modified samples in the cathodic zone increases from 12.13% to 36.71%. (3 The main reason for the increase in the number of pores of coal samples in the anodic and cathodic zones is the treatment of electrolytic dissolution of minerals and electrophoretic migration of charged particles, respectively.

  15. Indoleamine 2,3-dioxygenase and immune changes under antidepressive treatment in major depression in females. (United States)

    Zoga, Margarita; Oulis, Panagiotis; Chatzipanagiotou, Stylianos; Masdrakis, Vasilios G; Pliatsika, Paraskevi; Boufidou, Fotini; Foteli, Stefania; Soldatos, Constantin R; Nikolaou, Chryssoula; Papageorgiou, Charalampos


    Indoleamine 2, 3-dioxygenase (IDO) induction has been suggested as a mechanism by which immune activation affects tryptophan metabolism and serotonin synthesis in major depressive disorder (MDD). We investigated IDO and changes in inflammatory mediators in patients with MDD undergoing effective treatment. Forty female patients with MDD and 40 controls were recruited. Serum IDO was assessed by enzyme-linked immunosorbent assay (ELISA). We also determined tumor necrosis factor-α (TNFα), interferon-γ (IFNγ), C-reactive protein (CRP) and serotonin concentrations. Patients' baseline concentrations of IDO and immune mediators were higher and serotonin concentrations were lower compared to controls. IDO and TNFα concentrations decreased under treatment and IDO changes were positively correlated with patient improvement. IFNγ and CRP concentrations remained unchanged. Serotonin concentration tended to increase. IDO might play an important role in the pathophysiology of MDD. Moreover, antidepressant therapy might reduce IDO production through an IFNγ-independent pathway. Finally, peripheral concentration of IDO assessed by ELISA might be a useful marker of MDD. Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  16. Smartphone Interventions for Weight Treatment and Behavioral Change in Pediatric Obesity: A Systematic Review. (United States)

    Chaplais, Elodie; Naughton, Geraldine; Thivel, David; Courteix, Daniel; Greene, David


    Traditional approaches for treating or managing children and adolescents with overweight or obesity have limited effectiveness. Current advances in smartphone technology may improve the attractiveness and accessibility of weight management support for children and adolescents with overweight or obesity. This systematic review aimed to provide a comparative evaluation of the effectiveness of using smartphones in the multidisciplinary treatment of child and adolescent overweight or obesity, with a specific interest in behavior change. The databases of Medline complete, OVID, CINAHL, EMBASE, and PubMed were searched for randomized controlled trial (RCT) studies addressing behavioral change using smartphone technology, plus nutrition and/or physical activity, to treat or manage child and adolescent obesity. Only two RCTs have described the effectiveness of smartphone devices in pediatric overweight or obesity treatment. Within the limitation of the two studies, electronic contact (e-contact) appeared unsuccessful in achieving weight loss. However, smartphone usage was linked to improved engagement and reduced dropout rates during important sustainability phases of these long-term interventions. Smartphone technologies allow users to accomplish tasks anywhere and anytime and, as such, provide researchers with additional and generationally appropriate capacities to deliver health promotion. E-contact should be used for its significant capacity to prolong engagement and decrease withdrawal during sustainability phases that follow intensive intervention for weight management in young populations. Despite increasing popularity in published protocols of weight management trials, the effectiveness of the impact of smartphone technology in pediatric programs remains equivocal.

  17. Changes in the human mitochondrial genome after treatment of malignant disease

    International Nuclear Information System (INIS)

    Wardell, Theresa M.; Ferguson, Elaine; Chinnery, Patrick F.; Borthwick, Gillian M.; Taylor, Robert W.; Jackson, Graham; Craft, Alan; Lightowlers, Robert N.; Howell, Neil; Turnbull, Douglass M.


    Mitochondrial DNA (mtDNA) is the only extrachromosomal DNA in human cells. The mitochondrial genome encodes essential information for the synthesis of the mitochondrial respiratory chain. Inherited defects of this genome are an important cause of human disease. In addition, the mitochondrial genome seems to be particularly prone to DNA damage and acquired mutations may have a role in ageing, cancer and neurodegeneration. We wished to determine if radiotherapy and chemotherapy used in the treatment of cancer could induce changes in the mitochondrial genome. Such changes would be an important genetic marker of DNA damage and may explain some of the adverse effects of treatment. We studied samples from patients who had received radiotherapy and chemotherapy for point mutations within the mtDNA control region, and for large-scale deletions. In blood samples from patients, we found a significantly increased number of point mutations compared to the control subjects. In muscle biopsies from 7 of 8 patients whom had received whole body irradiation as well as chemotherapy, the level of a specific mtDNA deletion was significantly greater than in control subjects. Our studies have shown that in patients who have been treated for cancer there is an increased level of mtDNA damage

  18. Regression of left ventricular hypertrophy and microalbuminuria changes during antihypertensive treatment. (United States)

    Rodilla, Enrique; Pascual, Jose Maria; Costa, Jose Antonio; Martin, Joaquin; Gonzalez, Carmen; Redon, Josep


    The objective of the present study was to assess the regression of left ventricular hypertrophy (LVH) during antihypertensive treatment, and its relationship with the changes in microalbuminuria. One hundred and sixty-eight previously untreated patients with echocardiographic LVH, 46 (27%) with microalbuminuria, were followed during a median period of 13 months (range 6-23 months) and treated with lifestyle changes and antihypertensive drugs. Twenty-four-hour ambulatory blood pressure monitoring, echocardiography and urinary albumin excretion were assessed at the beginning and at the end of the study period. Left ventricular mass index (LVMI) was reduced from 137 [interquartile interval (IQI), 129-154] to 121 (IQI, 104-137) g/m (P 50%) had the same odds of achieving regression of LVH as patients with normoalbuminuria (ORm 1.1; 95% CI 0.38-3.25; P = 0.85). However, those with microalbuminuria at baseline, who did not regress, had less probability of achieving LVH regression than the normoalbuminuric patients (OR 0.26; 95% CI 0.07-0.90; P = 0.03) even when adjusted for age, sex, initial LVMI, GFR, blood pressure and angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) treatment during the follow-up. Patients who do not have a significant reduction in microalbuminuria have less chance of achieving LVH regression, independent of blood pressure reduction.

  19. Changes of occlusal plane inclination after orthodontic treatment in different dentoskeletal frames. (United States)

    Li, Jin-le; Kau, Chung; Wang, Min


    The inclination of the occlusal plane (OP) is related to facial types and experiences physiological growth-related changes. The aims of this research were to determine if there were any differences in the inclination of OP in subjects with three types of skeletal malocclusion and to investigate the characteristics and differences of functional occlusal plane (FOP) compared to bisected occlusal plane (BOP). A sample of 90 Caucasians patients was skeletal-classified into three (n = 30), and pre- and post-treatment cephalograms were digitized. Six linear and 8 angular cephalometric measurements were selected. The changes of OP inclination within each group and the differences among the three groups pre- and post-treatment were compared with paired t test and ANOVA test, respectively. The comparison and correlation between BOP and FOP were analyzed with paired t test and coefficient of correlation, respectively. The BOP angle increased in all of the three groups but only had statistically significant differences in skeletal class II patients in a mean of 1.51° (p stability (p > 0.05) in all three groups. The inclination of FOP was closely related to that of BOP (p stability in orthodontically treated patients with all three skeletal patterns.

  20. What 'empirical turn in bioethics'? (United States)

    Hurst, Samia


    Uncertainty as to how we should articulate empirical data and normative reasoning seems to underlie most difficulties regarding the 'empirical turn' in bioethics. This article examines three different ways in which we could understand 'empirical turn'. Using real facts in normative reasoning is trivial and would not represent a 'turn'. Becoming an empirical discipline through a shift to the social and neurosciences would be a turn away from normative thinking, which we should not take. Conducting empirical research to inform normative reasoning is the usual meaning given to the term 'empirical turn'. In this sense, however, the turn is incomplete. Bioethics has imported methodological tools from empirical disciplines, but too often it has not imported the standards to which researchers in these disciplines are held. Integrating empirical and normative approaches also represents true added difficulties. Addressing these issues from the standpoint of debates on the fact-value distinction can cloud very real methodological concerns by displacing the debate to a level of abstraction where they need not be apparent. Ideally, empirical research in bioethics should meet standards for empirical and normative validity similar to those used in the source disciplines for these methods, and articulate these aspects clearly and appropriately. More modestly, criteria to ensure that none of these standards are completely left aside would improve the quality of empirical bioethics research and partly clear the air of critiques addressing its theoretical justification, when its rigour in the particularly difficult context of interdisciplinarity is what should be at stake.

  1. Life changes among homeless persons with mental illness: a longitudinal study of housing first and usual treatment. (United States)

    Nelson, Geoffrey; Patterson, Michelle; Kirst, Maritt; Macnaughton, Eric; Isaak, Corinne A; Nolin, Danielle; McAll, Christopher; Stergiopoulos, Vicky; Townley, Greg; MacLeod, Timothy; Piat, Myra; Goering, Paula N


    This study compared the life changes of homeless people with mental illness participating in Housing First or treatment as usual and examined factors related to various changes. Semistructured narrative interviews were conducted with 219 participants in five Canadian cities at baseline; 197 were interviewed again at 18 months after random assignment to Housing First (N=119) or treatment as usual (N=78). Interviews were coded across 13 life domains, and each participant was categorized as reporting positive, mixed-neutral, or negative changes. Housing First and treatment as usual participants were compared with respect to change patterns. Thematic analysis was used to examine factors related to various changes. The percentage of participants in Housing First reporting positive changes was more than double that for participants in treatment as usual, and treatment as usual participants were four times more likely than Housing First participants to report negative changes. Factors related to positive changes included having stable good-quality housing, increased control over substance use, positive relationships and social support, and valued social roles. Factors related to negative changes included precarious housing, negative social contacts, isolation, heavy substance use, and hopelessness. Factors related to mixed-neutral changes were similar to those for participants reporting negative changes but were less intense. Housing First with intensive support was related to more positive changes among homeless adults with mental illness across five Canadian cities. Those with poor housing or support, more common in treatment as usual, continued to struggle. These findings are relevant for services and social change to benefit this population.

  2. Vulnerability of Quebec drinking-water treatment plants to cyanotoxins in a climate change context. (United States)

    Carrière, Annie; Prévost, Michèle; Zamyadi, Arash; Chevalier, Pierre; Barbeau, Benoit


    Cyanobacteria are a growing concern in the province of Quebec due to recent highly publicised bloom episodes. The health risk associated with the consumption of drinking water coming from contaminated sources was unknown. A study was undertaken to evaluate treatment plants' capacity to treat cyanotoxins below the maximum recommended concentrations of 1.5 microg/L microcystin-LR (MC-LR) and the provisional concentration of 3.7 microg/L anatoxin-a, respectively. The results showed that close to 80% of the water treatment plants are presently able to treat the maximum historical concentration measured in Quebec (5.35 microg/L MC-LR equ.). An increase, due to climate change or other factors, would not represent a serious threat because chlorine, the most popular disinfectant, is effective in treating MC-LR under standard disinfection conditions. The highest concentration of anatoxin-a (2.3 microg/L) measured in natural water thus far in source water is below the current guideline for treated waters. However, higher concentrations of anatoxin-a would represent a significant challenge for the water industry as chlorine is not an efficient treatment option. The use of ozone, potassium permanganate or powder activated carbon would have to be considered.

  3. Short-term postharvest carbon dioxide treatments induce selective molecular and metabolic changes in grape berries. (United States)

    Becatti, Elisa; Chkaiban, Lamia; Tonutti, Pietro; Forcato, Claudio; Bonghi, Claudio; Ranieri, Anna Maria


    Detached wine grapes ( Vitis vinifera cv. 'Trebbiano', white skinned) were treated for 3 days with 30 kPa of CO(2) and then transferred to air for an additional 9 days to partially dehydrate (about 20% weight loss). At the end of the CO(2) treatment on withering berries, total polyphenols and flavonoids were maintained in the skin, but to a more limited extent in the pulp. An induction of the proanthocyanidin synthesis appeared to be one of the responses to the treatment because both (+)-catechin and (-)-epicatechin concentrations increased in the skin. The skin and pulp of the grape berries showed different molecular responses to a high CO(2) treatment. As revealed by microarray hybridizations, 217 and 75 genes appeared differentially expressed in the skin and pulp of treated samples, respectively. Functional categorization and gene enrichment analyses pointed out that epicarp cells undergo more pronounced changes in transcript profiling at the end of the incubation period. Highly represented categories in both tissues were related to protein, stress, transcript, RNA, and hormone (ethylene, ABA) metabolism. Fermentation, CHO metabolism, and redox regulation functional categories were represented only in the skin.

  4. Cognitive and emotional behavioural changes associated with methylphenidate treatment: a review of preclinical studies. (United States)

    Britton, Gabrielle B


    There is evidence from animal studies that repeated exposure to methylphenidate (MPH), a widely used psychostimulant for the treatment of attention deficit hyperactivity disorder (ADHD), produces behavioural, structural and neurochemical changes that persist long after drug administration has ended. However, the translational utility of much of this work is compromised by the use of drug doses and routes of administration that produce plasma and brain MPH levels that fall outside the clinical range, i.e. experimental parameters more relevant to drug abuse than ADHD. We used PubMed to identify pre-clinical studies that employed repeated MPH administration at low doses in young rodents and examined long-term effects on cognition, emotion, and brain structure and function. A review of this work suggests that repeated MPH treatment during early development can modify a number of cognitive, behavioural and brain processes, but these are reduced when low therapeutic doses are employed. Moreover, MPH sites of action extend beyond those implicated in ADHD. Studies that combined neurobiological and behavioural approaches provide important insights into the mechanisms underlying MPH-produced effects on cognitive and behavioural processes, which may be relevant to MPH therapeutic efficacy. There is an emerging consensus that pharmacological treatment of childhood psychiatric disorders produces persistent neuroadaptations, highlighting the need for studies that assess long-term effects of early developmental pharmacotherapy. In this regard, studies that mimic clinical therapy with rodents are useful experimental approaches for defining the behavioural and neural plasticity associated with stimulant therapy in paediatric populations.

  5. Volatility and change in chronic pain severity predict outcomes of treatment for prescription opioid addiction. (United States)

    Worley, Matthew J; Heinzerling, Keith G; Shoptaw, Steven; Ling, Walter


    Buprenorphine-naloxone (BUP-NLX) can be used to manage prescription opioid addiction among persons with chronic pain, but post-treatment relapse is common and difficult to predict. This study estimated whether changes in pain over time and pain volatility during BUP-NLX maintenance would predict opioid use during the taper BUP-NLX taper. Secondary analysis of a multi-site clinical trial for prescription opioid addiction, using data obtained during a 12-week BUP-NLX stabilization and 4-week BUP-NLX taper. Community clinics affiliated with a national clinical trials network in 10 US cities. Subjects with chronic pain who entered the BUP-NLX taper phase (n = 125) with enrollment occurring from June 2006 to July 2009 (52% male, 88% Caucasian, 31% married). Outcomes were weekly biologically verified and self-reported opioid use from the 4-week taper phase. Predictors were estimates of baseline severity, rate of change and volatility in pain from weekly self-reports during the 12-week maintenance phase. Controlling for baseline pain and treatment condition, increased pain [odds ratio (OR) = 2.38, P = 0.02] and greater pain volatility (OR = 2.43, P = 0.04) predicted greater odds of positive opioid urine screen during BUP-NLX taper. Increased pain (IRR = 1.40, P = 0.04) and greater pain volatility [incidence-rate ratio (IRR) = 1.66, P = 0.009] also predicted greater frequency of self-reported opioid use. Adults with chronic pain receiving out-patient treatment with buprenorphine-naloxone (BUP-NLX) for prescription opioid addiction have an elevated risk for opioid use when tapering off maintenance treatment. Those with relative persistence in pain over time and greater volatility in pain during treatment are less likely to sustain abstinence during BUP-NLX taper. © 2017 Society for the Study of Addiction.

  6. Changes in neurophysiologic markers of visual processing following beneficial anti-VEGF treatment in macular degeneration

    Directory of Open Access Journals (Sweden)

    Vottonen P


    Full Text Available Pasi Vottonen,1 Kai Kaarniranta,1,2 Ari Pääkkönen,3 Ina M Tarkka41Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland; 2Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; 3Department of Clinical Neurophysiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; 4Department of Health Sciences, University of Jyväskylä, Jyväskylä, FinlandPurpose: Antivascular endothelial growth factor (VEGF agents have been shown to improve visual acuity and prevent vision loss in exudative age-related macular degeneration. As the vision improves relatively quickly in response to intravitreal injections, we wanted to know whether this improvement is reflected in electrophysiological markers of visual cortical processing.Patients and methods: Our interventional case series included six elderly patients who underwent injection treatment to the affected eye. Their visual acuity, tomographic images of retinal thickness, and visual evoked potentials (VEP were assessed before treatment and six weeks after the last injection.Results: All patients showed improved visual acuity and reduced retinal fluid after the treatment. All but one patient showed increased VEP P100 component amplitudes and/or shortened latencies in the treated eye. These VEP changes were consistent with improved vision while the untreated eyes showed no changes.Conclusions: Our results indicate that antivascular endothelial growth factor injections improved visual function of the treated eyes both in the level of the retina and in the level of visual cortical processing.Keywords: age-related eye diseases, exudative age-related macular degeneration, visual evoked potentials, scalp-recorded EEG, visual acuity

  7. Changes of serum contents of LPO, SOD after treatment with vita. E-C complex in patients with liver spot

    International Nuclear Information System (INIS)

    Li Qing; Feng Zheng


    Objective: To investigate the changes of serum contents of LPO, SOD and therapeutic efficacy after treatment with Vita. E-C complex in patients with liver spot. Methods: Serum LPO and SOD contents were measured both before and after treatment with Vita E-C complex (Vita. E l00mg, Vita. C 200mg x 3/d for 3 months) in 30 patients with liver spot as well as in 10 controls. Results: Before treatment, the serum LPO contents in the patients were significantly higher than those in controls. After treatment, the LPO contents dropped markedly, being significantly lower than the values before treatment. However, the SOD contents were about the same as those in controls and changes little after treatment. Conclusion: Vita. E-C complex was of definite therapeutic value for the treatment of liver spot. (authors)


    Directory of Open Access Journals (Sweden)

    V. B. Nefedov


    Full Text Available Total lung capacity (TLC, lung capacity (LC, forced LC (FLC, intrathoracic volume (ITV, pulmonary residual volume (PRV, forced expiratory volume in one second (FEV1 , (FEV1 /LC%, peak expiratory flow (PEF, maximum expiratory flow rate (MEFR25, MEFR50, MEFR75, Raw, Rin, Rex, DLCO-SB, DLCO-SB/VА, РаО2 , and РаСО2 were determined in 43 patients with exogenous allergic alveolitis (EAA before, during, and after treatment with glucocorticosteroids, hemapheresis, ambroxol, and fluimucil. Lung function became better in more than half (53.5% of the patients and worse in one fourth (25.6%; a combination of positive and negative functional changes was detected in 14.0%. Improved lung function was noted in 75.0, 50.0, and 38.5% of the patients with acute, subacute, and chronic EAA, respectively. Deterioration of lung function was determined in 46.2, 22.2, and 8.3% of the patients with chronic, subacute, and acute alveolitis, respectively. Better lung function manifested itself mainly as positive changes in lung volumes and capacities and pulmonary gas exchange function, less frequently as improved bronchial patency in the patients with acute and subacute EAA whereas the rate of positive functional changes in lung volumes and capacities, bronchial patency, and pulmonary gas exchange function was equal in those with chronic EAA. Poorer lung function appeared as negative changes in lung volumes and capacities in the patients with acute EAA, as worse pulmonary gas exchange function and negative changes in lung volumes and capacities and deteriorated bronchial patency in those with subacute and chronic EAA.

  9. Orbscan II anterior elevation changes following corneal collagen cross-linking treatment for keratoconus. (United States)

    Tu, Kyaw Lin; Aslanides, Ioannis M


    To analyze anterior corneal elevation changes on Orbscan II following corneal collagen cross-linking (CXL) with riboflavin. This retrospective study included 8 patients (14 eyes) with keratoconus who underwent CXL, with a mean follow-up of 7 months (range: 5 to 10 months). Pre- and postoperative (at last clinic attendance) anterior elevation difference maps were examined for overall patterns of change. On preoperative maps, distances from maximum anterior elevation to pupil center and to topographic geometric center were compared between the two patterns identified. Pre- and postoperative topography, best spectacle-corrected visual acuity (BSCVA), and refraction were also compared between the two patterns. Two patterns of anterior elevation change were visually identified: (1) paracentral steepening, no change, or flattening centrally; and (2) central steepening. The preoperative maps of eyes that manifested pattern 1 had shorter mean distances for maximum anterior elevation to pupil center (1.70 vs. 2.27 mm) and maximum anterior elevation to geometric center (1.45 vs. 1.99 mm) than those that resulted in pattern 2. Mean maximum topographic simulated keratometry decreased (P = .004) and mean irregularity indices at 3 mm (P =.03) and 5 mm (P =.04) were reduced postoperatively in pattern 1 eyes; all increased in pattern 2 eyes. Mean BSCVA improved postoperatively for both patterns. Mean preoperative myopia decreased in pattern 1 eyes by 0.44 diopters (D), whereas it increased for pattern 2 eyes by 1.83 D. Corneal shape change influenced by anisotropy of collagen distribution is a factor in the outcome of CXL treatment for keratoconus.

  10. Aceptabilidad del tratamiento "empírico" de la infección urinaria aguda en el niño Acceptability of the "empirical" treatment of acute urinary infection in children

    Directory of Open Access Journals (Sweden)

    Sandalio Durán Álvarez


    Full Text Available Las guías propuestas por grupos internacionales enfatizan en la importancia del diagnóstico de la infección del tracto urinario en la atención primaria de salud, para poder iniciar un tratamiento precoz con antibióticos en los casos de mayor riesgo. El médico de atención primaria en ocasiones realiza su trabajo lejos de los laboratorios de microbiología y no puede realizar el urocultivo con la rapidez necesaria para un tratamiento adecuado. Este médico necesita disponer de pruebas diagnósticas rápidas que le ayuden a tomar la decisión médica más adecuada, aunque ninguna combinación de ellas puede sustituir al urocultivo. En esta propuesta se analizan las situaciones en las que el médico debe esperar el resultado del estudio bacteriológico y en las que puede iniciar un tratamiento «empírico» después de tomar la muestra para el urocultivo, si este puede realizarse. En los casos excepcionales de imposibilidad de realizar el estudio bacteriológico, el médico tiene que actuar utilizando los llamados métodos de «diagnóstico rápido».The guidances proposed for international groups emphasize the significance of diagnosis of the urinary tract infection in primary health care to start an early antibiotics treatment in cases of a major risk. The primary care physician sometimes works far from the microbiology laboratories and can not to carry out a fast uroculture for an appropriate treatment. This physician needs to have available fast diagnostic tests helping him to make a more suitable medical decision, although any combination of them may to replace the uroculture. In present proposal are analyzed those situations where the physician must to await for bacteriological study results to start the "empirical" treatment after the sample take for uroculture if it may to be carry out. In exceptional cases of impossibility to conduct the bacteriological study, the physician must to act using the so called "fast diagnosis" methods.

  11. Changes observed in radionuclide bone scans during and after teriparatide treatment for osteoporosis

    International Nuclear Information System (INIS)

    Moore, Amelia E.B.; Blake, Glen M.; Fogelman, Ignac; Taylor, Kathleen A.; Ruff, Valerie A.; Rana, Asad E.; Wan, Xiaohai


    Visual changes on radionuclide bone scans have been reported with teriparatide treatment. To assess this, serial studies were evaluated and quantified in ten postmenopausal women with osteoporosis treated with teriparatide (20 μg/day subcutaneous) who had 99m Tc-methylene diphosphonate (MDP) bone scans (baseline, 3 and 18 months, then after 6 months off therapy). Women were injected with 600 MBq 99m Tc-MDP, and diagnostic bone scan images were assessed at 3.5 h. Additional whole-body scans (10 min, 1, 2, 3 and 4 h) were analysed for 99m Tc-MDP skeletal plasma clearance (K bone ). Regional K bone differences were obtained for the whole skeleton and six regions (calvarium, mandible, spine, pelvis, upper and lower extremities). Bone turnover markers (BTM) were also measured. Most subjects showed visual changes on 3- and 18-month bone scan images that disappeared after 6 months off therapy. Enhanced uptake was seen predominantly in the calvarium and lower extremities. Whole skeleton K bone displayed a median increase of 22% (3 months, p = 0.004) and 34% (18 months, p = 0.002) decreasing to 0.7% (6 months off therapy). Calvarium K bone changes were three times larger than other sites. After 6 months off therapy, all K bone and BTM values returned towards baseline. The increased 99m Tc-MDP skeletal uptake with teriparatide indicated increased bone formation which was supported by BTM increases. After 6 months off therapy, metabolic activity diminished towards baseline. The modulation of 99m Tc-MDP skeletal uptake during treatment was the result of teriparatide's metabolic activity. These findings may aid the radiological evaluation of similar teriparatide patients having radionuclide bone scans. (orig.)

  12. Deep brain stimulation effects in dystonia: time course of electrophysiological changes in early treatment. (United States)

    Ruge, Diane; Tisch, Stephen; Hariz, Marwan I; Zrinzo, Ludvic; Bhatia, Kailash P; Quinn, Niall P; Jahanshahi, Marjan; Limousin, Patricia; Rothwell, John C


    Deep brain stimulation to the internal globus pallidus is an effective treatment for primary dystonia. The optimal clinical effect often occurs only weeks to months after starting stimulation. To better understand the underlying electrophysiological changes in this period, we assessed longitudinally 2 pathophysiological markers of dystonia in patients prior to and in the early treatment period (1, 3, 6 months) after deep brain stimulation surgery. Transcranial magnetic stimulation was used to track changes in short-latency intracortical inhibition, a measure of excitability of GABA(A) -ergic corticocortical connections and long-term potentiation-like synaptic plasticity (as a response to paired associative stimulation). Deep brain stimulation remained on for the duration of the study. Prior to surgery, inhibition was reduced and plasticity increased in patients compared with healthy controls. Following surgery and commencement of deep brain stimulation, short-latency intracortical inhibition increased toward normal levels over the following months with the same monotonic time course as the patients' clinical benefit. In contrast, synaptic plasticity changed rapidly, following a nonmonotonic time course: it was absent early (1 month) after surgery, and then over the following months increased toward levels observed in healthy individuals. We postulate that before surgery preexisting high levels of plasticity form strong memories of dystonic movement patterns. When deep brain stimulation is turned on, it disrupts abnormal basal ganglia signals, resulting in the absent response to paired associative stimulation at 1 month. Clinical benefit is delayed because engrams of abnormal movement persist and take time to normalize. Our observations suggest that plasticity may be a driver of long-term therapeutic effects of deep brain stimulation in dystonia. Copyright © 2011 Movement Disorder Society.

  13. Changes observed in radionuclide bone scans during and after teriparatide treatment for osteoporosis

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Amelia E.B.; Blake, Glen M.; Fogelman, Ignac [King' s College London, School of Medicine, Department of Nuclear Medicine, London (United Kingdom); Taylor, Kathleen A.; Ruff, Valerie A.; Rana, Asad E.; Wan, Xiaohai [Eli Lilly and Company, Indianapolis, IN (United States)


    Visual changes on radionuclide bone scans have been reported with teriparatide treatment. To assess this, serial studies were evaluated and quantified in ten postmenopausal women with osteoporosis treated with teriparatide (20 {mu}g/day subcutaneous) who had {sup 99m}Tc-methylene diphosphonate (MDP) bone scans (baseline, 3 and 18 months, then after 6 months off therapy). Women were injected with 600 MBq {sup 99m}Tc-MDP, and diagnostic bone scan images were assessed at 3.5 h. Additional whole-body scans (10 min, 1, 2, 3 and 4 h) were analysed for {sup 99m}Tc-MDP skeletal plasma clearance (K{sub bone}). Regional K{sub bone} differences were obtained for the whole skeleton and six regions (calvarium, mandible, spine, pelvis, upper and lower extremities). Bone turnover markers (BTM) were also measured. Most subjects showed visual changes on 3- and 18-month bone scan images that disappeared after 6 months off therapy. Enhanced uptake was seen predominantly in the calvarium and lower extremities. Whole skeleton K{sub bone} displayed a median increase of 22% (3 months, p = 0.004) and 34% (18 months, p = 0.002) decreasing to 0.7% (6 months off therapy). Calvarium K{sub bone} changes were three times larger than other sites. After 6 months off therapy, all K{sub bone} and BTM values returned towards baseline. The increased {sup 99m}Tc-MDP skeletal uptake with teriparatide indicated increased bone formation which was supported by BTM increases. After 6 months off therapy, metabolic activity diminished towards baseline. The modulation of {sup 99m}Tc-MDP skeletal uptake during treatment was the result of teriparatide's metabolic activity. These findings may aid the radiological evaluation of similar teriparatide patients having radionuclide bone scans. (orig.)

  14. Raman spectroscopy detects biomolecular changes associated with nanoencapsulated hesperetin treatment in experimental oral carcinogenesis

    International Nuclear Information System (INIS)

    Gurushankar, K; Gohulkumar, M; Krishnakumar, N; Kumar, Piyush; Murali Krishna, C


    Recently it has been shown that Raman spectroscopy possesses great potential in the investigation of biomolecular changes of tumor tissues with therapeutic drug response in a non-invasive and label-free manner. The present study is designed to investigate the antitumor effect of hespertin-loaded nanoparticles (HETNPs) relative to the efficacy of native hesperetin (HET) in modifying the biomolecular changes during 7,12-dimethyl benz(a)anthracene (DMBA)-induced oral carcinogenesis using a Raman spectroscopic technique. Significant differences in the intensity and shape of the Raman spectra between the control and the experimental tissues at 1800–500 cm −1 were observed. Tumor tissues are characterized by an increase in the relative amount of proteins, nucleic acids, tryptophan and phenylalanine and a decrease in the percentage of lipids when compared to the control tissues. Further, oral administration of HET and its nanoparticulates restored the status of the lipids and significantly decreased the levels of protein and nucleic acid content. Treatment with HETNPs showed a more potent antitumor effect than treatment with native HET, which resulted in an overall reduction in the intensity of several biochemical Raman bands in DMBA-induced oral carcinogenesis being observed. Principal component and linear discriminant analysis (PC–LDA), together with leave-one-out cross validation (LOOCV) on Raman spectra yielded diagnostic sensitivities of 100%, 80%, 91.6% and 65% and specificities of 100%, 65%, 60% and 55% for classification of control versus DMBA, DMBA versus DMBA  +  HET, DMBA versus DMBA  +  HETNPs and DMBA  +  HET versus DMBA  +  HETNPs treated tissue groups, respectively. These results further demonstrate that Raman spectroscopy associated with multivariate statistical algorithms could be a valuable tool for developing a comprehensive understanding of the process of biomolecular changes, and could reveal the signatures of the

  15. Microbial control of soil organic matter mineralization responses to labile carbon in subarctic climate change treatments. (United States)

    Rousk, Kathrin; Michelsen, Anders; Rousk, Johannes


    Half the global soil carbon (C) is held in high-latitude systems. Climate change will expose these to warming and a shift towards plant communities with more labile C input. Labile C can also increase the rate of loss of native soil organic matter (SOM); a phenomenon termed 'priming'. We investigated how warming (+1.1 °C over ambient using open top chambers) and litter addition (90 g m -2  yr -1 ) treatments in the subarctic influenced the susceptibility of SOM mineralization to priming, and its microbial underpinnings. Labile C appeared to inhibit the mineralization of C from SOM by up to 60% within hours. In contrast, the mineralization of N from SOM was stimulated by up to 300%. These responses occurred rapidly and were unrelated to microbial successional dynamics, suggesting catabolic responses. Considered separately, the labile C inhibited C mineralization is compatible with previously reported findings termed 'preferential substrate utilization' or 'negative apparent priming', while the stimulated N mineralization responses echo recent reports of 'real priming' of SOM mineralization. However, C and N mineralization responses derived from the same SOM source must be interpreted together: This suggested that the microbial SOM-use decreased in magnitude and shifted to components richer in N. This finding highlights that only considering SOM in terms of C may be simplistic, and will not capture all changes in SOM decomposition. The selective mining for N increased in climate change treatments with higher fungal dominance. In conclusion, labile C appeared to trigger catabolic responses of the resident microbial community that shifted the SOM mining to N-rich components; an effect that increased with higher fungal dominance. Extrapolating from these findings, the predicted shrub expansion in the subarctic could result in an altered microbial use of SOM, selectively mining it for N-rich components, and leading to a reduced total SOM-use. © 2016 John Wiley

  16. Empirical methods for estimating future climatic conditions

    International Nuclear Information System (INIS)



    Applying the empirical approach permits the derivation of estimates of the future climate that are nearly independent of conclusions based on theoretical (model) estimates. This creates an opportunity to compare these results with those derived from the model simulations of the forthcoming changes in climate, thus increasing confidence in areas of agreement and focusing research attention on areas of disagreements. The premise underlying this approach for predicting anthropogenic climate change is based on associating the conditions of the climatic optimums of the Holocene, Eemian, and Pliocene with corresponding stages of the projected increase of mean global surface air temperature. Provided that certain assumptions are fulfilled in matching the value of the increased mean temperature for a certain epoch with the model-projected change in global mean temperature in the future, the empirical approach suggests that relationships leading to the regional variations in air temperature and other meteorological elements could be deduced and interpreted based on use of empirical data describing climatic conditions for past warm epochs. Considerable care must be taken, of course, in making use of these spatial relationships, especially in accounting for possible large-scale differences that might, in some cases, result from different factors contributing to past climate changes than future changes and, in other cases, might result from the possible influences of changes in orography and geography on regional climatic conditions over time

  17. Mediation of the relationship of behavioural treatment type and changes in psychological predictors of healthy eating by body satisfaction changes in women with obesity. (United States)

    Annesi, James J

    Psychological correlates of both short- and long-term weight loss are poorly understood. Changes in satisfaction with one's body might serve to motivate healthier eating by mediating treatments' effect on psychological factors previously suggested to be associated with weight loss. Women with obesity (age 48.6±7.1 years; BMI 35.4±3.3kg/m 2 ) were randomly assigned to social cognitive theory-based weight-management treatments that were either group sessions emphasizing physical activity-derived self-regulation (experimental; n=53) or review of a written manual and phone support (comparison; n=54). Changes in weight, physical activity, body satisfaction, negative mood, and self-efficacy and self-regulation for controlled eating were assessed over 3, 6, 12, and 24 months. The experimental treatment was associated with significantly more favourable changes across variables. Over 6, 12, and 24 months, body satisfaction change mediated relationships between treatment type and changes in each of the psychological predictors of healthier eating (mood, self-efficacy, self-regulation). Reciprocal, mutually reinforcing, relationships between changes in body satisfaction and those psychological predictors were also found. Increased physical activity was associated with improved body satisfaction, even after controlling for weight changes. Findings increased understandings of the role of body satisfaction in improving psychological predictors of healthier eating over both the short- and longer-term. Results also suggested that body satisfaction could be improved through increased physical activity, irrespective of change in weight. Although results were limited to women with class 1 and 2 obesity, findings on interactions of psychological factors associated with eating changes have implications for the architecture of improved behavioural treatments. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  18. Behavioral and neurogenomic transcriptome changes in wild-derived zebrafish with fluoxetine treatment (United States)


    Background Stress and anxiety-related behaviors are seen in many organisms. Studies have shown that in humans and other animals, treatment with selective serotonin reuptake inhibitors (e.g. fluoxetine) can reduce anxiety and anxiety-related behaviors. The efficacies and side effects, however, can vary between individuals. Fluoxetine can modulate anxiety in a stereospecific manner or with equal efficacy regardless of stereoisomer depending on the mechanism of action (e.g. serotonergic or GABAergic effects). Zebrafish are an emerging and valuable translational model for understanding human health related issues such as anxiety. In this study we present data showing the behavioral and whole brain transcriptome changes with fluoxetine treatment in wild-derived zebrafish and suggest additional molecular mechanisms of this widely-prescribed drug. Results We used automated behavioral analyses to assess the effects of racemic and stereoisomeric fluoxetine on male wild-derived zebrafish. Both racemic and the individual isomers of fluoxetine reduced anxiety-related behaviors relative to controls and we did not observe stereospecific fluoxetine effects. Using RNA-sequencing of the whole brain, we identified 411 genes showing differential expression with racemic fluoxetine treatment. Several neuropeptides (neuropeptide Y, isotocin, urocortin 3, prolactin) showed consistent expression patterns with the alleviation of stress and anxiety when anxiety-related behavior was reduced with fluoxetine treatment. With gene ontology and KEGG pathway analyses, we identified lipid and amino acid metabolic processes, and steroid biosynthesis among other terms to be over-enriched. Conclusion Our results demonstrate that fluoxetine reduces anxiety-related behaviors in wild-derived zebrafish and alters their neurogenomic state. We identify two biological processes, lipid and amino acid metabolic synthesis that characterize differences in the fluoxetine treated fish. Fluoxetine may be acting on

  19. Changes in protein and starch digestibility in sorghum flour during heat-moisture treatments. (United States)

    Vu, Thanh-Hien; Bean, Scott; Hsieh, Chao-Feng; Shi, Yong-Cheng


    Heat-moisture treatment (HMT) has been used to modify properties of sorghum starches. However, information is limited on the effects of HMT on the digestibility of starch and the concurrent changes in protein in sorghum flour. The objectives of this research were to identify heat-moisture conditions to increase the resistant starch (RS) content of sorghum flour and investigate changes in sorghum proteins and starch structure. Sorghum flours with different moisture contents (0, 125, 200, and 300 g kg -1 w.b.) were heated at three temperatures (100, 120 and 140 °C) and times (1, 2 and 4 h). HMT of sorghum flour increased its RS level. The flour treated at 200 g kg -1 moisture and 100 °C for 4 h had a high RS content (221 g kg -1 vs. 56 g kg -1 for the untreated flour). Starch was not gelatinized when sorghum flours heated at moisture content of 200 g kg -1 or below. Sorghum protein digestibility and solubility decreased during HMT. The increase in RS of sorghum flour upon HMT was attributed to enhanced amylose-lipid complexes and heat induced structural changes in its protein fraction. HMT can be used to increase RS content in sorghum flour without gelatinizing its starch, thereby providing sorghum flour with unique food applications. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  20. Surface changes of biopolymers PHB and PLLA induced by Ar+ plasma treatment and wet etching (United States)

    Slepičková Kasálková, N.; Slepička, P.; Sajdl, P.; Švorčík, V.


    Polymers, especially group of biopolymers find potential application in a wide range of disciplines due to their biodegradability. In biomedical applications these materials can be used as a scaffold or matrix. In this work, the influence of the Ar+ plasma treatment and subsequent wet etching (acetone/water) on the surface properties of polymers were studied. Two biopolymers - polyhydroxybutyrate with 8% polyhydroxyvalerate (PHB) and poly-L-lactic acid (PLLA) were used in these experiments. Modified surface layers were analyzed by different methods. Surface wettability was characterized by determination of water contact angle. Changes in elemental composition of modified surfaces were performed by X-ray Photoelectron Spectroscopy (XPS). Surface morphology and roughness was examined using Atomic Force Microscopy (AFM). Gravimetry method was used to study the mass loss. It was found that the modification from both with plasma and wet etching leads to dramatic changes of surface properties (surface chemistry, morphology and roughness). Rate of changes of these features strongly depends on the modification parameters.

  1. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012 (United States)

    Sengul, Sule; Akpolat, Tekin; Erdem, Yunus; Derici, Ulver; Arici, Mustafa; Sindel, Sukru; Karatan, Oktay; Turgan, Cetin; Hasanoglu, Enver; Caglar, Sali; Erturk, Sehsuvar


    Objectives: The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension. Methods: The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg. Results: Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7% in 2003. The hypertension treatment rate increased from 31.1% in 2003 to 47.4% in 2012, and the control rate in hypertensives increased from 8.1% in 2003 to 28.7% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7%) and 2012 (53.9%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey. Conclusion: Although some progress has been made in

  2. EGG: Empirical Galaxy Generator (United States)

    Schreiber, C.; Elbaz, D.; Pannella, M.; Merlin, E.; Castellano, M.; Fontana, A.; Bourne, N.; Boutsia, K.; Cullen, F.; Dunlop, J.; Ferguson, H. C.; Michałowski, M. J.; Okumura, K.; Santini, P.; Shu, X. W.; Wang, T.; White, C.


    The Empirical Galaxy Generator (EGG) generates fake galaxy catalogs and images with realistic positions, morphologies and fluxes from the far-ultraviolet to the far-infrared. The catalogs are generated by egg-gencat and stored in binary FITS tables (column oriented). Another program, egg-2skymaker, is used to convert the generated catalog into ASCII tables suitable for ingestion by SkyMaker (ascl:1010.066) to produce realistic high resolution images (e.g., Hubble-like), while egg-gennoise and egg-genmap can be used to generate the low resolution images (e.g., Herschel-like). These tools can be used to test source extraction codes, or to evaluate the reliability of any map-based science (stacking, dropout identification, etc.).

  3. Assessing the impacts of changes in treatment technology on energy and greenhouse gas balances for organic waste and wastewater treatment using historical data. (United States)

    Poulsen, Tjalfe G; Hansen, Jens Aage


    Historical data on organic waste and wastewater treatment during the period of 1970-2020 were used to assess the impact of treatment on energy and greenhouse gas (GHG) balances. The assessment included the waste fractions: Sewage sludge, food waste, yard waste and other organic waste (paper, plastic, etc.). Data were collected from Aalborg, a municipality located in Northern Denmark. During the period from 1970-2005, Aalborg Municipality has changed its waste treatment strategy from landfilling of all wastes toward composting of yard waste and incineration with combined heat and power production from the remaining organic municipal waste. Wastewater treatment has changed from direct discharge of untreated wastewater to full organic matter and nutrient (N, P) removal combined with anaerobic digestion of the sludge for biogas production with power and heat generation. These changes in treatment technology have resulted in the waste and wastewater treatment systems in Aalborg progressing from being net consumers of energy and net emitters of GHG, to becoming net producers of energy and net savers of GHG emissions (due to substitution of fossil fuels elsewhere). If it is assumed that the organic waste quantity and composition is the same in 1970 and 2005, the technology change over this time period has resulted in a progression from a net annual GHG emission of 200 kg CO( 2)-eq. capita(-1) in 1970 to a net saving of 170 kg CO(2)-eq. capita(-1) in 2005 for management of urban organic wastes.

  4. Effects of Vitamin D Treatment on Skeletal Muscle Histology and Ultrastructural Changes in a Rodent Model

    Directory of Open Access Journals (Sweden)

    Sobhy M. Yakout


    Full Text Available Vitamin D is well known for its role in maintaining calcium and phosphorus homeostasis and in promoting bone mineralization; however, more of its pleiotropic effects have been described recently. The aim of the present investigation was to study the effect of vitamin D treatment on skeletal muscles changes under different dietary conditions using an animal model. Four groups of C57BL/6J mice (n = 11 each were maintained on either low fat diet (LFD or high fat diet ‎‎(HFD with and without 1α,25–dihydroxyvitamin D3 (calcitriol for 16 weeks. Animal weigh was recorded at baseline and then regular intervals, and at the end of the study, skeletal muscle tissues were harvested for the evaluation of the histopathological and ultrastructural changes. When control C57BL/6J mice were fed high-fat diet for 12 weeks, body weight gain was significantly increased compared with mice fed a LFD. (30.2% vs. 8.4%, p < 0.01. There was a significant gradual decrease in the weight of HFD fed mice that were treated with vitamin D as compared with a steady increase in the weights of controls (6.8% vs. 28.7%, p < 0.01. While the LFD group showed some ultrastructural changes, HDF fed on mice showed great muscle structural abnormalities. The whole sarcosome along with its membrane and cristae were severely damaged with scattered myocytes in HFD group. Furthermore, the mitochondria appeared weak and were on the verge of degenerations. The bands were diminished with loss of connections among myofibrils. These changes were attenuated in the HFD group treated with vitamin D with tissues have regained their normal structural appearance. The current findings indicate an important effect of vitamin D on skeletal muscle histology under HFD conditions.

  5. Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis

    Directory of Open Access Journals (Sweden)

    Barata José T


    Full Text Available Abstract Background Changes in body image and subjective well-being variables (e.g. self-esteem are often reported as outcomes of obesity treatment. However, they may, in turn, also influence behavioral adherence and success in weight loss. The present study examined associations among obesity treatment-related variables, i.e., change in weight, quality of life, body image, and subjective well-being, exploring their role as both mediators and outcomes, during a behavioral obesity treatment. Methods Participants (BMI = 31.1 ± 4.1 kg/m2; age = 38.4 ± 6.7 y were 144 women who attended a 12-month obesity treatment program and a comparison group (n = 49, who received a general health education program. The intervention included regular group meetings promoting lasting behavior changes in physical activity and dietary intake. Body image, quality of life, subjective well-being, and body weight were measured at baseline and treatment's end. Mediation was tested by multiple regression and a resampling approach to measure indirect effects. Treatment group assignment was the independent variable while changes in weight and in psychosocial variables were analyzed alternatively as mediators and as dependent variables. Results At 12 months, the intervention group had greater weight loss (-5.6 ± 6.8% vs. -1.2 ± 4.6%, p Conclusion Changes in weight and body image may reciprocally affect each other during the course of behavioral obesity treatment. No evidence of reciprocal relationships was found for the other models under analysis; however, weight changes partially explained the effects of treatment on quality of life and self-esteem. Weight and psychosocial changes co-occur during treatment and will probably influence each other dynamically, in ways not yet adequately understood. Results from this study support the inclusion of intervention contents aimed at improving body image in weight management programs.

  6. Changes in brain connectivity related to the treatment of depression measured through fMRI: a systematic review (United States)

    Gudayol-Ferré, Esteve; Peró-Cebollero, Maribel; González-Garrido, Andrés A.; Guàrdia-Olmos, Joan


    Depression is a mental illness that presents alterations in brain connectivity in the Default Mode Network (DMN), the Affective Network (AN) and other cortical-limbic networks, and the Cognitive Control Network (CCN), among others. In recent years the interest in the possible effect of the different antidepressant treatments on functional connectivity has increased substantially. The goal of this paper is to conduct a systematic review of the studies on the relationship between the treatment of depression and brain connectivity. Nineteen studies were found in a systematic review on this topic. In all of them, there was improvement of the clinical symptoms after antidepressant treatment. In 18 out of the 19 studies, clinical improvement was associated to changes in brain connectivity. It seems that both DMN and the connectivity between cortical and limbic structures consistently changes after antidepressant treatment. However, the current evidence does not allow us to assure that the treatment of depression leads to changes in the CCN. In this regard, some papers report a positive correlation between changes in brain connectivity and improvement of depressive symptomatology, particularly when they measure cortical-limbic connectivity, whereas the changes in DMN do not significantly correlate with clinical improvement. Finally, some papers suggest that changes in connectivity after antidepressant treatment might be partly related to the mechanisms of action of the treatment administered. This effect has been observed in two studies with stimulation treatment (one with rTMS and one with ECT), and in two papers that administered three different pharmacological treatments. Our review allows us to make a series of recommendations that might guide future researchers exploring the effect of anti-depression treatments on brain connectivity. PMID:26578927

  7. Changes in soft tissue profile using functional appliances in the treatment of skeletal class II malocclusion

    Directory of Open Access Journals (Sweden)

    Stamenković Zorana


    Full Text Available Introduction. The effects of orthodontic treatment are considered to be successful if the facial harmony is achieved, while the structures of soft tissue profile are in harmony with skeletal structures of neurocranium and viscerocranium. In patients with skeletal distal bite caused by mandibular retrognathism, facial esthetics is disturbed often, in terms of pronounced convexity of the profile and change in the position and relationship of the lips. Objective. The aim of this study was to determine the extent of soft tissue profile changes in patients with skeletal Class II malocclusion treated with three different orthodontic appliances: Fränkel functional regulator type I (FR-I, Balters’ Bionator type I and Hotz appliance. Methods. The study included 60 patients diagnosed with skeletal Class II malocclusion caused by mandibular retrognathism, in the period of early mixed dentition. Each subgroup of 20 patients was treated with a variety of orthodontic appliances. On the lateral cephalogram, before and after treatment, the following parameters were analyzed: T angle, H angle, the height of the upper lip, the position of the upper and lower lip in relation to the esthetic line. Within the statistical analysis the mean, maximum, minimum, standard deviation, coefficient of variation, two-factor analysis of variance with repeated measures and the factor analysis of variance were calculated using ANOVA, Bonferroni test and Student’s t-test. Results. A significant decrease of angles T and H was noticed in the application of FR-I, from 21.60° to 17.15°, and from 16.45° to 13.40° (p<0.001. FR-I decreased the height of the upper lip from 26.15 mm to 25.85 mm, while Hotz appliance and Balters’ Bionator type I increased the height of the upper lip, thereby deteriorating esthetics of the patient. Conclusion. All used orthodontic appliances lead to changes in soft tissue profile in terms of improving facial esthetics, with the most distinctive

  8. CBT for childhood anxiety disorders: differential changes in selective attention between treatment responders and non-responders. (United States)

    Legerstee, Jeroen S; Tulen, Joke H M; Dierckx, Bram; Treffers, Philip D A; Verhulst, Frank C; Utens, Elisabeth M W J


    This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Ninety-one children with an anxiety disorder were included in the present study. Children received a standardized stepped-care CBT. Three treatment response groups were distinguished: initial responders (anxiety disorder free after phase one: child-focused CBT), secondary responders (anxiety disorder free after phase two: child-parent-focused CBT), and treatment non-responders. Treatment response was determined using a semi-structured clinical interview. Children performed a pictorial dot-probe task before and after stepped-care CBT (i.e., before phase one and after phase two CBT). Changes in selective attention to severely threatening pictures, but not to mildly threatening pictures, were significantly associated with treatment success. At pre-treatment assessment, initial responders selectively attended away from severely threatening pictures, whereas secondary responders selectively attended toward severely threatening pictures. After stepped-care CBT, initial and secondary responders did not show any selectivity in the attentional processing of severely threatening pictures. Treatment non-responders did not show any changes in selective attention due to CBT. Initial and secondary treatment responders showed a reduction of their predisposition to selectively attend away or toward severely threatening pictures, respectively. Treatment non-responders did not show any changes in selective attention. The pictorial dot-probe task can be considered a potentially valuable tool in assigning children to appropriate treatment formats as well as for monitoring changes in selective attention during the course of CBT.

  9. The 2015 hospital treatment choice reform in Norway: Continuity or change? (United States)

    Ringard, Ånen; Saunes, Ingrid Sperre; Sagan, Anna


    In several European countries, including Norway, polices to increase patient choice of hospital provider have remained high on the political agenda. The main reason behind the interest in hospital choice reforms in Norway has been the belief that increasing choice can remedy the persistent problem of long waiting times for elective hospital care. Prior to the 2013 General Election, the Conservative Party campaigned in favour of a new choice reform: "the treatment choice reform". This article describes the background and process leading up to introduction of the reform in the autumn of 2015. It also provides a description of the content and discusses possible implications of the reform for patients, providers and government bodies. In sum, the reform contains elements of both continuity and change. The main novelty of the reform lies in the increased role of private for-profit healthcare providers. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  10. Cytokine Status, Thyroid Autoantibodies and Their Dynamic Changes During the Treatment of Graves' Disease

    Directory of Open Access Journals (Sweden)

    V V Lazanovich


    Full Text Available It has been found during the research that the changes of Th1 and Th2 marker cytokine content in Graves Disease are dynamic and are directly correlated not only with the severity of autoimmune thyrotoxicosis, but also with the method of treatment used and duration of Thiamazole therapy. The beginning of autoimmune thyrotoxicosis shows the largest amounts of both pro-inflammatory (IL-1a, IL-8, IFN-γ and anti-inflammatory (IL-10 cytokines which are significantly reduced during Thiamazole therapy, with the exception of the cases of severe disease course. Thyroid resection does not result in immunologic remission either, which is confirmed by persisting high serum levels of IL-1a, IL-8, IFN-γ, IL-10 and TSH antibodies in the severe GBD group. Among the unfavorable prognostic factors for recurrent disease are high serum levels of TSH antibodies, IL-1a and IFN-γ during pre-surgery period.

  11. Negative symptoms in nondeficit syndrome respond to neuroleptic treatment with changes in plasma homovanillic acid concentrations. (United States)

    Suzuki, E; Kanba, S; Koshikawa, H; Nibuya, M; Yagi, G; Asai, M


    Deficit syndrome (DS) in schizophrenia is characterized by serious, chronic, and primary negative symptoms. We investigated differences in response to neuroleptic treatment between 8 DS patients and 6 nondeficit syndrome (NDS) patients who had the selective dopamine-D2 receptor blocker bromperidol added to their neuroleptic regimens. First, 9 mg/d was administered for 4 weeks, followed by 18 mg/d for another 4 weeks. Plasma homovanillic acid (pHVA) and plasma bromperidol concentrations were measured, and psychiatric symptoms were scored. In the NDS patients, both positive and negative symptoms improved. However, only the positive symptom scores changed in the DS patients. On day 4, pHVA concentrations of the NDS patients alone were significantly elevated. Plasma bromperidol concentrations did not differ between the groups. These results suggest that bromperidol exerts different effects on negative symptoms and pHVA concentrations between NDS and DS patients, effects that are unrelated to plasma bromperidol concentrations.

  12. Weight Change over the Course of Binge Eating Disorder Treatment: Relationship to Binge Episodes and Psychological Factors. (United States)

    Pacanowski, Carly R; Mason, Tyler B; Crosby, Ross D; Mitchell, James E; Crow, Scott J; Wonderlich, Stephen A; Peterson, Carol B


    Treatment for binge eating disorder (BED), a condition associated with both excess adiposity and psychological distress, has not typically produced significant weight loss despite reducing binge eating. Characterizing factors that promote or inhibit weight loss in individuals with co-occurring BED and obesity may help explain overall nonsignificant weight changes during treatment. In this study, 189 adults with BED participated in a randomized clinical trial evaluating the efficacy of 5 months of cognitive behavioral therapy. Assessments included measured height and weight at baseline, midtreatment, end of treatment (EOT), and 6-month follow-up, the Eating Disorder Examination interview, and questionnaires. During treatment, there was a mean weight gain of 1.3 ± 12.0 lb. Twenty-two percent of the sample lost ≥ 5 lb, and 25% of the sample gained ≥ 8 lb. Results showed that baseline objective binge eating episodes predicted weight over treatment. Changes in weight were significantly positively related to concurrent changes in shape concern, weight concern, and disinhibition, but not binge eating episodes. Changes in objective binge eating episodes from baseline to EOT were associated with changes in weight from EOT to follow-up. Further investigation of eating behavior during BED treatment to understand the energy balance contributions to weight change or stability is warranted. © 2018 The Obesity Society.

  13. Volumetric changes and clinical outcome for petroclival meningiomas after primary treatment with Gamma Knife radiosurgery. (United States)

    Sadik, Zjiwar H A; Lie, Suan Te; Leenstra, Sieger; Hanssens, Patrick E J


    OBJECTIVE Petroclival meningiomas (PCMs) can cause devastating clinical symptoms due to mass effect on cranial nerves (CNs); thus, patients harboring these tumors need treatment. Many neurosurgeons advocate for microsurgery because removal of the tumor can provide relief or result in symptom disappearance. Gamma Knife radiosurgery (GKRS) is often an alternative for surgery because it can cause tumor shrinkage with improvement of symptoms. This study evaluates qualitative volumetric changes of PCM after primary GKRS and its impact on clinical symptoms. METHODS The authors performed a retrospective study of patients with PCM who underwent primary GKRS between 2003 and 2015 at the Gamma Knife Center of the Elisabeth-Tweesteden Hospital in Tilburg, the Netherlands. This study yields 53 patients. In this study the authors concentrate on qualitative volumetric tumor changes, local tumor control rate, and the effect of the treatment on trigeminal neuralgia (TN). RESULTS Local tumor control was 98% at 5 years and 93% at 7 years (Kaplan-Meier estimates). More than 90% of the tumors showed regression in volume during the first 5 years. The mean volumetric tumor decrease was 21.2%, 27.1%, and 31% at 1, 3, and 6 years of follow-up, respectively. Improvement in TN was achieved in 61%, 67%, and 70% of the cases at 1, 2, and 3 years of follow-up, respectively. This was associated with a mean volumetric tumor decrease of 25% at the 1-year follow-up to 32% at the 3-year follow-up. CONCLUSIONS GKRS for PCMs yields a high tumor control rate with a low incidence of neurological deficits. Many patients with TN due to PCM experienced improvement in TN after radiosurgery. GKRS achieves significant volumetric tumor decrease in the first years of follow-up and thereafter.

  14. Changes in Initial Treatment for Prostate Cancer Among Medicare Beneficiaries, 1999–2007

    International Nuclear Information System (INIS)

    Dinan, Michaela A.; Robinson, Timothy J.; Zagar, Timothy M.; Scales, Charles D.; Curtis, Lesley H.; Reed, Shelby D.; Lee, W. Robert; Schulman, Kevin A.


    Purpose: In the absence of evidence from large clinical trials, optimal therapy for localized prostate cancer remains unclear; however, treatment patterns continue to change. We examined changes in the management of patients with prostate cancer in the Medicare population. Methods and Materials: We conducted a retrospective claims-based analysis of the use of radiation therapy, surgery, and androgen deprivation therapy in the 12 months after diagnosis of prostate cancer in a nationally representative 5% sample of Medicare claims. Patients were Medicare beneficiaries 67 years or older with incident prostate cancer diagnosed between 1999 and 2007. Results: There were 20,918 incident cases of prostate cancer between 1999 and 2007. The proportion of patients receiving androgen deprivation therapy decreased from 55% to 36%, and the proportion of patients receiving no active therapy increased from 16% to 23%. Intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the most common method of radiation therapy, accounting for 77% of external beam radiotherapy by 2007. Minimally invasive radical prostatectomy began to replace open surgical approaches, being used in 49% of radical prostatectomies by 2007. Conclusions: Between 2002 and 2007, the use of androgen deprivation therapy decreased, open surgical approaches were largely replaced by minimally invasive radical prostatectomy, and intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the predominant method of radiation therapy in the Medicare population. The aging of the population and the increasing use of newer, higher-cost technologies in the treatment of patients with prostate cancer may have important implications for nationwide health care costs.

  15. "Changes in cartilage of rats after treatment with Quinolone and in Magnesium-deficient diet "

    Directory of Open Access Journals (Sweden)

    Shakibaei M


    Full Text Available Ultrastructural changes in immature articular carilage were studied after treatment of 5-weeks-old rats with ofloxacin, a fluoroquinolone, and in magnesium deficiency.We concluded that quinolone-induced arthropathy is probably due to chelation of functionally available magnesium in joint cartilage as magnesium deficiency in joint cartilage could impair chondrocyte-matrix- interaction which is mediated by cation-dependent integrin-receptors of the β1-subfamily. With immuno-histochemical methods using monoclonal and polyclonal antibodies we showed that B1 integrins were expressed in rat joint cartilage. Joint cartilage lesions were detected in ofloxacin-treated and magnesium-deficient rats. Lesions were more pronounced in the quinolone-treated group. Expression of several integrins was reduced in the vicinity of lesions after oral treatment with 2×600 mg ofloxacin/kg body wt for one day. Gross-structural lesions (e.g. cleft formation, unmasked collagen fibres in magnesium deficient rats were very similar but changes in intergrin expression were less pronounced. Alterations observed on the ultrastructural level showed striking similarities in magnesium-deficient rats and in rats treated with single doses of 600 mg ofloxacin per kg body wt.Typical observation were: bundle shaped, electron-dense aggregates on the surface and in the cytoplasm of chondrocytes, detachement of the cell membrance from the matrix and necrotic chondrocytes, reduced synthesis and/or reduced of extracellular matrix and swelling of cell organelles such as mitochondria.The results of this study confirm our previously reported finding that quinolone-induced arthropathy probably is caued by a reduction of functionally available magnesium (ionized Mg2+ in cartilage. Furthermore, they provide a basis for aimed studies with human cartilage samples from quinolone-treated patients which might be available postmortal or after hip replacement surgery

  16. CBT for childhood anxiety disorders: differential changes in selective attention between treatment responders and non-responders

    NARCIS (Netherlands)

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Dierckx, Bram; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.


    This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Ninety-one children with an anxiety disorder

  17. Neural Rhythms of Change: Long-Term Improvement after Successful Treatment in Children with Disruptive Behavior Problems

    NARCIS (Netherlands)

    Woltering, S.; Liao, V.; Liu, Z.X.; Granic, I.


    Neural changes were investigated for children with disruptive behavior problems one year after a treatment program ended. Thirty-nine children and their parents visited the research lab before, after, and a year after treatment ended. During those lab visits, electroencephalography (EEG) was

  18. Processes of Change in Cognitive-Behavioural Treatment of Obsessive-Compulsive Disorder : Current Status and Some Future Directions

    NARCIS (Netherlands)

    Polman, Annemiek; Bouman, Theo K.; van Hout, Wiljo J. P. J.; de Jong, Peter J.; den Boer, Johan A.


    The present paper discusses theoretical and methodological issues involved in the processes of change in cognitive-behavioural treatment (CBT) of obsessive-compulsive disorder (OCD). Treatment outcome studies showed that CBT is effective in reducing obsessive-compulsive symptoms. However, why and

  19. CBT for Childhood Anxiety Disorders: Differential Changes in Selective Attention between Treatment Responders and Non-Responders (United States)

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Dierckx, Bram; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.


    Background: This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Methods: Ninety-one children with an anxiety disorder were included in the present…

  20. Metabolites change in Jatropha plants due to seed treatment with rhizobacteria and Rhizoctonia bataticola

    Directory of Open Access Journals (Sweden)

    Surender Kumar


    Full Text Available An experiment on the metabolite [salicylic acid (SA, jasmonicacid (JA, hydrocyanic acid (HCN and chitinase activity] changes owing to seed treatment with pathogen, plant growth promoting rhizobacteria (PGPRs - (P. maltophilia, P. fluorescens and Bacillus subtilis alone and in combination was conducted at Chaudhary Charan Singh, Haryana Agricultural University, Regional Research Station, Bawal. Jatropha curcas plants raised from root rot pathogen (Rhizoctonia bataticola treated seeds showed an initial increase in SA and hydrocyanic acid HCN content and an opposite trend was observed for JA level and chitinase activity. Though, PGPRs inoculation resulted in higher increase in SA level, JA level and chitinaseactivity in both the cases alone as well as in integration with pathogen, however, maximum increase in JA content was explicited in plants raised after seed treatment with P. fluorescens, the most effective rhizobacteria amongst PGPRs studied. Highest increase in HCN content (45 μg g-1 over control (24 μg g-1 was noticed for P. fluorescens followed by co-seed inoculation with P. fluorescens + pathogen (43 μg g-1 at 10 DPI. The co-seed inoculation elicited 68 units at 10 DPI whereas the pathogen challenged plants showed lower chitinase activity with 42 units. All the metabolites declinedslightly or sharply with age of the plant irrespective of inoculations.

  1. Evaluation of changes in prescription medication use after a residential treatment programme for borderline personality disorder. (United States)

    Broadbear, Jillian H; Nesci, Julian; Thomas, Rosemary; Thompson, Katherine; Beatson, Josephine; Rao, Sathya


    Residential patients diagnosed with borderline personality disorder were evaluated to determine whether borderline personality disorder-focused psychotherapy reduced prescribing, personality disorder and co-morbid symptom severity. Psychotropic prescriptions were measured at admission, discharge and 1 year later in 74 female participants with one or more personality disorder diagnosis and co-morbid mood disorders. Changes in pharmacotherapy were examined in the context of improvements in borderline personality disorder and/or co-morbid disorder symptom severity. Residential treatment included individual and group psychotherapy for borderline personality disorder. The Structured Clinical Interview for DSM-IV was used to confirm the borderline personality disorder diagnosis and associated co-morbid conditions. The Beck Depression Inventory was completed at each time point. A significant reduction in the incidence and severity of self-rated depression as well as clinician assessed personality disorder, including borderline personality disorder, was accompanied by a reduction in prescription of psychoactive medications. Three to six months of intensive borderline personality disorder-specific psychotherapy showed lasting benefit with regard to symptom severity of personality disorders (borderline personality disorder in particular) as well as depressive symptoms. This improvement corresponded with a reduction in prescriptions for psychoactive medications, which is consistent with current thinking regarding treatment for borderline personality disorder. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  2. BnNHL18A shows a localization change by stress-inducing chemical treatments

    International Nuclear Information System (INIS)

    Lee, Suk-Bae; Ham, Byung-Kook; Park, Jeong Mee; Kim, Young Jin; Paek, Kyung-Hee


    The two genes, named BnNHL18A and BnNHL18B, showing sequence homology with Arabidopsis NDR1/HIN1-like (NHL) genes, were isolated from cDNA library prepared with oilseed rape (Brassica napus) seedlings treated with NaCl. The transcript level of BnNHL18A was increased by sodium chloride, ethephon, hydrogen peroxide, methyl jasmonate, or salicylic acid treatment. The coding regions of BnNHL18A and BnNHL18B contain a sarcolipin (SLN)-like sequence. Analysis of the localization of smGFP fusion proteins showed that BnNHL18A is mainly localized to endoplasmic reticulum (ER). This result suggests that the SLN-like sequence plays a role in retaining proteins in ER membrane in plants. In response to NaCl, hydrogen peroxide, ethephon, and salicylic acid treatments, the protein localization of BnNHL18A was changed. Our findings suggest a common function of BnNHL18A in biotic and abiotic stresses, and demonstrate the presence of the shared mechanism of protein translocalization between the responses to plant pathogen and to osmotic stress

  3. Changes in hippocampal metabolites after effective treatment for fibromyalgia: a case study. (United States)

    Wood, Patrick B; Ledbetter, Christina R; Patterson, James C


    Fibromyalgia has been associated with disrupted hippocampal brain metabolite ratios by studies using single voxel magnetic resonance spectroscopy (1H-MRS). Exposure to stress is considered a risk factor for the development and exacerbation of fibromyalgia symptoms. Basic science has demonstrated the hippocampus to be exquisitely sensitive to the effects of stressful experience, which results in changes including alterations in metabolite content and frank atrophy. This report details the case of a 47-year-old woman with fibromyalgia who was originally found to have a profound depression of the ratio of N-acetylaspartate to creatine in her right hippocampus during participation in a study to assess brain metabolite disturbances in fibromyalgia utilizing single voxel proton magnetic resonance spectroscopy. An individualized treatment strategy was developed based both on physiological abnormalities associated with the disorder and symptoms that characterized the patient's unique clinical profile. Clinical and spectroscopic evaluation following nine months of treatment demonstrated both an improvement in her clinical profile and normalization of the NAA/Cr ratio within her right hippocampus. Therapeutic strategies aimed at demonstrable lesions associated with fibromyalgia appear to represent rational targets for pharmacological intervention. The rationale for development of novel pharmacotherapies for this unusual disorder is discussed.

  4. Early change of thyroid hormone concentration after 131I treatment in patients with solitary toxic adenoma

    International Nuclear Information System (INIS)

    Pirnat, E.; Fidler, V.; Zaletel, K.; Gaberscek, S.; Hojker, S.


    Aim: In spite of extensive use of 131 I for treatment of hyperthyroidism, the results of early outcome are variable. In our prospective clinical study we tested whether 131 I induced necrosis causing clinical aggravation of hyperthyroidism and increasing the free thyroid hormone concentration in the serum of patients with solitary toxic adenoma not pretreated with antithyroid drugs. Patients and methods: 30 consecutive patients were treated with 925 MBq 131 I. Serum concentration of thyrotropin (TSH), free thyroxine (fT 4 ), free triiodothyronine (fT 3 ), thyroglobulin (Tg), and interleukin-6 (IL-6) were measured before and after application of 131 I. Results: After application of 131 I no clinical worsening was observed. FT 4 and fT 3 concentration did not change significantly within the first five days, whereas both of them significantly decreased after 12 days (p 131 I induced necrosis of thyroid cells was found. Therefore, the application of 131 I may be considered as a safe and effective treatment for patients with hyperthyroidism due to toxic adenoma. (orig.)

  5. Hypericum perforatum L. treatment restored bone mass changes in swimming stressed rats. (United States)

    Seferos, Nikos; Petrokokkinos, Loukas; Kotsiou, Antonia; Rallis, George; Tesseromatis, Christine


    Stress, via corticosteroids release, influences bone mass density. Hypericum perforatum (Hp) a traditional remedy possess antidepressive activity (serotonin reuptake inhibitor) and wound healing properties. Hp preparation contains mainly hypericin, hyperforin, hyperoside and flavonoids exerting oestrogen-mimetic effect. Cold swimming represents an experimental model of stress associating mental strain and corporal exhaustion. This study investigates the Hp effect on femur and mandible bone mass changes in rats under cold forced swimming procedure. 30 male Wistar rats were randomized into three groups. Group A was treated with Methanolic extract of Hp (Jarsin®) via gastroesophageal catheter, and was submitted to cold swimming stress for 10 min/daily. Group B was submitted to cold stress, since group C served as control. Experiment duration was 10 days. Haematocrite and serum free fatty acids (FFA) were estimated. Furthermore volume and specific weight of each bone as well as bone mass density via dual energy X-Ray absorptiometry (DEXA) were measured. Statistic analysis by t-test. Hp treatment restores the stress injuries. Adrenals and bone mass density regain their normal values. Injuries occurring by forced swimming stress in the rats are significantly improved by Hp treatment. Estrogen-like effects of Hp flavonoids eventually may act favorable in bone remodeling.

  6. Birds of the Mongol Empire


    Eugene N. Anderson


    The Mongol Empire, the largest contiguous empire the world has ever known, had, among other things, a goodly number of falconers, poultry raisers, birdcatchers, cooks, and other experts on various aspects of birding. We have records of this, largely in the Yinshan Zhengyao, the court nutrition manual of the Mongol empire in China (the Yuan Dynasty). It discusses in some detail 22 bird taxa, from swans to chickens. The Huihui Yaofang, a medical encyclopedia, lists ten taxa used medicinally. Ma...


    Directory of Open Access Journals (Sweden)

    A. V. Kil'dyushevskiy


    Full Text Available Background: Despite the availability of a  large number of treatments for multiple sclerosis with various targets, these treatments are not always effective. According to the literature, experimental studies have shown a  significant decrease in tumor necrosis factor alfa (TNF-α with the use of extracorporeal photochemotherapy. Aim: To assess changes in TNF-α in patients with multiple sclerosis during treatment with transimmunization. Materials and methods: The study recruited 13 adult patients with multiple sclerosis. Serum TNF-α was measured by immunochemiluminescence analysis (IMMULITE 1000, Siemens. The patients were treated by transimmunization, i.e. a  modified photopheresis. Two hours before the procedure, Ammifurin (8-methoxypsoralene was administered to all the patients, then their mononuclear cells were isolated under PBSC protocol with Haemonetics MCS+ cell separator. Thereafter, mononuclear cells were irradiated with ultraviolet for 90  minutes and incubated for 20 hours at 37 °С. The next day the cells were re-infused to the patients. The procedure was performed 2  times per week for 6  months, then once per 4  months. Results: Before transimmunization, mean TNF-α level in adult patients with multiple sclerosis was 9.958±0.812  pg/mL (normal, below 8.1 pg/mL. After transimmunization, its level was 6.992±0.367  pg/mL (р<0.05. Conclusion: Ultraviolet irradiation of peripheral blood monocytes with their subsequent incubation (transimmunization led to a 30% decrease of serum TNF-α in patients with multiple sclerosis. This indicates a suppressive effect of transimmunization on TNF-α. Hence, in patients with multiple sclerosis transimmunization exerts an anti-inflammatory effect.

  8. Meta-analysis of skeletal mandibular changes during Frankel appliance treatment. (United States)

    Perillo, Letizia; Cannavale, Rosangela; Ferro, Fabrizia; Franchi, Lorenzo; Masucci, Caterina; Chiodini, Paolo; Baccetti, Tiziano


    The purpose of this study was to perform a meta-analysis of articles to verify the mandibular changes produced by the Fränkel-2 (FR-2) appliance during the treatment of growing patients with Class II malocclusions when compared with untreated growing Class II subjects. The literature published from January 1966 to January 2009 was reviewed with search engines. A quality analysis was performed. The effects on primary end points were calculated with random-effect models. Heterogeneity was assessed using Q statistic and investigated using study-level meta-regression. A total of nine articles were identified. The quality of the studies ranged from low to medium. Meta-analysis showed that the FR-2 was associated with enhancement of mandibular body length [0.4 mm/year 95 per cent confidence interval (CI) 0.182-0.618], total mandibular length (1.069 mm/year, 95 per cent CI 0.683-1.455), and mandibular ramus height (0.654 mm/year, 95 per cent CI 0.244-1.064). A consistent heterogeneity among studies was found for all the considered linear measurements. The FR-2 appliance had a statistically significant effect on mandibular growth. Nevertheless, the heterogeneity of the FR-2 effects, the quality of studies, the differences in age, skeletal age, treatment duration, and the inconsistent initial diagnosis seem to overstate the benefits of the FR-2 appliance. An evidence-based approach to the orthodontic outcomes of FR-2 appliance is needed, by selecting and comparing groups of children with the same cephalometric characteristics with and without treatment.

  9. Changes in tumor oxygenation during a combined treatment with fractionated irradiation and hyperthermia: an experimental study. (United States)

    Zywietz, F; Reeker, W; Kochs, E


    To determine the influence of adjuvant hyperthermia on the oxygenation status of fractionated irradiated tumors. Oxygen partial pressure (pO2) in rat rhabdomyosarcomas (R1H) was measured sequentially at weekly intervals during a fractionated irradiation with 60Co-gamma-rays (60 Gy/20f/4 weeks) in combination with local hyperthermia (8 f(HT) at 43 degrees C, 1 h/4 weeks). Tumors were heated twice weekly with a 2450 MHz microwave device at 43 degrees C, 1 h starting 10 min after irradiation. The pO2 measurements (pO2-histograph, Eppendorf, Germany) were performed in anesthetized animals during mechanical ventilation and in hemodynamic steady state. All tumor pO2 measurements were correlated to measurements of the arterial oxygen partial pressure (paO2) determined by a blood gas analyzer. The oxygenation status of R1H tumors decreased continuously from the start of the combined treatment, with increasing radiation dose and number of heat fractions. In untreated controls a median tumor pO2 of 23 +/- 2 mmHg (mean +/- SEM) was measured. Tumor pO2 decreased to 11 +/- 2 mmHg after 30 Gy + 4 HT (2 weeks), and to 6 +/- 2 mmHg after 60 Gy + 8HT (4 weeks). The increase in the frequency of pO2-values below 5 mmHg and the decrease in the range of the pO2 histograms [delta p(10/90)] further indicated that tumor hypoxia increased relatively rapidly from the start of combined treatment. After 60 Gy + 8HT 48 +/- 5% (mean +/- SEM) of the pO2-values recorded were below 5 mmHg. These findings suggest that adjuvant hyperthermia to radiotherapy induces greater changes in tumor oxygenation than radiation alone [cf. (39)]. This might be of importance for the temporary application of hyperthermia in the course of a conventional radiation treatment.

  10. The detection and treatment of Plasmodium falciparum malaria: Time for change

    Directory of Open Access Journals (Sweden)

    Nosten F


    Full Text Available In most countries where malaria is endemic, P. falciparum malaria is on the rise. This is primarily due to the spread of drug-resistant strains. Drug resistance is mediated by spontaneous changes in the parasite genome that allow resistant parasites to escape the action of the drugs. The spread of drug resistance increases the transmission of malaria parasites. The consequences for the populations at risk are profound both in terms of consequences for health and economy. In order to halt the progression of drug resistance, we need to change the way antimalarials are used. As in tuberculosis and HIV/AIDS, we must use a combination of drugs for the treatment of malaria. Taking into account the pharmacokinetic and pharmacodynamic properties of the various anti-malarial agents, artemisinin-based combination therapy (ACT seems to be the best option. This strategy should be used in conjunction with early diagnosis and appropriate vector control measures to achieve reduction in the emergence and spread of drug resistance.

  11. Changing treatment of breast cancer in New Mexico from 1969 through 1985

    International Nuclear Information System (INIS)

    Mann, B.A.; Samet, J.M.; Hunt, W.C.; Key, C.R.; Goodwin, J.M.; Goodwin, J.S.


    A review of information from the New Mexico Tumor Registry on women diagnosed as having primary breast cancer from 1969 through 1985 revealed temporal changes in the surgical treatment of this disease. After 1980 the percentage of women receiving breast-conserving surgery for local-stage disease increased from 6% to 25%. Most surgeons performing operations for breast cancer had not performed a breast-conserving operation before 1981 but had used this procedure at least once in the period from 1981 through 1985. Women younger than 50 years or older than 80 years were most likely to undergo this procedure. In that period, radiotherapy after breast-conserving surgery could not be documented for 26% of the women 65 years old or younger or for 56% of the women aged 65 years or older. Thus, there has been a marked shift in New Mexico in the surgical approach to local-stage breast cancer in the 1980s. This shift involved most surgeons treating the disease and included women of all age groups. The apparent lack of adjuvant radiotherapy in some women receiving conservative surgeries may prove to be deleterious consequence of this change in surgical management

  12. Empirically Based Psychosocial Therapies for Schizophrenia: The Disconnection between Science and Practice

    Directory of Open Access Journals (Sweden)

    Glenn D. Shean


    Full Text Available Empirically validated psychosocial therapies for individuals diagnosed with schizophrenia were described in the report of the Schizophrenia Patient Outcomes Research Team (PORT, 2009. The PORT team identified eight psychosocial treatments: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. PORT listings of empirically validated psychosocial therapies provide a useful template for the design of effective recovery-oriented mental health care systems. Unfortunately, surveys indicate that PORT listings have not been implemented in clinical settings. Obstacles to the implementation of PORT psychosocial therapy listings and suggestions for changes needed to foster implementation are discussed. Limitations of PORT therapy listings that are based on therapy outcome efficacy studies are discussed, and cross-cultural and course and outcome studies of correlates of recovery are summarized.

  13. Clinical significance of determination of changes of serum TNF and SA levels after treatment in patients with gonorrhea

    International Nuclear Information System (INIS)

    Zhong Chengwu


    Objective: To investigate the changes of serum TNF and sialic acid (SA) levels after treatment in patients with gonorrhea. Methods: Serum TNF (with RIA) and SA (with spectrophotometer ) levels were measured both before and after treatment in 42 patients with gonorrhea as well as in 35 controls. Results: Before treatment, the serum levels of TNF and SA were significantly higher than those in the controls (P 0.05). Conclusion: Changes of serum levels of TNF and SA could reflect the severity of infection in patients with gonorrhea. (authors)

  14. Empirical techniques in finance

    CERN Document Server

    Bhar, Ramaprasad


    This book offers the opportunity to study and experience advanced empi- cal techniques in finance and in general financial economics. It is not only suitable for students with an interest in the field, it is also highly rec- mended for academic researchers as well as the researchers in the industry. The book focuses on the contemporary empirical techniques used in the analysis of financial markets and how these are implemented using actual market data. With an emphasis on Implementation, this book helps foc- ing on strategies for rigorously combing finance theory and modeling technology to extend extant considerations in the literature. The main aim of this book is to equip the readers with an array of tools and techniques that will allow them to explore financial market problems with a fresh perspective. In this sense it is not another volume in eco- metrics. Of course, the traditional econometric methods are still valid and important; the contents of this book will bring in other related modeling topics tha...

  15. Oestrus synchronization treatment induces histomorphological changes on the uterine tube epithelium of the gilt. (United States)

    Juárez-Mosqueda, M L; Anzaldúa Arce, S R; Palma Lara, I; García Dalmán, C; Cornejo Cortés, M A; Córdova Izquierdo, A; Villaseñor Gaona, H; Trujillo Ortega, M E


    The aim of this study was to determine the histomorphological changes that occurred in response to two treatments for oestrus synchronization in three different regions of the gilt's uterine tubes epithelium: the ampulla (AMP), ampulla-isthmic junction (AIJ) and isthmus (IST). Nine prepuberal gilts were divided into three groups (n = 3): (1) eCG 400 IU and hCG 200 IU (eCG/hCG), (2) progesterone agonist (P4) and (3) control group. The number of secretory cells (stained with periodic acid-Schiff reaction or PAS-positive cells) decreased in the AMP in the P4 treated group when compared to the control group, whereas, no difference was observed in the number of PAS-negative cells in the AMP of the three groups. A significant decrease in the number of PAS-positive cells was observed in the AIJ and IST of the P4 treated group when compared to the eCG/hCG and control groups. An increase in the number of PAS-negative cells was observed in the AIJ and IST in the P4 treated group. The epithelium height in the AMP and AIJ was increased in the eCG/hCG group when compared to the control and P4 groups. In this last group, we observed a reduced height compared with the other two groups for the AIJ. In the IST, there were no significant changes in the epithelium height of the control or the other two groups (eCG/hCG and P4). The epithelial cells of the P4 treated group had the least amount of cytoplasmic granules and the lowest intensity of PAS staining in the AMP, AIJ and IST. Animals treated with eCG/hCG showed an intermediate number of cytoplasmic granules and intensity in all regions evaluated. These data show that P4 treatment for synchronization induces a significant (P epithelium. Moreover, eCG/hCG treatment increased the height of the epithelium in the AMP and AIJ, while in this last region, the P4 treatment decreased the epithelium height. These results show that synchronization treatments with P4 and in a smaller proportion with eCG/hCG can modify the amount of PAS

  16. Dropout among patients in qualified detoxification treatment : the effect of treatment motivation is moderated by trauma load


    Odenwald, Michael; Semrau, Peter


    Background: Motivation to change has been proposed as a prerequisite for behavioral change, although empirical results are contradictory. Traumatic experiences are frequently found amongst patients in alcohol treatment, butthis has not been systematically studied in terms of effects on treatment outcomes. This study aimed to clarify whether individual Trauma Load explains some of the inconsistencies between motivation to change andbehavioral change.Methods: Over the course of two months in 20...

  17. Early weight loss predicts weight loss treatment response regardless of binge-eating disorder status and pretreatment weight change. (United States)

    Barnes, Rachel D; Ivezaj, Valentina; Pittman, Brian P; Grilo, Carlos M


    Individuals seeking weight loss treatment have diverse pretreatment weight trajectories, and once enrolled, individuals' response to weight loss treatments also varies greatly and may be influenced by the presence of binge-eating disorder (BED). Reported average weight losses may obscure these considerable differences. This study examined whether BED status and different weight-related change variables are associated with successful weight loss treatment outcomes in a controlled treatment study. Participants (N = 89) with overweight/obesity, with and without BED, participated in a 3-month weight loss trial in primary care with 3- and 12-month follow-ups. We tested the prognostic significance of four weight-related change variables (the last supper, early weight loss, pretreatment weight trajectory, weight suppression) on outcomes (weight loss-overall, weight loss-"subsequent," weight loss during second half of treatment). Early weight loss was positively associated with weight loss-overall at post-treatment, and at 3-month and 12-month follow-up. Early weight loss was positively associated with weight loss-subsequent at post-treatment only. No other weight-related variables were significantly associated with weight loss. Models including BED status and treatment condition were not significant. Participants with early weight loss were more likely to continue losing weight, regardless of BED status or treatment condition. The results highlight the importance of early dedication to weight loss treatment to increase the likelihood of positive outcomes. © 2018 Wiley Periodicals, Inc.

  18. Antibiotic treatment in patients with low-back pain associated with Modic changes Type 1 (bone oedema): a pilot study

    DEFF Research Database (Denmark)

    Albert, HB; Manniche, C; Sørensen, JS


    OBJECTIVE: The aim of this study was to assess the clinical effect of antibiotic treatment in a cohort of patients with low-back pain (LBP) and Modic changes Type 1 (bone oedema) following a lumbar herniated disc. DESIGN: This was a prospective uncontrolled trial of 32 LBP patients who had Modic...... and LBP at 14 months follow-up (n = 37) were invited to participate in this subsequent antibiotic trial but five did not meet the inclusion criteria. RESULTS: 29 patients completed the treatment, as three patients dropped out due to severe diarrhoea. At the end of treatment and at long-term follow...... changes and were treated with Amoxicillin-clavulanate (500 mg/125 mg) 3 x day for 90 days. All patients had previously participated in a randomised controlled trial (RCT) that investigated active conservative treatment for a lumbar herniated disc (n = 166). All patients in that RCT who had Modic changes...

  19. Pre-treatment attachment anxiety predicts change in depressive symptoms in women who complete day hospital treatment for anorexia and bulimia nervosa. (United States)

    Keating, Leah; Tasca, Giorgio A; Bissada, Hany


    Individuals with eating disorders are prone to depressive symptoms. This study examines whether depressive symptoms can change in women who complete intensive day treatment for anorexia and bulimia nervosa (BN), and whether these changes are associated with pre-treatment attachment insecurity. Participants were 141 women with anorexia nervosa restricting type (n = 24), anorexia nervosa binge purge type (n = 30), and BN (n = 87) who completed a day hospital treatment programme for eating disorders. They completed a pre-treatment self-report measure of attachment, and a pre-treatment and post-treatment self-report measure of depressive symptoms. Participants experienced significant reductions in depressive symptoms at post-treatment. Eating disorder diagnosis was not related to these improvements. However, participants lower in attachment anxiety experienced significantly greater improvement in depressive symptoms than those who were higher in attachment anxiety. These results suggest that clinicians may tailor eating disorders treatments to patients' attachment patterns and focus on their pre-occupation with relationships and affect regulation to improve depressive symptoms. That depressive symptoms can decrease in women who complete day hospital treatment for anorexia and BN. That improvements in depressive symptoms do not vary according to eating disorder diagnosis in these women. That patients who complete treatment and who have higher attachment anxiety experience less improvements in depressive symptoms compared to those lower in attachment anxiety. That clinicians may attend to aspects of attachment anxiety, such as need for approval and up-regulation of emotions, to improve depressive symptoms in female patients with eating disorders. © 2014 The British Psychological Society.

  20. Changing trends in the aetiology, treatment and outcomes of bloodstream infection occurring in the first year after solid organ transplantation: a single-centre prospective cohort study. (United States)

    Oriol, Isabel; Sabé, Núria; Simonetti, Antonella F; Lladó, Laura; Manonelles, Anna; González, Jose; Tubau, Fe; Carratalà, Jordi


    To analyse trends in the aetiology, treatment and outcomes of bloodstream infection (BSI) within the first year post-transplant over the last 10-year period, we prospectively recorded all episodes of BSI occurring in solid organ transplant (SOT) recipients during the first year post-transplant from 2007 to 2016. Trends of factors were analysed by 2-year periods. Of 475 consecutive episodes of BSI, 218 occurred within a year of SOT in 178 SOT recipients. Gram-positive BSI decreased over time (40.5-2.2%). In contrast, there was a steady increase in Gram-negative bacilli (GNB) BSI (54.1-93.3%; P < 0.001), mainly due to Pseudomonas aeruginosa (2.4-20.4%) and Klebsiella pneumoniae (7.1-26.5%). Multidrug-resistant (MDR) GNB (4.8-38.8%; P < 0.001) rose dramatically, especially due to extended-spectrum β-lactamase (ESBL) production (7.1-34.7%). There was a sharp rise in the use of carbapenems, both as empirical (11.9-55.3%; P < 0.001) and as targeted antibiotic treatment (11.9-46.9%; P < 0.001). In conclusion, today, GNB are the leading causative agents of BSI in SOT recipients within the first year after SOT. In addition, MDR GNB have emerged mainly due to ESBL-producing strains. In spite of these changes, length of hospital stay, days of treatment and mortality have remained stable over time. © 2017 Steunstichting ESOT.