Cost considerations in determining the affordability of adjuvant ...

African Journals Online (AJOL)

growth factor receptor 2 (HER2)-positive breast cancer, particularly in low- and middle-income countries. Affordability and value differ in patient groups with different baseline prognoses. This is illustrated below using the hazard ratio (HR) of survival rates obtained from a. Cochrane review[2] and personal communication ...

System engineering of complex optical systems for mission assurance and affordability

Science.gov (United States)

Ahmad, Anees

2017-08-01

Affordability and reliability are equally important as the performance and development time for many optical systems for military, space and commercial applications. These characteristics are even more important for the systems meant for space and military applications where total lifecycle costs must be affordable. Most customers are looking for high performance optical systems that are not only affordable but are designed with "no doubt" mission assurance, reliability and maintainability in mind. Both US military and commercial customers are now demanding an optimum balance between performance, reliability and affordability. Therefore, it is important to employ a disciplined systems design approach for meeting the performance, cost and schedule targets while keeping affordability and reliability in mind. The US Missile Defense Agency (MDA) now requires all of their systems to be engineered, tested and produced according to the Mission Assurance Provisions (MAP). These provisions or requirements are meant to ensure complex and expensive military systems are designed, integrated, tested and produced with the reliability and total lifecycle costs in mind. This paper describes a system design approach based on the MAP document for developing sophisticated optical systems that are not only cost-effective but also deliver superior and reliable performance during their intended missions.

PLK-1 Silencing in Bladder Cancer by siRNA Delivered With Exosomes.

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Greco, Kristin A; Franzen, Carrie A; Foreman, Kimberly E; Flanigan, Robert C; Kuo, Paul C; Gupta, Gopal N

2016-05-01

To use exosomes as a vector to deliver small interfering ribonucleic acid (siRNA) to silence the polo-like kinase 1 (PLK-1) gene in bladder cancer cells. Exosomes were isolated from both human embryonic kidney 293 (HEK293) cell and mesenchymal stem cell (MSC) conditioned media. Fluorescently labeled exosomes were co-cultured with bladder cancer and normal epithelial cells and uptake was quantified by image cytometry. PLK-1 siRNA and negative control siRNA were loaded into HEK293 and MSC exosomes using electroporation. An invasive bladder cancer cell line (UMUC3) was co-cultured with the electroporated exosomes. Quantitative reverse transcriptase polymerase chain reaction was performed. Protein analysis was performed by Western blot. Annexin V staining and MTT assays were used to investigate effects on apoptosis and viability. Bladder cancer cell lines internalize an increased percentage of HEK293 exosomes when compared to normal bladder epithelial cells. Treatment of UMUC3 cells with exosomes electroporated with PLK-1 siRNA achieved successful knockdown of PLK-1 mRNA and protein when compared to cells treated with negative control exosomes. HEK293 and MSC exosomes were effectively used as a delivery vector to transport PLK-1 siRNA to bladder cancer cells in vitro, resulting in selective gene silencing of PLK-1. The use of exosomes as a delivery vector for potential intravesical therapy is attractive. Copyright © 2016 Elsevier Inc. All rights reserved.

An innovation in curriculum content and delivery of cancer education within undergraduate nurse training in the UK. What impact does this have on the knowledge, attitudes and confidence in delivering cancer care?

Science.gov (United States)

Edwards, Deborah; Anstey, Sally; Kelly, Daniel; Hopkinson, Jane

2016-04-01

This was an evaluation of an innovation in curriculum content and delivery within undergraduate nursing education in the UK. Its purpose was to investigate the effect on knowledge, attitudes and confidence in delivering cancer care. The study design was a pre-test post-test survey design with a comparison group. Participants were two cohorts of undergraduate nursing students (n(intervention) = 84, n(comparison) = 91). The intervention cohort were exposed to a new 3.5 day programme of cancer education, coproduced with patients, carers and health professionals, which focused on cancer as a life changing long-term condition. The comparison cohort had been exposed to a 2 day programme produced by a lecturer. Following exposure to the new model for the delivery of undergraduate nurse cancer education, the intervention cohort demonstrated good overall knowledge of the impact of cancer, more positive attitudes towards cancer treatment and more confidence in their ability to deliver cancer care. Attitudes were more positive and confidence in ability to support cancer patients at all stages of the cancer journey were greater than in the comparison group. Insights gained into the cancer patient and carer perspectives were highly valued. This study has found that a new model for the delivery of cancer education focusing on survivorship and delivered in partnership with patients, carers and clinicians, may improve knowledge, attitudes and confidence in the delivery of cancer care. Further work is now needed, using a more robust experimental design, to investigate the generalisability of the results to other education programs. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Delivering breast cancer care in urban India: Heterotopia, hospital ethnography and voluntarism.

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Macdonald, Alison

2016-05-01

Despite substantial strides to improve cancer control in India, challenges to deliver oncology services persist. One major challenge is the provision and accessibility of adequate infrastructure. This paper offers ethnographic insight on the conceptual and material conditions that are currently shaping the delivery of oncology in Mumbai, focusing specifically on the way India's socio-economic context necessitates non-biomedical acts of voluntarism or 'seva' (selfless service). Developing the premise that hospitals are not identical clones of a biomedical model, detailed attention is paid to the way 'care' emerges through 'praxis of place' (Casey, 2003) within the cancer hospital as a multi-scalar 'heterotopic' (Street and Coleman, 2012) site. Such a perspective enables global/local tensions to come into view, together with the heterogeneous confluence of juxtaposing materialities, imaginations, social practices and values that both propels and constrains the everyday delivery of care. The paper reflects on the theoretical implications of hospital seva in Mumbai in light of social science studies of hospital ethnography and health activism and contributes important ethnographic insight into the current global health debates regarding effective implementation of cancer services in India. Copyright © 2016 Elsevier Ltd. All rights reserved.

Novel HER2 Aptamer Selectively Delivers Cytotoxic Drug to HER2-positive Breast Cancer Cells in Vitro

Directory of Open Access Journals (Sweden)

Liu Zhe

2012-07-01

Full Text Available Abstract Background Aptamer-based tumor targeted drug delivery system is a promising approach that may increase the efficacy of chemotherapy and reduce the related toxicity. HER2 protein is an attractive target for tumor-specific drug delivery because of its overexpression in multiple malignancies, including breast, gastric, ovarian, and lung cancers. Methods In this paper, we developed a new HER2 aptamer (HB5 by using systematic evolution of ligands by exponential enrichment technology (SELEX and exploited its role as a targeting ligand for delivering doxorubicin (Dox to breast cancer cells in vitro. Results The selected aptamer was an 86-nucleotide DNA molecule that bound to an epitope peptide of HER2 with a Kd of 18.9 nM. The aptamer also bound to the extracellular domain (ECD of HER2 protein with a Kdof 316 nM, and had minimal cross reactivity to albumin or trypsin. In addition, the aptamer was found to preferentially bind to HER2-positive but not HER2-negative breast cancer cells. An aptamer-doxorubicin complex (Apt-Dox was formulated by intercalating Dox into the DNA structure of HB5. The Apt-Dox complex could selectively deliver Dox to HER2-positive breast cancer cells while reducing the drug intake by HER2-negative cells in vitro. Moreover, Apt-Dox retained the cytotoxicity of Dox against HER2-positive breast cancer cells, but reduced the cytotoxicity to HER2-negative cells. Conclusions The results suggest that the selected HER2 aptamer may have application potentials in targeted therapy against HER2-positive breast cancer cells.

Historicizing affordance theory

DEFF Research Database (Denmark)

Pedersen, Sofie; Bang, Jytte Susanne

2017-01-01

The aim of this article is to discuss how mutually enriching points from both affordance theory and cultural-historical activity theory can promote theoretical ideas which may prove useful as analytical tools for the study of human life and human development. There are two issues that need...... to be overcome in order to explore the potentials of James Gibson’s affordance theory: it does not sufficiently theorize (a) development and (b) society. We claim that Gibson’s affordance theory still needs to be brought beyond “the axiom of immediacy.” Ambivalences in Gibson’s affordance theory...... societal character of affordance theory....

Network Affordances

DEFF Research Database (Denmark)

Samson, Audrey; Soon, Winnie

2015-01-01

This paper examines the notion of network affordance within the context of network art. Building on Gibson's theory (Gibson, 1979) we understand affordance as the perceived and actual parameters of a thing. We expand on Gaver's affordance of predictability (Gaver, 1996) to include ecological...... and computational parameters of unpredictability. We illustrate the notion of unpredictability by considering four specific works that were included in a network art exhibiton, SPEED SHOW [2.0] Hong Kong. The paper discusses how the artworks are contingent upon the parameteric relations (Parisi, 2013......), of the network. We introduce network affordance as a dynamic framework that could articulate the experienced tension arising from the (visible) symbolic representation of computational processes and its hidden occurrences. We base our proposal on the experience of both organising the SPEED SHOW and participating...

Addressing Cancer Drug Costs and Value

Science.gov (United States)

The President’s Cancer Panel has released its latest report, Promoting Value, Affordability, and Innovation in Cancer Drug Treatment. The report recommends six actions to maximize the value and affordability of cancer drug treatment.

A randomized trial of videoconference-delivered cognitive behavioral therapy for survivors of breast cancer with self-reported cognitive dysfunction.

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Ferguson, Robert J; Sigmon, Sandra T; Pritchard, Andrew J; LaBrie, Sharon L; Goetze, Rachel E; Fink, Christine M; Garrett, A Merrill

2016-06-01

Long-term chemotherapy-related cognitive dysfunction (CRCD) affects a large number of cancer survivors. To the authors' knowledge, to date there is no established treatment for this survivorship problem. The authors herein report results of a small randomized controlled trial of a cognitive behavioral therapy (CBT), Memory and Attention Adaptation Training (MAAT), compared with an attention control condition. Both treatments were delivered over a videoconference device. A total of 47 survivors of female breast cancer who reported CRCD were randomized to MAAT or supportive therapy and were assessed at baseline, after treatment, and at 2 months of follow-up. Participants completed self-report measures of cognitive symptoms and quality of life and a brief telephone-based neuropsychological assessment. MAAT participants made gains in perceived (self-reported) cognitive impairments (P = .02), and neuropsychological processing speed (P = .03) compared with supportive therapy controls. A large MAAT effect size was observed at the 2-month follow-up with regard to anxiety concerning cognitive problems (Cohen's d for standard differences in effect sizes, 0.90) with medium effects noted in general function, fatigue, and anxiety. Survivors rated MAAT and videoconference delivery with high satisfaction. MAAT may be an efficacious psychological treatment of CRCD that can be delivered through videoconference technology. This research is important because it helps to identify a treatment option for survivors that also may improve access to survivorship services. Cancer 2016;122:1782-91. © 2016 American Cancer Society. © 2016 American Cancer Society.

How to deliver better policy integration?

International Nuclear Information System (INIS)

Hattori, Takashi

2015-01-01

Several challenges and possible ways forward in reconciling the delivery of energy policy goals including security and affordability are presented, based on the recent analyses by the International Energy Agency (IEA). This article addresses five topics: multiple challenging policy goals of the IEA’s 3 E’s (energy security, economic growth, and environmental sustainability); needs in the transformation to low carbon societies in the energy sectors; major policies and measures for energy sector transformation; multiple related policy goals and multiple benefits of energy efficiency policy; and realising climate and energy policy integration. Overall, this article explores how to better deliver climate and energy policy integration in the real world.

Actant affordances: a brief history of affordance theory and a ...

African Journals Online (AJOL)

Affordance theory provides a useful lens to explore the action opportunities that arise between users and technology, especially in education. However developments in the theory have resulted both in confusion and misapplication, due partly to issues related to affordance theory's ontology. This paper outlines two ...

55 Actant affordances: a brief history of affordance theory and a ...

African Journals Online (AJOL)

He combined affordances and perceptual information in a simple matrix, as shown in figure ... Secondly it shows up cases of False Affordances that appear to be useful ..... Distributed Cognitions: Psychological and Educational Considerations.

Living well after breast cancer randomized controlled trial protocol: evaluating a telephone-delivered weight loss intervention versus usual care in women following treatment for breast cancer.

Science.gov (United States)

Reeves, Marina M; Terranova, Caroline O; Erickson, Jane M; Job, Jennifer R; Brookes, Denise S K; McCarthy, Nicole; Hickman, Ingrid J; Lawler, Sheleigh P; Fjeldsoe, Brianna S; Healy, Genevieve N; Winkler, Elisabeth A H; Janda, Monika; Veerman, J Lennert; Ware, Robert S; Prins, Johannes B; Vos, Theo; Demark-Wahnefried, Wendy; Eakin, Elizabeth G

2016-10-28

Obesity, physical inactivity and poor diet quality have been associated with increased risk of breast cancer-specific and all-cause mortality as well as treatment-related side-effects in breast cancer survivors. Weight loss intervention trials in breast cancer survivors have shown that weight loss is safe and achievable; however, few studies have examined the benefits of such interventions on a broad range of outcomes and few have examined factors important to translation (e.g. feasible delivery method for scaling up, assessment of sustained changes, cost-effectiveness). The Living Well after Breast Cancer randomized controlled trial aims to evaluate a 12-month telephone-delivered weight loss intervention (versus usual care) on weight change and a range of secondary outcomes including cost-effectiveness. Women (18-75 years; body mass index 25-45 kg/m 2 ) diagnosed with stage I-III breast cancer in the previous 2 years are recruited from public and private hospitals and through the state-based cancer registry (target n = 156). Following baseline assessment, participants are randomized 1:1 to either a 12-month telephone-delivered weight loss intervention (targeting diet and physical activity) or usual care. Data are collected at baseline, 6-months (mid-intervention), 12-months (end-of-intervention) and 18-months (maintenance). The primary outcome is change in weight at 12-months. Secondary outcomes are changes in body composition, bone mineral density, cardio-metabolic and cancer-related biomarkers, metabolic health and chronic disease risk, physical function, patient-reported outcomes (quality of life, fatigue, menopausal symptoms, body image, fear of cancer recurrence) and behaviors (dietary intake, physical activity, sitting time). Data collected at 18-months will be used to assess whether outcomes achieved at end-of-intervention are sustained six months after intervention completion. Cost-effectiveness will be assessed, as will mediators and moderators of

Impact of caregivers' unmet needs for supportive care on quality of terminal cancer care delivered and caregiver's workforce performance.

Science.gov (United States)

Park, Sang Min; Kim, Young Jin; Kim, Samyong; Choi, Jong Soo; Lim, Ho-Yeong; Choi, Youn Seon; Hong, Young Seon; Kim, Si-Young; Heo, Dae Seog; Kang, Ki Moon; Jeong, Hyun Sik; Lee, Chang Geol; Moon, Do Ho; Choi, Jin-Young; Kong, In Sik; Yun, Young Ho

2010-06-01

Family caregivers play an important role in caring for cancer patients, but the impact of caregivers' unmet needs on the quality of end-of-life (EOL) care they deliver and on their workplace performance are less understood. We identified 1,662 family caregivers of cancer patients who had died at any of 17 hospitals in Korea during 2004. The caregivers answered a telephone questionnaire about needs that were not met when they delivered terminal cancer care and how those unmet their needs affected their workplace performance; they also answered the Quality Care Questionnaire-End of Life (QCQ-EOL). Compared with caregivers who did not have unmet needs, caregivers who had unmet needs for symptom management, financial support, or community support showed poorer QCQ-EOL scores (P < 0.01). Caregivers who had unmet needs for financial support (adjusted odds ratio (aOR) = 7.55; 95% confidential interval (CI) 3.80-15.00), psychosocial support (aOR = 6.24; 95% CI 2.95-13.05), symptom management (aOR = 3.21; 95% CI 2.26-4.54), community support (aOR = 3.82; 95% CI 2.38-6.11), or religious support (aOR = 4.55; 95% CI 1.84-11.26) were more likely to experience work limitations. Caregivers of patients receiving conventional hospital care were more likely to have unmet needs for symptom management (aOR = 1.21; 95% CI 1.00-1.47), psychosocial support (aOR = 1.99; 95% CI 1.37-2.88), and religious support (aOR = 1.73; 95% CI 1.08-2.78) than those of patients receiving palliative hospice care. Caregivers' unmet needs negatively affected both the quality of EOL care they delivered and their workplace performance. More investment in caregiver support and public policies that meet caregiver needs are needed, and hospice use should be encouraged.

Economic Burden of Bladder Cancer Across the European Union.

Science.gov (United States)

Leal, Jose; Luengo-Fernandez, Ramon; Sullivan, Richard; Witjes, J Alfred

2016-03-01

More than 120,000 people are diagnosed annually with bladder cancer in the 28 countries of the European Union (EU). With >40,000 people dying of it each year, it is the sixth leading cause of cancer. However, to date, no systematic cost-of-illness study has assessed the economic impact of bladder cancer in the EU. To estimate the annual economic costs of bladder cancer in the EU for 2012. Country-specific cancer cost data were estimated using aggregate data on morbidity, mortality, and health care resource use, obtained from numerous international and national sources. Health care costs were estimated from expenditures on primary, outpatient, emergency, and inpatient care, as well as medications. Costs of unpaid care and lost earnings due to morbidity and early death were estimated. Bladder cancer cost the EU €4.9 billion in 2012, with health care accounting for €2.9 billion (59%) and representing 5% of total health care cancer costs. Bladder cancer accounted for 3% of all cancer costs in the EU (€143 billion) in 2012 and represented an annual health care cost of €57 per 10 EU citizens, with costs varying >10 times between the country with the lowest cost, Bulgaria (€8 for every 10 citizens), and highest cost, Luxembourg (€93). Productivity losses and informal care represented 23% and 18% of bladder cancer costs, respectively. The quality and availability of comparable cancer-related data across the EU need further improvement. Our results add to essential public health and policy intelligence for delivering affordable bladder cancer care systems and prioritising the allocation of public research funds. We looked at the economic costs of bladder cancer across the European Union (EU). We found bladder cancer to cost €4.9 billion in 2012, with health care accounting for €2.9 billion. Our study provides data that can be used to inform affordable cancer care in the EU. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All

Assuring Access to Affordable Coverage

Data.gov (United States)

U.S. Department of Health & Human Services — Under the Affordable Care Act, millions of uninsured Americans will gain access to affordable coverage through Affordable Insurance Exchanges and improvements in...

NASA's Space Launch System: Affordability for Sustainability

Science.gov (United States)

May, Todd A.; Creech, Stephen D.

2012-01-01

The National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center, is charged with delivering a new capability for human exploration beyond Earth orbit in an austere economic climate. But the SLS value is clear and codified in United States (U.S.) budget law. The SLS Program knows that affordability is the key to sustainability and will provide an overview of initiatives designed to fit within the funding guidelines by using existing engine assets and hardware now in testing to meet a first launch by 2017 within the projected budget. It also has a long-range plan to keep the budget flat, yet evolve the 70-tonne (t) initial lift capability to 130-t lift capability after the first two flights. To achieve the evolved configuration, advanced technologies must offer appropriate return on investment to be selected through the competitive process. For context, the SLS will be larger than the Saturn V that took 12 men on 6 trips for a total of 11 days on the lunar surface some 40 years ago. Astronauts train for long-duration voyages on platforms such as the International Space Station, but have not had transportation to go beyond Earth orbit in modern times, until now. To arrive at the launch vehicle concept, the SLS Program conducted internal engineering and business studies that have been externally validated by industry and reviewed by independent assessment panels. In parallel with SLS concept studies, NASA is now refining its mission manifest, guided by U.S. space policy and the Global Exploration Roadmap, which reflects the mutual goals of a dozen member nations. This mission planning will converge with a flexible heavy-lift rocket that can carry international crews and the air, water, food, and equipment they need for extended trips to asteroids and Mars. In addition, the SLS capability will accommodate very large science instruments and other payloads, using a series of modular fairings and

A feasibility study of using conventional jaws to deliver complex IMRT plans for head and neck cancer

International Nuclear Information System (INIS)

Mu, G; Xia, P

2009-01-01

Previous studies have demonstrated that simple intensity-modulated radiotherapy (IMRT) plans can be produced with a series of rectangular segments formed by conventional jaws. This study investigates whether complex IMRT plans for head and neck cancer can be delivered with the conventional jaws efficiently. Six nasopharyngeal cancer patients, previously treated with multi-leaf collimator (MLC)-IMRT plans, were re-planned using conventional jaw delivery options. All IMRT plans were subject to the plan acceptance criteria of the RTOG-0225 protocol. For a selected patient, the maximum number of segments varied from five to nine per beam, and was tested for both jaws-only IMRT (JO-IMRT) plans and MLC-IMRT plans. Subsequently, JO-IMRT plans and MLC-IMRT on the same treatment planning system were attempted for all patients with identical beams. The dose distribution, dose volume histograms (DVH), the conformal index (COIN), the uniformity index and delivery efficiency were compared between the MLC-IMRT and JO-IMRT plans. All JO-IMRT plans met the RTOG-0225 criteria for tumor coverage and sensitive structures sparing. The corresponding MLC-IMRT and JO-IMRT plans show comparable conformality and uniformity, with average COINs of the planning gross tumor volume(pGTV) 37.7% ± 18.7% versus 37.9% ± 18.1%, and the average uniformity index 82.8% ± 2.5% versus 83.6% ± 3.1%, respectively. The average monitor unit for JO-IMRT plans was about twice that of MLC-IMRT plans. In conclusion, conventional jaws can be used solely to deliver complex IMRT plans for patients with nasopharyngeal cancer yet still within a practical delivery time.

Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial.

Science.gov (United States)

Hawkes, Anna L; Chambers, Suzanne K; Pakenham, Kenneth I; Patrao, Tania A; Baade, Peter D; Lynch, Brigid M; Aitken, Joanne F; Meng, Xingqiong; Courneya, Kerry S

2013-06-20

Colorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors. In this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care. Assessment of primary (ie, physical activity [Godin Leisure Time Index], health-related quality of life [HRQoL; Short Form-36], and cancer-related fatigue [Functional Assessment of Chronic Illness Therapy Fatigue Scale]) and secondary outcomes (ie, body mass index [kg/m(2)], diet and alcohol intake [Food Frequency Questionnaire], and smoking) were conducted at baseline and 6 and 12 months. At 12 months, significant intervention effects were observed for moderate physical activity (28.5 minutes; P = .003), body mass index (-0.9 kg/m(2); P = .001), energy from total fat (-7.0%; P = .006), and energy from saturated fat (-2.8%; P = .016). A significant intervention effect was reported for vegetable intake (0.4 servings per day; P = .001) at 6 months. No significant group differences were found at 6 or 12 months for HRQoL, cancer-related fatigue, fruit, fiber, or alcohol intake, or smoking. The CanChange intervention was effective for improving physical activity, dietary habits, and body mass index in colorectal cancer survivors. The intervention is translatable through existing telephone cancer support and information services in Australia and other countries.

Is quality affordable?

Directory of Open Access Journals (Sweden)

Robert Lindfield

2008-12-01

Full Text Available The question “Is quality affordable?” is loaded with dynamite!Can a person who lives on less than US $1 per day afford a high-quality cataract operation? If the answer is ‘No’, then do we offer that person poor or low-quality services? Do people living in poverty have a ‘right’ to high-quality eye or health care? If the answer is ‘Yes’, then at what price and who should pay? Should we ignore quality and focus on affordability? Or should we provide high-quality services in the hope that someone else will pay?These are difficult questions, which policy makers, managers, and clinicians must face and try to answer.

Effects of patient-centered communication on anxiety, negative affect, and trust in the physician in delivering a cancer diagnosis: A randomized, experimental study.

Science.gov (United States)

Zwingmann, Jelena; Baile, Walter F; Schmier, Johann W; Bernhard, Jürg; Keller, Monika

2017-08-15

When bad news about a cancer diagnosis is being delivered, patient-centered communication (PCC) has been considered important for patients' adjustment and well-being. However, few studies have explored how interpersonal skills might help cancer patients cope with anxiety and distress during bad-news encounters. A prospective, experimental design was used to investigate the impact of the physician communication style during a bad-news encounter. Ninety-eight cancer patients and 92 unaffected subjects of both sexes were randomly assigned to view a video of a clinician delivering a first cancer diagnosis with either an enhanced patient-centered communication (E-PCC) style or a low patient-centered communication (L-PCC) style. Participants rated state anxiety and negative affect before and immediately after the video exposure, whereas trust in the physician was rated after the video exposure only. Main and interaction effects were analyzed with generalized linear models. Viewing the disclosure of a cancer diagnosis resulted in a substantial increase in state anxiety and negative affect among all participants. This emotional response was moderated by the physician's communication style: Participants viewing an oncologist displaying an E-PCC style were significantly less anxious than those watching an oncologist displaying an L-PCC style. They also reported significantly higher trust in the physician. Under a threatening, anxiety-provoking disclosure of bad news, a short sequence of empathic PCC influences subjects' psychological state, insofar that they report feeling less anxious and more trustful of the oncologist. Video exposure appears to be a valuable method for investigating the impact of a physician's communication style during critical encounters. Cancer 2017;123:3167-75. © 2017 American Cancer Society. © 2017 American Cancer Society.

Affordable Care Act (ACA)

Data.gov (United States)

Social Security Administration — The Affordable Care Act (ACA) is a federal statute enacted with a goal of increasing the quality and affordability of health insurance. Through a web service, CMS...

A global comparison of the cost of patented cancer drugs in relation to global differences in wealth.

Science.gov (United States)

Goldstein, Daniel A; Clark, Jonathon; Tu, Yifan; Zhang, Jie; Fang, Fenqi; Goldstein, Robert; Stemmer, Salomon M; Rosenbaum, Eli

2017-09-22

There are major differences in cancer drug prices around the world. However, the patterns of affordability of these drugs are poorly understood. The objective of this study was to compare patterns of affordability of cancer drugs in Australia, China, India, Israel, South Africa, the United Kingdom, and the United States. Cancer drug prices are highest in the United States. Cancer drugs are the least affordable in India by a large margin. Despite lower prices than in the USA, cancer drugs are less affordable in middle-income countries than in high-income countries. We obtained the prices of a basket of cancer drugs in all 7 countries, and converted the prices to US$ using both foreign exchange rates and purchasing power parity. We assessed international differences in wealth by collecting values for gross domestic product (GDP) per capita in addition to average salaries. We compared patterns of affordability of cancer drugs by dividing the drug prices by the markers of wealth. Cancer drugs are less affordable in middle-income countries than in high-income countries. Differential pricing may be an acceptable policy to ensure global affordability and access to highly active anti-cancer therapies.

Affordances theory in multilingualism studies

Directory of Open Access Journals (Sweden)

Larissa Aronin

2012-10-01

Full Text Available The concept of affordances originating in Gibson’s work (Gibson, 1977 is gaining ground in multilingualism studies (cf. Aronin and Singleton, 2010; Singleton and Aronin, 2007; Dewaele, 2010. Nevertheless, studies investigating affordances in respect of teaching, learning or using languages are still somewhat rare and tend to treat isolated aspects of multilingualism. This is despite the fact that the theory of affordances can actually provide a valuable, supplementary, up-to-date framework within which a clearer, sharper description and explication of the intriguing range of attributes of multilingual communities, educational institutions and individuals, as well as teaching practices, become feasible. It is important that not only researchers and practitioners (teachers, educators, parents, community and political actors but also language users and learners themselves should be aware of how to identify or, if necessary, design new affordances for language acquisition and learning. The aim of this article is to adapt the concept of affordances to multilingualism studies and additional language teaching, and in so doing advance theoretical understanding in this context. To this end the article contains a brief summary of the findings so far available. The article also goes further into defining the ways of how affordances work in relation to multilingualism and second language teaching and puts forward an integrated model of affordances.

F-127-PEI co-delivering docetaxel and TFPI-2 plasmid for nasopharyngeal cancer therapy

Energy Technology Data Exchange (ETDEWEB)

Liu, Tao, E-mail: taoliu18@126.com [Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282 (China); Zhang, Xinyu [Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282 (China); Ke, Bo [Jiangxi Key Laboratory of Hematological Oncology and Cell Biology, Jiangxi Provincial People' s Hospital, Nanchang 330006 (China); Wang, Yigang [School of Life Sciences, Zhejiang Sci-Tech University, Hangzhou 310018 (China); Wu, Xidong [Department of Pharmacology, Jiangxi Institute of Materia Medica,Nanchang 330029 (China); Jiang, Gang [Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282 (China); Wu, Ting [Department of Light Chemical Engineering, Guangdong Polytechnic, Foshan 528041 (China); Nie, Guohui, E-mail: nghui@21cn.com [Department of Otolaryngological, Peking University Shenzhen Hospital, Shenzhen 518036 (China)

2016-04-01

The co-delivery of drug and gene has become the primary strategy in cancer therapy. However, to construct one safe co-delivering system with higher drug loading and gene transfection efficiency for cancer therapy is still challenging. Herein, a novel degradable nanocarriers were synthesized and characterized in this study, which was composed of polyethylenimine (PEI)-linked PEO–PPO–PEO (Pluronic F127), called F127-PEI. Then the nanocarrier was used for hydrophobic docetaxel (DOC) and functional gene (TFPI-2 plasmid) co-delivery to treat nasopharyngeal cancer (NPC). The results indicated that F127-PEI nanocarriers had higher DOC loading amount and possessed good gene delivery effect in vitro. For co-delivery analysis, the obtained F127-PEI/DOC/TFPI-2 complexes could induce a more significant apoptosis than DOC or TFPI-2 alone, and decreased invasive capacity of NPC HNE-1 cells more obviously. Moreover, the F127-PEI copolymer exhibited better blood compatibility and lower cytotoxicity compared to PEI-25k by the hemolysis and MTT assays, which suggests a promising potential for NPC therapy. - Highlights: • F127-PEI was synthesized and used for drug and gene co-delivery. • F127-PEI showed good delivery ability to docetaxel and TFPI-2 plasmid. • The co-loaded complexes showed synergistic effect to nasopharyngeal carcinoma. • F127-PEI showed better blood safety and lower cytotoxicity compared to PEI-25k.

F-127-PEI co-delivering docetaxel and TFPI-2 plasmid for nasopharyngeal cancer therapy

International Nuclear Information System (INIS)

Liu, Tao; Zhang, Xinyu; Ke, Bo; Wang, Yigang; Wu, Xidong; Jiang, Gang; Wu, Ting; Nie, Guohui

2016-01-01

The co-delivery of drug and gene has become the primary strategy in cancer therapy. However, to construct one safe co-delivering system with higher drug loading and gene transfection efficiency for cancer therapy is still challenging. Herein, a novel degradable nanocarriers were synthesized and characterized in this study, which was composed of polyethylenimine (PEI)-linked PEO–PPO–PEO (Pluronic F127), called F127-PEI. Then the nanocarrier was used for hydrophobic docetaxel (DOC) and functional gene (TFPI-2 plasmid) co-delivery to treat nasopharyngeal cancer (NPC). The results indicated that F127-PEI nanocarriers had higher DOC loading amount and possessed good gene delivery effect in vitro. For co-delivery analysis, the obtained F127-PEI/DOC/TFPI-2 complexes could induce a more significant apoptosis than DOC or TFPI-2 alone, and decreased invasive capacity of NPC HNE-1 cells more obviously. Moreover, the F127-PEI copolymer exhibited better blood compatibility and lower cytotoxicity compared to PEI-25k by the hemolysis and MTT assays, which suggests a promising potential for NPC therapy. - Highlights: • F127-PEI was synthesized and used for drug and gene co-delivery. • F127-PEI showed good delivery ability to docetaxel and TFPI-2 plasmid. • The co-loaded complexes showed synergistic effect to nasopharyngeal carcinoma. • F127-PEI showed better blood safety and lower cytotoxicity compared to PEI-25k

Potential implementation of light steel housing system for affordable housing project in Malaysia

Science.gov (United States)

Saikah, M.; Kasim, N.; Zainal, R.; Sarpin, N.; Rahim, M. H. I. A.

2017-11-01

An unparalleled number between housing demand and housing supply in Malaysia has increased the housing prices, which gives consequences to the homeownership issue. One way to reduce the housing price is by faster increase the number of affordable housing, but the construction sector faces difficulties in delivering as expected number by using conventional and current industrialised building system (IBS) due to the issue related high project cost, time and labour. Therefore, light steel housing (LSH) system as one of another type of IBS method can be utilised in housing construction project. This method can replace the conventional method that was currently used in the construction of affordable housing project. The objectives of this study are to identify the potential of LSH and influencing factors of system implementation. This is an initial stage to review the previous study related to LSH implementation in developed and developing countries. The previous study will be analysed regarding advantages and disadvantages of LSH and factors that influence the implementation of the system. Based on the literature review it is expected to define the potential and influencing factors of the LSH system. The findings are meaningful in framing and enhance construction housing method of an affordable housing project in Malaysia.

Dynamic properties of energy affordability measures

International Nuclear Information System (INIS)

Heindl, Peter; Schuessler, Rudolf

2015-01-01

Measures of affordability and of fuel poverty are applied in practice to assess the affordability of energy services, for example, or of water or housing. The extensive body of literature on affordability measures has little overlap with the existing literature on poverty measurement. A comprehensive assessment of the response of affordability measures as a result of changes in the distribution of income or expenditure (the dynamic properties) is missing. This paper aims to fill this gap by providing a conceptual discussion on the ‘dynamics’ of both energy affordability measures and fuel poverty measures. Several types of measures are examined in a microsimulation framework. Our results indicate that some measures exhibit odd dynamic behavior. This includes measures used in practice, such as the low income/high cost measure and the double median of expenditure share indicator. Odd dynamic behavior causes the risk of drawing false policy recommendations from the measures. Thus, an appropriate response of affordability measures to changes in relevant variables is a prerequisite for defining meaningful measures that inform about affordability or deprivation in certain domains of consumption. - Highlights: • We investigate changes in fuel poverty measures as result from changes in income and expenditure. • More generally, we investigate dynamic behavior of affordability measures using microsimulation. • We propose axioms regarding dynamic behavior of affordability measures. • Some measures which are used in practice show unintuitive dynamic behavior. • Inappropriate dynamic behavior causes a risk of false policy implications.

Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial.

Science.gov (United States)

Zachariae, Robert; Amidi, Ali; Damholdt, Malene F; Clausen, Cecilie D R; Dahlgaard, Jesper; Lord, Holly; Thorndike, Frances P; Ritterband, Lee M

2018-02-20

Insomnia is two to three times more prevalent in cancer survivors than in the general population, where it is estimated to be 10% to 20%. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia, but meeting survivor needs remains a challenge. Internet-delivered CBT-I (iCBT-I) has been shown efficacious in otherwise healthy adults. We tested the efficacy of iCBT-I in breast cancer survivors with clinically significant sleep disturbance. Women from a national sample of Danish breast cancer survivors who experienced clinically significant sleep disturbance were randomly allocated to iCBT-I or waitlist control (55:45). The fully automated iCBT-I program consisted of six cores. Online measures of insomnia severity, sleep quality, and fatigue were collected at baseline, postintervention (nine weeks), and follow-up (15 weeks). Online sleep diaries were completed over two-week periods pre- and postintervention. Intention-to-treat analyses (time × group interactions) were conducted with mixed linear models and corrected for multiple outcomes. All statistical tests were two-sided. A total of 255 women were randomly allocated to iCBT-I (n = 133) or waitlist control (n = 122). Statistically significant (P ≤ .02) time × group interactions were found for all sleep-related outcomes from pre- to postintervention. Effect sizes (Cohen's d) ranged from 0.33 (95% confidence interval [CI] = 0.06 to 0.61) for wake after sleep onset to 1.17 (95% CI = 0.87 to 1.47) for insomnia severity. Improvements were maintained for outcomes measured at follow-up (d = 0.66-1.10). iCBT-I appears to be effective in breast cancer survivors, with additional benefit in terms of reduced fatigue. This low-cost treatment could be incorporated in cancer rehabilitation programs.

A global comparison of the cost of patented cancer drugs in relation to global differences in wealth

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Goldstein, Daniel A.; Clark, Jonathon; Tu, Yifan; Zhang, Jie; Fang, Fenqi; Goldstein, Robert

2017-01-01

Introduction There are major differences in cancer drug prices around the world. However, the patterns of affordability of these drugs are poorly understood. The objective of this study was to compare patterns of affordability of cancer drugs in Australia, China, India, Israel, South Africa, the United Kingdom, and the United States. Results Cancer drug prices are highest in the United States. Cancer drugs are the least affordable in India by a large margin. Despite lower prices than in the USA, cancer drugs are less affordable in middle-income countries than in high-income countries. Materials and Methods We obtained the prices of a basket of cancer drugs in all 7 countries, and converted the prices to US$ using both foreign exchange rates and purchasing power parity. We assessed international differences in wealth by collecting values for gross domestic product (GDP) per capita in addition to average salaries. We compared patterns of affordability of cancer drugs by dividing the drug prices by the markers of wealth. Conclusions Cancer drugs are less affordable in middle-income countries than in high-income countries. Differential pricing may be an acceptable policy to ensure global affordability and access to highly active anti-cancer therapies. PMID:29069727

Affordance

DEFF Research Database (Denmark)

Olesen, Mogens

2016-01-01

This entry presents the concept of affordances as part of an ecological approach to understanding how agents interact with objects in their environment. It examines some of the central developments of the concept, from J. J. Gibson’s original definition within psychology and Donald Norman’s design...

Collaborative Affordances of Medical Records

DEFF Research Database (Denmark)

Bardram, Jakob Eyvind; Houben, Steven

2017-01-01

by Sellen and Harper (2003) on the affordances of physical paper. Sellen and Harper describe how the physical properties of paper affords easy reading, navigation, mark-up, and writing, but focuses, we argue, mainly on individual use of paper and digital technology. As an extension to this, Collaborative...... Affordances; being portable across patient wards and the entire hospital, by providing collocated access, by providing a shared overview of medical data, and by giving clinicians ways to maintain mutual awareness. We then discuss how the concept of Collaborative Affordances can be used in the design of new...... technology by providing a design study of a ‘Hybrid Patient Record’ (HyPR), which is designed to seamlessly blend and integrate paper-based with electronic patient records....

Protein Nanoscaffolds for Delivering Toxic Inorganic Cargo to Cancer Cells

Science.gov (United States)

Cioloboc, Daniela

Targeted delivery of anticancer drugs or prodrugs to tumors can minimize systemic toxicity and side effects. This study develops platforms for targeted delivery of two potentially less systemically toxic prodrugs by exploiting the native and/or bioinorganic properties of two ferritins, both of which function naturally as iron storage proteins. Two delivery approaches were investigated. The first system was designed to serve as either an enhancement or alternative to traditional photodynamic therapy by generating hydroxyl radical in addition to singlet oxygen as the toxic reactive oxygen species. This system used Escherichia coli bacterioferritin (Bfr) loaded with 2,500 irons and multiple zinc-porphyrin (ZnP) photosensitizers. Ferrous iron was released by photoreduction of ferric iron stored within the Bfr protein shell. Hydroxyl radicals were generated via the Fenton reaction between hydrogen peroxide and the released ferrous iron. The outer surface of the Bfr protein shell was coated with peptides that specifically bind to a receptor known to be overexpressed in many tumor cells and tumor vasculature. The iron-loaded peptide-ZnP-Bfr was endocytosed by melanoma cells, where it showed photo-triggered release of iron and light-dependent cytotoxicity. The second system, built around human heavy chain ferritin (HFn), was loaded with arsenate as a less toxic "prodrug" and designed to release arsenic in its toxic, therapeutically effective reduced form, arsenic trioxide (ATO). The Hfn shell was coated with peptides targeting receptors that are hyperexpressed in triple negative breast cancers. The arsenate/iron-loaded-Hfn was endocytosed by a breast cancer cell line and showed cytotoxicity equivalent to that of free ATO on an arsenic basis, whereas the "empty" or iron-only loaded Hfn showed no cytotoxicity. Although HFn has previously been used to deliver organic drugs and imaging agents, these new results demonstrate that both Bfr and HFn can be manipulated to function

The Impact of the Affordable Care Act on North Carolinian Breast Cancer Patients Seeking Financial Support for Treatment.

Science.gov (United States)

Obeng-Gyasi, Samilia; Tolnitch, Lisa; Greenup, Rachel A; Shelley Hwang, E

2016-10-01

The Affordable Care Act (ACA) was instated on 23 March 2010 to improve healthcare quality, reduce costs, and increase access. The Pretty in Pink Foundation (PIPF), a non-profit 501(C)(3) organization in North Carolina, provides financial assistance and in-kind support to individuals seeking help with breast cancer care. The objective of this study was to determine whether sociodemographic variables and treatment services varied among PIPF recipients since enactment of the ACA. North Carolinians who received financial assistance from the PIPF between 1 January 2013 and 31 December 2014 were included in the study, and the cohort was divided into two groups based on receipt of assistance before or after the enactment of the ACA. Descriptive statistics were tabulated as frequencies. Comparative univariate analysis between both groups was conducted using the χ (2) and Mann-Whitney U tests. All tests were two-sided and a p value reduction in subjects receiving assistance from the PIPF; however, no change in their insurance status has been observed.

Assessment of radiation doses to the para-aortic, pelvic, and inguinal lymph nodes delivered by image-guided adaptive brachytherapy in locally advanced cervical cancer

DEFF Research Database (Denmark)

Mohamed, Sandy M I; Aagaard, Torben; Fokdal, Lars U

2015-01-01

PURPOSE: This study evaluated the dose delivered to lymph nodes (LNs) by brachytherapy (BT) and the effect of BT image-guided optimization on the LN dose. METHODS AND MATERIALS: Twenty-five patients with locally advanced cervical cancer were retrospectively analyzed, 16 patients of them had LN...

Social affordances and the possibility of ecological linguistics.

Science.gov (United States)

Kono, Tetsuya

2009-12-01

This paper includes an effort to extend the notion of affordance from a philosophical point of view the importance of ecological approach for social psychology, ethics, and linguistics. Affordances are not always merely physical but also interpersonal and social. I will conceptualize affordance in general and social affordance in particular, and will elucidate the relation between intentional action and affordances, and that between affordances and free will. I will also focus on the relation between social institution and affordance. An extended theory of affordances can provide a way to analyze in concrete ways how social institution works as an implicit background of interpersonal interactions. Ecological approach considers social institution as the producer and maintainer of affordances. Social institutions construct the niches for human beings. Finally, I will argue the possibility of the ecological linguistics. Language is a social institution. The system of signs is the way to articulate and differentiate interpersonal affordances. Language acquires its meaning, i.e. communicative power in the interpersonal interactions, and interpersonal interactions, in turn, develop and are elaborated through the usage of signs. Communication is seen as never aimed to transmit inner ideas to others, but to guide and adjust the behaviors of others thorough articulating the affordance of responsible-ness.

Reduction of Dose Delivered to Organs at Risk in Prostate Cancer Patients via Image-Guided Radiation Therapy

International Nuclear Information System (INIS)

Pawlowski, Jason M.; Yang, Eddy S.; Malcolm, Arnold W.; Coffey, Charles W.; Ding, George X.

2010-01-01

Purpose: To determine whether image guidance can improve the dose delivered to target organs and organs at risk (OARs) for prostate cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eight prostate cancer patients were treated with IMRT to 76 Gy at 2 Gy per fraction. Daily target localization was performed via alignment of three intraprostatic fiducials and weekly kV-cone beam computed tomography (CBCT) scans. The prostate and OARs were manually contoured on each CBCT by a single physician. Daily patient setup shifts were obtained by comparing alignment of skin tattoos with the treatment position based on fiducials. Treatment fields were retrospectively applied to CBCT scans. The dose distributions were calculated using actual treatment plans (an 8-mm PTV margin everywhere except for 6-mm posteriorly) with and without image guidance shifts. Furthermore, the feasibility of margin reduction was evaluated by reducing planning margins to 4 mm everywhere except for 3 mm posteriorly. Results: For the eight treatment plans on the 56 CBCT scans, the average doses to 98% of the prostate (D98) were 102% (range, 99-104%) and 99% (range, 45-104%) with and without image guidance, respectively. Using margin reduction, the average D98s were 100% (range, 84-104%) and 92% (range, 40-104%) with and without image guidance, respectively. Conclusions: Currently, margins used in IMRT plans are adequate to deliver a dose to the prostate with conventional patient positioning using skin tattoos or bony anatomy. The use of image guidance may facilitate significant reduction of planning margins. Future studies to assess the efficacy of decreasing margins and improvement of treatment-related toxicities are warranted.

Exosomes derived from hypoxic epithelial ovarian cancer deliver microRNA-940 to induce macrophage M2 polarization.

Science.gov (United States)

Chen, Xin; Ying, Xiang; Wang, Xinjing; Wu, Xiaoli; Zhu, Qinyi; Wang, Xipeng

2017-07-01

Hypoxia is a common feature of solid tumors. It is closely related to tumor progression. Exosomal microRNAs derived from cancers are considered to be mediators between cancer cells and the tumor microenvironment. In addition, the number of tumor-associated macrophages (TAMs) in the tumor microenvironment has also been demonstrated to correlate with tumor development. However, the relationship between tumor-secreted exosomes and TAM polarization under hypoxic conditions during tumor progression is not clear. Herein, we demonstrated that hypoxia induces the high expression of microRNA-940 (miR‑940) in exosomes derived from epithelial ovarian cancer (EOC). We also found that miR‑940 is highly expressed in exosomes isolated from ascites of EOC patients. Moreover, the overexpression of miR‑940 in macrophages delivered by exosomes stimulated M2 phenotype polarization, while the M2 subtype macrophages promoted EOC proliferation and migration. These results highlight the function of hypoxia in enhancing the high level of expression of miR‑940 in tumor exosomes taken up by macrophages. We also showed that the tumor-promoting function of miR‑940 is mediated by TAM polarization in EOC. These findings show that tumor-derived exosomal miR‑940 induced by hypoxia plays an important role in stimulating TAM polarization in the progression of EOC.

Lifestyle behavior interventions delivered using technology in childhood, adolescent, and young adult cancer survivors: A systematic review.

Science.gov (United States)

Kopp, Lisa M; Gastelum, Zachary; Guerrero, Christian H; Howe, Carol L; Hingorani, Pooja; Hingle, Melanie

2017-01-01

Childhood, adolescent, and young adult cancer survivors demonstrate increased cardio-metabolic risk factors, which are amenable to lifestyle changes. The use of technology to impact lifestyle change expands previously limited intervention access, yet little is known about its use. We summarized lifestyle interventions for survivors delivered using technology, finding six studies, primarily targeting physical activity. Study samples were small and durations ranged from 5 to 16 weeks and outcomes modest. Participants were older, white, survivors of leukemia or brain tumors, and the majority received Web-based interventions. Study quality was moderate. Few technology-based interventions have been developed, suggesting an area of opportunity for survivors. © 2016 Wiley Periodicals, Inc.

SU-F-J-203: Retrospective Assessment of Delivered Proton Dose in Prostate Cancer Patients Based On Daily In-Room CT Imaging

Energy Technology Data Exchange (ETDEWEB)

Stuetzer, K; Paessler, T [OncoRay - National Center for Radiation Research in Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Valentini, C; Thiele, J; Hoelscher, T [Department of Radiation Oncology, University Hospital Carl Gustav Carus, Techenische Universitaet Dresden (Germany); Exner, F [OncoRay - National Center for Radiation Research in Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); now with: University of Wuerzburg, Department of Radiation Oncology, Wuerzburg (Germany); Krause, M; Richter, C [OncoRay - National Center for Radiation Research in Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Department of Radiation Oncology, University Hospital Carl Gustav Carus, Techenische Universitaet Dresden (Germany); Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology, Dresden (Germany); German Cancer Consortium (DKTK), Dresden, Germany and German Cancer Research Center (DKFZ), Heidelberg (Germany)

2016-06-15

Purpose: Retrospective calculation of the delivered proton dose in prostate cancer patients based on a unique dataset of daily CT images. Methods: Inter-fractional motion in prostate cancer patients treated at our proton facility is counteracted by water-filled endorectal ballon and bladder filling protocol. Typical plans (XiO, Elekta Instruments AB, Stockholm) for 74 Gy(RBE) sequential boost treatment in 37 fractions include two series of opposing lateral double-scattered proton beams covering the respective iCTV. Stability of fiducial markers and anatomy were checked in 12 patients by daily scheduled in-room control CT (cCT) after immobilization and positioning according to bony anatomy utilizing orthogonal X-ray. In RayStation 4.6 (RaySearch Laboritories AB, Stockholm), all cCTs are delineated retrospectively and the treatment plans were recalculated on the planning CT and the registered cCTs. All fraction doses were accumulated on the planning CT after deformable registration. Parameters of delivered dose to iCTV (D98%>95%, D2%<107%), bladder (V75Gy<15%, V70Gy<25%, V65Gy<30%), rectum (V70Gy<10%, V50Gy<40%) and femoral heads (V50Gy<5%) are compared to those in the treatment plan. Intra-therapy variation is represented in DVH bands. Results: No alarming differences were observed between planned and retrospectively accumulated dose: iCTV constraints were met, except for one patient (D98%=94.6% in non-boosted iCTV). Considered bladder and femoral head values were below the limits. Rectum V70Gy was slightly exceeded (<11.3%) in two patients. First intra-therapy variability analysis in 4 patients showed no timedependent parameter drift, revealed strongest variability for bladder dose. In some fractions, iCTV coverage (D98%) and rectum V70Gy was missed. Conclusion: Double scattered proton plans are accurately delivered to prostate cancer patients due to fractionation effects and the applied precise positioning and immobilization protocols. As a result of rare

Vital affordances, occupying niches

DEFF Research Database (Denmark)

Dokumaci, Arseli

2017-01-01

This article proposes a new conceptual approach to disability and performance through a contribution that comes entirely from outside the disciplines; a re-theorisation of Gibson’s [1979. The Ecological Approach to Visual Perception. Hillsdale: Lawrence Erlbaum Associates] theory of affordances....... Drawing on three visual ethnographies with differently disabled individuals, and building upon my previous consideration of performance as ‘affordance creation’ in itself [Dokumaci, A. 2013. “On Falling Ill.” Performance Research 18 (4): 107–115], the article conceptualises affordances as a form of micro......-activism–one that can allow us to unpack the entanglements of disability, performance, and matter. Putting Gibson’s theory in conversation with Canguilhem’s philosophy of life, it proposes the concept ‘vital affordances’ as a new way to think through this micro-activism, and the way disabled individuals might transform...

CanPrevent: a telephone-delivered intervention to reduce multiple behavioural risk factors for colorectal cancer

Directory of Open Access Journals (Sweden)

Hawkes Anna L

2012-11-01

Full Text Available Abstract Background This pilot study aimed to test the acceptability and short-term effectiveness of a telephone-delivered multiple health behaviour change intervention for relatives of colorectal cancer survivors. Methods A community-based sample of 22 first-degree relatives of colorectal cancer survivors were recruited via a media release. Data were collected at baseline and at six weeks (post-intervention. Outcome measures included health behaviours (physical activity, television viewing, diet, alcohol, body mass index, waist circumference and smoking, health-related quality of life (Short Form-36 and perceived colorectal cancer risk. Intervention satisfaction levels were also measured. The intervention included six telephone health coaching sessions, a participant handbook and a pedometer. It focused on behavioural risk factors for colorectal cancer [physical activity, diet (red and processed meat consumption, fruit and vegetable intake, alcohol, weight management and smoking], and colorectal cancer risk. Results From baseline to six weeks, improvements were observed for minutes moderate-vigorous physical activity (150.7 minutes, processed meat intake (−1.2 serves/week, vegetable intake (1 serve/day, alcohol intake (−0.4 standard drinks/day, body mass index (−1.4 kg/m2, and waist circumference (−5.1 cm. Improvements were also observed for physical (3.3 and mental (4.4 health-related quality of life. Further, compared with baseline, participants were more likely to meet Australian recommendations post-intervention for: moderate-vigorous physical activity (27.3 vs 59.1%; fruit intake (68.2 vs 81.8%; vegetable intake (4.6 vs 18.2%; alcohol consumption (59.1 vs 72.7%; body mass index (31.8 vs 45.5% and waist circumference (18.2 vs 27.3%. At six weeks participants were more likely to believe a diagnosis of CRC was related to family history, and there was a decrease in their perceived risk of developing CRC in their lifetime following

The Transformation of Ergonomic Affordances into Cultural Affordances: The Case of the Alnuset System

Science.gov (United States)

Chiappini, Giampaolo

2012-01-01

Is it possible to study the ergonomic affordances offered by a system designed for educational aims and their transformation into cultural affordances? To this purpose, what references can we adopt? This work describes the theoretical framework used to realise this study referring to AlNuSet, a system realised within the EC ReMath project to…

Sequentially delivered boost plans are superior to simultaneously delivered plans in head and neck cancer when the boost volume is located further away from the parotid glands

International Nuclear Information System (INIS)

Lamers-Kuijper, Emmy; Heemsbergen, Wilma; Mourik, Anke van; Rasch, Coen

2011-01-01

Purpose: To find parameters that predict which head and neck patients benefit from a sequentially delivered boost treatment plan compared to a simultaneously delivered plan, with the aim to spare the salivary glands. Methods and materials: We evaluated 50 recently treated head and neck cancer patients. Apart from the clinical plan with a sequentially (SEQ) given boost using an Intensity Modulated Radiotherapy Technique (IMRT), a simultaneous integrated boost (SIB) technique plan was constructed with the same beam set-up. The mean dose to the parotid glands was calculated and compared. The elective nodal areas were bilateral in all cases, with a boost on either one side or both sides of the neck. Results: When the parotid gland volume and the Planning Target Volume (PTV) for the boost overlap there is on average a lower dose to the parotid gland with a SIB technique (-1.2 Gy), which is, however, not significant (p = 0.08). For all parotid glands with no boost PTV overlap, there is a benefit from a SEQ technique compared to a SIB technique for the gland evaluated (on average a 2.5 Gy lower dose to the parotid gland, p < 0.001). When the distance between gland and PTV is 0-1 cm, this difference is on average 0.8 Gy, for 1-2 cm distance 2.9 Gy and for glands with a distance greater than 2 cm, 3.3 Gy. When the lymph nodes on the evaluated side are also included in the boost PTV, however, this relationship between the distance and the gain of a SEQ seems less clear. Conclusions: A sequentially delivered boost technique results in a better treatment plan for most cases, compared to a simultaneous integrated boost IMRT technique, if the boost PTV is more than 1 cm away from at least one parotid gland.

Affordances Theory in Multilingualism Studies

Science.gov (United States)

Aronin, Larissa; Singleton, David

2012-01-01

The concept of affordances originating in Gibson's work (Gibson, 1977) is gaining ground in multilingualism studies (cf. Aronin and Singleton, 2010; Singleton and Aronin, 2007; Dewaele, 2010). Nevertheless, studies investigating affordances in respect of teaching, learning or using languages are still somewhat rare and tend to treat isolated…

Energy Servers Deliver Clean, Affordable Power

Science.gov (United States)

2010-01-01

K.R. Sridhar developed a fuel cell device for Ames Research Center, that could use solar power to split water into oxygen for breathing and hydrogen for fuel on Mars. Sridhar saw the potential of the technology, when reversed, to create clean energy on Earth. He founded Bloom Energy, of Sunnyvale, California, to advance the technology. Today, the Bloom Energy Server is providing cost-effective, environmentally friendly energy to a host of companies such as eBay, Google, and The Coca-Cola Company. Bloom's NASA-derived Energy Servers generate energy that is about 67-percent cleaner than a typical coal-fired power plant when using fossil fuels and 100-percent cleaner with renewable fuels.

Cancer articles in weekly magazines: useful media to deliver cancer information to the public?

Science.gov (United States)

Nagata, Masayoshi; Takita, Morihito; Kishi, Yukiko; Kodama, Yuko; Matsumura, Tomoko; Murashige, Naoko; Homma, Yukio; Kami, Masahiro

2013-04-01

Japanese weekly magazines, which have a circulation of over 2 700 000, play important roles in communicating with the public. They offer a wide range of information, entertainment, gossip, politics and economics, and often include articles on cancer. However, cancer articles in magazines have not been systematically analyzed. We investigated cancer-related articles and advertisements in six major Japanese weekly magazines to demonstrate trends in public interest regarding cancer. The total number of articles assessed from July 2009 to December 2010 was 36 914, of which 696 (1.9%) were cancer articles. The total number of advertisements was 21 718, of which 340 (1.6%) were related to cancer. The number of cancer articles demonstrated an upward trend during the study period. Articles focused on lung (n = 145) and urogenital cancer (n = 122). The most common content comprised therapies and diagnosis (n = 340) and case reports on individual patients (n = 160). After a famous Japanese comedian revealed his prostate cancer diagnosis, the number of articles on prostate cancer increased from 2.0 to 6.6 per month. Immunotherapy including some dubious folk therapies was the most frequently reported cancer therapy in articles and advertisements (30.4%). A small group of oncologists were repeatedly referred to in comment sources; 35.6% of comments were presented by only five doctors. Cancer articles in weekly magazines are common paper media for providing cancer information to the public. However, the information provided might place emphasis on unestablished treatments or biased opinions.

Exosomes decrease sensitivity of breast cancer cells to adriamycin by delivering microRNAs.

Science.gov (United States)

Mao, Ling; Li, Jian; Chen, Wei-Xian; Cai, Yan-Qin; Yu, Dan-Dan; Zhong, Shan-Liang; Zhao, Jian-Hua; Zhou, Jian-Wei; Tang, Jin-Hai

2016-04-01

While adriamycin (adr) offers improvement in survival for breast cancer (BCa) patients, unfortunately, drug resistance is almost inevitable. Mounting evidence suggests that exosomes act as a vehicle for genetic cargo and constantly shuttle biologically active molecules including microRNAs (miRNAs) between heterogeneous populations of tumor cells, engendering a resistance-promoting niche for cancer progression. Our recent study showed that exosomes from docetaxel-resistance BCa cells could modulate chemosensitivity by delivering miRNAs. Herein, we expand on our previous finding and explore the relevance of exosome-mediated miRNA delivery in resistance transmission of adr-resistant BCa sublines. We now demonstrated the selective packing of miRNAs within the exosomes (A/exo) derived from adr-resistant BCa cells. The highly expressed miRNAs in A/exo were significantly increased in recipient fluorescent sensitive cells (GFP-S) after A/exo incorporation. Gene ontology analysis of predicted targets showed that the top 30 most abundant miRNAs in A/exo were involved in crucial biological processes. Moreover, A/exo not only loaded miRNAs for its production and release but also carried miRNAs associated with Wnt signaling pathway. Furthermore, A/exo co-culture assays indicated that miRNA-containing A/exo was able to increase the overall resistance of GFP-S to adr exposure and regulate gene levels in GFP-S. Our results reinforce our earlier reports that adr-resistant BCa cells could manipulate a more deleterious microenvironment and transmit resistance capacity through altering gene expressions in sensitive cells by transferring specific miRNAs contained within exosomes.

Three key affordances for serendipity

DEFF Research Database (Denmark)

Björneborn, Lennart

2017-01-01

Purpose Serendipity is an interesting phenomenon to study in information science as it plays a fundamental – but perhaps underestimated – role in how we discover, explore, and learn in all fields of life. The purpose of this paper is to operationalize the concept of serendipity by providing termi...... terminological “building blocks” for understanding connections between environmental and personal factors in serendipitous encounters. Understanding these connections is essential when designing affordances in physical and digital environments that can facilitate serendipity. Design....../methodology/approach In this paper, serendipity is defined as what happens when we, in unplanned ways, encounter resources (information, things, people, etc.) that we find interesting. In the outlined framework, serendipity is understood as an affordance, i.e., a usage potential when environmental and personal factors correspond...... the three key affordances and three key personal serendipity factors: curiosity, mobility, and sensitivity. Ten sub-affordances for serendipity and ten coupled personal sub-factors are also briefly outlined. Related research is compared with and mapped into the framework aiming at a theoretical validation...

Imagined Affordance: Reconstructing a Keyword for Communication Theory

Directory of Open Access Journals (Sweden)

Peter Nagy

2015-09-01

Full Text Available In this essay, we reconstruct a keyword for communication—affordance. Affordance, adopted from ecological psychology, is now widely used in technology studies, yet the term lacks a clear definition. This is especially problematic for scholars grappling with how to theorize the relationship between technology and sociality for complex socio-technical systems such as machine-learning algorithms, pervasive computing, the Internet of Things, and other such “smart” innovations. Within technology studies, emerging theories of materiality, affect, and mediation all necessitate a richer and more nuanced definition for affordance than the field currently uses. To solve this, we develop the concept of imagined affordance. Imagined affordances emerge between users’ perceptions, attitudes, and expectations; between the materiality and functionality of technologies; and between the intentions and perceptions of designers. We use imagined affordance to evoke the importance of imagination in affordances—expectations for technology that are not fully realized in conscious, rational knowledge. We also use imagined affordance to distinguish our process-oriented, socio-technical definition of affordance from the “imagined” consensus of the field around a flimsier use of the term. We also use it in order to better capture the importance of mediation, materiality, and affect. We suggest that imagined affordance helps to theorize the duality of materiality and communication technology: namely, that people shape their media environments, perceive them, and have agency within them because of imagined affordances.

Affording Sustainability: Adopting a Theory of Affordances as a Guiding Heuristic for Environmental Policy

Directory of Open Access Journals (Sweden)

Roope O. Kaaronen

2017-11-01

Full Text Available Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition ‘to the brain,’ focusing only to a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude–action, value–action or knowledge–action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio–ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio–ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio–ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective

Affording Sustainability: Adopting a Theory of Affordances as a Guiding Heuristic for Environmental Policy.

Science.gov (United States)

Kaaronen, Roope O

2017-01-01

Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition 'to the brain,' focusing only to a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude-action, value-action or knowledge-action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio-ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio-ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio-ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective. Increasing the fit between local

Affording Sustainability: Adopting a Theory of Affordances as a Guiding Heuristic for Environmental Policy

Science.gov (United States)

Kaaronen, Roope O.

2017-01-01

Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition ‘to the brain,’ focusing only to a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude–action, value–action or knowledge–action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio–ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio–ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio–ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective. Increasing the fit

Experiments on affordance in the journal "ecological psychology"

DEFF Research Database (Denmark)

Trettvik, Johan

2009-01-01

There are two general aims: 1) to review how the concept of affordance is construed, in theory as well as in practice/experiments, and 2) to review the experiments on affordances.......There are two general aims: 1) to review how the concept of affordance is construed, in theory as well as in practice/experiments, and 2) to review the experiments on affordances....

Correlates of housing affordability stress among older Australians.

Science.gov (United States)

Temple, Jeromey B

2008-03-01

The purpose of this study was to examine the prevalence and correlates of housing affordability stress among community-dwelling older Australians. The 2002 ABS General Social Survey was used to measure the prevalence of housing affordability stress. Rare event logistic regression was used to measure the potential correlates of housing affordability stress. Almost 5% of Australians aged 55 years and older, and 20% of those younger than 55 years, are estimated to experience housing affordability stress. Men and women living alone are more likely to experience affordability stress when compared to couples. Low-income earners, those with a consumer debt or who do not hold assets, are at a heightened risk of such stress. Home ownership, regardless of income, is the strongest buffer against housing affordability problems in old age. Although the prevalence of housing affordability stress is low among older Australians when compared to the younger population, a definite social gradient exists in those at risk.

Energy efficiency and economic value in affordable housing

International Nuclear Information System (INIS)

Chegut, Andrea; Eichholtz, Piet; Holtermans, Rogier

2016-01-01

Strong rental protection in the affordable housing market often prohibits landlords from charging rental premiums for energy-efficient dwellings. This may impede (re)development of energy efficient affordable housing. In the Netherlands, affordable housing institutions regularly sell dwellings from their housing stock to individual households. If they can sell energy efficient dwellings at a premium, this may stimulate investments in the environmental performance of homes. We analyze the value effects of energy efficiency in the affordable housing market, by using a sample of 17,835 homes sold by Dutch affordable housing institutions in the period between 2008 and 2013. We use Energy Performance Certificates to determine the value of energy efficiency in these transactions. We document that dwellings with high energy efficiency sell for 2.0–6.3% more compared to otherwise similar dwellings with low energy efficiency. This implies a premium of some EUR 3,000 to EUR 9,700 for highly energy efficient affordable housing. - Highlights: • Dutch affordable housing suppliers recoup sustainability investment by selling dwellings. • Energy-efficient affordable dwellings sell at a premium. • A-labeled dwellings are 6.3% – 9,300 euros – more valuable than C-labeled ones. • The combined value effect of refurbishing an affordable housing dwelling, including improving the energy efficiency, of 20% would more than pay for the retrofit.

Exosomes from adriamycin-resistant breast cancer cells transmit drug resistance partly by delivering miR-222.

Science.gov (United States)

Yu, Dan-Dan; Wu, Ying; Zhang, Xiao-Hui; Lv, Meng-Meng; Chen, Wei-Xian; Chen, Xiu; Yang, Su-Jin; Shen, Hongyu; Zhong, Shan-Liang; Tang, Jin-Hai; Zhao, Jian-Hua

2016-03-01

Breast cancer (BCa) is one of the major deadly cancers in women. However, treatment of BCa is still hindered by the acquired-drug resistance. It is increasingly reported that exosomes take part in the development, metastasis, and drug resistance of BCa. However, the specific role of exosomes in drug resistance of BCa is poorly understood. In this study, we investigate whether exosomes transmit drug resistance through delivering miR-222. We established an adriamycin-resistant variant of Michigan Cancer Foundation-7 (MCF-7) breast cancer cell line (MCF-7/Adr) from a drug-sensitive variant (MCF-7/S). Exosomes were isolated from cell supernatant by ultracentrifugation. Cell viability was assessed by MTT assay and apoptosis assay. Individual miR-222 molecules in BCa cells were detected by fluorescence in situ hybridization (FISH). Then, FISH was combined with locked nucleic acid probes and enzyme-labeled fluorescence (LNA-ELF-FISH). Individual miR-222 could be detected as bright photostable fluorescent spots and then the quantity of miR-222 per cell could be counted. Stained exosomes were taken in by the receipt cells. MCF-7/S acquired drug resistance after co-culture with exosomes from MCF-7/Adr (A/exo) but did not after co-culture with exosomes from MCF-7/S (S/exo). The quantity of miR-222 in A/exo-treated MCF-7/S was significantly greater than in S/exo-treated MCF-7/S. MCF-7/S transfected with miR-222 mimics acquired adriamycin resistance while MCF-7/S transfected with miR-222 inhibitors lost resistance. In conclusion, exosomes are effective in transmitting drug resistance and the delivery of miR-222 via exosomes may be a mechanism.

Bootstrapping Relational Affordances of Object Pairs using Transfer

DEFF Research Database (Denmark)

Fichtl, Severin; Kraft, Dirk; Krüger, Norbert

2018-01-01

leverage past knowledge to accelerate current learning (which we call bootstrapping). We learn Random Forest based affordance predictors from visual inputs and demonstrate two approaches to knowledge transfer for bootstrapping. In the first approach (direct bootstrapping), the state-space for a new...... affordance predictor is augmented with the output of previously learnt affordances. In the second approach (category based bootstrapping), we form categories that capture underlying commonalities of a pair of existing affordances and augment the state-space with this category classifier’s output. In addition......, we introduce a novel heuristic, which suggests how a large set of potential affordance categories can be pruned to leave only those categories which are most promising for bootstrapping future affordances. Our results show that both bootstrapping approaches outperform learning without bootstrapping...

Influence of daily setup measurements and corrections on the estimated delivered dose during IMRT treatment of prostate cancer patients

International Nuclear Information System (INIS)

Haaren, Paul M.A. van; Bel, Arjan; Hofman, Pieter; Vulpen, Marco van; Kotte, Alexis N.T.J.; Heide, Uulke A. van der

2009-01-01

Purpose: To evaluate the impact of marker-based position verification, using daily imaging and an off-line correction protocol, by calculating the delivered dose to prostate, rectum and bladder. Methods: Prostate cancer patients (n = 217) were treated with IMRT, receiving 35 daily fractions. Plans with five beams were optimized taking target coverage (CTV, boost) and organs-at-risk (rectum and bladder) into account. PTV margins were 8 mm. Prostate position was verified daily using implanted fiducial gold markers by imaging the first segment of all the five beams on an EPID. Setup deviations were corrected off-line using an adapted shrinking-action-level protocol. The estimated delivered dose, including daily organ movements, was calculated using a version of PLATO's dose engine, enabling batch processing of large numbers of patients. The dose was calculated ± inclusion of setup corrections, and was evaluated relative to the original static plan. The marker-based measurements were considered representative for all organs. Results: Daily organ movements would result in an underdosage of 2-3 Gy to CTV and boost volume relative to the original plan, which was prevented by daily setup corrections. The dose to rectum and bladder was on average unchanged, but a large spread was introduced by organ movements, which was reduced by including setup corrections. Conclusions: Without position verification and setup corrections, margins of 8mm would be insufficient to account for position uncertainties during IMRT of prostate cancer. With the daily off-line correction protocol, the remaining variations are accommodated adequately

Evaluation of delivered dose for a clinical daily adaptive plan selection strategy for bladder cancer radiotherapy

International Nuclear Information System (INIS)

Lutkenhaus, Lotte J.; Visser, Jorrit; Jong, Rianne de; Hulshof, Maarten C.C.M.; Bel, Arjan

2015-01-01

Purpose: To account for variable bladder size during bladder cancer radiotherapy, a daily plan selection strategy was implemented. The aim of this study was to calculate the actually delivered dose using an adaptive strategy, compared to a non-adaptive approach. Material and methods: Ten patients were treated to the bladder and lymph nodes with an adaptive full bladder strategy. Interpolated delineations of bladder and tumor on a full and empty bladder CT scan resulted in five PTVs for which VMAT plans were created. Daily cone beam CT (CBCT) scans were used for plan selection. Bowel, rectum and target volumes were delineated on these CBCTs, and delivered dose for these was calculated using both the adaptive plan, and a non-adaptive plan. Results: Target coverage for lymph nodes improved using an adaptive strategy. The full bladder strategy spared the healthy part of the bladder from a high dose. Average bowel cavity V30Gy and V40Gy significantly reduced with 60 and 69 ml, respectively (p < 0.01). Other parameters for bowel and rectum remained unchanged. Conclusions: Daily plan selection compared to a non-adaptive strategy yielded similar bladder coverage and improved coverage for lymph nodes, with a significant reduction in bowel cavity V30Gy and V40Gy only, while other sparing was limited

Parotid Glands Dose–Effect Relationships Based on Their Actually Delivered Doses: Implications for Adaptive Replanning in Radiation Therapy of Head-and-Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Hunter, Klaudia U. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Fernandes, Laura L. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Vineberg, Karen A.; McShan, Daniel; Antonuk, Alan E. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Cornwall, Craig [Department of Hospital Dentistry, University of Michigan, Ann Arbor, Michigan (United States); Feng, Mary [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Schipper, Mathew J. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Balter, James M. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Eisbruch, Avraham, E-mail: eisbruch@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

2013-11-15

Purpose: Doses actually delivered to the parotid glands during radiation therapy often exceed planned doses. We hypothesized that the delivered doses correlate better with parotid salivary output than the planned doses, used in all previous studies, and that determining these correlations will help make decisions regarding adaptive radiation therapy (ART) aimed at reducing the delivered doses. Methods and Materials: In this prospective study, oropharyngeal cancer patients treated definitively with chemoirradiation underwent daily cone-beam computed tomography (CBCT) with clinical setup alignment based on the C2 posterior edge. Parotid glands in the CBCTs were aligned by deformable registration to calculate cumulative delivered doses. Stimulated salivary flow rates were measured separately from each parotid gland pretherapy and periodically posttherapy. Results: Thirty-six parotid glands of 18 patients were analyzed. Average mean planned doses was 32 Gy, and differences from planned to delivered mean gland doses were −4.9 to +8.4 Gy, median difference +2.2 Gy in glands in which delivered doses increased relative to planned. Both planned and delivered mean doses were significantly correlated with posttreatment salivary outputs at almost all posttherapy time points, without statistically significant differences in the correlations. Large dispersions (on average, SD 3.6 Gy) characterized the dose–effect relationships for both. The differences between the cumulative delivered doses and planned doses were evident at first fraction (r=.92, P<.0001) because of complex setup deviations (eg, rotations and neck articulations), uncorrected by the translational clinical alignments. Conclusions: After daily translational setup corrections, differences between planned and delivered doses in most glands were small relative to the SDs of the dose–saliva data, suggesting that ART is not likely to gain measurable salivary output improvement in most cases. These differences were

L-Asparaginase delivered by Salmonella typhimurium suppresses solid tumors

Directory of Open Access Journals (Sweden)

Kwangsoo Kim

Full Text Available Bacteria can be engineered to deliver anticancer proteins to tumors via a controlled expression system that maximizes the concentration of the therapeutic agent in the tumor. L-asparaginase (L-ASNase, which primarily converts asparagine to aspartate, is an anticancer protein used to treat acute lymphoblastic leukemia. In this study, Salmonellae were engineered to express L-ASNase selectively within tumor tissues using the inducible araBAD promoter system of Escherichia coli. Antitumor efficacy of the engineered bacteria was demonstrated in vivo in solid malignancies. This result demonstrates the merit of bacteria as cancer drug delivery vehicles to administer cancer-starving proteins such as L-ASNase to be effective selectively within the microenvironment of cancer tissue.

Technology scale and supply chains in a secure, affordable and low carbon energy transition

International Nuclear Information System (INIS)

Hoggett, Richard

2014-01-01

Highlights: • Energy systems need to decarbonise, provide security and remain affordable. • There is uncertainty over which technologies will best enable this to happen. • A strategy to deal with uncertainty is to assess a technologies ability to show resilience, flexibility and adaptability. • Scale is important and smaller scale technologies are like to display the above characteristics. • Smaller scale technologies are therefore more likely to enable a sustainable, secure, and affordable energy transition. - Abstract: This research explores the relationship between technology scale, energy security and decarbonisation within the UK energy system. There is considerable uncertainty about how best to deliver on these goals for energy policy, but a focus on supply chains and their resilience can provide useful insights into the problems uncertainty causes. Technology scale is central to this, and through an analysis of the supply chains of nuclear power and solar photovoltaics, it is suggested that smaller scale technologies are more likely to support and enable a secure, low carbon energy transition. This is because their supply chains are less complex, show more flexibility and adaptability, and can quickly respond to changes within an energy system, and as such they are more resilient than large scale technologies. These characteristics are likely to become increasingly important in a rapidly changing energy system, and prioritising those technologies that demonstrate resilience, flexibility and adaptability will better enable a transition that is rapid, sustainable, secure and affordable

Hyaluronic Acid-Chitosan Nanoparticles to Deliver Gd-DTPA for MR Cancer Imaging

Directory of Open Access Journals (Sweden)

Li Zhang

2015-08-01

Full Text Available Molecular imaging is essential to increase the sensitivity and selectivity of cancer diagnosis especially at the early stage of tumors. Recently, polyionic nanocomplexes (PICs, which are composed of polyanions and opposite polycations, have been demonstrated to be a promising strategy for biomedical applications. In this work, chitosan-hyaluronic acid nanoparticles (GCHN were developed to deliver Gd-DTPA as MRI contrast agents for tumor diagnosis. The Gd-labeled conjugates (CS-DTPA-Gd were successfully synthesized by carbodiimide reaction, and then GCHN were prepared by ionic gelation using the obtained CS-DTPA-Gd and hyaluronic acid. The morphology of GCHN was spherical or ellipsoidal, which is observed by transmission electronic microscopy (TEM. The mean particle size and zeta potential of GCHN were 213.8 ± 2.6 nm and 19.92 ± 1.69 mV, respectively. The significant enhancement of signal intensity induced by GCHN was observed both in vitro and in vivo. Also, compared with Magnevist, GCHN was witnessed for a prolonged imaging time in the B16 tumor-bearing mice model. Furthermore, GCHN were verified as below toxic both in vitro and in vivo. These results indicated that GCHN could potentially be an alternative to current MRI contrast agents for tumor diagnosis.

Affordances of agricultural systems analysis tools

NARCIS (Netherlands)

Ditzler, Lenora; Klerkx, Laurens; Chan-Dentoni, Jacqueline; Posthumus, Helena; Krupnik, Timothy J.; Ridaura, Santiago López; Andersson, Jens A.; Baudron, Frédéric; Groot, Jeroen C.J.

2018-01-01

The increasingly complex challenges facing agricultural systems require problem-solving processes and systems analysis (SA) tools that engage multiple actors across disciplines. In this article, we employ the theory of affordances to unravel what tools may furnish users, and how those affordances

24 CFR 572.120 - Affordability standards.

Science.gov (United States)

2010-04-01

... by homeowners in the eligible property. Financing that would impair the continued affordability of... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Affordability standards. 572.120 Section 572.120 Housing and Urban Development Regulations Relating to Housing and Urban Development...

A novel vascular-targeting peptide for gastric cancer delivers low-dose TNFα to normalize the blood vessels and improve the anti-cancer efficiency of 5-fluorouracil.

Science.gov (United States)

Lu, Lan; Li, Zhi Jie; Li, Long Fei; Shen, Jing; Zhang, Lin; Li, Ming Xing; Xiao, Zhan Gang; Wang, Jian Hao; Cho, Chi Hin

2017-11-01

Various vascular-targeted agents fused with tumor necrosis factor α (TNFα) have been shown to improve drug absorption into tumor tissues and enhance tumor vascular function. TCP-1 is a peptide selected through in vivo phage library biopanning against a mouse orthotopic colorectal cancer model and is a promising agent for drug delivery. This study further investigated the targeting ability of TCP-1 phage and peptide to blood vessels in an orthotopic gastric cancer model in mice and assessed the synergistic anti-cancer effect of 5-fluorouracil (5-FU) with subnanogram TNFα targeted delivered by TCP-1 peptide. In vivo phage targeting assay and in vivo colocalization analysis were carried out to test the targeting ability of TCP-1 phage/peptide. A targeted therapy for improvement of the therapeutic efficacy of 5-FU and vascular function was performed through administration of TCP-1/TNFα fusion protein in this model. TCP-1 phage exhibited strong homing ability to the orthotopic gastric cancer after phage injection. Immunohistochemical staining suggested that and TCP-1 phage/TCP-1 peptide could colocalize with tumor vascular endothelial cells. TCP-1/TNFα combined with 5-FU was found to synergistically inhibit tumor growth, induce apoptosis and reduce cell proliferation without evident toxicity. Simultaneously, subnanogram TCP-1/TNFα treatment normalized tumor blood vessels. Targeted delivery of low-dose TNFα by TCP-1 peptide can potentially modulate the vascular function of gastric cancer and increase the drug delivery of chemotherapeutic drugs. Copyright © 2017. Published by Elsevier Inc.

AFFORDABILITY OF LOW INCOME HOUSING IN PUMWANI, NAIROBI, KENYA

Directory of Open Access Journals (Sweden)

Crispino C. Ochieng

2007-07-01

Full Text Available Since 1987, in Kenya, through the National Housing Corporation (NHC, an arm of the central government that delivers affordable houses, the local government embarked on the redevelopment of Pumwani the oldest surviving affordable low income housing in Nairobi. Pumwani was started in 1923 and it targeted early African immigrants to Nairobi. Currently, the old Pumwani is home to some of the city’s poorest dwellers majorities who depend on the informal sector for an income. Redevelopment was targeted at housing all the genuine dwellers. Instead delivery ended up with house types that were at first rejected by the beneficiaries. Although the new housing was slightly of an improved physical and spatial quality it was unaffordable. Beneficiaries were required to pay an average monthly rent of US$157 for up to eighteen years towards purchase of the new house. In the beginning, some of them had declined to take position of the newly built houses. To raise the basic rent majorities of those who have since moved in have opted to rent out some of the space. To date there is still standoff with some of the houses still unoccupied. Except during the period of social survey when the beneficiaries were brought in to supply the necessary information, the entire construction process was undertaken by NHC under a turnkey project. Among other factors the construction process was at fault for it raised the costs. Also, some of the basic housing needs were not effectively looked into. There was a housing mismatch.

Critical Care Implications of the Affordable Care Act.

Science.gov (United States)

Dogra, Anjali P; Dorman, Todd

2016-03-01

To provide an overview of key elements of the Affordable Care Act. To evaluate ways in which the Affordable Care Act will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the Affordable Care Act. Data sources for this concise review include search results from the PubMed and Embase databases, as well as sources relevant to public policy such as the text of the Patient Protection and Affordable Care Act and reports of the Congressional Budget Office. As all of the Affordable Care Act's provisions will not be fully implemented until 2019, we also drew upon cost, population, and utilization projections, as well as the experience of existing state-based healthcare reforms. The Affordable Care Act represents the furthest reaching regulatory changes in the U.S. healthcare system since the 1965 Medicare and Medicaid provisions of the Social Security Act. The Affordable Care Act aims to expand health insurance coverage to millions of Americans and place an emphasis on quality and cost-effectiveness of care. From models which link pay and performance to those which center on episodic care, the Affordable Care Act outlines sweeping changes to health systems, reimbursement structures, and the delivery of critical care. Staffing models that include daily rounding by an intensivist, palliative care integration, and expansion of the role of telemedicine in areas where intensivists are inaccessible are potential strategies that may improve quality and profitability of ICU care in the post-Affordable Care Act era.

Delivering care to oncology patients in the community: an innovative integrated approach.

LENUS (Irish Health Repository)

Hanan, Terry

2014-08-01

A community oncology nursing programme was developed in Ireland between the hospital and community health services for patients receiving systemic cancer therapy, in response to a service need. A robust evaluation of the pilot programme was undertaken, which found that defined clinical procedures traditionally undertaken in hospitals were safely undertaken in the patient\\'s home with no adverse effects. There was a dramatic decrease in hospital attendances for these defined clinical procedures, and hospital capacity was consequently freed up. Patients valued having aspects of their care delivered at home and reported that it improved their quality of life, including reduced hospital visits and travel time. Community nurses expanded their scope of practice and became partners with oncology day-ward nurses in caring for these patients. Community nurses developed the competence and confidence to safely deliver cancer care in the community. This initiative shows that defined elements of acute cancer care can be safely delivered in the community so long as the training and support are provided. The findings and recommendations of the evaluation resulted in university accreditation and approval for national roll-out of the programme. Integration of services between primary and secondary care is a key priority. This innovative programme is a good example of shared integrated care that benefits both patients and health-care providers.

Growing community : rooftop gardens for affordable housing

Energy Technology Data Exchange (ETDEWEB)

Weeks, K.N. [California Univ., Berkeley, CA (United States)

2007-07-01

This paper reviewed the processes used in recently designed affordable housing roof garden projects in California, Montana and Georgia. Gardens create a sense of community through shared space and social interactions. As such, roof gardens can give residents of affordable housing the opportunity to experience the community-fostering benefits of gardening, with the added advantages of potentially lower energy bills and wastewater fees. The factors that should be considered in planning, design, construction and maintenance of roof gardens for affordable housing were also outlined. As places of refuge, gardens help people relax and promote healing, which is particularly important for physical, emotional, social and economic well-being. For the many residents of affordable housing who earn less than 50 per cent of the area median income, gardens offer a venue for establishing relationships with neighbours, many of whom they might otherwise never meet. They also offer a means to improved nutrition and food security, education and positive recreation for youth, and better aesthetic surroundings. While motivations for choosing green roofs varied widely across the projects, affordability was linked to 3 main areas, namely saving costs in design, construction and operations; getting the roof to generate funding; and, improving the quality of life in affordable housing. 17 refs., 12 figs.

No Role for Motor Affordances in Visual Working Memory

Science.gov (United States)

Pecher, Diane

2013-01-01

Motor affordances have been shown to play a role in visual object identification and categorization. The present study explored whether working memory is likewise supported by motor affordances. Use of motor affordances should be disrupted by motor interference, and this effect should be larger for objects that have motor affordances than for…

Rethinking Affordable Housing Delivery: An Analytical Insight

Directory of Open Access Journals (Sweden)

Olanrewaju Abdullateef

2016-01-01

Full Text Available Malaysia currently has a housing shortage of 12 million units. Towards the year 2020, this would require an annual supply of a minimum of 2 million homes. With the current production rate, the deficits will remain over the next 100 years. The crisis will lead to poor standards of living, un-affordable rental price, high mortgage payment, abandonment, and dilapidation of the existing housing stock. Lack of affordable housing is already a source of concern among many Malaysians. The middle and lower income earners spend more than 30% of their income on rent or for mortgage payment. Housing rent or mortgage is a basic need like foods, education, clothing and health. The government has introduced various measures to address the housing deficit. Despite these measures, the housing supply and distribution gaps continue to grow. To better understand the issues, there is a need to examine how the procurement planning in the affordable housing delivery supply chain and market is formulated, explore how cost of affordable housing would be reduced, identify the user value systems in affordable housing, and identify the criteria in the current regulatory framework? For these purposes, this paper reviews the relevant literature to reach preliminary findings on the stated issues. Among the factors found accounting for housing shortages, the overwhelming factors were that of poor policies, strategies, practice, management, and finance. The findings are meaningful in framing an affordable housing delivery model. It could also be useful to stakeholders involved in affordable housing delivery in Malaysia and elsewhere.

What is an affordance? 40 years later.

Science.gov (United States)

Osiurak, François; Rossetti, Yves; Badets, Arnaud

2017-06-01

About 40 years ago, James J. Gibson coined the term "affordance" to describe the action possibilities offered to an animal by the environment with reference to the animal's action capabilities. Since then, this notion has acquired a multitude of meanings, generating confusion in the literature. Here, we offer a clear operationalization of the concept of affordances and related concepts in the field of tool use. Our operationalization is organized around the distinction between the physical (what is objectively observable) and neurocognitive (what is subjectively experienced) levels. This leads us to propose that motor control (dorso-dorsal system), mechanical knowledge (ventro-dorsal system) and function knowledge (ventral system) could be neurocognitive systems respectively involved in the perception of affordances, the understanding of mechanical actions and the storage of contextual relationships (three action-system model; 3AS). We end by turning to two key issues that can be addressed within 3AS. These issues concern the link between affordances and tool incorporation, and the constraints posed by affordances for tool use. Copyright © 2017 Elsevier Ltd. All rights reserved.

Daily variations in delivered doses in patients treated with radiotherapy for localized prostate cancer

International Nuclear Information System (INIS)

Kupelian, Patrick A.; Langen, Katja M.; Zeidan, Omar A.; Meeks, Sanford L.; Willoughby, Twyla R.; Wagner, Thomas H.; Jeswani, Sam; Ruchala, Kenneth J.; Haimerl, Jason; Olivera, Gustavo H.

2006-01-01

Purpose: The aim of this work was to study the variations in delivered doses to the prostate, rectum, and bladder during a full course of image-guided external beam radiotherapy. Methods and Materials: Ten patients with localized prostate cancer were treated with helical tomotherapy to 78 Gy at 2 Gy per fraction in 39 fractions. Daily target localization was performed using intraprostatic fiducials and daily megavoltage pelvic computed tomography (CT) scans, resulting in a total of 390 CT scans. The prostate, rectum, and bladder were manually contoured on each CT by a single physician. Daily dosimetric analysis was performed with dose recalculation. The study endpoints were D95 (dose to 95% of the prostate), rV2 (absolute rectal volume receiving 2 Gy), and bV2 (absolute bladder volume receiving 2 Gy). Results: For the entire cohort, the average D95 (±SD) was 2.02 ± 0.04 Gy (range, 1.79-2.20 Gy). The average rV2 (±SD) was 7.0 ± 8.1 cc (range, 0.1-67.3 cc). The average bV2 (±SD) was 8.7 ± 6.8 cc (range, 0.3-36.8 cc). Unlike doses for the prostate, there was significant daily variation in rectal and bladder doses, mostly because of variations in volume and shape of these organs. Conclusion: Large variations in delivered doses to the rectum and bladder can be documented with daily megavoltage CT scans. Image guidance for the targeting of the prostate, even with intraprostatic fiducials, does not take into account the variation in actual rectal and bladder doses. The clinical impact of techniques that take into account such dosimetric parameters in daily patient set-ups should be investigated

To be an affordable healthy house, case study Medan

Science.gov (United States)

Silitonga, Shanty

2018-03-01

House has a paramount meaning in human life. Provision of adequate housing will be able to improve the quality of life. Provision of an affordable house is a major step to fulfilling the needs of houses in the big city. Medan has built a lot of affordable houses, and mostly it takes place in the suburbs. Although the affordable house is for low-income people, it must be worthy of its physical condition, affordable in the budget and healthy for its users. House often saw only as physical alone, the provision of a house only to achieve solely in quantity regardless its quality. This study aims to examine the condition of affordable houses in the suburbs of Medan. The research method used qualitative descriptive, using indicator according to affordable healthy house standard according to the regulation in Indonesia and other related theories. This study took place in Medan by taking three areas in the suburbs of Medan. The results show that most affordable houses in the suburbs of Medan are unhealthy. There are several design recommendations for the houses to meet the affordable healthy house category; the most important is the addition of ventilation and window holes.

Creating Affordable Housing through self-management:

DEFF Research Database (Denmark)

Jensen, Jesper Ole; Stensgaard, Anne Gro

The paper presents a case on self-management in the Danish social housing sector as a way of providing affordable housing. It is based on an evaluation of a Danish concept for affordable housing, Social Housing Plus (“AlmenBolig+”). The concept was introduced in 2007, and so far app 1.400 housing...

Organizational Media Affordances : Operationalization and Associations with Media Use

OpenAIRE

Rice, Ronald E.; Evans, Sandra K.; Pearce, Katy E.; Sivunen, Anu; Vitak, Jessica; Treem, Jeffrey W.

2017-01-01

The concept of affordances has been increasingly applied to the study of information and communication technologies (ICTs) in organizational contexts. However, almost no research operationalizes affordances, limiting comparisons and programmatic research. This article briefly reviews conceptualizations and possibilities of affordances in general and for media, then introduces the concept of organizational media affordances as organizational resources. Analysis of survey data from a large Nord...

Affordances and the musically extended mind.

Science.gov (United States)

Krueger, Joel

2014-01-06

I defend a model of the musically extended mind. I consider how acts of "musicking" grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of "musical affordances" and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances - via soliciting different forms of entrainment - enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea.

Malaysian Affordability Housing Policies Revisited

Directory of Open Access Journals (Sweden)

Samad Diwa

2016-01-01

Full Text Available Housing has always been a significant aspiration of family expression and distinctly priciest investment by household. It plays a momentous role in the country’s economy and so central to the societal well-being that is emplaced in the United Nation Universal declaration of Human rights. Yet in developed and developing world alike, cities struggle to provide decent housing for lower and middle income population. The provision of affordable housing is a major policy concern around the world with Malaysia being no exception; rising income hardly keep pace with price hike of housing unit and housing interventions has majorly concentrated on demand side leading to a non-responsive supply sector. Therefore, this paper highlights affordable housing issues pertaining Malaysia. It formulates Malaysian Map of affordability and conducts an evaluation of global housing schemes to better identify policy priorities for Malaysia. It’s significant to harmonize supply and demand side factors in the housing market to ensure that housing supply fits the needs of citizens based on the location, price and target group. In case of Malaysia supply oriented initiative are of urgency in short and medium run. This must be supported by long term demand side schemes in parallel. Convergence of these two factors is essential for a balanced equilibrium and obtaining affordability.

The concept of a structural affordance

Directory of Open Access Journals (Sweden)

Adrian Alsmith

2012-12-01

Full Text Available I provide an analysis of the concept of an “affordance” that enables one to conceive of “structural affordance” as a kind of affordance relation that might hold between an agent and its body. I then review research in the science of humanoid bodily movement to indicate the empirical reality of structural affordance.

Utility payments in Ukraine: Affordability, subsidies and arrears

International Nuclear Information System (INIS)

Fankhauser, Samuel; Rodionova, Yulia; Falcetti, Elisabetta

2008-01-01

The transition from a planned economy to a market economy has caused considerable hardship for the people of Eastern Europe. One important aspect of the social costs of transition is access to, and the affordability of, basic services like electricity, heat and water, which under communism had been supplied fairly cheaply and abundantly. This paper provides evidence on this issue from the Ukraine Longitudinal Monitoring Survey (ULMS). The paper identifies considerable differences in both access and affordability between different localities in Ukraine. Social protection measures can help to alleviate affordability constraints, but the analysis finds that social support is not well targeted. The currently low tariffs prevent an escalation of affordability problems but constraints nevertheless exist. Many households have accumulated substantial arrears as a consequence, although non-payment is a complex issue and not solely a function of affordability

Utility payments in Ukraine: Affordability, subsidies and arrears

Energy Technology Data Exchange (ETDEWEB)

Fankhauser, Samuel [London School of Economics, London (United Kingdom); Rodionova, Yulia [School of Slavonic and East European Studies, University College London, 16 Taviton street, London WC1H 0BW (United Kingdom)], E-mail: y.rodionova@ssees.ucl.ac.uk; Falcetti, Elisabetta [European Bank for Reconstruction and Development (EBRD), London (United Kingdom)

2008-11-15

The transition from a planned economy to a market economy has caused considerable hardship for the people of Eastern Europe. One important aspect of the social costs of transition is access to, and the affordability of, basic services like electricity, heat and water, which under communism had been supplied fairly cheaply and abundantly. This paper provides evidence on this issue from the Ukraine Longitudinal Monitoring Survey (ULMS). The paper identifies considerable differences in both access and affordability between different localities in Ukraine. Social protection measures can help to alleviate affordability constraints, but the analysis finds that social support is not well targeted. The currently low tariffs prevent an escalation of affordability problems but constraints nevertheless exist. Many households have accumulated substantial arrears as a consequence, although non-payment is a complex issue and not solely a function of affordability.

Utility payments in Ukraine. Affordability, subsidies and arrears

Energy Technology Data Exchange (ETDEWEB)

Fankhauser, Samuel [London School of Economics, London (United Kingdom); Rodionova, Yulia [School of Slavonic and East European Studies, University College London, 16 Taviton street, London WC1H 0BW (United Kingdom); Falcetti, Elisabetta [European Bank for Reconstruction and Development (EBRD), London (United Kingdom)

2008-11-15

The transition from a planned economy to a market economy has caused considerable hardship for the people of Eastern Europe. One important aspect of the social costs of transition is access to, and the affordability of, basic services like electricity, heat and water, which under communism had been supplied fairly cheaply and abundantly. This paper provides evidence on this issue from the Ukraine Longitudinal Monitoring Survey (ULMS). The paper identifies considerable differences in both access and affordability between different localities in Ukraine. Social protection measures can help to alleviate affordability constraints, but the analysis finds that social support is not well targeted. The currently low tariffs prevent an escalation of affordability problems but constraints nevertheless exist. Many households have accumulated substantial arrears as a consequence, although non-payment is a complex issue and not solely a function of affordability. (author)

What are the affordances of information and communication technologies?

Directory of Open Access Journals (Sweden)

Grainne Conole

2004-12-01

Full Text Available The paper examines the notion that Information and Communication Technologies (ICT have affordances that epitomize the features of our late modern age (Giddens, 1991 and explores whether these affordances (Salomon, 1993, p. 51 can be used to facilitate particular approaches to educational practice. It argues that a clear articulation of these affordances would enable us to understand how these technologies can be most effectively used to support learning and teaching. We believe that any one affordance can be considered to have both positive and negative connotations and the paper draws on social and educational theory to provide an initial taxonomy of these affordances.

Pre-test genetic counseling services for hereditary breast and ovarian cancer delivered by non-genetics professionals in the state of Florida.

Science.gov (United States)

Vadaparampil, S T; Scherr, C L; Cragun, D; Malo, T L; Pal, T

2015-05-01

Genetic counseling and testing for hereditary breast and ovarian cancer now includes practitioners from multiple healthcare professions, specialties, and settings. This study examined whether non-genetics professionals (NGPs) perform guideline-based patient intake and informed consent before genetic testing. NGPs offering BRCA testing services in Florida (n = 386) were surveyed about clinical practices. Among 81 respondents (response rate = 22%), approximately half reported: sometimes scheduling a separate session for pre-test counseling lasting 11-30 min prior to testing, discussing familial implications of testing, benefits and limitations of risk management options, and discussing the potential psychological impact and insurance-related issues. Few constructed a three-generation pedigree, discussed alternative hereditary cancer syndromes, or the meaning of a variant result. This lack of adherence to guideline-based practice may result in direct harm to patients and their family members. NGPs who are unable to deliver guideline adherent cancer genetics services should focus on identification and referral of at-risk patients to in person or telephone services provided by genetics professionals. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An Affordability Comparison Tool (ACT) for Space Transportation

Science.gov (United States)

McCleskey, C. M.; Bollo, T. R.; Garcia, J. L.

2012-01-01

NASA bas recently emphasized the importance of affordability for Commercial Crew Development Program (CCDP), Space Launch Systems (SLS) and Multi-Purpose Crew Vehicle (MPCV). System architects and designers are challenged to come up with architectures and designs that do not bust the budget. This paper describes the Affordability Comparison Tool (ACT) analyzes different systems or architecture configurations for affordability that allows for a comparison of: total life cycle cost; annual recurring costs, affordability figures-of-merit, such as cost per pound, cost per seat, and cost per flight, as well as productivity measures, such as payload throughput. Although ACT is not a deterministic model, the paper develops algorithms and parametric factors that use characteristics of the architectures or systems being compared to produce important system outcomes (figures-of-merit). Example applications of outcome figures-of-merit are also documented to provide the designer with information on the relative affordability and productivity of different space transportation applications.

Affordances for robots: a brief survey

Directory of Open Access Journals (Sweden)

Thomas E. Horton

2012-12-01

Full Text Available In this paper, we consider the influence of Gibson's affordance theory on the design of robotic agents. Affordance theory (and the ecological approach to agent design in general has in many cases contributed to the development of successful robotic systems; we provide a brief survey of AI research in this area. However, there remain significant issues that complicate discussions on this topic, particularly in the exchange of ideas between researchers in artificial intelligence and ecological psychology. We identify some of these issues, specifically the lack of a generally accepted definition of "affordance" and fundamental differences in the current approaches taken in AI and ecological psychology. While we consider reconciliation between these fields to be possible and mutually beneficial, it will require some flexibility on the issue of direct perception.

In vivo targeting of ADAM9 gene expression using lentivirus-delivered shRNA suppresses prostate cancer growth by regulating REG4 dependent cell cycle progression.

Directory of Open Access Journals (Sweden)

Che-Ming Liu

Full Text Available Cancer cells respond to stress by activating a variety of survival signaling pathways. A disintegrin and metalloproteinase (ADAM 9 is upregulated during cancer progression and hormone therapy, functioning in part through an increase in reactive oxygen species. Here, we present in vitro and in vivo evidence that therapeutic targeting of ADAM9 gene expression by lentivirus-delivered small hairpin RNA (shRNA significantly inhibited proliferation of human prostate cancer cell lines and blocked tumor growth in a murine model of prostate cancer bone metastasis. Cell cycle studies confirmed an increase in the G1-phase and decrease in the S-phase population of cancer cells under starvation stress conditions, which correlated with elevated intracellular superoxide levels. Microarray data showed significantly decreased levels of regenerating islet-derived family member 4 (REG4 expression in prostate cancer cells with knockdown of ADAM9 gene expression. This REG4 downregulation also resulted in induction of expression of p21(Cip1/WAF1, which negatively regulates cyclin D1 and blocks the G1/S transition. Our data reveal a novel molecular mechanism of ADAM9 in the regulation of prostate cancer cell proliferation, and suggests a combined modality of ADAM9 shRNA gene therapy and cytotoxic agents for hormone refractory and bone metastatic prostate cancer.

What Does Electronic Conferencing Afford Distance Education?

Science.gov (United States)

Barnes, Sally

2000-01-01

Discusses the use of technology for distance learning in higher education and examines the similarities and differences between face-to-face seminars and online discussions. Considers the concept of affordance in relation to information and communication technologies and distance education; and examines affordances of electronic conferencing and…

Dissociating Simon and affordance compatibility effects: silhouettes and photographs.

Science.gov (United States)

Pappas, Zissis

2014-12-01

When a graspable object's handle is oriented to the same side as the response hand, responses are quicker and more accurate than when it is oriented to the opposite side. This effect has been attributed to the affordance of the object's handle (Tucker & Ellis, 1998). Recent findings suggest this effect results instead from an abstract spatial response code (i.e., Simon effect; Cho & Proctor, 2010). However, the stimuli used in these previous studies differ in the amount of object and environmental depth information they contain, which may be critical to conveying an affordance. This information could explain these disparate findings as well as dissociate Simon and affordance compatibility effects. Four experiments demonstrate that the Simon effect results from the absence of this information, as in a silhouette, and the affordance effect results from its presence, as in a photograph. A fifth experiment confirmed that modifying information associated with the affordance, rather than the modification itself, produced the effects observed in the previous experiments. These findings support the following: (a) the internal details of an object and environmental depth can dissociate Simon and affordance compatibility effects, (b) this information is necessary to convey the object's graspable affordance, and (c) the outer shape of the object is not sufficient to elicit an affordance effect. These findings are discussed in relation to the theory of embodied cognition. Copyright © 2014 Elsevier B.V. All rights reserved.

MENOS4 trial: a multicentre randomised controlled trial (RCT) of a breast care nurse delivered cognitive behavioural therapy (CBT) intervention to reduce the impact of hot flushes in women with breast cancer: Study Protocol.

Science.gov (United States)

Fenlon, Deborah; Nuttall, Jacqueline; May, Carl; Raftery, James; Fields, Jo; Kirkpatrick, Emma; Abab, Julia; Ellis, Mary; Rose, Taylor; Khambhaita, Priya; Galanopoulou, Angeliki; Maishman, Tom; Haviland, Jo; Griffiths, Gareth; Turner, Lesley; Hunter, Myra

2018-05-08

Women who have been treated for breast cancer may identify vasomotor symptoms, such as hot flushes and night sweats (HFNS), as a serious problem. HFNS are unpleasant to experience and can have a significant impact on daily life, potentially leading to reduced adherence to life saving adjuvant hormonal therapy. It is known that Cognitive Behavioural Therapy (CBT) is effective for the alleviation of hot flushes in both well women and women who have had breast cancer. Most women with breast cancer will see a breast care nurse and there is evidence that nurses can be trained to deliver psychological treatments to a satisfactory level, whilst also maintaining treatment fidelity. The research team will assess whether breast care nurses can effectively deliver a CBT intervention to alleviate hot flushes in women with breast cancer. This study is a multi-centre phase III individually randomised controlled trial of group CBT versus usual care to reduce the impact of hot flushes in women with breast cancer. 120-160 women with primary breast cancer experiencing seven or more problematic HFNS a week will be randomised to receive either treatment as usual (TAU) or participation in the group CBT intervention plus TAU (CBT Group). A process evaluation using May's Normalisation Process Theory will be conducted, as well as practical and organisational issues relating to the implementation of the intervention. Fidelity of implementation of the intervention will be conducted by expert assessment. The cost effectiveness of the intervention will also be assessed. There is a need for studies that enable effective interventions to be implemented in practice. There is good evidence that CBT is helpful for women with breast cancer who experience HFNS, yet it is not widely available. It is not yet known whether the intervention can be effectively delivered by breast care nurses or implemented in practice. This study will provide information on both whether the intervention can effectively

An Activity Theory Approach to Affordance

DEFF Research Database (Denmark)

Bærentsen, Klaus B.; Trettvik, Johan

2002-01-01

We present an analysis of the concept of affordance as it was originally introduced by J. J. Gibson, and elaborate on this concept, acknowledging, that the general theoretical landscape in psychology is in fundamental ways different from the situation in which Gibson found himself when he crafted...... the notion. Specifically we will suggest the inclusion of the ecological theory of perception in the paradigm of cultural historical psychology and activity theory developed in the former Soviet Union by most notably Lev Vygotsky, S. L. Rubinshtein, A. N. Leontjev and others. It will be suggested, that much...... of the confusion in HCI concerning the concept of affordance is a consequence of the attempt of using it inside a theoretical paradigm that is unable to capture and encompass one of the most essential aspect of Gibsons concept of affordance, that is its foundation in activity...

Melanin distribution in human epidermis affords localized protection against DNA photodamage and concurs with skin cancer incidence difference in extreme phototypes.

Science.gov (United States)

Fajuyigbe, Damilola; Lwin, Su M; Diffey, Brian L; Baker, Richard; Tobin, Desmond J; Sarkany, Robert P E; Young, Antony R

2018-02-02

Epidermal DNA damage, especially to the basal layer, is an established cause of keratinocyte cancers (KCs). Large differences in KC incidence (20- to 60-fold) between white and black populations are largely attributable to epidermal melanin photoprotection in the latter. The cyclobutane pyrimidine dimer (CPD) is the most mutagenic DNA photolesion; however, most studies suggest that melanin photoprotection against CPD is modest and cannot explain the considerable skin color-based differences in KC incidence. Along with melanin quantity, solar-simulated radiation-induced CPD assessed immediately postexposure in the overall epidermis and within 3 epidermal zones was compared in black West Africans and fair Europeans. Melanin in black skin protected against CPD by 8.0-fold in the overall epidermis and by 59.0-, 16.5-, and 5.0-fold in the basal, middle, and upper epidermis, respectively. Protection was related to the distribution of melanin, which was most concentrated in the basal layer of black skin. These results may explain, at least in part, the considerable skin color differences in KC incidence. These data suggest that a DNA protection factor of at least 60 is necessary in sunscreens to reduce white skin KC incidence to a level that is comparable with that of black skin.-Fajuyigbe, D., Lwin, S. M., Diffey, B. L., Baker, R., Tobin, D. J., Sarkany, R. P. E., Young, A. R. Melanin distribution in human epidermis affords localized protection against DNA photodamage and concurs with skin cancer incidence difference in extreme phototypes.

American surgery and the Affordable Care Act.

Science.gov (United States)

Stain, Steven C; Hoyt, David B; Hunter, John G; Joyce, Geoffrey; Hiatt, Jonathan R

2014-09-01

The Affordable Care Act (ACA) attempts to change the way we finance and deliver health care by coordinating the delivery of primary, specialty, and hospital services in accountable care organizations. The ways in which accountable care organizations will develop and evolve is unclear; however, the effects on surgeons and their patients will be substantial. High-value care in the ACA emphasizes quality, safety, resource use and appropriateness, and the patient's experience of care. Payment will be linked to these principles. Department chairs overseeing a clinical enterprise in academic medical centers now must add financial and quality measures to the traditional missions of education, research, and clinical service. At a time when surgical training is in dramatic evolution, with work hour limitations for residents and an emphasis on quality, productivity, and increasing oversight of trainees for faculty, residency programs will need to meet the increasing demands of an aging population and newly insured patients under the ACA. The American College of Surgeons, with its century-long commitment to quality improvement, research-based standards, and performance measurement and verification, has begun its Inspiring Quality Campaign, is developing new educational tools, and is preparing proposals for payment reform based on surgeons' participation in quality programs.

Learning outcomes afforded by self-assessed, segmented video–print combinations

OpenAIRE

Jack Koumi

2015-01-01

Learning affordances of video and print are examined in order to assess the learning outcomes afforded by hybrid video–print learning packages. The affordances discussed for print are: navigability, surveyability and legibility. Those discussed for video are: design for constructive reflection, provision of realistic experiences, presentational attributes, motivational influences and teacher personalisation. The video affordances are examined through a framework of pedagogic design principles...

Affordances and the musically extended mind

OpenAIRE

Joel eKrueger

2014-01-01

I defend a model of the musically extended mind. I consider how acts of “musicking” grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of “musical affordances” and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances – via soliciting different forms of entrainment – enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel exper...

Affordances in Mobile Augmented Reality Applications

OpenAIRE

Gjøsæter, Tor

2014-01-01

This paper explores the affordances of augmented reality content in a mobile augmented reality application. A user study was conducted by performing a multi-camera video recording of seven think aloud sessions. The think aloud sessions consisted of individual users performing tasks, exploring and experiencing a mobile augmented reality (MAR) application we developed for the iOS platform named ARad. We discuss the instrumental affordances we observed when users interacted with augmented realit...

Affordability Funding Models for Early Childhood Services

Science.gov (United States)

Purcal, Christiane; Fisher, Karen

2006-01-01

This paper presents a model of the approaches open to government to ensure that early childhood services are affordable to families. We derived the model from a comparative literature review of affordability approaches taken by government, both in Australia and internationally. The model adds significantly to the literature by proposing a means to…

Enhancement of radiomodulatory effect through liposome encapsulated radio-modifier on cancer bearing mice

International Nuclear Information System (INIS)

Alam, A.; Chakraborty, S.; Rapthap, C.; Sharan, R.N.

1999-01-01

Efficacy of a radioprotective drug, 2-mercaptopropionylglycine (MPG), in its free form and after its encapsulation into liposomes have been studied in normal and cancer bearing mice. Cancer was induced in micy by oral administration of aqueous extract of betel nut (AEBN) for 3 months. Radioprotection afforded by free MPG and liposome encapsulated MPG (LEM) in normal and cancerous tissue were evaluated by monitoring levels of glutathione (GSH) and γ-glutamyltranspeptidase (GGT) enzyme and state of structural organization of chromatin. The results of our studies reveal that in cancerous tissues LEM afforded better radioprotection than the free form of MPG. (orig.)

Enhancement of radiomodulatory effect through liposome encapsulated radio-modifier on cancer bearing mice

Energy Technology Data Exchange (ETDEWEB)

Alam, A.; Chakraborty, S.; Rapthap, C. [North-Eastern Hill Univ., Shillong (India). Immunology Lab.; Srivastava, P.N. [Jawaharlal Nehru Univ., New Delhi (India); Sharan, R.N. [North-Eastern Hill Univ., Shillong (India). Dept. of Biochemistry

1999-07-01

Efficacy of a radioprotective drug, 2-mercaptopropionylglycine (MPG), in its free form and after its encapsulation into liposomes have been studied in normal and cancer bearing mice. Cancer was induced in micy by oral administration of aqueous extract of betel nut (AEBN) for 3 months. Radioprotection afforded by free MPG and liposome encapsulated MPG (LEM) in normal and cancerous tissue were evaluated by monitoring levels of glutathione (GSH) and {gamma}-glutamyltranspeptidase (GGT) enzyme and state of structural organization of chromatin. The results of our studies reveal that in cancerous tissues LEM afforded better radioprotection than the free form of MPG. (orig.)

Housing Affordability And Children's Cognitive Achievement.

Science.gov (United States)

Newman, Sandra; Holupka, C Scott

2016-11-01

Housing cost burden-the fraction of income spent on housing-is the most prevalent housing problem affecting the healthy development of millions of low- and moderate-income children. By affecting disposable income, a high burden affects parents' expenditures on both necessities for and enrichment of their children, as well as investments in their children. Reducing those expenditures and investments, in turn, can affect children's development, including their cognitive skills and physical, social, and emotional health. This article summarizes the first empirical evidence of the effects of housing affordability on children's cognitive achievement and on one factor that appears to contribute to these effects: the larger expenditures on child enrichment by families in affordable housing. We found that housing cost burden has the same relationship to both children's cognitive achievement and enrichment spending on children, exhibiting an inverted U shape in both cases. The maximum benefit occurs when housing cost burden is near 30 percent of income-the long-standing rule-of-thumb definition of affordable housing. The effect of the burden is stronger on children's math ability than on their reading comprehension and is more pronounced with burdens above the 30 percent standard. For enrichment spending, the curve is "shallower" (meaning the effect of optimal affordability is less pronounced) but still significant. Project HOPE—The People-to-People Health Foundation, Inc.

Diabetes and the Affordable Care Act.

Science.gov (United States)

Burge, Mark R; Schade, David S

2014-07-01

The Affordable Care Act--"Obamacare"--is the most important federal medical legislation to be enacted since Medicare. Although the goal of the Affordable Care Act is to improve healthcare coverage, access, and quality for all Americans, people with diabetes are especially poised to benefit from the comprehensive reforms included in the act. Signed into law in 2010, this massive legislation will slowly be enacted over the next 10 years. In the making for at least a decade, it will affect every person in the United States, either directly or indirectly. In this review, we discuss the major changes in healthcare that will take place in the next several years, including (1) who needs to purchase insurance on the Web-based exchange, (2) the cost to individuals and the rebates that they may expect, (3) the rules and regulations for purchasing insurance, (4) the characteristics of the different "metallic" insurance plans that are available, and (5) the states that have agreed to participate. With both tables and figures, we have tried to make the Affordable Care Act both understandable and appreciated. The goal of this comprehensive review is to highlight aspects of the Affordable Care Act that are of importance to practitioners who care for people with diabetes by discussing both the positive and the potentially negative aspects of the program as they relate to diabetes care.

Vaccination via Chloroplast Genetics: Affordable Protein Drugs for the Prevention and Treatment of Inherited or Infectious Human Diseases.

Science.gov (United States)

Daniell, Henry; Chan, Hui-Ting; Pasoreck, Elise K

2016-11-23

Plastid-made biopharmaceuticals treat major metabolic or genetic disorders, including Alzheimer's, diabetes, hypertension, hemophilia, and retinopathy. Booster vaccines made in chloroplasts prevent global infectious diseases, such as tuberculosis, malaria, cholera, and polio, and biological threats, such as anthrax and plague. Recent advances in this field include commercial-scale production of human therapeutic proteins in FDA-approved cGMP facilities, development of tags to deliver protein drugs to targeted human cells or tissues, methods to deliver precise doses, and long-term stability of protein drugs at ambient temperature, maintaining their efficacy. Codon optimization utilizing valuable information from sequenced chloroplast genomes enhanced expression of eukaryotic human or viral genes in chloroplasts and offered unique insights into translation in chloroplasts. Support from major biopharmaceutical companies, development of hydroponic production systems, and evaluation by regulatory agencies, including the CDC, FDA, and USDA, augur well for advancing this novel concept to the clinic and revolutionizing affordable healthcare.

Learning Grasp Affordance Densities

DEFF Research Database (Denmark)

Detry, Renaud; Kraft, Dirk; Kroemer, Oliver

2011-01-01

and relies on kernel density estimation to provide a continuous model. Grasp densities are learned and refined from exploration, by letting a robot “play” with an object in a sequence of graspand-drop actions: The robot uses visual cues to generate a set of grasp hypotheses; it then executes......We address the issue of learning and representing object grasp affordance models. We model grasp affordances with continuous probability density functions (grasp densities) which link object-relative grasp poses to their success probability. The underlying function representation is nonparametric...... these and records their outcomes. When a satisfactory number of grasp data is available, an importance-sampling algorithm turns these into a grasp density. We evaluate our method in a largely autonomous learning experiment run on three objects of distinct shapes. The experiment shows how learning increases success...

Biotin-targeted Pluronic(®) P123/F127 mixed micelles delivering niclosamide: A repositioning strategy to treat drug-resistant lung cancer cells.

Science.gov (United States)

Russo, Annapina; Pellosi, Diogo Silva; Pagliara, Valentina; Milone, Maria Rita; Pucci, Biagio; Caetano, Wilker; Hioka, Noboru; Budillon, Alfredo; Ungaro, Francesca; Russo, Giulia; Quaglia, Fabiana

2016-09-10

With the aim to develop alternative therapeutic tools for the treatment of resistant cancers, here we propose targeted Pluronic(®) P123/F127 mixed micelles (PMM) delivering niclosamide (NCL) as a repositioning strategy to treat multidrug resistant non-small lung cancer cell lines. To build multifunctional PMM for targeting and imaging, Pluronic(®) F127 was conjugated with biotin, while Pluronic(®) P123 was fluorescently tagged with rhodamine B, in both cases at one of the two hydroxyl end groups. This design intended to avoid any interference of rhodamine B on biotin exposition on PMM surface, which is a key fundamental for cell trafficking studies. Biotin-decorated PMM were internalized more efficiently than non-targeted PMM in A549 lung cancer cells, while very low internalization was found in NHI3T3 normal fibroblasts. Biotin-decorated PMM entrapped NCL with good efficiency, displayed sustained drug release in protein-rich media and improved cytotoxicity in A549 cells as compared to free NCL (Pbiotin-decorated PMM carrying NCL at low doses demonstrated a significantly higher cytotoxicity than free NCL in CPr-A549. These results point at NCL-based regimen with targeted PMM as a possible second-line chemotherapy for lung cancer showing cisplatin or multidrug resistance. Copyright © 2016 Elsevier B.V. All rights reserved.

Nuevo Amanecer: results of a randomized controlled trial of a community-based, peer-delivered stress management intervention to improve quality of life in Latinas with breast cancer.

Science.gov (United States)

Nápoles, Anna María; Ortíz, Carmen; Santoyo-Olsson, Jasmine; Stewart, Anita L; Gregorich, Steven; Lee, Howard E; Durón, Ysabel; McGuire, Peggy; Luce, Judith

2015-07-01

We evaluated a community-based, translational stress management program to improve health-related quality of life in Spanish-speaking Latinas with breast cancer. We adapted a cognitive-behavioral stress management program integrating evidence-based and community best practices to address the needs of Latinas with breast cancer. Spanish-speaking Latinas with breast cancer were randomly assigned to an intervention or usual-care control group. Trained peers delivered the 8-week intervention between February 2011 and February 2014. Primary outcomes were breast cancer-specific quality of life and distress, and general symptoms of distress. Of 151 participants, 95% were retained at 6 months (between May 2011 and May 2014). Improvements in quality of life from baseline to 6 months were greater for the intervention than the control group on physical well-being, emotional well-being, breast cancer concerns, and overall quality of life. Decreases from baseline to 6 months were greater for the intervention group on depression and somatization. Results suggest that translation of evidence-based programs can reduce psychosocial health disparities in Latinas with breast cancer. Integration of this program into community-based organizations enhances its dissemination potential.

24 CFR 1000.102 - What are eligible affordable housing activities?

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What are eligible affordable housing activities? 1000.102 Section 1000.102 Housing and Urban Development Regulations Relating to... § 1000.102 What are eligible affordable housing activities? Eligible affordable housing activities are...

Affordances in Mobile Augmented Reality Applications

Directory of Open Access Journals (Sweden)

Tor Gjøsæter

2014-10-01

Full Text Available This paper explores the affordances of augmented reality content in a mobile augmented reality application. A user study was conducted by performing a multi-camera video recording of seven think aloud sessions. The think aloud sessions consisted of individual users performing tasks, exploring and experiencing a mobile augmented reality (MAR application we developed for the iOS platform named ARad. We discuss the instrumental affordances we observed when users interacted with augmented reality content, as well as more complex affordances rising from conventions from media content, AR and the traditional WIMP paradigm. We find that remediation of traditional newspaper content through the MAR medium can provide engaging, pleasing and exciting user experiences. However, the some of the content still suffers from being shoveled onto the MAR platform without adapting it properly. Finally, we discuss what content was most successfully mediated to the user and how the content impacts the user experience.

Young children's tool innovation across culture: Affordance visibility matters.

Science.gov (United States)

Neldner, Karri; Mushin, Ilana; Nielsen, Mark

2017-11-01

Young children typically demonstrate low rates of tool innovation. However, previous studies have limited children's performance by presenting tools with opaque affordances. In an attempt to scaffold children's understanding of what constitutes an appropriate tool within an innovation task we compared tools in which the focal affordance was visible to those in which it was opaque. To evaluate possible cultural specificity, data collection was undertaken in a Western urban population and a remote Indigenous community. As expected affordance visibility altered innovation rates: young children were more likely to innovate on a tool that had visible affordances than one with concealed affordances. Furthermore, innovation rates were higher than those reported in previous innovation studies. Cultural background did not affect children's rates of tool innovation. It is suggested that new methods for testing tool innovation in children must be developed in order to broaden our knowledge of young children's tool innovation capabilities. Copyright © 2017 Elsevier B.V. All rights reserved.

Delivering Science from Big Data

Science.gov (United States)

Quinn, Peter Joseph

2015-08-01

The SKA will be capable of producing a stream of science data products that are Exa-scale in terms of their storage and processing requirements. This Google-scale enterprise is attracting considerable international interest and excitement from within the industrial and academic communities. In this paper we examine the data flow, storage and processing requirements of a number of key SKA survey science projects to be executed on the baseline SKA1 configuration. Based on a set of conservative assumptions about trends for HPC and storage costs, and the data flow process within the SKA Observatory, it is apparent that survey projects of the scale proposed will potentially drive construction and operations costs beyond the current anticipated SKA1 budget. This implies a sharing of the resources and costs to deliver SKA science between the community and what is contained within the SKA Observatory. A similar situation was apparent to the designers of the LHC more than 10 years ago. We propose that it is time for the SKA project and broader community to consider the effort and process needed to design and implement a distributed science data system that leans on the lessons of other projects and looks to recent developments in Cloud technologies to ensure an affordable, effective and global achievement of science goals.

77 FR 55095 - National Ovarian Cancer Awareness Month, 2012

Science.gov (United States)

2012-09-06

... National Ovarian Cancer Awareness Month, 2012 By the President of the United States of America A... leave in our hearts will be deeply felt forever. During National Ovarian Cancer Awareness Month, we... campaign, we are working to raise awareness about the signs and symptoms of ovarian cancer. The Affordable...

Stable and variable affordances are both automatic and flexible

Directory of Open Access Journals (Sweden)

Anna M Borghi

2015-06-01

Full Text Available The mere observation of pictures or words referring to manipulable objects is sufficient to evoke their affordances since objects and their nouns elicit components of appropriate motor programs associated with object interaction. While nobody doubts that objects actually evoke motor information, the degree of automaticity of this activation has been recently disputed. Recent evidence has indeed revealed that affordances activation is flexibly modulated by the task and by the physical and social context. It is therefore crucial to understand whether these results challenge previous evidence showing that motor information is activated independently from the task. The context and the task can indeed act as an early or late filter. We will review recent data consistent with the notion that objects automatically elicit multiple affordances and that top-down processes select among them probably inhibiting motor information that is not consistent with behaviour goals. We will therefore argue that automaticity and flexibility of affordances are not in conflict. We will also discuss how language can incorporate affordances showing similarities, but also differences, between the motor information elicited by vision and language. Finally we will show how the distinction between stable and variable affordances can accommodate all these effects.

Affordability for sustainable energy development products

International Nuclear Information System (INIS)

Riley, Paul H.

2014-01-01

Highlights: • Clean cookstoves that also generate electricity improve affordability. • Excel spreadsheet model to assist stakeholders to choose optimum technology. • Presents views for each stakeholder villager, village and country. • By adding certain capital costs, affordability and sustainability are improved. • Affordability is highly dependent on carbon credits and social understandings. - Abstract: Clean burning products, for example cooking stoves, can reduce household air pollution (HAP), which prematurely kills 3.5 million people each year. By careful selection of components into a product package with micro-finance used for the capital payment, barriers to large-scale uptake of products that remove HAP are reduced. Such products reduce smoke from cooking and the lighting from electricity produced, eliminates smoke from kerosene lamps. A bottom-up financial model, that is cognisant of end user social needs, has been developed to compare different products for use in rural areas of developing countries. The model is freely available for use by researchers and has the ability to assist in the analysis of changing assumptions. Business views of an individual villager, the village itself and a country view are presented. The model shows that affordability (defined as the effect on household expenses as a result of a product purchase) and recognition of end-user social needs are as important as product cost. The effects of large-scale deployment (greater that 10 million per year) are described together with level of subsidy required by the poorest people. With the assumptions given, the model shows that pico-hydro is the most cost effective, but not generally available, one thermo-acoustic technology option does not require subsidy, but it is only at technology readiness level 2 (NASA definition) therefore costs are predicted and very large investment in manufacturing capability is needed to meet the cost target. Thermo-electric is currently the only

The Price of (Perceived Affordance: Commentary for Huron and Berec

Directory of Open Access Journals (Sweden)

Robert Gjerdingen

2009-11-01

Full Text Available It is argued that the symbolic objects in music and musical scores can permit affordances much as physical objects can. This construction of "affordance" places greater emphasis on cultural forms and human memory than the original idea proposed by James J. Gibson, and it aligns itself more closely with the refinements to "affordance" suggested by Donald Norman. For symbolic objects to permit strongly perceived affordances, it may be necessary for perceivers to have developed schematized perception in the course of over-learning culturally significant forms.

Improving perceptions of healthy food affordability: results from a pilot intervention.

Science.gov (United States)

Williams, Lauren K; Abbott, Gavin; Thornton, Lukar E; Worsley, Anthony; Ball, Kylie; Crawford, David

2014-03-10

Despite strong empirical support for the association between perceived food affordability and dietary intake amongst families with a lower socioeconomic position (SEP), there is limited evidence of the most effective strategies for promoting more positive perceptions of healthy food affordability among this group. This paper reports findings from a pilot intervention that aimed to improve perceptions of healthy food affordability amongst mothers. Participants were 66 mothers who were the parents of children recruited from primary schools located in socioeconomically disadvantaged suburbs. Intervention group participants viewed a slideshow focussed on healthy snack food affordability that illustrated cheaper healthier alternatives to common snack foods as well as food budgeting tips and price comparison education. A mixed between-within ANCOVA was conducted to examine group differences in perceived affordability of healthy food across three time points. Results revealed no difference in perceived affordability of healthy food between the two groups at baseline whereas at post-intervention and follow-up, mothers in the intervention group perceived healthy food as more affordable than the control group. Focussing on education-based interventions to improve perceptions of healthy food affordability may be a promising approach that complements existing nutrition promotion strategies.

Therapeutic Efficacy of Orally Delivered Doxorubicin Nanoparticles in Rat Tongue Cancer Induced by 4-Nitroquinoline 1-Oxide

Directory of Open Access Journals (Sweden)

Monir Moradzadeh Khiavi

2015-06-01

Full Text Available Purpose: Oral cancer is one of the most significant cancers in the world, and squamous cell carcinoma makes up about 94% of oral malignancies. The aim of the present study was to compare the efficacy of doxorubicin plus methotrexate - loaded nanoparticles on tongue squamous cell carcinoma induced by 4NQO and compare it with the commercial doxorubicin and methotrexate delivered orally on seventy SD male rats. Methods: 70 rats were divided into five groups. During the study, the animals were weighed by a digital scale once a week. Number of mortalities was recorded in the data collection forms. At the end of the treatment, biopsy samples were taken from rat tongues in order to evaluate the severity of dysplasia and the extent of cell proliferation. The results were analyzed using ANOVA, descriptive statistics and chi-square test. Results: No statistically significant difference was found in the mean weight of five groups (p>0.05. No significant relationship was found between groups and mortality rate (P = 0. 39. In addition, there was a significant relationship between groups and the degree of dysplasia (P <0.001. The statistical analysis showed a significant relationship between groups and the rate of cell proliferation (p <0.001. Conclusion: The results of the present study showed that the use of doxorubicin plus methotrexate - loaded nanoparticles orally had more therapeutic effects than commercial doxorubicin plus methotrexate.

Affordability Engineering: Bridging the Gap Between Design and Cost

Science.gov (United States)

Reeves, J. D.; DePasquale, Dominic; Lim, Evan

2010-01-01

Affordability is a commonly used term that takes on numerous meanings depending on the context used. Within conceptual design of complex systems, the term generally implies comparisons between expected costs and expected resources. This characterization is largely correct, but does not convey the many nuances and considerations that are frequently misunderstood and underappreciated. In the most fundamental sense, affordability and cost directly relate to engineering and programmatic decisions made throughout development programs. Systems engineering texts point out that there is a temporal aspect to this relationship, for decisions made earlier in a program dictate design implications much more so than those made during latter phases. This paper explores affordability engineering and its many sub-disciplines by discussing how it can be considered an additional engineering discipline to be balanced throughout the systems engineering and systems analysis processes. Example methods of multidisciplinary design analysis with affordability as a key driver will be discussed, as will example methods of data visualization, probabilistic analysis, and other ways of relating design decisions to affordability results.

STATE OF THE ART OF CANCER CARE DELIVER Y IN MOSCOW

Directory of Open Access Journals (Sweden)

A. P. Gnatyuk

2015-01-01

Full Text Available Abstract:The globally increased concern with the situation, existing in oncology, is conditioned by a steady incidence rate of malignant neoplasms, having a tendency to its growth. Annually over 7 million people die in the world due to cancer, by 2020, according to WHO estimations, this index will increase to 10 million. By the end of the 2013 report year patient population with cancer, registered in cancer care facilities of the Russian Federation, is 3 098 855 (2 995 566 in 2012, i. e. 2,1% of the population of the country. The system of cancer care delivery to the population in the Russian Federation and in Moscow is aimed at an early diagnostics and prevention of malignant neoplasms. Municipal cancer care service establishes the patients’ routes at suspicion on oncological disease and determines the functions of all links of health care for this type of patients. Stateof-the-art delivery of oncological specialty care has been built up with account of modern demands and is functionally structured in accordance with tree-level municipal health care system.

Planning and User Interface Affordances

National Research Council Canada - National Science Library

St. Amant, Robert

1999-01-01

.... We identify a number of similarities between executing plans and interacting with a graphical user interface, and argue that affordances for planning environments apply equally well to user interface environments...

Affordances in activity theory and cognitive systems engineering

DEFF Research Database (Denmark)

Albrechtsen, H.; Andersen, H.H.K.; Bødker, S.

2001-01-01

on design for low level interaction modalities. To incorporate the concept of affordances in the design of human computer interaction it is necessary to systematically unravel affordances that supporthuman action possibilities. Furthermore, it is a necessity that Gibson's theory of affordances...... is supplemented by careful analyses of other human modalities and activities than visual perception. Within HMI two well established perspectives on HMI,Activity Theory (AT) and Cognitive Systems Engineering (CSE), have discussed such analyses and design of action possibilities focusing on providing computer...... to cover deeper semantic and pragmatic aspects of the ecology of work, as compared with the previous applications of Gibson's theory in HMI....

Defining and Measuring the Affordability of New Medicines: A Systematic Review.

Science.gov (United States)

Antoñanzas, Fernando; Terkola, Robert; Overton, Paul M; Shalet, Natalie; Postma, Maarten

2017-08-01

In many healthcare systems, affordability concerns can lead to restrictions on the use of expensive efficacious therapies. However, there does not appear to be any consensus as to the terminology used to describe affordability, or the thresholds used to determine whether new drugs are affordable. The aim of this systematic review was to investigate how affordability is defined and measured in healthcare. MEDLINE, EMBASE and EconLit databases (2005-July 2016) were searched using terms covering affordability and budget impact, combined with definitions, thresholds and restrictions, to identify articles describing a definition of affordability with respect to new medicines. Additional definitions were identified through citation searching, and through manual searches of European health technology assessment body websites. In total, 27 definitions were included in the review. Of these, five definitions described affordability in terms of the value of a product; seven considered affordability within the context of healthcare system budgets; and 15 addressed whether products are affordable in a given country based on economic factors. However, there was little in the literature to indicate that the price of medicines is considered alongside both their value to individual patients and their budget impact at a population level. Current methods of assessing affordability in healthcare may be limited by their focus on budget impact. A more effective approach may involve a broader perspective than is currently described in the literature, to consider the long-term benefits of a therapy and cost savings elsewhere in the healthcare system, as well as cooperation between healthcare payers and the pharmaceutical industry to develop financing models that support sustainability as well as innovation.

Radiation exposure and familial aggregation of cancers as risk factors for colorectal cancer after radioiodine treatment for thyroid carcinoma

International Nuclear Information System (INIS)

Rubino, Carole; Adjadj, Elisabeth; Doyon, Francoise; Shamsaldin, Akhtar; Abbas, Tahaa Moncef; Caillou, Bernard; Colonna, Marc; Cecarreli, Claudia; Schvartz, Claire; Bardet, Stephane; Langlois, Christiane B.Sc.; Ricard, Marcel; Schlumberger, Martin; Vathaire, Florent de

2005-01-01

Purpose: In thyroid cancer patients, radioiodine treatment has been shown to be associated with an increased risk of colon carcinoma. The aim of this study in thyroid cancer patients was to evaluate the role of familial factors in the risk of colorectal cancer and their potential interaction with radioiodine exposure. Methods and Materials: We performed a case-control study on 15 colorectal cancer patients and 76 matched control subjects, nested in a cohort of 3708 thyroid cancer patients treated between 1933 and 1998. For each patient, the radiation dose delivered to the colon by radioiodine was estimated by use of standard tables. In those who received external radiation therapy, the average radiation doses delivered to the colon and rectum were estimated by use of DOS E g software. A complete familial history was obtained by face-to-face interviews, and a familial index was defined to evaluate the degree of familial aggregation. Results: The risk of colorectal cancer increased with familial aggregation of colorectal cancer (p = 0.02). After adjustment for the radiation dose delivered to the colon and rectum, the risk of colorectal cancer was 2.8-fold higher (95% CI, 1.0-8.0) for patients with at least one relative affected by colorectal cancer than for patients without such a family history (p = 0.05). The radiation dose delivered to the colon and rectum by 131 I and external radiation therapy was associated with an increase of risk near the significance threshold (p = 0.1). No significant interaction was found between radiation dose and having an affected relative (p = 0.9). Conclusions: The role of familial background in the risk of colorectal cancer following a differentiated thyroid carcinoma appears to increase with the radiation dose delivered to the colon and rectum. However, the study population was small and no interaction was found between these two factors

Affordances are Signs

Directory of Open Access Journals (Sweden)

John Pickering

2008-07-01

Full Text Available Peirce and Whitehead share a common project: to restrict the over-extension of reductionism, to show how matter must be sensate and to create an ontology of process and subjectivity. This article claims that biosemiotics can assist this project. Moreover, it shows that the concept of affordance is a means to produce a theory of causation that embraces physical, natural and cultural levels of order.

Bullying and social media affordances

OpenAIRE

Brailas, Alexios

2016-01-01

What constitutes a good and sustainabledigital living?Social media literacyCan we talk about social media intelligence?Can we talk about digital intelligence?How bullying is complicated by special social media affordances?

Web-Delivered Cognitive Behavioral Therapy for Distressed Cancer Patients: Randomized Controlled Trial.

Science.gov (United States)

Chambers, Suzanne K; Ritterband, Lee M; Thorndike, Frances; Nielsen, Lisa; Aitken, Joanne F; Clutton, Samantha; Scuffham, Paul A; Youl, Philippa; Morris, Bronwyn; Baade, Peter D; Dunn, Jeff

2018-01-31

Web-based interventions present a potentially cost-effective approach to supporting self-management for cancer patients; however, further evidence for acceptability and effectiveness is needed. The goal of our research was to assess the effectiveness of an individualized Web-based cognitive behavioral therapy (CBT) intervention on improving psychological and quality of life outcomes in cancer patients with elevated psychological distress. A total of 163 distressed cancer patients (111 female, 68.1%) were recruited through the Queensland Cancer Registry and the Cancer Council Queensland Cancer Helpline and randomly assigned to either a Web-based tailored CBT intervention (CancerCope) (79/163) or a static patient education website (84/163). At baseline and 8-week follow-up we assessed primary outcomes of psychological and cancer-specific distress and unmet psychological supportive care needs and secondary outcomes of positive adjustment and quality of life. Intention-to-treat analyses showed no evidence of a statistically significant intervention effect on primary or secondary outcomes. However, per-protocol analyses found a greater decrease for the CancerCope group in psychological distress (P=.04), cancer-specific distress (P=.02), and unmet psychological care needs (P=.03) from baseline to 8 weeks compared with the patient education group. Younger patients were more likely to complete the CancerCope intervention. This online CBT intervention was associated with greater decreases in distress for those patients who more closely adhered to the program. Given the low costs and high accessibility of this intervention approach, even if only effective for subgroups of patients, the potential impact may be substantial. Australian New Zealand Clinical Trials Registry ACTRN12613001026718; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364768&isReview=true (Archived by WebCite at http://www.webcitation.org/6uPvpcovl). ©Suzanne K Chambers, Lee M Ritterband

Energy affordability and the benefits system in Italy

International Nuclear Information System (INIS)

Miniaci, Raffaele; Scarpa, Carlo; Valbonesi, Paola

2014-01-01

In this paper, we discuss a number of ways to define and measure the affordability of energy consumption, and we examine the emergence of energy poverty in Italy in the period from 1998 to 2011. The paper examines the eligibility criteria for claiming the benefits available to support energy consumption for vulnerable families and it identifies the potential beneficiaries. The study assesses the appropriateness of the eligibility criteria by comparing the population targeted by the policy with the population actually facing affordability problems. A simulation exercise, using the hypothetical scenario most likely to result in energy benefits being made available, shows that, regardless of the affordability index adopted, the provision of state energy benefits has little impact on fuel poverty. - Highlights: • The paper provides a discussion of alternative measure of energy affordability. • We examine the emergence of fuel poverty in Italy from 1998 to 2011. • We assess the appropriateness of the Italian energy benefits eligibility criteria. • A simulation shows that the energy benefits have little impact on fuel poverty

Risk of second primary lung cancer in women after radiotherapy for breast cancer

International Nuclear Information System (INIS)

Grantzau, Trine; Thomsen, Mette Skovhus; Væth, Michael; Overgaard, Jens

2014-01-01

Background: Several epidemiological studies have reported increased risks of second lung cancers after breast cancer irradiation. In this study we assessed the effects of the delivered radiation dose to the lung and the risk of second primary lung cancer. Methods: We conducted a nested case–control study of second lung cancer in a population based cohort of 23,627 early breast cancer patients treated with post-operative radiotherapy from 1982 to 2007. The cohort included 151 cases diagnosed with second primary lung cancer and 443 controls. Individual dose-reconstructions were performed and the delivered dose to the center of the second lung tumor and the comparable location for the controls were estimated, based on the patient specific radiotherapy charts. Results: The median age at breast cancer diagnosis was 54 years (range 34–74). The median time from breast cancer treatment to second lung cancer diagnosis was 12 years (range 1–26 years). 91% of the cases were categorized as ever smokers vs. 40% among the controls. For patients diagnosed with a second primary lung cancer five or more years after breast cancer treatment the rate of lung cancer increased linearly with 8.5% per Gray (95% confidence interval = 3.1–23.3%; p < 0.001). This rate was enhanced for ever smokers with an excess rate of 17.3% per Gray (95% CI = 4.5–54%; p < 0.005). Conclusions: Second lung cancer after radiotherapy for early breast cancer is associated with the delivered dose to the lung. Although the absolute risk is relative low, the growing number of long-time survivors after breast cancer treatment highlights the need for advances in normal tissue sparing radiation techniques

The Affordance Template ROS Package for Robot Task Programming

Science.gov (United States)

Hart, Stephen; Dinh, Paul; Hambuchen, Kimberly

2015-01-01

This paper introduces the Affordance Template ROS package for quickly programming, adjusting, and executing robot applications in the ROS RViz environment. This package extends the capabilities of RViz interactive markers by allowing an operator to specify multiple end-effector waypoint locations and grasp poses in object-centric coordinate frames and to adjust these waypoints in order to meet the run-time demands of the task (specifically, object scale and location). The Affordance Template package stores task specifications in a robot-agnostic XML description format such that it is trivial to apply a template to a new robot. As such, the Affordance Template package provides a robot-generic ROS tool appropriate for building semi-autonomous, manipulation-based applications. Affordance Templates were developed by the NASA-JSC DARPA Robotics Challenge (DRC) team and have since successfully been deployed on multiple platforms including the NASA Valkyrie and Robonaut 2 humanoids, the University of Texas Dreamer robot and the Willow Garage PR2. In this paper, the specification and implementation of the affordance template package is introduced and demonstrated through examples for wheel (valve) turning, pick-and-place, and drill grasping, evincing its utility and flexibility for a wide variety of robot applications.

Developing an Assessment Framework for Affordable and Sustainable Housing

Directory of Open Access Journals (Sweden)

Stephen Pullen

2010-07-01

Full Text Available Sustainable housing has been subject to research, practice and policy making for some considerable time. More recently attention has been drawn to the separate problem of declining affordability in housing. This paper describes research aimed at developing an assessment framework for both affordability and sustainability as part of the effort to incorporate both of these features into new housing projects. The research has a particular focus on developments aimed at urban densification. Background literature on both affordability and sustainability is reviewed as well as emerging schemes aimed at dealing with both aspects of housing developments. Performance indicators are identified and these are incorporated in an interim assessment framework which is tested using a group of industry experts. The research has highlighted areas where further development is required to attain quantitative assessments of affordable and sustainable housing developments

Housing Affordability Data System (HADS)

Data.gov (United States)

Department of Housing and Urban Development — The Housing Affordability Data System (HADS) is a set of files derived from the 1985 and later national American Housing Survey (AHS) and the 2002 and later Metro...

Active Affordance Learning in Continuous State and Action Spaces

NARCIS (Netherlands)

Wang, C.; Hindriks, K.V.; Babuska, R.

2014-01-01

Learning object affordances and manipulation skills is essential for developing cognitive service robots. We propose an active affordance learning approach in continuous state and action spaces without manual discretization of states or exploratory motor primitives. During exploration in the action

iCanADAPT Early protocol: randomised controlled trial (RCT) of clinician supervised transdiagnostic internet-delivered cognitive behaviour therapy (iCBT) for depression and/or anxiety in early stage cancer survivors -vs- treatment as usual

OpenAIRE

Murphy, M. J.; Newby, J. M.; Butow, P.; Kirsten, L.; Allison, K.; Loughnan, S.; Price, M. A.; Shaw, J.; Shepherd, H.; Smith, J.; Andrews, G.

2017-01-01

Background This RCT with two parallel arms will evaluate the efficacy of an internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for the treatment of clinical depression and/or anxiety in early stage cancer survivors. Methods/design Early stage cancer survivors will be recruited via the research arm of a not-for-profit clinical research unit and randomised to an intervention (iCBT) group or a ?treatment as usual? (TAU) control group. The minimum sample size for...

High-dose-rate brachytherapy as monotherapy delivered in two fractions within one day for favorable/intermediate-risk prostate cancer: preliminary toxicity data.

Science.gov (United States)

Ghilezan, Michel; Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye, Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy

2012-07-01

To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy × 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy × 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of ≤12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. The median follow-up was 17 months (range, 6-40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Favorable-risk prostate cancer patients treated with a single implant HDR-BT to 24-27 Gy in two fractions

High-Dose-Rate Brachytherapy as Monotherapy Delivered in Two Fractions Within One Day for Favorable/Intermediate-Risk Prostate Cancer: Preliminary Toxicity Data

Energy Technology Data Exchange (ETDEWEB)

Ghilezan, Michel, E-mail: mghilezan@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital and Rose Cancer Institute, Royal Oak, Michigan (United States); Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J. Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy [Department of Radiation Oncology, William Beaumont Hospital and Rose Cancer Institute, Royal Oak, Michigan (United States)

2012-07-01

Purpose: To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy Multiplication-Sign 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy Multiplication-Sign 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. Methods and Materials: A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of {<=}12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. Results: The median follow-up was 17 months (range, 6-40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Conclusions: Favorable

High-Dose-Rate Brachytherapy as Monotherapy Delivered in Two Fractions Within One Day for Favorable/Intermediate-Risk Prostate Cancer: Preliminary Toxicity Data

International Nuclear Information System (INIS)

Ghilezan, Michel; Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J. Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy

2012-01-01

Purpose: To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy × 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy × 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. Methods and Materials: A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of ≤12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. Results: The median follow-up was 17 months (range, 6–40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Conclusions: Favorable-risk prostate cancer patients treated with

TECHNOLOGICAL TOOLS: FROM TECHNICAL AFFORDANCES TO EDUCATIONAL AFFORDANCES

Directory of Open Access Journals (Sweden)

Nicos Valanides

2018-04-01

Full Text Available The integration of these tools in education and in authentic and effective learning/teaching environments has become an issue of great concern among educators, researchers and other related audiences. All emphasize the need to design and develop technology-enhanced curricula and teaching/learning environments (formal, non-formal and informal that are developmentally appropriate for young and/or older learners. The vision is to integrate the tools and their associated technical affordance in teaching/learning environments in such a way, so that all learners, irrespective of their cognitive differences and abilities, could increase their learning gains, and develop the abilities and skills that are needed for citizens of the 21st century.

Affordances: Ten Years On

Science.gov (United States)

Brown, Jill P.; Stillman, Gloria

2014-01-01

Ten years ago the construct, affordance, was rising in prominence in scholarly literature. A proliferation of different uses and meanings was evident. Beginning with its origin in the work of Gibson, we traced its development and use in various scholarly fields. This paper revisits our original question with respect to its utility in mathematics…

Affordability and Paradigms in Agent-Based Systems

Directory of Open Access Journals (Sweden)

Boldur E. Barbat

2007-07-01

Full Text Available The paper aims at substantiating that in universities with scarce resources, applied Information Technologies (IT research is affordable, even in most advanced and dynamic sub-domains. This target is split into four specific objectives: a to set up a framework for IT research affordability in universities representative for current East-European circumstances; b to outline a workable approach based on synergistic leverage and to assess the paradigms prevalent in modern artificial intelligence through this ``affordability filter''; c to describe the evolution and the current stages of two undertakings exploiting paradigms founded on emergence (the sub-domains are stigmergic coordination and agent self-awareness; d to summarise for both sub domains the mechanisms and the architectonics (the focus is on computer science aspects; implementation details will be given in future papers. The results in both directions appear as promising and reveal significant potential for transdisciplinarity. From this perspective, the paper is a call to improved cooperation.

Breast Cancer After Chest Radiation Therapy for Childhood Cancer

Science.gov (United States)

Moskowitz, Chaya S.; Chou, Joanne F.; Wolden, Suzanne L.; Bernstein, Jonine L.; Malhotra, Jyoti; Friedman, Danielle Novetsky; Mubdi, Nidha Z.; Leisenring, Wendy M.; Stovall, Marilyn; Hammond, Sue; Smith, Susan A.; Henderson, Tara O.; Boice, John D.; Hudson, Melissa M.; Diller, Lisa R.; Bhatia, Smita; Kenney, Lisa B.; Neglia, Joseph P.; Begg, Colin B.; Robison, Leslie L.; Oeffinger, Kevin C.

2014-01-01

Purpose The risk of breast cancer is high in women treated for a childhood cancer with chest irradiation. We sought to examine variations in risk resulting from irradiation field and radiation dose. Patients and Methods We evaluated cumulative breast cancer risk in 1,230 female childhood cancer survivors treated with chest irradiation who were participants in the CCSS (Childhood Cancer Survivor Study). Results Childhood cancer survivors treated with lower delivered doses of radiation (median, 14 Gy; range, 2 to 20 Gy) to a large volume (whole-lung field) had a high risk of breast cancer (standardized incidence ratio [SIR], 43.6; 95% CI, 27.2 to 70.3), as did survivors treated with high doses of delivered radiation (median, 40 Gy) to the mantle field (SIR, 24.2; 95% CI, 20.7 to 28.3). The cumulative incidence of breast cancer by age 50 years was 30% (95% CI, 25 to 34), with a 35% incidence among Hodgkin lymphoma survivors (95% CI, 29 to 40). Breast cancer–specific mortality at 5 and 10 years was 12% (95% CI, 8 to 18) and 19% (95% CI, 13 to 25), respectively. Conclusion Among women treated for childhood cancer with chest radiation therapy, those treated with whole-lung irradiation have a greater risk of breast cancer than previously recognized, demonstrating the importance of radiation volume. Importantly, mortality associated with breast cancer after childhood cancer is substantial. PMID:24752044

Availability, accessibility, and affordability of neurodiagnostic tests in 37 countries.

Science.gov (United States)

McLane, Hannah C; Berkowitz, Aaron L; Patenaude, Bryan N; McKenzie, Erica D; Wolper, Emma; Wahlster, Sarah; Fink, Günther; Mateen, Farrah J

2015-11-03

To determine the availability, accessibility, and affordability of EEG, EMG, CSF analysis, head CT, and brain MRI for neurologic disorders across countries. An online, 60-question survey was distributed to neurology practitioners in 2014 to assess the presence, wait time, and cost of each test in private and public health sectors. Data were stratified by World Bank country income group. Affordability was calculated with reference to the World Health Organization's definition of catastrophic health expenditure as health-related out-of-pocket expenditure of >40% of disposable household income, and assessment of providers' perceptions of affordability to the patient. Availability of EEG and EMG is correlated with higher World Bank income group (correlation coefficient 0.38, test for trend p = 0.046; 0.376, p = 0.043); CSF, CT, and MRI did not show statistically significant associations with income groups. Patients in public systems wait longer for neurodiagnostic tests, especially MRI, EEG, and urgent CT (p private sector (US $55.25 vs $214.62, p income group is associated with a 29% decrease in the estimated share of the population who can afford a given test (95% confidence interval -33.4, 25.2; p income countries surveyed, only the top 10% or 20% of the population was able to afford tests below catastrophic levels. In surveyed lower-middle-income countries, >40% of the population, on average, could not afford neurodiagnostic tests. Neurodiagnostic tests are least affordable in the lowest income settings. Closing this "diagnostic gap" for countries with the lowest incomes is essential. © 2015 American Academy of Neurology.

Mindfulness-Based Cognitive Therapy for Cancer Patients Delivered via Internet: Qualitative Study of Patient and Therapist Barriers and Facilitators.

Science.gov (United States)

Compen, Félix R; Bisseling, Else M; Schellekens, Melanie Pj; Jansen, Ellen Tm; van der Lee, Marije L; Speckens, Anne Em

2017-12-18

The number of patients living with cancer is growing, and a substantial number of patients suffer from psychological distress. Mindfulness-based interventions (MBIs) seem effective in alleviating psychological distress. Unfortunately, several cancer patients find it difficult, if not impossible, to attend a group-based course. Internet-based MBIs (eMBIs) such as Internet-based mindfulness-based cognitive therapy (eMBCT) may offer solutions. However, it is yet to be studied what facilitators and barriers cancer patients experience during eMBCT. This study aimed to explore facilitators and barriers of individual asynchronous therapist-assisted eMBCT as experienced by both patients and therapists. Patients with heterogeneous cancer diagnoses suffering from psychological distress were offered eMBCT. This 9-week intervention mirrored the group-based MBCT protocol and included weekly asynchronous written therapist feedback. Patients were granted access to a website that contained the eMBCT protocol and a secured inbox, and they were asked to practice and fill out diaries on which the therapist provided feedback. In total, 31 patients participated in an individual posttreatment interview on experienced facilitators and barriers during eMBCT. Moreover, eight therapists were interviewed. The data were analyzed with qualitative content analysis to identify barriers and facilitators in eMBCT. Both patients and therapists mentioned four overarching themes as facilitators and barriers: treatment setting (the individual and Internet-based nature of the treatment), treatment format (how the treatment and its guidance were organized and delivered), role of the therapist, and individual patient characteristics. The eMBCT provided flexibility in when, where, and how patients and therapists engage in MBCT. Future studies should assess how different eMBCT designs could further improve barriers that were found. ©Félix R Compen, Else M Bisseling, Melanie PJ Schellekens, Ellen TM

Cancer Patient Navigator Tasks across the Cancer Care Continuum

Science.gov (United States)

Braun, Kathryn L.; Kagawa-Singer, Marjorie; Holden, Alan E. C.; Burhansstipanov, Linda; Tran, Jacqueline H.; Seals, Brenda F.; Corbie-Smith, Giselle; Tsark, JoAnn U.; Harjo, Lisa; Foo, Mary Anne; Ramirez, Amelie G.

2011-01-01

Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their potential to make cancer services understandable, available, accessible, affordable, appropriate, and accountable. Although navigators perform similar tasks across the five programs, their specific approaches reflect differences in community culture, context, program setting, and funding. Task lists can inform the development of programs, job descriptions, training, and evaluation. They also may be useful in the move to certify navigators and establish mechanisms for reimbursement for navigation services. PMID:22423178

Affordances of Ditches for Children in Preschool

DEFF Research Database (Denmark)

Lerstrup, Inger Elisabeth; Møller, Maja Steen

2016-01-01

This study aims to expand understanding of the affordances provided by ditches in a Danish preschool context. Affordances are defined as the meaningful action possibilities of the environment. At a forest preschool, a group of 21 children aged approximately 3to 6.5 years accompanied by two to three...... offered varied and changing action possibilities for the preschool children. The paper discusses the possible incorporation of this largely unrecognized design element by planners and managers of green spaces and playgrounds for children in preschool....

Challenges of Integrating Affordable and Sustainable Housing in Malaysia

Science.gov (United States)

Syed Jamaludin, S. Z. H.; Mahayuddin, S. A.; Hamid, S. H. A.

2018-04-01

Developing countries including Malaysia have begun to comprehend the needs for affordable and sustainable housing development. The majority of the population is still aspiring for a comfortable, safe and reasonably priced house. Households in the low-middle income range face difficulties to find housing that can satisfy their needs and budget. Unfortunately, most of the housing development programs are considering affordability rather than sustainable aspects. Furthermore, developers are more interested in profit and neglect sustainability issues. Thus, the aim of this paper is to review the challenges in integrating affordable housing and sustainable practices in Malaysia. This paper is produced based on an extensive literature review as a basis to develop strategies of integrated affordable and sustainable housing in Malaysia. The challenges are divided into four sections, namely market challenges, professional challenges, societal challenges and technological challenges. The outcomes of this paper will assist in the decision making involving housing development and in enhancing quality of life for sustainable communities.

Are essential medicines in Malaysia accessible, affordable and available?

Science.gov (United States)

Saleh, Kamaruzaman; Ibrahim, Mohamed I M

2005-12-01

To assess the pharmaceutical sector to know whether people have access to essential medicines. The study was conducted in 20 public health clinics, five public district drug stores and 20 private retail pharmacies selected randomly in five different areas randomly selected (four states and a federal territory). The methodology used was adopted from the World Health Organization study protocol. The degree of attainment of the strategic pharmaceutical objectives of improved access is measured by a list of tested indicators. Access is measured in terms of the availability and affordability of essential medicines, especially to the poor and in the public sector. The first survey in the public health clinics and public district drug stores gathered information about current availability of essential medicines, prevalence of stock-outs and affordability of treatment (except drug stores). The second survey assessed affordability of treatment in public health clinics and private retail pharmacies. Availability, stock-out duration, percent of medicines dispensed, accessibility and affordability of key medicines. The average availability of key medicines in the public health clinics for the country was 95.4%. The average stock-out duration of key medicines was 6.5 days. However, average availability of key medicines in the public district drug stores was 89.2%; with an average stock-out duration of 32.4 days. Medicines prescribed were 100% dispensed to the patients. Average affordability for public health clinics was 1.5 weeks salary and for the private pharmacies, 3.7 weeks salary. The present pharmaceutical situation in the context of essential medicines list implementation reflected that the majority of the population in Malaysia had access to affordable essential medicines. If medicines need to be obtained from the private sector, they are hardly affordable. Although the average availability of essential medicines in Malaysia was high being more than 95.0%, in certain

Achieving a deeper understanding of the implemented provisions of the Affordable Care Act.

Science.gov (United States)

Zhang, Shuang Qin; Polite, Blase N

2014-01-01

The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.

Availability and affordability of antiglaucoma drugs in Benin city ...

African Journals Online (AJOL)

Glaucoma is a leading cause of blindness. Affordability and availability are key factors that determine access to effective treatment. The aim of this study is to investigate the availability and affordability of antiglaucoma medicines in Benin City. A cross sectional survey of the major drug distribution sectors was conducted.

Affordances and the musically extended mind

Directory of Open Access Journals (Sweden)

Joel eKrueger

2014-01-01

Full Text Available I defend a model of the musically extended mind. I consider how acts of musicking grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of musical affordances and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances—via soliciting different forms of entrainment—enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I suggest that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea.

Affordances and distributed cognition in museum exhibitions

DEFF Research Database (Denmark)

Achiam, Marianne; May, Michael; Marandino, Martha

2014-01-01

consistent framework. Here, we invoke the notions of affordance and distributed cognition to explain in a coherent way how visitors interact with exhibits and exhibit spaces and make meaning from those interactions, and we exemplify our points using observations of twelve visitors to exhibits at a natural...... history museum. We show how differences in exhibit characteristics give rise to differences in the interpretive strategies used by visitors in their meaning-making process, and conclude by discussing how the notions of affordance and distributed cognition can be used in an exhibit design perspective....

Imagined affordance: reconstructing a keyword for communication theory

OpenAIRE

Neff, G; Nagy, P

2015-01-01

In this essay, we reconstruct a keyword for communication—affordance. Affordance, adopted from ecological psychology, is now widely used in technology studies, yet the term lacks a clear definition. This is especially problematic for scholars grappling with how to theorize the relationship between technology and sociality for complex socio-technical systems such as machine-learning algorithms, pervasive computing, the Internet of Things, and other such “smart” innovations. Within technology s...

WE-AB-207B-09: Margin Reduction for Planning Target Volume (PTV) in Patients with Localized Prostate Cancer: Impact On Delivered Dose and Quality of Life

Energy Technology Data Exchange (ETDEWEB)

Kumarasiri, A; Liu, C; Brown, S; Glide-Hurst, C; Elshaikh, M; Chetty, I; Movsas, B [Henry Ford Health System, Detroit, MI (United States)

2016-06-15

Purpose: To estimate the delivered (cumulative) dose to targets and organs at risk for localized prostate cancer patients treated with reduced PTV margins and to evaluate preliminary patient reported quality-of-life (QOL). Methods: Under an IRB-approved protocol, 20 prostate cancer patients (including 11 control patients) were treated with reduced planning margins (5 mm uniform with 4 mm at prostate/rectum interface). Control patients had standard margin (10/6 mm)-based treatments. A parameter-optimized Elastix algorithm along with energy-mass mapping was used to deform and resample dose of the day onto the planning CT for each fraction to estimate the delivered dose over all fractions. QOL data were collected via Expanded Prostate cancer Index Composite (EPIC-26) questionnaires at time points pre-treatment, post-treatment, and at 2, 6, 12, 18 month follow-ups. Standardized QOL scores [range: 0–100] were determined and baseline-corrected by subtracting pre-treatment QOL data. Mean QOL differences between the margin reduced group and control group (QOLmr-QOLcontrol) were calculated for first 18 months. Results: The difference between the cumulative mean dose (Dmean) and the planned mean dose (±SD) for PTV, prostate, bladder, and rectum were −2.2±1.0, 0.3±0.5, −0.7±2.6, and −2.1±1.3 Gy respectively for the margin-reduced group, and −0.8±2.0, 0.9±1.4, - 0.7±3.1 and −1.0±2.4 Gy for the control group. Difference between the two groups was statistically insignificant (p=0.1). Standardized and baseline corrected QOLmr-QOLcontrol for EPIC domains categorized as “Urinary Incontinence”, “Urinary Irritative/Obstructive”, “Bowel”, “Sexual”, and “Hormonal” were 0.6, 12.1, 9.1, 13.3, and −0.9 for the 18 months following radiation therapy (higher values better). Delivered dose to rectum showed a weak correlation to “Bowel” domain (Pearson’s coefficient −0.24, p<0.001), while bladder dose did not correlate to Urinary Incontinence

WE-AB-207B-09: Margin Reduction for Planning Target Volume (PTV) in Patients with Localized Prostate Cancer: Impact On Delivered Dose and Quality of Life

International Nuclear Information System (INIS)

Kumarasiri, A; Liu, C; Brown, S; Glide-Hurst, C; Elshaikh, M; Chetty, I; Movsas, B

2016-01-01

Purpose: To estimate the delivered (cumulative) dose to targets and organs at risk for localized prostate cancer patients treated with reduced PTV margins and to evaluate preliminary patient reported quality-of-life (QOL). Methods: Under an IRB-approved protocol, 20 prostate cancer patients (including 11 control patients) were treated with reduced planning margins (5 mm uniform with 4 mm at prostate/rectum interface). Control patients had standard margin (10/6 mm)-based treatments. A parameter-optimized Elastix algorithm along with energy-mass mapping was used to deform and resample dose of the day onto the planning CT for each fraction to estimate the delivered dose over all fractions. QOL data were collected via Expanded Prostate cancer Index Composite (EPIC-26) questionnaires at time points pre-treatment, post-treatment, and at 2, 6, 12, 18 month follow-ups. Standardized QOL scores [range: 0–100] were determined and baseline-corrected by subtracting pre-treatment QOL data. Mean QOL differences between the margin reduced group and control group (QOLmr-QOLcontrol) were calculated for first 18 months. Results: The difference between the cumulative mean dose (Dmean) and the planned mean dose (±SD) for PTV, prostate, bladder, and rectum were −2.2±1.0, 0.3±0.5, −0.7±2.6, and −2.1±1.3 Gy respectively for the margin-reduced group, and −0.8±2.0, 0.9±1.4, - 0.7±3.1 and −1.0±2.4 Gy for the control group. Difference between the two groups was statistically insignificant (p=0.1). Standardized and baseline corrected QOLmr-QOLcontrol for EPIC domains categorized as “Urinary Incontinence”, “Urinary Irritative/Obstructive”, “Bowel”, “Sexual”, and “Hormonal” were 0.6, 12.1, 9.1, 13.3, and −0.9 for the 18 months following radiation therapy (higher values better). Delivered dose to rectum showed a weak correlation to “Bowel” domain (Pearson’s coefficient −0.24, p<0.001), while bladder dose did not correlate to Urinary Incontinence

Combined Regional Investments Could Substantially Enhance Health System Performance And Be Financially Affordable.

Science.gov (United States)

Homer, Jack; Milstein, Bobby; Hirsch, Gary B; Fisher, Elliott S

2016-08-01

Leaders across the United States face a difficult challenge choosing among possible approaches to transform health system performance in their regions. The ReThink Health Dynamics Model simulates how alternative scenarios could unfold through 2040. This article compares the likely consequences if four interventions were enacted in layered combinations in a prototypical midsize US city. We estimated the effects of efforts to deliver higher-value care; reinvest savings and expand global payment; enable healthier behaviors; and expand socioeconomic opportunities. Results suggest that there may be an effective and affordable way to unlock much greater health and economic potential, ultimately reducing severe illness by 20 percent, lowering health care costs by 14 percent, and improving economic productivity by 9 percent. This would require combined investments in clinical and population-level initiatives, coupled with financial agreements that reduce incentives for costly care and reinvest a share of the savings to ensure adequate long-term financing. Project HOPE—The People-to-People Health Foundation, Inc.

Making Sense of Biodiversity: The Affordances of Systems Ecology.

Science.gov (United States)

Andersson, Erik; McPhearson, Timon

2018-01-01

We see two related, but not well-linked fields that together could help us better understand biodiversity and how it, over time, provides benefits to people. The affordances approach in environmental psychology offers a way to understand our perceptual appraisal of landscapes and biodiversity and, to some extent, intentional choice or behavior, i.e., a way of relating the individual to the system s/he/it lives in. In the field of ecology, organism-specific functional traits are similarly understood as the physiological and behavioral characteristics of an organism that informs the way it interacts with its surroundings. Here, we review the often overlooked role of traits in the provisioning of ecosystem services as a potential bridge between affordance theory and applied systems ecology. We propose that many traits can be understood as the basis for the affordances offered by biodiversity, and that they offer a more fruitful way to discuss human-biodiversity relations than do the taxonomic information most often used. Moreover, as emerging transdisciplinary studies indicate, connecting affordances to functional traits allows us to ask questions about the temporal and two-way nature of affordances and perhaps most importantly, can serve as a starting point for more fully bridging the fields of ecology and environmental psychology with respect to how we understand human-biodiversity relationships.

Affordable Care Act and Women

Science.gov (United States)

... quality care for older women, and ends the gender discrimination that requires women to pay more for the same insurance coverage ... the Affordable Care Act and 13 million more women will gain coverage by 2016. Maternity Coverage Preventive ... Expanded Insurance Coverage Endnotes Download "rb. ...

User Costs and Housing Expenses : Towards a more Comprehensive Approach to Affordability

NARCIS (Netherlands)

Haffner, M.E.A.; Heylen, K.

2011-01-01

Recently housing affordability has reached the agenda in Flanders and the Netherlands, giving a good reason to present a review of the concept of affordability and different definitions. The concept of short-term affordability, which is concerned with financial access to a dwelling and is based on

Understanding social engagement in autism: Being different in perceiving and sharing affordances

Directory of Open Access Journals (Sweden)

Annika eHellendoorn

2014-08-01

Full Text Available In the current paper I will argue that the notion of affordances offers an alternative to theory of mind (ToM approaches in studying social engagement in general and in explaining social engagement in autism spectrum disorder (ASD specifically. Affordances are the possibilities for action offered by the environment. In contrast to ToM approaches, the concept of affordances implies the complementarity of person and environment and rejects the dualism of mind and behaviour. In line with the Gibsonian idea that a child must eventually perceive the affordances of the environment for others as well for herself in order to become socialized, I will hypothesize that individuals with ASD often do not perceive the same affordances in the environment as other people do and have difficulties perceiving others' affordances. This can lead to a disruption of interpersonal behaviours. I will further argue that the methods for studying social engagement should be adapted if we want to take interaction into account.

Promoting Value, Affordability, and Innovation in Cancer Drug Treatment - The Rising Cost of Cancer Drugs: Impact on Patients and Society

Science.gov (United States)

Innovative new drugs have improved outcomes for many cancer patients. But spending on cancer drugs has increased dramatically in recent years, placing a burden on cancer patients and a strain on health system and societal resources.

Embodied perception: A proposal to reconcile affordance and spatial perception

NARCIS (Netherlands)

Canal Bruland, R.; van der Kamp, J.

2015-01-01

Proffitt's embodied approach to perception is deeply indebted to Gibson's ecological approach to visual perception, in particular the idea that the primary objects of perception are affordances or what the environment offers for action. Yet, rather than directly addressing affordance perception,

Implications of free breathing motion assessed by 4D-computed tomography on the delivered dose in radiotherapy for esophageal cancer

Energy Technology Data Exchange (ETDEWEB)

Duma, Marciana Nona, E-mail: Marciana.Duma@mri.tum.de [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, München (Germany); Berndt, Johannes [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, München (Germany); Rondak, Ina-Christine [Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universität München, München (Germany); Devecka, Michal; Wilkens, Jan J. [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, München (Germany); Geinitz, Hans [Department of Radiation Oncology, Krankenhaus Barmherzige Schwestern Linz (Austria); Combs, Stephanie Elisabeth; Oechsner, Markus [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, München (Germany)

2015-01-01

The aim of this study was to assess the effect of breathing motion on the delivered dose in esophageal cancer 3-dimensional (3D)-conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and volumetric modulated arc therapy (VMAT). We assessed 16 patients with esophageal cancer. All patients underwent 4D-computed tomography (4D-CT) for treatment planning. For each of the analyzed patients, 1 3D-CRT, 1 IMRT, and 1 VMAT (RapidArc—RA) plan were calculated. Each of the 3 initial plans was recalculated on the 4D-CT (for the maximum free inspiration and maximum free expiration) to assess the effect of breathing motion. We assessed the minimum dose (D{sub min}) and mean dose (D{sub mean}) to the esophagus within the planning target volume, the volume changes of the lungs, the D{sub mean} and the total lung volume receiving at least 40 Gy (V{sub 40}), and the V{sub 30}, V{sub 20}, V{sub 10}, and V{sub 5}. For the heart we assessed the D{sub mean} and the V{sub 25}. Over all techniques and all patients the change in D{sub mean} as compared with the planned D{sub mean} (planning CT [PCT]) to the esophagus was 0.48% in maximum free inspiration (CT-insp) and 0.55% in maximum free expiration (CT-exp). The D{sub min} CT-insp change was 0.86% and CT-exp change was 0.89%. The D{sub mean} change of the lungs (heart) was in CT-insp 1.95% (2.89%) and 3.88% (2.38%) in CT-exp. In all, 4 patients had a clinically relevant change of the dose (≥ 5% D{sub mean} to the heart and the lungs) between inspiration and expiration. These patients had a very cranially or caudally situated tumor. There are no relevant differences in the delivered dose to the regions of interest among the 3 techniques. Breathing motion management could be considered to achieve a better sparing of the lungs or heart in patients with cranially or caudally situated tumors.

Affordability Assessment to Implement Light Rail Transit (LRT for Greater Yogyakarta

Directory of Open Access Journals (Sweden)

Anjang Nugroho

2015-06-01

Full Text Available The high population density and the increasing visitors in Yogyakarta aggravate the traffic congestion problem. BRT (Bus Rapid Transit services, Trans Jogja has not managed to solve this problem yet. Introducing Light Rail Transit (LRT has been considered as one of the solutions to restrain the congestion in Greater Yogyakarta. As the first indication that the LRT can be built in Greater Yogyakarta, the transportation affordability index was used to understand whether the LRT tariff was affordable. That tariff was calculated based on government policy in determining railway tariff. The forecasted potential passengers and LRT route have been analyzed as the previous steps to get LRT tariff. Potential passenger was forecasted from gravity mode, and the proposed LRT route was chosen using Multi Criteria Decision Analysis (MCDA. The existing transportation affordability index was calculated for comparison analysis using the percentage of the expenditures for transportation made by monthly income of each household. The result showed that the LRT for Greater Yogyakarta was the most affordable transport mode compared to the Trans Jogja Bus and motorcycle. The affordability index of Tram Jogja for people having average income was 10.66% while another people with bottom quartile income was 13.56%. Keywords: Greater Yogyakarta, LRT, affordability.

Economic burden of cancer across the European Union: a population-based cost analysis.

Science.gov (United States)

Luengo-Fernandez, Ramon; Leal, Jose; Gray, Alastair; Sullivan, Richard

2013-11-01

In 2008, 2·45 million people were diagnosed with cancer and 1·23 million died because of cancer in the 27 countries of the European Union (EU). We aimed to estimate the economic burden of cancer in the EU. In a population-based cost analysis, we evaluated the cost of all cancers and also those associated with breast, colorectal, lung, and prostate cancers. We obtained country-specific aggregate data for morbidity, mortality, and health-care resource use from international and national sources. We estimated health-care costs from expenditure on care in the primary, outpatient, emergency, and inpatient settings, and also drugs. Additionally, we estimated the costs of unpaid care provided by relatives or friends of patients (ie, informal care), lost earnings after premature death, and costs associated with individuals who temporarily or permanently left employment because of illness. Cancer cost the EU €126 billion in 2009, with health care accounting for €51·0 billion (40%). Across the EU, the health-care costs of cancer were equivalent to €102 per citizen, but varied substantially from €16 per person in Bulgaria to €184 per person in Luxembourg. Productivity losses because of early death cost €42·6 billion and lost working days €9·43 billion. Informal care cost €23·2 billion. Lung cancer had the highest economic cost (€18·8 billion, 15% of overall cancer costs), followed by breast cancer (€15·0 billion, 12%), colorectal cancer (€13·1 billion, 10%), and prostate cancer (€8·43 billion, 7%). Our results show wide differences between countries, the reasons for which need further investigation. These data contribute to public health and policy intelligence, which is required to deliver affordable cancer care systems and inform effective public research funds allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Anti-tumoral effect of the mitochondrial target domain of Noxa delivered by an engineered Salmonella typhimurium.

Directory of Open Access Journals (Sweden)

Jae-Ho Jeong

Full Text Available Bacterial cancer therapy relies on the fact that several bacterial species are capable of targeting tumor tissue and that bacteria can be genetically engineered to selectively deliver therapeutic proteins of interest to the targeted tumors. However, the challenge of bacterial cancer therapy is the release of the therapeutic proteins from the bacteria and entry of the proteins into tumor cells. This study employed an attenuated Salmonella typhimurium to selectively deliver the mitochondrial targeting domain of Noxa (MTD as a potential therapeutic cargo protein, and examined its anti-cancer effect. To release MTD from the bacteria, a novel bacterial lysis system of phage origin was deployed. To facilitate the entry of MTD into the tumor cells, the MTD was fused to DS4.3, a novel cell-penetrating peptide (CPP derived from a voltage-gated potassium channel (Kv2.1. The gene encoding DS4.3-MTD and the phage lysis genes were placed under the control of PBAD , a promoter activated by L-arabinose. We demonstrated that DS4.3-MTD chimeric molecules expressed by the Salmonellae were anti-tumoral in cultured tumor cells and in mice with CT26 colon carcinoma.

Affordances and Landscapes: Overcoming the Nature-Culture Dichotomy through Niche Construction Theory.

Science.gov (United States)

Heras-Escribano, Manuel; De Pinedo-García, Manuel

2017-01-01

In this paper we reject the nature-culture dichotomy by means of the idea of affordance or possibility for action, which has important implications for landscape theory. Our hypothesis is that, just as the idea of affordance can serve to overcome the subjective-objective dichotomy, the ideas of landscape and ecological niche, properly defined, would allow us to also transcend the nature-culture dichotomy. First, we introduce an overview of landscape theory, emphasizing processual landscape theory as the most suitable approach for satisfying both cultural and naturalist approaches. After that, we introduce the idea of affordance and we analyze a tension between sociocultural and transcultural affordances (affordances that depend on cultural conventions and affordances that depend on lawful information and bodily aspects of agents). This tension has various implications for landscape theory and ecological niches. Our proposal is that sociocultural and transcultural aspects of affordances could be systematically accommodated if we apply niche construction theory (the theory that explains the process by which organisms modify their selective environments) as a methodological framework for explaining the emergence of ecological niches. This approach will lead us to an integrative account of landscapes as the products of the interaction between human and environmental elements, making it a clear example of a concept that transcends the nature-culture dichotomy.

Public health service options for affordable and accessible noncommunicable disease and related chronic disease prevention and management

Directory of Open Access Journals (Sweden)

Brownie S

2014-11-01

Full Text Available Sharon Brownie,1,2 Andrew P Hills,3,4 Rachel Rossiter51Workforce and Health Services, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 2Oxford PRAXIS Forum, Green Templeton College, Oxford University, Oxford, United Kingdom; 3Allied Health Research, Mater Research Institute – The University of Queensland and Mater Mothers' Hospital, South Brisbane, QLD, Australia; 4Griffith Health Institute, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 5MMHN and Nurse Practitioner Programs, School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, AustraliaAbstract: Globally, nations are confronted with the challenge of providing affordable health services to populations with increasing levels of noncommunicable and chronic disease. Paradoxically, many nations can both celebrate increases in life expectancy and bemoan parallel increases in chronic disease prevalence. Simply put, despite living longer, not all of that time is spent in good health. Combined with factors such as rising levels of obesity and related noncommunicable disease, the demand for health services is requiring nations to consider new models of affordable health care. Given the level of disease burden, all staff, not just doctors, need to be part of the solution and encouraged to innovate and deliver better and more affordable health care, particularly preventative primary health care services. This paper draws attention to a range of exemplars to encourage and stimulate readers to think beyond traditional models of primary health service delivery. Examples include nurse-led, allied health-led, and student-led clinics; student-assisted services; and community empowerment models. These are reported for the interest of policy makers and health service managers involved in preventative and primary health service redesign initiatives.Keywords: primary health care planning, community health care, nurse-led clinics, allied health personnel

Affordance Realization in Climbing: Learning and Transfer.

Science.gov (United States)

Seifert, Ludovic; Orth, Dominic; Mantel, Bruno; Boulanger, Jérémie; Hérault, Romain; Dicks, Matt

2018-01-01

The aim of this study was to investigate how the affordances of an indoor climbing wall changed for intermediate climbers following a period of practice during which hold orientation was manipulated within a learning and transfer protocol. The learning protocol consisted of four sessions, in which eight climbers randomly ascended three different routes of fixed absolute difficulty (5c on the French scale), as fluently as possible. All three routes were 10.3 m in height and composed of 20 hand-holds at the same locations on an artificial climbing wall; only hold orientations were altered: (i) a horizontal-edge route (H) was designed to afford horizontal hold grasping, (ii) a vertical-edge route (V) afforded vertical hold grasping, and (iii), a double-edge route (D) was designed to afford both horizontal and vertical hold grasping. Five inertial measurement units (IMU) (3D accelerometer, 3D gyroscope, 3D magnetometer) were attached to the hip, feet and forearms to analyze the vertical acceleration and direction (3D unitary vector) of each limb and hip in ambient space during the entire ascent. Segmentation and classification processes supported detection of movement and stationary phases for each IMU. Depending on whether limbs and/or hip were moving, a decision tree distinguished four states of behavior: stationary (absence of limb and hip motion), hold exploration (absence of hip motion but at least one limb in motion), hip movement (hip in motion but absence of limb motion) and global motion (hip in motion and at least one limb in motion). Results showed that with practice, the learners decreased the relative duration of hold exploration, suggesting that they improved affordance perception of hold grasp-ability. The number of performatory movements also decreased as performance increased during learning sessions, confirming that participants' climbing efficacy improved as a function of practice. Last, the results were more marked for the H route, while the D route

Affordance Realization in Climbing: Learning and Transfer

Directory of Open Access Journals (Sweden)

Ludovic Seifert

2018-05-01

Full Text Available The aim of this study was to investigate how the affordances of an indoor climbing wall changed for intermediate climbers following a period of practice during which hold orientation was manipulated within a learning and transfer protocol. The learning protocol consisted of four sessions, in which eight climbers randomly ascended three different routes of fixed absolute difficulty (5c on the French scale, as fluently as possible. All three routes were 10.3 m in height and composed of 20 hand-holds at the same locations on an artificial climbing wall; only hold orientations were altered: (i a horizontal-edge route (H was designed to afford horizontal hold grasping, (ii a vertical-edge route (V afforded vertical hold grasping, and (iii, a double-edge route (D was designed to afford both horizontal and vertical hold grasping. Five inertial measurement units (IMU (3D accelerometer, 3D gyroscope, 3D magnetometer were attached to the hip, feet and forearms to analyze the vertical acceleration and direction (3D unitary vector of each limb and hip in ambient space during the entire ascent. Segmentation and classification processes supported detection of movement and stationary phases for each IMU. Depending on whether limbs and/or hip were moving, a decision tree distinguished four states of behavior: stationary (absence of limb and hip motion, hold exploration (absence of hip motion but at least one limb in motion, hip movement (hip in motion but absence of limb motion and global motion (hip in motion and at least one limb in motion. Results showed that with practice, the learners decreased the relative duration of hold exploration, suggesting that they improved affordance perception of hold grasp-ability. The number of performatory movements also decreased as performance increased during learning sessions, confirming that participants' climbing efficacy improved as a function of practice. Last, the results were more marked for the H route, while the D

How to Deliver Open Sustainable Innovation: An Integrated Approach for a Sustainable Marketable Product

Directory of Open Access Journals (Sweden)

Francesco Cappa

2016-12-01

Full Text Available The adoption of open innovation and peer production, powered by 3D printing technology, is transforming traditional manufacturing methods towards a “third industrial revolution”. The purpose of this research is to provide empirical evidence for an integrated approach, based on collaborative product development and peer production, combined with 3D printing, to deliver more sustainable, yet competitive, marketable products. In particular, this experimental study is conducted in the context of mobile forensics, an emerging market where limited expensive products exist and alternative solutions are needed. The technical viability and economic feasibility of the prototype developed in this research validate the proposed integrated approach, which could be a game-changer in the field of mobile forensics, as well as in other sectors. The sustainability improvements with this approach are a reduction of the total cost, thereby making it affordable for lower income users, and a decrease in energy consumption and pollutant emissions. The validated integrated approach offers start-up opportunities to develop and deliver more sustainable, marketable products, towards the paradigm of Open Sustainable Innovation. While the device developed and tested in this research has similar features to existing products, the methodology, implementation, and motivation are original.

A cancer genetics education campaign: delivering parallel messages to clinicians and the public.

Science.gov (United States)

Piniewski-Bond, Joanne; Celestino, Paul B; Mahoney, Martin C; Farrell, Carolyn D; Bauer, Joseph E; Hastrup, Janice L; Cummings, K Michael

2003-01-01

Up to 10% of all cancers are thought to have a familial basis through complex interactions between genes and environment. A community-wide education campaign was conducted that included several elements: a five part television news series; an educational newsletter; web site pages and links to educational materials; a Continuing Medical Education (CME) program for professionals; and an evaluation survey. Survey estimates revealed that 39000 households recalled seeing the series; 14800 households changed their views about the risks of hereditary cancers; and about 9900 households were made more aware/informed about cancer and hereditary risk. This awareness campaign broadened public knowledge about the myths and realities associated with genetic factors and cancer risk. It reinforced the importance of early screening for persons at high risk of cancer due to hereditary factors.

A snapshot of cancer in Chile:Analytical frameworks for developing a cancer policy

OpenAIRE

De Jimenez La Jara, Jorge; Bastias, Gabriel; Ferreccio, Catterina; Moscoso, Cristian; Sagues, Sofia; Cid, Camilo; Bronstein, Eduardo; Herrera, Cristian; Nervi, Bruno; Corvalan, Alejandro; Velasquez, Ethel V.; Gonzalez, Pamela; Castellon, Enrique; Bustamante, Eva; Oñate, Sergio

2015-01-01

Introduction: The South American country Chile now boasts a life expectancy of over 80 years. As a consequence, Chile now faces the increasing social and economic burden of cancer and must implement political policy to deliver equitable cancer care. Hindering the development of a national cancer policy is the lack of comprehensive analysis of cancer infrastructure and economic impact. Objectives: Evaluate existing cancer policy, the extent of national investigation and the socio-economic impa...

Affordances and Landscapes: Overcoming the Nature–Culture Dichotomy through Niche Construction Theory

Science.gov (United States)

Heras-Escribano, Manuel; De Pinedo-García, Manuel

2018-01-01

In this paper we reject the nature–culture dichotomy by means of the idea of affordance or possibility for action, which has important implications for landscape theory. Our hypothesis is that, just as the idea of affordance can serve to overcome the subjective–objective dichotomy, the ideas of landscape and ecological niche, properly defined, would allow us to also transcend the nature–culture dichotomy. First, we introduce an overview of landscape theory, emphasizing processual landscape theory as the most suitable approach for satisfying both cultural and naturalist approaches. After that, we introduce the idea of affordance and we analyze a tension between sociocultural and transcultural affordances (affordances that depend on cultural conventions and affordances that depend on lawful information and bodily aspects of agents). This tension has various implications for landscape theory and ecological niches. Our proposal is that sociocultural and transcultural aspects of affordances could be systematically accommodated if we apply niche construction theory (the theory that explains the process by which organisms modify their selective environments) as a methodological framework for explaining the emergence of ecological niches. This approach will lead us to an integrative account of landscapes as the products of the interaction between human and environmental elements, making it a clear example of a concept that transcends the nature–culture dichotomy. PMID:29375426

77 FR 36272 - SunShot Prize: America's Most Affordable Rooftop

Science.gov (United States)

2012-06-18

...The Department of Energy (DOE) announces in this notice the release of the SunShot Prize: America's Most Affordable Rooftop Solar for public comment. Interested persons are encouraged to learn about the SunShot Prize: America's Most Affordable Rooftop rules at eere.energy.gov/solar/sunshot/prize.html.

Affordances and Cognitive Walkthrough for Analyzing Human-Virtual Human Interaction

NARCIS (Netherlands)

Ruttkay, Z.M.; op den Akker, Hendrikus J.A.; Esposito, A.; Bourbakis, N.; Avouris, N.; Hatzilygeroudis, I.

2008-01-01

This study investigates how the psychological notion of affordance, known from human computer interface design, can be adopted for the analysis and design of communication of a user with a Virtual Human (VH), as a novel interface. We take as starting point the original notion of affordance, used to

Facilitating investment in affordable housing : Towards an Australian model. Draft

NARCIS (Netherlands)

Lawson, J.M.; Berry, M.; Milligan, V.; Yates, J.

2009-01-01

This paper argues that sustainable and affordable finance provides a crucial pillar to support the provision of affordable housing in the long term. This finance can take on a variety of forms, comprising grants, public loans, commercial loans as well as shareholder equity. It can be facilitated by

The Role of Motor Affordances in Visual Working Memory

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Diane Pecher

2014-12-01

Full Text Available Motor affordances are important for object knowledge. Semantic tasks on visual objects often show interactions with motor actions. Prior neuro-imaging studies suggested that motor affordances also play a role in visual working memory for objects. When participants remembered manipulable objects (e.g., hammer greater premotor cortex activation was observed than when they remembered non-manipulable objects (e.g., polar bear. In the present study participants held object pictures in working memory while performing concurrent tasks such as articulation of nonsense syllables and performing hand movements. Although concurrent tasks did interfere with working memory performance, in none of the experiments did we find any evidence that concurrent motor tasks affected memory differently for manipulable and non-manipulable objects. I conclude that motor affordances are not used for visual working memory.

Overcoming cisplatin resistance in non-small cell lung cancer with Mad2 silencing siRNA delivered systemically using EGFR-targeted chitosan nanoparticles.

Science.gov (United States)

Nascimento, Ana Vanessa; Singh, Amit; Bousbaa, Hassan; Ferreira, Domingos; Sarmento, Bruno; Amiji, Mansoor M

2017-01-01

Efficiency of chemotherapy is often limited by low therapeutic index of the drug as well as emergence of inherent and acquired drug resistance in cancer cells. As a common strategy to overcome drug resistance, higher doses of chemo-agents are administered. However, adverse side effects are usually increased as a consequence. A potentially effective approach is to combine chemotherapy with other therapeutic strategies such as small interfering RNAs (siRNAs) that allow the use of lower yet efficient doses of the anticancer drugs. We previously developed epidermal growth factor receptor (EGFR)-targeted chitosan (CS) nanoparticles as a versatile delivery system for silencing the essential mitotic checkpoint gene Mad2, and induce cell death. Here, we tested this system as a single therapy and in combination with cisplatin in cisplatin sensitive and resistant lung cancer models, and characterized its in vivo efficacy and safety. Combination treatment resulted in significant improvement in tumor inhibition that was strikingly more effective in cisplatin-resistant tumors. Importantly, effective cisplatin dosage was dramatically reduced in the co-therapy regimen resulting in negligible toxic effects from the drug as confirmed by parameters such as body weight gain, biochemical markers of hepatic and renal function, and histopathology of liver/kidney/spleen tissues. Overall, we demonstrate that the combination of Mad2 siRNA-loaded CS nanoparticles strategy with chemotherapeutic agents such as cisplatin constitutes an efficient and safe approach for the treatment of drug resistant tumors. Lung cancer remains one of the leading killers in the United States and around the world. Platinum agents, including cisplatin, are the first line treatment in lung cancer, including non-small cell lung cancer (NSCLC), which is the predominant form of lung cancer. In this study, we have evaluated Mad2 cell-cycle checkpoint gene silencing using small interfering RNA (siRNA) delivered

Refining Grasp Affordance Models by Experience

DEFF Research Database (Denmark)

Detry, Renaud; Kraft, Dirk; Buch, Anders Glent

2010-01-01

We present a method for learning object grasp affordance models in 3D from experience, and demonstrate its applicability through extensive testing and evaluation on a realistic and largely autonomous platform. Grasp affordance refers here to relative object-gripper configurations that yield stable...... with a visual model of the object they characterize. We explore a batch-oriented, experience-based learning paradigm where grasps sampled randomly from a density are performed, and an importance-sampling algorithm learns a refined density from the outcomes of these experiences. The first such learning cycle...... is bootstrapped with a grasp density formed from visual cues. We show that the robot effectively applies its experience by downweighting poor grasp solutions, which results in increased success rates at subsequent learning cycles. We also present success rates in a practical scenario where a robot needs...

Recruitment of representative samples for low incidence cancer populations: Do registries deliver?

Directory of Open Access Journals (Sweden)

Sanson-Fisher Rob

2011-01-01

Full Text Available Abstract Background Recruiting large and representative samples of adolescent and young adult (AYA cancer survivors is important for gaining accurate data regarding the prevalence of unmet needs in this population. This study aimed to describe recruitment rates for AYAs recruited through a cancer registry with particular focus on: active clinician consent protocols, reasons for clinicians not providing consent and the representativeness of the final sample. Methods Adolescents and young adults aged 14 to19 years inclusive and listed on the cancer registry from January 1 2002 to December 31 2007 were identified. An active clinician consent protocol was used whereby the registry sent a letter to AYAs primary treating clinicians requesting permission to contact the survivors. The registry then sent survivors who received their clinician's consent a letter seeking permission to forward their contact details to the research team. Consenting AYAs were sent a questionnaire which assessed their unmet needs. Results The overall consent rate for AYAs identified as eligible by the registry was 7.8%. Of the 411 potentially eligible survivors identified, just over half (n = 232, 56% received their clinician's consent to be contacted. Of those 232 AYAs, 65% were unable to be contacted. Only 18 AYAs (7.8% refused permission for their contact details to be passed on to the research team. Of the 64 young people who agreed to be contacted, 50% (n = 32 completed the questionnaire. Conclusions Cancer registries which employ active clinician consent protocols may not be appropriate for recruiting large, representative samples of AYAs diagnosed with cancer. Given that AYA cancer survivors are highly mobile, alternative methods such as treatment centre and clinic based recruitment may need to be considered.

Developing a longitudinal cancer nursing education program in Honduras.

Science.gov (United States)

Sheldon, Lisa Kennedy; Wise, Barbara; Carlson, Julie R; Dowds, Cynthia; Sarchet, Vanessa; Sanchez, Jose Angel

2013-12-01

The present paper is a longitudinal study which aims to develop and deliver cancer nursing education conferences in Honduras using volunteer nurse educators. This program intends to (1) perform site assessments of work environments and resources for cancer care in Honduras, (2) develop cancer nursing education programs, (3) survey conference participants continuing education needs, (4) deliver cancer nursing education conferences, and (5) share data with local and global partners for future cancer programs. The study draws on a longitudinal program development with site assessments, data collection, and educational conferences at two time points. Assessments and surveys were used for conference development and delivery by volunteer nurse educators. Site assessments and conferences were delivered twice. Data were collected regarding assessments and surveys to inform program development. Survey data revealed that 65 % had internet access. Participants desired more information about handling of chemotherapy, symptom management, and palliative care. Volunteer nurse educators perform site assessments and develop educational programming for cancer nurses. Local and global partners should explore internet-based programs between site visits to create sustainable education programs.

Active design in affordable housing: A public health nudge

Directory of Open Access Journals (Sweden)

Elizabeth Garland

2018-06-01

Full Text Available This pilot study investigates the impact of active design (AD strategies on physical activity (PA among adults living in two Leadership in Energy and Environmental Design (LEED certified affordable housing developments in the South Bronx, New York. One building incorporates LEED Innovation in Design (ID Credit: Design for Health through Increased Physical Activity. Tenants in an affordable housing building (AH incorporating active design strategies completed PA self-assessments at their lease signing and one year later in 2015. Trained research assistants obtained body measurements. Residents of neighboring non-AD affordable housing (MCV served as a comparison. Thirty four adults were recruited from AH and 29 from MCV, retention was 56% (n = 19 and 52% (n = 15 respectively at one year. The two groups' body mass index (BMI and high-risk waist-to-hip ratio (WHR were not statistically significantly different when analyzed as continuous variables, although BMI category had a greater decline at AH than at MCV (p = 0.054. There was a 31.5% increase in AH participants meeting MPA requirements and a statistically significant improvement in females (p = 0.031; while there was no change in the MCV participants overall or when stratified by gender. AH participants were significantly more likely to have reported increased stair use and less likely to have reported no change or decreased stair use than participants from MCV participants (p = 0.033. Housing has a role in individual health outcomes and behavior change, broad adoption of active design strategies in affordable housing is warranted to improve physical activity measures. Keywords: Active design, Physical activity, Built environment, Affordable housing

Understanding and using technological affordances: a response to Boyle and Cook

Directory of Open Access Journals (Sweden)

Gráinne Conole

2004-12-01

Full Text Available Our use of affordance draws on Salomon (Salomon, 1993 who takes the definition back to Gibson and Norman (Gibson, 1977; Norman, 1988. Perhaps a key difference between the use of the term affordance in design is the emphasis on intended use, whereas our approach reflects Salomon's focus on ‘possible' use. Like Gibson the approach taken in our paper is focused on the relationship between the infrastructure of information and communication technologies and people's use of those technologies. We are interested in asking questions about what uses ICT invites and facilitates, what it lends itself to and what it can do well. A potential difficulty with using a term so popular in the field of design is that ‘use' tends to be focused on how something ‘should' be used, what it is designed for. Discussion about affordance can be limited to the intended, prescribed or designed function of technology. We are also interested in exploring the creative and innovative way people respond to technologies and perhaps adapt them for use in unforeseen circumstances. An affordance of the technology does not simply refer to the intended use but also to the unintended consequences. Google's use of hyper text links to drive the indexing of web searches might be an example of an affordance that is a consequence of creative engagement with technology, the adaptation rather than a feature of the original design related to hypertext. Another example of this adaptive use of hypertext might include its use by teachers to provide a digital framework for formative assessment and support for student learning. Class room teachers were quick to adapt presentation software and hyper text to present more interactive activity lessons. Software affording transmission modes of delivery was thereby adapted to users needs and a more interactive affordance created.

The U.S. health insurance marketplace: are premiums truly affordable?

Science.gov (United States)

Graetz, Ilana; Kaplan, Cameron M; Kaplan, Erin K; Bailey, James E; Waters, Teresa M

2014-10-21

The Patient Protection and Affordable Care Act requires that individuals have health insurance or pay a penalty. Individuals are exempt from paying this penalty if the after-subsidy cost of the least-expensive plan available to them is greater than 8% of their income. For this study, premium data for all health plans offered on the state and federal health insurance marketplaces were collected; the after-subsidy cost of premiums for the least-expensive bronze plan for every county in the United States was calculated; and variations in premium affordability by age, income, and geographic area were assessed. Results indicated that-although marketplace subsidies ensure affordable health insurance for most persons in the United States-many individuals with incomes just above the subsidy threshold will lack affordable coverage and will be exempt from the mandate. Furthermore, young individuals with low incomes often pay as much as or more than older individuals for bronze plans. If substantial numbers of younger, healthier adults choose to remain uninsured because of cost, health insurance premiums across all ages may increase over time.

The Value of Full Correction: Achieving Excellent and Affordable Results.

Science.gov (United States)

Kaplan, Julie Bass

2016-01-01

Patients often come to medical aesthetic offices with hopes to fully correct lost facial volume and achieve a natural appearance. Unfortunately, the cost per syringe of dermal filler can be a barrier to desired outcomes. Many aesthetic practitioners do the best they can with the amount of product the patient can afford, often falling short of the "wow" effect for the patient. This article describes what one office implemented to solve the conundrum of affordability while still allowing offices to cover its own financial realities. This tool can help patients achieve beautiful, natural, and affordable outcomes while helping offices advance in manufacturer's tiers, improve word-of-mouth advertising, and increase job satisfaction.

The Affordances of Social Media Platforms

NARCIS (Netherlands)

Bucher, T.; Helmond, A.; Burgess, J.; Marwick, A.; Poell, T.

2018-01-01

This chapter reflects on the concept of affordance as a key term for understanding and analysing social media interfaces and the relations between technology and its users. In outlining its specific intellectual trajectory from psychology, to technology and design studies, sociology, and

Automatic activation of motor programs by object affordances in patients with Parkinson's disease.

Science.gov (United States)

Oguro, Hiroaki; Ward, Robert; Bracewel, Martyn; Hindle, John; Rafal, Robert

2009-09-29

Clinical observations of kinesia paradoxica and freezing in patients with Parkinson's disease suggest that the automatic activation of motor programmes by visual stimuli may not require intact basal ganglia function, and that an increased sensitivity to such object affordances may contribute to some symptoms of the disease. Employing a paradigm that measures the degree of interference from object affordances on voluntary actions, we confirm that activation of object affordances are preserved in Parkinson's disease, but find no evidence that there is an increased sensitivity to the effects of object affordances on voluntary action.

Automatic activation of motor programs by object affordances in patients with Parkinson's disease

Science.gov (United States)

Oguro, Hiroaki; Ward, Robert; Bracewel, Martyn; Hindle, John; Rafal, Robert

2009-01-01

Clinical observations of kinesia paradoxica and freezing in patients with Parkinson's disease suggest that the automatic activation of motor programmes by visual stimuli may not require intact basal ganglia function, and that an increased sensitivity to such object affordances may contribute to some symptoms of the disease. Employing a paradigm that measures the degree of interference from object affordances on voluntary actions, we confirm that activation of object affordances are preserved in Parkinson's disease, but find no evidence that there is an increased sensitivity to the effects of object affordances on voluntary action. PMID:19616073

Price, availability and affordability of medicines

Directory of Open Access Journals (Sweden)

Brenda S. Mhlanga

2014-01-01

Full Text Available Background: Medicines play an important role in healthcare, but prices can be a barrier to patient care. Few studies have looked at the prices of essential medicines in low- and middle-income countries in terms of patient affordability.Aim: To determine the prices, availability and affordability of medicines along the supply chain in Swaziland.Setting: Private- and public-sector facilities in Manzini, Swaziland.Methods: The standardised methodology designed by the World Health Organization and Health Action International was used to survey 16 chronic disease medicines. Data were collected in one administrative area in 10 private retail pharmacies and 10 public health facilities. Originator brand (OB and lowest-priced generic equivalent (LPG medicines were monitored and these prices were then compared with international reference prices (IRPs. Affordability was calculated in terms of the daily wage of the lowest-paid unskilled government worker.Results: Mean availability was 68% in the public sector. Private sector OB medicines were priced 32.4 times higher than IRPs, whilst LPGs were 7.32 times higher. OBs cost473% more than LPGs. The total cumulative mark-ups for individual medicines range from 190.99% – 440.27%. The largest contributor to add-on cost was the retail mark-up (31% – 53%. Standard treatment with originator brands cost more than a day’s wage.Conclusion: Various policy measures such as introducing price capping at all levels of the medicine supply chain, may increase the availability, whilst at the same time reducing the prices of essential medicines for the low income population.

Price, availability and affordability of medicines

Directory of Open Access Journals (Sweden)

Brenda S. Mhlanga

2014-06-01

Full Text Available Background: Medicines play an important role in healthcare, but prices can be a barrier to patient care. Few studies have looked at the prices of essential medicines in low- and middle-income countries in terms of patient affordability. Aim: To determine the prices, availability and affordability of medicines along the supply chain in Swaziland. Setting: Private- and public-sector facilities in Manzini, Swaziland. Methods: The standardised methodology designed by the World Health Organization and Health Action International was used to survey 16 chronic disease medicines. Data were collected in one administrative area in 10 private retail pharmacies and 10 public health facilities. Originator brand (OB and lowest-priced generic equivalent (LPG medicines were monitored and these prices were then compared with international reference prices (IRPs. Affordability was calculated in terms of the daily wage of the lowest-paid unskilled government worker. Results: Mean availability was 68% in the public sector. Private sector OB medicines were priced 32.4 times higher than IRPs, whilst LPGs were 7.32 times higher. OBs cost473% more than LPGs. The total cumulative mark-ups for individual medicines range from 190.99% – 440.27%. The largest contributor to add-on cost was the retail mark-up (31% – 53%. Standard treatment with originator brands cost more than a day’s wage. Conclusion: Various policy measures such as introducing price capping at all levels of the medicine supply chain, may increase the availability, whilst at the same time reducing the prices of essential medicines for the low income population.

Assessing doses of radiotherapy with the risk of developing cancer in the head and neck

International Nuclear Information System (INIS)

Yu, Cheng-Ching; Hsu, Fang-Yuh; Yu, Wan-Hsuan; Liu, Mu-Tai; Huang, Sheng-Shien

2011-01-01

Radiation is known to be a major cause of cancer in normal tissue. After treatment with radiotherapy, for young patients or the patients can survive for a long time, the radiation-induced cancer risk is noteworthy. This research investigated the dose delivered by the treatment of intensity modulated radiation therapy (IMRT) for head and neck cancer, such as NPC and oral cancer, and assessed the risk of developing radiation-induced secondary cancer in non-targeted normal tissues. A Rando phantom was used to simulate a patient with NPC or oral cancer, and thermoluminescent dosimeter (TLD) chips were placed inside the phantom to estimate the doses delivered by IMRT. In summary, the risks to patients with NPC was somewhat higher than for those with oral cancer, because the region of the PTV was lower, requiring larger field sizes be used for cases of NPC. The smaller the field size used, the less the risk was of developing secondary cancer. In addition, the higher the value of MU used, the higher the dose delivered to normal tissues was. The risk of radiation-induced secondary cancer was proportional to the delivered dose.

Relative Affordability of Health Insurance Premiums under CHIP Expansion Programs and the ACA.

Science.gov (United States)

Gresenz, Carole Roan; Laugesen, Miriam J; Yesus, Ambeshie; Escarce, José J

2011-10-01

Affordability is integral to the success of health care reforms aimed at ensuring universal access to health insurance coverage, and affordability determinations have major policy and practical consequences. This article describes factors that influenced the determination of affordability benchmarks and premium-contribution requirements for Children's Health Insurance Program (CHIP) expansions in three states that sought to universalize access to coverage for youth. It also compares subsidy levels developed in these states to the premium subsidy schedule under the Affordable Care Act (ACA) for health insurance plans purchased through an exchange. We find sizeable variability in premium-contribution requirements for children's coverage as a percentage of family income across the three states and in the progressivity and regressivity of the premium-contribution schedules developed. These findings underscore the ambiguity and subjectivity of affordability standards. Further, our analyses suggest that while the ACA increases the affordability of family coverage for families with incomes below 400 percent of the federal poverty level, the evolution of CHIP over the next five to ten years will continue to have significant implications for low-income families.

Social Media, Privacy, and Self-Disclosure: The Turbulence Caused by Social Media’s Affordances

Directory of Open Access Journals (Sweden)

Sabine Trepte

2015-04-01

Full Text Available The struggle we currently perceive in terms of social media privacy may be the result of the incompatible natures of “warm” and “cold” affordances. Whereas social media’s warm affordances reflect long-standing privacy routines and expectations, cold affordances seem to challenge and sometimes violate them. Sharing under the realm of warm affordances means sharing according to the routines and habits we know. Sharing under the realm of cold affordances means understanding social media’s terms and conditions and how they reflect on our relationships and experiences - similar to assimilating to a new culture that seems opaque and constantly in flux.

Affordance estimation for vision-based object replacement on a humanoid robot

DEFF Research Database (Denmark)

Mustafa, Wail; Wächter, Mirko; Szedmak, Sandor

2016-01-01

In this paper, we address the problem of finding replacements of missing objects, involved in the execution of manipulation tasks. Our approach is based on estimating functional affordances for the unknown objects in order to propose replacements. We use a vision-based affordance estimation syste...

Defining and Measuring the Affordability of New Medicines : A Systematic Review

NARCIS (Netherlands)

Antonanzas, Fernando; Terkola, Robert; Overton, Paul M.; Shalet, Natalie; Postma, Maarten

Background In many healthcare systems, affordability concerns can lead to restrictions on the use of expensive efficacious therapies. However, there does not appear to be any consensus as to the terminology used to describe affordability, or the thresholds used to determine whether new drugs are

Medicaid expansion and access to care among cancer survivors: a baseline overview.

Science.gov (United States)

Tarazi, Wafa W; Bradley, Cathy J; Harless, David W; Bear, Harry D; Sabik, Lindsay M

2016-06-01

Medicaid expansion under the Affordable Care Act facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Medicaid expansions may provide increased access to care for cancer survivors, a growing population with chronic conditions. We compare access to health care services among cancer survivors living in non-expansion states to those living in expansion states, prior to Medicaid expansion under the Affordable Care Act. We use the 2012 and 2013 Behavioral Risk Factor Surveillance System to estimate multiple logistic regression models to compare inability to see a doctor because of cost, having a personal doctor, and receiving an annual checkup in the past year between cancer survivors who lived in non-expansion states and survivors who lived in expansion states. Cancer survivors in non-expansion states had statistically significantly lower odds of having a personal doctor (adjusted odds ratio [AOR] 0.76, 95 % confidence interval [CI] 0.63-0.92, p Medicaid could potentially leave many cancer survivors with limited access to routine care. Existing disparities in access to care are likely to widen between cancer survivors in Medicaid non-expansion and expansion states.

Pedagogical Affordances of Multiple External Representations in Scientific Processes

Science.gov (United States)

Wu, Hsin-Kai; Puntambekar, Sadhana

2012-12-01

Multiple external representations (MERs) have been widely used in science teaching and learning. Theories such as dual coding theory and cognitive flexibility theory have been developed to explain why the use of MERs is beneficial to learning, but they do not provide much information on pedagogical issues such as how and in what conditions MERs could be introduced and used to support students' engagement in scientific processes and develop competent scientific practices (e.g., asking questions, planning investigations, and analyzing data). Additionally, little is understood about complex interactions among scientific processes and affordances of MERs. Therefore, this article focuses on pedagogical affordances of MERs in learning environments that engage students in various scientific processes. By reviewing literature in science education and cognitive psychology and integrating multiple perspectives, this article aims at exploring (1) how MERs can be integrated with science processes due to their different affordances, and (2) how student learning with MERs can be scaffolded, especially in a classroom situation. We argue that pairing representations and scientific processes in a principled way based on the affordances of the representations and the goals of the activities is a powerful way to use MERs in science education. Finally, we outline types of scaffolding that could help effective use of MERs including dynamic linking, model progression, support in instructional materials, teacher support, and active engagement.

Poly (N-isopropylacrylamide)-functionalized dendrimer as a thermosensitive nanoplatform for delivering malloapelta B against HepG2 cancer cell proliferation

Science.gov (United States)

Ngan Le, Phung; Chuong Pham, Dinh; Hai Nguyen, Dai; Quyen Tran, Ngoc; Dimitrov, Vladimir; Ivanov, Petko; Nguyen Xuan, Cuong; Nguyen, Hoai Nam; Khoa Nguyen, Cuu

2017-06-01

In recent years, nanocarriers have emerged as effective platforms for delivering several kinds of herbal medicine and naturally bioactive compounds. In this study we developed an outstanding thermosensitive dendritic nanocarrier to efficiently deliver malloapelta B (Mall B), which is a water insoluble bioactive compound isolated from leaves of Mallotus apelta—Vietnamese medicinal plant. The thermosensitive poly(N-isopropylacrylamide) (PNIPAM) polymer-conjugated polyamidoamine (PAMAM) dendrimer copolymer was prepared via Michael reaction. The copolymer structures were confirmed by proton nuclear magnectic resonance (1H NMR). Morphology of the nanocarrier was observered around 70-120 nm by transmission electron microscopy (TEM). Size distributions were measured by dynamic light scattering (DLS) of the nanocarrier and its Mall B-loaded performed at 146.8 nm and 194.5 nm, respectively. The PNIPAM-g-PAMAM-based nanocarrier exhibited higher Mall B loading efficiency (DL  =  59.93  ±  0.19%) and entrapment efficiency (EE  =  89.98  ±  2.06%) as compared to PNIPAM (DL  =  52.54  ±  0.45% and EE  =  66.45  ±  2.78%). In vitro release indicated that approximately 30% amount of the loaded Mall B released at pH 5.5 after 54 h tracking. At the same time, 12.5% amount of the molecules released at pH 7.4.Cytotoxicity assay results showed that the Mall B-loaded nanocarrier significantly inhibited HepG2 cancer cell proliferation. These obtained results indicated that the nanocarrier could solve hydrophobic property of Mall B for further medicine applications.

Automatic contour propagation using deformable image registration to determine delivered dose to spinal cord in head-and-neck cancer radiotherapy

Science.gov (United States)

Yeap, P. L.; Noble, D. J.; Harrison, K.; Bates, A. M.; Burnet, N. G.; Jena, R.; Romanchikova, M.; Sutcliffe, M. P. F.; Thomas, S. J.; Barnett, G. C.; Benson, R. J.; Jefferies, S. J.; Parker, M. A.

2017-08-01

To determine delivered dose to the spinal cord, a technique has been developed to propagate manual contours from kilovoltage computed-tomography (kVCT) scans for treatment planning to megavoltage computed-tomography (MVCT) guidance scans. The technique uses the Elastix software to perform intensity-based deformable image registration of each kVCT scan to the associated MVCT scans. The registration transform is then applied to contours of the spinal cord drawn manually on the kVCT scan, to obtain contour positions on the MVCT scans. Different registration strategies have been investigated, with performance evaluated by comparing the resulting auto-contours with manual contours, drawn by oncologists. The comparison metrics include the conformity index (CI), and the distance between centres (DBC). With optimised registration, auto-contours generally agree well with manual contours. Considering all 30 MVCT scans for each of three patients, the median CI is 0.759 +/- 0.003 , and the median DBC is (0.87 +/- 0.01 ) mm. An intra-observer comparison for the same scans gives a median CI of 0.820 +/- 0.002 and a DBC of (0.64 +/- 0.01 ) mm. Good levels of conformity are also obtained when auto-contours are compared with manual contours from one observer for a single MVCT scan for each of 30 patients, and when they are compared with manual contours from six observers for two MVCT scans for each of three patients. Using the auto-contours to estimate organ position at treatment time, a preliminary study of 33 patients who underwent radiotherapy for head-and-neck cancers indicates good agreement between planned and delivered dose to the spinal cord.

Automatic contour propagation using deformable image registration to determine delivered dose to spinal cord in head-and-neck cancer radiotherapy.

Science.gov (United States)

Yeap, P L; Noble, D J; Harrison, K; Bates, A M; Burnet, N G; Jena, R; Romanchikova, M; Sutcliffe, M P F; Thomas, S J; Barnett, G C; Benson, R J; Jefferies, S J; Parker, M A

2017-07-12

To determine delivered dose to the spinal cord, a technique has been developed to propagate manual contours from kilovoltage computed-tomography (kVCT) scans for treatment planning to megavoltage computed-tomography (MVCT) guidance scans. The technique uses the Elastix software to perform intensity-based deformable image registration of each kVCT scan to the associated MVCT scans. The registration transform is then applied to contours of the spinal cord drawn manually on the kVCT scan, to obtain contour positions on the MVCT scans. Different registration strategies have been investigated, with performance evaluated by comparing the resulting auto-contours with manual contours, drawn by oncologists. The comparison metrics include the conformity index (CI), and the distance between centres (DBC). With optimised registration, auto-contours generally agree well with manual contours. Considering all 30 MVCT scans for each of three patients, the median CI is [Formula: see text], and the median DBC is ([Formula: see text]) mm. An intra-observer comparison for the same scans gives a median CI of [Formula: see text] and a DBC of ([Formula: see text]) mm. Good levels of conformity are also obtained when auto-contours are compared with manual contours from one observer for a single MVCT scan for each of 30 patients, and when they are compared with manual contours from six observers for two MVCT scans for each of three patients. Using the auto-contours to estimate organ position at treatment time, a preliminary study of 33 patients who underwent radiotherapy for head-and-neck cancers indicates good agreement between planned and delivered dose to the spinal cord.

Engineering an Affordable Self-Driving Car

KAUST Repository

Budisteanu, Alexandru Ionut

2018-01-01

for affordable self-driving cars and he designed a low-cost self-driving car. The car's roof has cameras and low-resolution 3D LiDAR equipment to detect traffic lanes, other cars, curbs and obstacles, such as people crossing by. To process this dizzying amount

Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania

Science.gov (United States)

2012-01-01

Background Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. Methods We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). Results Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. Conclusions Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially

Quantification of incidental mediastinal and hilar irradiation delivered during definitive stereotactic body radiation therapy for peripheral non-small cell lung cancer

Energy Technology Data Exchange (ETDEWEB)

Martin, Kate L.; Gomez, Jorge; Nazareth, Daryl P.; Warren, Graham W. [Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY (United States); Singh, Anurag K., E-mail: anurag.singh@roswellpark.org [Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY (United States)

2012-07-01

To determine the amount of incidental radiation dose received by the mediastinal and hilar nodes for patients with non-small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy (SBRT). Fifty consecutive patients with NSCLC, treated using an SBRT technique, were identified. Of these patients, 38 had a prescription dose of 60 Gy in 20-Gy fractions and were eligible for analysis. For each patient, ipsilateral upper (level 2) and lower (level 4) paratracheal, and hilar (level 10) nodal regions were contoured on the planning computed tomography (CT) images. Using the clinical treatment plan, dose and volume calculations were performed retrospectively for each nodal region. SBRT to upper lobe tumors resulted in an average total ipsilateral mean dose of between 5.2 and 7.8 Gy for the most proximal paratracheal nodal stations (2R and 4R for right upper lobe lesions, 2L and 4L for left upper lobe lesions). SBRT to lower lobe tumors resulted in an average total ipsilateral mean dose of between 15.6 and 21.5 Gy for the most proximal hilar nodal stations (10R for right lower lobe lesions, 10 l for left lower lobe lesions). Doses to more distal nodes were substantially lower than 5 Gy. The often substantial incidental irradiation, delivered during SBRT for peripheral NSCLC of the lower lobes to the most proximal hilar lymph nodes may be therapeutic for low-volume, subclinical nodal disease. Treatment of peripheral upper lobe lung tumors delivers less incidental irradiation to the paratracheal lymph nodes with lower likelihood of therapeutic benefit.

Quantification of incidental mediastinal and hilar irradiation delivered during definitive stereotactic body radiation therapy for peripheral non–small cell lung cancer

International Nuclear Information System (INIS)

Martin, Kate L.; Gomez, Jorge; Nazareth, Daryl P.; Warren, Graham W.; Singh, Anurag K.

2012-01-01

To determine the amount of incidental radiation dose received by the mediastinal and hilar nodes for patients with non–small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy (SBRT). Fifty consecutive patients with NSCLC, treated using an SBRT technique, were identified. Of these patients, 38 had a prescription dose of 60 Gy in 20-Gy fractions and were eligible for analysis. For each patient, ipsilateral upper (level 2) and lower (level 4) paratracheal, and hilar (level 10) nodal regions were contoured on the planning computed tomography (CT) images. Using the clinical treatment plan, dose and volume calculations were performed retrospectively for each nodal region. SBRT to upper lobe tumors resulted in an average total ipsilateral mean dose of between 5.2 and 7.8 Gy for the most proximal paratracheal nodal stations (2R and 4R for right upper lobe lesions, 2L and 4L for left upper lobe lesions). SBRT to lower lobe tumors resulted in an average total ipsilateral mean dose of between 15.6 and 21.5 Gy for the most proximal hilar nodal stations (10R for right lower lobe lesions, 10 l for left lower lobe lesions). Doses to more distal nodes were substantially lower than 5 Gy. The often substantial incidental irradiation, delivered during SBRT for peripheral NSCLC of the lower lobes to the most proximal hilar lymph nodes may be therapeutic for low-volume, subclinical nodal disease. Treatment of peripheral upper lobe lung tumors delivers less incidental irradiation to the paratracheal lymph nodes with lower likelihood of therapeutic benefit.

Insights into the use and affordances of social and collaborative applications for student projects

Directory of Open Access Journals (Sweden)

Omolola Ola Bankole

2017-10-01

Full Text Available The use of social and collaborative computing has the potential of assisting learning and improving the ability to work together as part of a team. Team work is a graduate attribute that students need to acquire before transitioning from university into the workplace. The aim of this exploratory research was to provide insights into the use of social and collaborative applications by Computer Science students, and the emergent affordances student project teams have created with the use of these applications. It answers the questions: What elearning platforms or applications do students use to collaborate for team projects? What technology affordance draws students to use these applications? This study adopts affordance theory as the theoretical framework. Two types of content analysis: conventional content analysis and summative content analysis were used to analyse the data. Data was gathered using a pre-designed questionnaire with the teams during the first semester of 2016. Findings show that the university’s elearning platform is utilised for some of their courses; however students seem to prefer free and open source platforms. Student project teams used applications such as WhatsApp, Telegram, Dropbox, Google Drive, Google Docs, as well as email messages, to work jointly, and were successfully able to complete their team projects. Four types of technology affordances: communicative-affordance, document share-affordance, course resource-affordance, and integrity-affordance, were identified as being relevant.

Affordability of medicines in the European Union.

Directory of Open Access Journals (Sweden)

Tomasz Zaprutko

Full Text Available Medications and their prices are key issues for healthcare. Although access to medicines at affordable prices had been specified as a key objective of the European Health Policy, it seems that these goals have not been achieved. Therefore, we attempted an evaluation of affordability of selected medicines at full prices.The analysis concerned 2012 and was conducted between 2013 and 2015 in all the European Union (EU countries divided into 3 groups depending on the date of their accession to the EU. Finally, we considered 9 originators used in the treatment of schizophrenia and multiple sclerosis. Information on drug prices were collected from pharmacies. Participation in the study was voluntary and anonymous in order to avoid accusations of advertising. To evaluate affordability, several factors were used (e.g. minimum earnings and Gini coefficient. Due to unavailability in some countries, the exact number of analyzed medicines varies.Drug prices vary significantly between EU Member States. Almost eleven fold difference was observed between Germany (EUR 1451.17 and Croatia (EUR 132.77 in relation to Interferone beta-1a 22 μg. Generally, prices were the highest in Germany. The cheapest drugs were found in various countries but never in the poorest ones like Bulgaria or Romania. Discrepancies in wages were observed too (the smallest minimum wage was EUR 138.00 in Bulgaria and the highest EUR 1801.00 in Luxembourg. Full price of olanzapine 5mg, however, was higher in Bulgaria (EUR 64.53 than, for instance, in Belgium (EUR 37.26.Analyzed medications are still unaffordable for many citizens of the EU. Besides, access to medicines is also impaired e.g. due to parallel trade. Unaffordability of medications may lead to the patients' non-compliance and therefore to increased direct and indirect costs of treatment. Common European solutions are needed to achieve a real affordability and accessibility of medications.

Affordance-based individuation of junctions in Open Street Map

Directory of Open Access Journals (Sweden)

Simon Scheider

2012-06-01

Full Text Available We propose an algorithm that can be used to identify automatically the subset of street segments of a road network map that corresponds to a junction. The main idea is to use turn-compliant locomotion affordances, i.e., restricted patterns of supported movement, in order to specify junctions independently of their data representation, and in order to motivate tractable individuation and classification strategies. We argue that common approaches based solely on geometry or topology of the street segment graph are useful but insufficient proxies. They miss certain turn restrictions essential to junctions. From a computational viewpoint, the main challenge of affordance-based individuation of junctions lies in its complex recursive definition. In this paper, we show how Open Street Map data can be interpreted into locomotion affordances, and how the recursive junction definition can be translated into a deterministic algorithm. We evaluate this algorithm by applying it to small map excerpts in order to delineate the contained junctions.

Strategies and opportunities to STOP colon cancer in priority populations: pragmatic pilot study design and outcomes

International Nuclear Information System (INIS)

Coronado, Gloria D; Turner, Ann; Sanchez, Jennifer; Retecki, Sally; Nelson, Christine; Green, Beverly; Vollmer, William M; Petrik, Amanda; Aguirre, Josue; Kapka, Tanya; DeVoe, Jennifer; Puro, Jon; Miers, Tran; Lembach, Jennifer

2014-01-01

Colorectal-cancer is a leading cause of cancer death in the United States, and Latinos have particularly low rates of screening. Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC) is a partnership among two research institutions and a network of safety net clinics to promote colorectal cancer screening among populations served by these clinics. This paper reports on results of a pilot study conducted in a safety net organization that serves primarily Latinos. The study assessed two clinic-based approaches to raise rates of colorectal-cancer screening among selected age-eligible patients not up-to-date with colorectal-cancer screening guidelines. One clinic each was assigned to: (1) an automated data-driven Electronic Health Record (EHR)-embedded program for mailing Fecal Immunochemical Test (FIT) kits (Auto Intervention); or (2) a higher-intensity program consisting of a mailed FIT kit plus linguistically and culturally tailored interventions delivered at the clinic level (Auto Plus Intervention). A third clinic within the safety-net organization was selected to serve as a passive control (Usual Care). Two simple measurements of feasibility were: 1) ability to use real-time EHR data to identify patients eligible for each intervention step, and 2) ability to offer affordable testing and follow-up care for uninsured patients. The study was successful at both measurements of feasibility. A total of 112 patients in the Auto clinic and 101 in the Auto Plus clinic met study inclusion criteria and were mailed an introductory letter. Reach was high for the mailed component (92.5% of kits were successfully mailed), and moderate for the telephone component (53% of calls were successful completed). After exclusions for invalid address and other factors, 206 (109 in the Auto clinic and 97 in the Auto Plus clinic) were mailed a FIT kit. At 6 months, fecal test completion rates were higher in the Auto (39.3%) and Auto Plus (36.6%) clinics

Effects of Affordance Perception on the Initiation and Actualization of Action

NARCIS (Netherlands)

Smith, Joanne; Pepping, Gert-Jan

2010-01-01

Studies have shown information specifying some affordances may be faster or easier to perceive than others. This article investigates the effect of affordance perception on the time taken to initiate and perform an action. In particular it focuses on how action timing varies as a function of a

Making care affordable.

Science.gov (United States)

Solomon, S

1999-01-01

The YRG Centre for AIDS Research and Education (CARE) in Chennai, India runs an integrated care program ensuring appropriate and affordable care to everyone who needs it. The program includes both voluntary counseling/testing and hospital/home-based care. YRG CARE developed several strategies for the care program, which include 1) different fees for an HIV test, 2) free counseling service, 3) different charges for other care services, 4) a subsidized pharmacy (involving purchasing drugs directly from manufacturers and wholesalers, ordering free samples from manufacturers, and acquiring drugs through the drug component of its clinical research projects, from overseas hospitals, and from YRG CARE hospital and community-based patients who have not used them), and 5) subsidized meals.

Affordable Exploration of Mars: Recommendations from a Community Workshop on Sustainable Initial Human Missions

Science.gov (United States)

Thronson, Harley; Carberry, Chris; Cassady, R. J.; Cooke, Doug; Hopkins, Joshua; Perino, Maria A.; Kirkpatrick, Jim; Raftery, Michael; Westenberg, Artemis; Zucker, Richard

2013-01-01

There is a growing consensus that within two decades initial human missions to Mars are affordable under plausible budget assumptions and with sustained international participation. In response to this idea, a distinguished group of experts from the Mars exploration stakeholder communities attended the "Affording Mars" workshop at George Washington University in December, 2013. Participants reviewed and discussed scenarios for affordable and sustainable human and robotic exploration of Mars, the role of the International Space Station over the coming decade as the essential early step toward humans to Mars, possible "bridge" missions in the 2020s, key capabilities required for affordable initial missions, international partnerships, and a usable definition of affordability and sustainability. We report here the findings, observations, and recommendations that were agreed to at that workshop.

Phase 2 Trial of Accelerated, Hypofractionated Whole-Breast Irradiation of 39 Gy in 13 Fractions Followed by a Tumor Bed Boost Sequentially Delivering 9 Gy in 3 Fractions in Early-Stage Breast Cancer

International Nuclear Information System (INIS)

Kim, Ja Young; Jung, So-Youn; Lee, Seeyoun; Kang, Han-Sung; Lee, Eun Sook; Park, In Hae; Lee, Keun Seok; Ro, Jungsil; Lee, Nam Kwon; Shin, Kyung Hwan

2013-01-01

Purpose: To report a phase 2 trial of accelerated, hypofractionated whole-breast irradiation (AH-WBI) delivered as a daily dose of 3 Gy to the whole breast followed by a tumor bed boost. Methods and Materials: Two hundred seventy-six patients diagnosed with breast cancer (pT1-2 and pN0-1a) who had undergone breast-conserving surgery in which the operative margins were negative were treated with AH-WBI delivered as 39 Gy in 13 fractions of 3 Gy to the whole breast once daily over 5 consecutive working days, and 9 Gy in 3 sequential fractions of 3 Gy to a lumpectomy cavity, all within 3.2 weeks. Results: After a median follow-up period of 57 months (range: 27-75 months), the rate of 5-year locoregional recurrence was 1.4% (n=4), whereas that of disease-free survival was 97.4%. No grade 3 skin toxicity was reported during the follow-up period. Qualitative physician cosmetic assessments of good or excellent were noted in 82% of the patients at 2 months after the completion of AH-WBI. The global cosmetic outcome did not worsen over time, and a good or excellent cosmetic outcome was reported in 82% of the patients at 3 years. The mean pretreatment percentage breast retraction assessment was 12.00 (95% confidence interval [CI]: 11.14-12.86). The mean value of percentage breast retraction assessment increased to 13.99 (95% CI: 12.17-15.96) after 1 year and decreased to 13.54 (95% CI: 11.84-15.46) after 3 years but was not significant (P>.05). Conclusions: AH-WBI consisting of 39 Gy in 13 fractions followed by a tumor bed boost sequentially delivering 9 Gy in 3 fractions can be delivered with excellent disease control and tolerable skin toxicity in patients with early-stage breast cancer after breast-conserving surgery

Alcohol affordability and alcohol demand: cross-country trends and panel data estimates, 1975 to 2008.

Science.gov (United States)

Nelson, Jon P

2014-04-01

Relatively little is known about cross-country differences in alcohol affordability or factors that determine differences in affordability over time. This information is potentially important for alcohol policy, especially policies that focus on higher taxes or prices to reduce total alcohol consumption. This study estimates cross-country alcohol consumption relationships using economic models incorporating income and prices and alternative models based on alcohol affordability. The data and analysis are restricted to higher income countries. Data for alcohol consumption per capita (ages 15+) are analyzed for 2 samples: first, 17 countries in the Organisation for Economic Co-operation and Development for the period 1975 to 2000; second, 22 countries in the European Union for the period from 2000 to 2008. Panel data models are utilized, with country and time fixed-effects to control for confounding influences. In economic demand models, covariates are real per capita income and real alcohol price indices. In affordability models, income is divided by prices to yield an index of alcohol affordability. Analysis of data trends reveals that much of the increase in affordability is due to rising real incomes, and not falling real prices. Economic models of demand perform slightly better statistically, but differences are not substantial as income and affordability are highly correlated. For both samples, exogenous rates of growth of alcohol consumption are negative. Price and income elasticities, on average, are within the range of prior estimates. Affordability elasticities are between 0.21 and 0.25. Although alcohol affordability is a valid concept statistically, its use in policy discussions tends to hide underlying causes of changes in affordability. A better approach is a comparison and analysis of trends and cross-country differences in real incomes and real alcohol prices together with the affordability index. Country-level analysis of income and price

Embodied Perception: A Proposal to Reconcile Affordance and Spatial Perception

OpenAIRE

Ca?al-Bruland, Rouwen; van der Kamp, John

2015-01-01

Proffitt's embodied approach to perception is deeply indebted to Gibson's ecological approach to visual perception, in particular the idea that the primary objects of perception are affordances or what the environment offers for action. Yet, rather than directly addressing affordance perception, most of the empirical work evaluating Proffitt's approach focuses on the perception of spatial properties of the environment. We propose that theoretical and empirical efforts should be directed towar...

User-inspired design methodology using Affordance Structure Matrix (ASM for construction projects

Directory of Open Access Journals (Sweden)

Maheswari J. Uma

2017-01-01

Full Text Available Traditionally, design phase of construction projects is often performed with incomplete and inaccurate user preferences. This is due to inefficiencies in the methodologies used for capturing the user requirements that can subsequently lead to inconsistencies and result in non-optimised end-result. Iterations and subsequent reworks due to such design inefficiencies is one of the major reasons for unsuccessful project delivery as they impact project performance measures such as time and cost among others. The existing design theories and practice are primarily based on functional requirements. Function-based design deals with design of artifact alone, which may yield favourable or unfavourable consequences with the design artifact. However, incorporating other interactions such as interactions between user & designer is necessary for optimised end-result. Hence, the objective of this research work is to devise a systematic design methodology considering all the three interactions among users, designers and artefacts for improved design efficiency. In this study, it has been attempted to apply the theory of affordances in a case project that involves the design of an offshore facility. A step-by-step methodology for developing Affordance Structure Matrix (ASM, which integrates House of Quality (HOQ and Design Structure Matrix (DSM, is proposed that can effectively capture the user requirements. HOQ is a popular quality management tool for capturing client requirements and DSM is a matrix-based tool that can capture the interdependency among the design entities. The proposed methodology utilises the strengths of both the tools, as DSM compliments HOQ in the process. In this methodology, different affordances such as AUA (Artifact-User-Affordance, AAA (Artifact-Artifact-Affordance and DDA (Designer-Designer-Affordance are captured systematically. Affordance is considered to be user-driven in this context that is in contrast to prevailing design

Affordance of Braille Music as a Mediational Means: Significance and Limitations

Science.gov (United States)

Park, Hyu-Yong; Kim, Mi-Jung

2014-01-01

Affordance refers to the properties or designs of a thing that offer the function of the thing. This paper discusses the affordance of Braille music in terms of three notions: mediational means, mastery and appropriation, and focuses on answering the following three questions: (i) How do musicians with visual impairments (MVI) perceive Braille…

Automatic activation of motor programs by object affordances in patients with Parkinson's disease

OpenAIRE

Oguro, Hiroaki; Ward, Robert; Bracewel, Martyn; Hindle, John; Rafal, Robert

2009-01-01

Clinical observations of kinesia paradoxica and freezing in patients with Parkinson's disease suggest that the automatic activation of motor programmes by visual stimuli may not require intact basal ganglia function, and that an increased sensitivity to such object affordances may contribute to some symptoms of the disease. Employing a paradigm that measures the degree of interference from object affordances on voluntary actions, we confirm that activation of object affordances are preserved ...

Cancer testis antigen vaccination affords long-term protection in a murine model of ovarian cancer.

Directory of Open Access Journals (Sweden)

Maurizio Chiriva-Internati

Full Text Available Sperm protein (Sp17 is an attractive target for ovarian cancer (OC vaccines because of its over-expression in primary as well as in metastatic lesions, at all stages of the disease. Our studies suggest that a Sp17-based vaccine can induce an enduring defense against OC development in C57BL/6 mice with ID8 cells, following prophylactic and therapeutic treatments. This is the first time that a mouse counterpart of a cancer testis antigen (Sp17 was shown to be expressed in an OC mouse model, and that vaccination against this antigen significantly controlled tumor growth. Our study shows that the CpG-adjuvated Sp17 vaccine overcomes the issue of immunologic tolerance, the major barrier to the development of effective immunotherapy for OC. Furthermore, this study provides a better understanding of OC biology by showing that Th-17 cells activation and contemporary immunosuppressive T-reg cells inhibition is required for vaccine efficacy. Taken together, these results indicate that prophylactic and therapeutic vaccinations can induce long-standing protection against OC and delay tumor growth, suggesting that this strategy may provide additional treatments of human OC and the prevention of disease onset in women with a family history of OC.

African Universities Need Affordable and Reliable Broadband ...

International Development Research Centre (IDRC) Digital Library (Canada)

2010-10-12

Oct 12, 2010 ... But it's a different story in most parts of Africa, where limited library ... on effective and affordable information and communication technology (ICT) ... who are using open-source software that complies with international open ...

Surgeon Reimbursements in Maxillofacial Trauma Surgery: Effect of the Affordable Care Act in Ohio.

Science.gov (United States)

Khansa, Ibrahim; Khansa, Lara; Pearson, Gregory D

2016-02-01

Surgical treatment of maxillofacial injuries has historically been associated with low reimbursements, mainly because of the high proportion of uninsured patients. The Affordable Care Act, implemented in January of 2014, aimed to reduce the number of uninsured. If the Affordable Care Act achieves this goal, surgeons may benefit from improved reimbursement rates. The authors' purpose was to evaluate the effects of the Affordable Care Act on payor distribution and surgeon reimbursements for maxillofacial trauma surgery at their institution. A review of all patients undergoing surgery for maxillofacial trauma between January of 2012 and December of 2014 was conducted. Insurance status, and amounts billed and collected by the surgeon, were recorded. Patients treated before implementation of the Affordable Care Act were compared to those treated after. Five hundred twenty-three patients were analyzed. Three hundred thirty-four underwent surgery before implementation of the Affordable Care Act, and 189 patients underwent surgery after. After implementation of the Affordable Care Act, the proportion of uninsured decreased (27.2 percent to 11.1 percent; p reimbursement rate increased from 14.3 percent to 19.8 percent (p reimbursement rate increased. These trends should be followed over a longer term to determine the full effect of the Affordable Care Act.

Affordability Constraints in Major Defense Acquisitions

Science.gov (United States)

2016-11-01

memo, does not provide a detailed recipe for those who must produce quantitative affordability constraints. Enclosure 8 of the January 7, 2015 version...3.0’s full title includes “Achieving Dominant Capabilities 2015 Lot 2028 Lot 2038 Lot $0 $100 $200 $300 $400 $ 500 $600 $700 $800 $900 0 10000 20000

Understanding and using technological affordances: a commentary on Conole and Dyke

Directory of Open Access Journals (Sweden)

Tom Boyle

2004-12-01

Full Text Available The paper by Conole and Dyke sets the context by pointing to a number of problems that inhibit the widespread, effective use of Information and Communication Technologies (ICT to support learning. They argue that this situation highlights the need to explore a theoretical basis for the use of ICT to support learning. The central argument of the paper is that the notion of affordances can make a significant contribution to this endeavour. The paper aims to articulate the potential impact of these affordances primarily through the development of a taxonomy. It draws on social constructivist theory to help understand and articulate the impact of these affordances. The concept of affordances is potentially both rich and provocative. Conole and Dyke provide a refreshing and diverse look at the theoretical basis for the use of ICT to support learning. We have structured our commentary around six questions that are provided by Conole and Dyke in their Discussion section. Whilst examining these questions we highlight various issues raised by the paper, which we believe, need further consideration and clarification.

Private sector participation in delivering tertiary health care: a dichotomy of access and affordability across two Indian states.

Science.gov (United States)

Katyal, Anuradha; Singh, Prabal Vikram; Bergkvist, Sofi; Samarth, Amit; Rao, Mala

2015-03-01

Poor quality care in public sector hospitals coupled with the costs of care in the private sector have trapped India's poor in a vicious cycle of poverty, ill health and debt for many decades. To address this, the governments of Andhra Pradesh (AP) and Maharashtra (MH), India, have attempted to improve people's access to hospital care by partnering with the private sector. A number of government-sponsored schemes with differing specifications have been launched to facilitate this strategy. This article aims to compare changes in access to, and affordability and efficiency of private and public hospital inpatient (IP) treatments between MH and AP from 2004 to 2012 and to assess whether the health financing innovations in one state resulted in larger or smaller benefits compared with the other. We used data from household surveys conducted in 2004 and 2012 in the two states and undertook a difference-in-difference (DID) analysis. The results focus on hospitalization, out-of-pocket expenditure and length of stay. The average IP expenditure for private hospital care has increased in both states, but more so in MH. There was also an observable increase in both utilization of and expenditure on nephrology treatment in private hospitals in AP. The duration of stay recorded in days for private hospitals has increased slightly in MH and declined in AP with a significant DID. The utilization of public hospitals has reduced in AP and increased in MH. The state of AP appears to have benefited more than MH in terms of improved access to care by involving the private sector. The Aarogyasri scheme is likely to have contributed to these impacts in AP at least in part. Our study needs to be followed up with repeated evaluations to ascertain the long-term impacts of involving the private sector in providing hospital care. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

Conflict between object structural and functional affordances in peripersonal space.

Science.gov (United States)

Kalénine, Solène; Wamain, Yannick; Decroix, Jérémy; Coello, Yann

2016-10-01

Recent studies indicate that competition between conflicting action representations slows down planning of object-directed actions. The present study aims to assess whether similar conflict effects exist during manipulable object perception. Twenty-six young adults performed reach-to-grasp and semantic judgements on conflictual objects (with competing structural and functional gestures) and non-conflictual objects (with similar structural and functional gestures) presented at difference distances in a 3D virtual environment. Results highlight a space-dependent conflict between structural and functional affordances. Perceptual judgments on conflictual objects were slower that perceptual judgments on non-conflictual objects, but only when objects were presented within reach. Findings demonstrate that competition between structural and functional affordances during object perception induces a processing cost, and further show that object position in space can bias affordance competition. Copyright © 2016 Elsevier B.V. All rights reserved.

The role of affordances in Libras acquisition as second language

Directory of Open Access Journals (Sweden)

Jéssica Puhl

2016-05-01

Full Text Available Libras is a visual-spatial language used by the Brazilian deaf community. Following the principles of spatiality and vision, the user of the sign language resorts more easily to stimuli from the environment than the user of the oral language. Thus, the hypothesis of this research is that the affordances (environmental properties that enable psychologically possible actions would be a facilitator element in the process of Libras acquisition. In this paper we use the narrative and interpretive-qualitative research to discuss the role of affordances in the listener perception, interpretation and action cycle in Libras acquisition as second language. Results show that the Libras’ iconic signs can be considered important affordances in the early stages of the acquisition. It is also observed the importance of the permanence in the niche where Libras is used for the sign language development.

Photochemical internalization enhanced macrophage delivered chemotherapy.

Science.gov (United States)

Shin, Diane; Christie, Catherine; Ju, David; Nair, Rohit Kumar; Molina, Stephanie; Berg, Kristian; Krasieva, Tatiana B; Madsen, Steen J; Hirschberg, Henry

2018-03-01

Macrophage (Ma) vectorization of chemotherapeutic drugs has the advantage for cancer therapy in that it can actively target and maintain an elevated concentration of drugs at the tumor site, preventing their spread into healthy tissue. A potential drawback is the inability to deliver a sufficient number of drug-loaded Ma into the tumor, thus limiting the amount of active drug delivered. This study examined the ability of photochemical internalization (PCI) to enhance the efficacy of released drug by Ma transport. Tumor spheroids consisting of either F98 rat glioma cells or F98 cells combined with a subpopulation of empty or doxorubicin (DOX)-loaded mouse Ma (RAW264.7) were used as in vitro tumor models. PCI was performed with the photosensitizer AlPcS 2a and laser irradiation at 670 nm. RAW264.7 Ma pulsed with DOX released the majority of the incorporated DOX within two hours of incubation. PCI significantly increased the toxicity of DOX either as pure drug or derived from monolayers of DOX-loaded Ma. Significant growth inhibition of hybrid spheroids was also observed with PCI even at subpopulations of DOX-loaded Ma as low as 11% of the total initial hybrid spheroid cell number. Results show that RAW264.7 Ma, pulsed with DOX, could effectively incorporate and release DOX. PCI significantly increased the ability of both free and Ma-released DOX to inhibit the growth of tumor spheroids in vitro. The growth of F98 + DOX loaded Ma hybrid spheroids were synergistically reduced by PCI, compared to either photodynamic therapy or released DOX acting alone. Copyright © 2017 Elsevier B.V. All rights reserved.

Engineering an Affordable Self-Driving Car

KAUST Repository

Budisteanu, Alexandru Ionut

2018-01-17

"More than a million people die in car accidents each year, and most of those accidents are the result of human errorﾔ Alexandru Budisteanu is 23 years old and owns a group of startups including Autonomix, an Artificial Intelligence software for affordable self-driving cars and he designed a low-cost self-driving car. The car\\'s roof has cameras and low-resolution 3D LiDAR equipment to detect traffic lanes, other cars, curbs and obstacles, such as people crossing by. To process this dizzying amount of data, Alexandru employed Artificial Intelligence algorithms to extract information from the visual data and plot a safe route for the car. Then, he built a manufacturing facility in his garage from Romania to assembly affordable VisionBot Pick and Place robots that are used to produce electronics. During this lecture, Alexandru will talk about this autonomous self-driving car prototype, for which he received the grand prize of the Intel International Science and Engineering Fair, and was nominated by TIME magazine as one of the worldﾒs most influential teens of 2013.

Normative Interfaces: Affordances, Gender, and Race in Facebook

Directory of Open Access Journals (Sweden)

Angela M. Cirucci

2017-06-01

Full Text Available This study investigates social network site affordances and their implications for perceptions of marginalized communities. I employ Facebook as a case study and speak with young adult users to comprehend how socially marginalized groups are perceived through Facebook’s affordances. In particular, I consider: How familiar are users with Facebook’s tools and functionalities? How are issues of gender and race represented through the site’s interface? How do users conceive of gender and race? The findings suggest that gender is perceived as a more important identifier than race and that Facebook is post-racial, because of the user interface choices made. In addition, my participants view Facebook as an official social space that should include “authentic” identities; although Facebook has shaped authentic to mean accurate. I conclude that while the construction of affordances is a negotiation between user, interface, and designer, the designers have the most power because they have created the spaces in ways that will most benefit Facebook. In addition, users who are more situated in the socio-cultural majority have no desire to enact agency within Facebook’s structure because they are accustomed to forms and official documents that are well suited to fit their identification needs.

Editorial: The call to battle cancer in South Sudan

Directory of Open Access Journals (Sweden)

Oromo Francis Seriano Omojo

2018-02-01

Full Text Available Cancer treatment is still nascent to non-existent in South Sudan. Basic surgical removal of cancer growths is the only option for many people. The country does not possess an oncology facility and consequently, with no access to chemotherapy and radiotherapy, treatment is a major challenge. Those who can afford it are referred for further management to countries such as the Sudan, Egypt, Uganda, India or South Africa.

Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ.

Science.gov (United States)

Albright, Len; Derickson, Elizabeth S; Massey, Douglas S

2013-06-01

This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ - the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities.

Can community care workers deliver a falls prevention exercise program? A feasibility study

Directory of Open Access Journals (Sweden)

Burton E

2018-03-01

were completed by the majority of community care workers (93.1%. Assessment staff found it difficult to find time to deliver the intervention. Support workers were able to complete the intervention within their current service delivery period, with the initial assessment taking a small amount of additional time. Support workers reported enjoying the additional responsibility afforded by delivering the falls prevention program and seeing changes in their clients. The majority of clients (82% reported enjoying the exercises, with 59% reporting that they felt it made a positive change in their health. Clients completed the exercises on average 4.8 (SD: 2.2 days per week. Conclusion: Community care workers who have completed appropriate training are able to deliver a falls prevention exercise program to their clients as part of their current services. Further research is required to determine whether the program reduces the rate of falls for community care clients and whether integration of a falls prevention program into an existing service is cost-effective. Keywords: strength, balance, pragmatic research, home and community care services, Regional Assessment Service (RAS, safety

Active design in affordable housing: A public health nudge.

Science.gov (United States)

Garland, Elizabeth; Garland, Victoria; Peters, Dominique; Doucette, John; Thanik, Erin; Rajupet, Sritha; Sanchez, Sadie H

2018-06-01

This pilot study investigates the impact of active design (AD) strategies on physical activity (PA) among adults living in two Leadership in Energy and Environmental Design (LEED) certified affordable housing developments in the South Bronx, New York. One building incorporates LEED Innovation in Design (ID) Credit: Design for Health through Increased Physical Activity. Tenants in an affordable housing building (AH) incorporating active design strategies completed PA self-assessments at their lease signing and one year later in 2015. Trained research assistants obtained body measurements. Residents of neighboring non-AD affordable housing (MCV) served as a comparison. Thirty four adults were recruited from AH and 29 from MCV, retention was 56% (n = 19) and 52% (n = 15) respectively at one year. The two groups' body mass index (BMI) and high-risk waist-to-hip ratio (WHR) were not statistically significantly different when analyzed as continuous variables, although BMI category had a greater decline at AH than at MCV (p = 0.054). There was a 31.5% increase in AH participants meeting MPA requirements and a statistically significant improvement in females (p = 0.031); while there was no change in the MCV participants overall or when stratified by gender. AH participants were significantly more likely to have reported increased stair use and less likely to have reported no change or decreased stair use than participants from MCV participants (p = 0.033). Housing has a role in individual health outcomes and behavior change, broad adoption of active design strategies in affordable housing is warranted to improve physical activity measures.

Healthy Body Image Intervention Delivered to Young Women via Facebook Groups: Formative Study of Engagement and Acceptability.

Science.gov (United States)

Stapleton, Jerod L; Manne, Sharon L; Day, Ashley K; Levonyan-Radloff, Kristine; Pagoto, Sherry L

2018-02-20

There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within an interactive social media format. The findings

Healthy Body Image Intervention Delivered to Young Women via Facebook Groups: Formative Study of Engagement and Acceptability

Science.gov (United States)

Manne, Sharon L; Day, Ashley K; Levonyan-Radloff, Kristine; Pagoto, Sherry L

2018-01-01

Background There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. Objective To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Methods Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. Results The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). Conclusions This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within

Tablets for Learning in Higher Education:The Top 10 Affordances

OpenAIRE

Godsk, Mikkel

2013-01-01

Based on a small-scale literature review this paper identifies the top 10 affordances of post PC tablets (sometimes referred to as ‘tablet computers’) for higher education in settings where the technology is used for learning. The review shows that the predominant affordances of the technology are related to its ability to support engaging, inclusive, and/or collaborative learning, to provide flexibility in place, and to include multimedia and interactive content in teaching practice. However...

Increasing the Supply of Affordable Housing in Urban India - Mumbai

OpenAIRE

Viswanathan, Upasna

2014-01-01

The need for housing in today's world is irrefutable. The growing population, accompanied with the fast pace of urbanization, are producing great housing demand, in urban areas in particular. This study focused on one segment of housing - affordable housing, in Mumbai, India, the demand for which has been on a steady rise over the past decade. Though traditionally the State was the provider of affordable housing, private sector has been increasingly involved in the segment, beginning the econ...

flexZhouse: New business model for affordable housing in Malaysia

OpenAIRE

Mohd Zairul bin Mohd Noor

2017-01-01

Central to this PhD research was the problem of the lack of affordable housing for young starters in Malaysia. The solutions for affordable housing that are available in the market do not truly solve the problem from the customer’s point of view. Hence, it was important to analyse the contributing factors associated with the term ‘affordability’. The term touches upon interconnected elements that cover many issues ranging from demand (housing needs, demographics, household income, quality hou...

Approach to an Affordable and Sustainable Space Transportation System

Science.gov (United States)

McCleskey, Caey M.; Rhodes, R. E.; Robinson, J. W.; Henderson, E. M.

2012-01-01

This paper describes an approach and a general procedure for creating space transportation architectural concepts that are at once affordable and sustainable. Previous papers by the authors and other members of the Space Propulsion Synergy Team (SPST) focused on a functional system breakdown structure for an architecture and definition of high-payoff design techniques with a technology integration strategy. This paper follows up by using a structured process that derives architectural solutions focused on achieving life cycle affordability and sustainability. Further, the paper includes an example concept that integrates key design techniques discussed in previous papers. !

24 CFR 1000.104 - What families are eligible for affordable housing activities?

Science.gov (United States)

2010-04-01

... affordable housing activities? 1000.104 Section 1000.104 Housing and Urban Development Regulations Relating... Activities § 1000.104 What families are eligible for affordable housing activities? The following families... Indian area. (b) A non-low income Indian family may receive housing assistance in accordance with § 1000...

16 CFR 1061.8 - Information on the heightened degree of protection afforded.

Science.gov (United States)

2010-01-01

... protection afforded. 1061.8 Section 1061.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL APPLICATIONS FOR EXEMPTION FROM PREEMPTION § 1061.8 Information on the heightened degree of protection afforded... State or local requirement provides a significantly higher degree of protection from the risk of injury...

Self-organization, free energy minimization, and optimal grip on a field of affordances.

Science.gov (United States)

Bruineberg, Jelle; Rietveld, Erik

2014-01-01

In this paper, we set out to develop a theoretical and conceptual framework for the new field of Radical Embodied Cognitive Neuroscience. This framework should be able to integrate insights from several relevant disciplines: theory on embodied cognition, ecological psychology, phenomenology, dynamical systems theory, and neurodynamics. We suggest that the main task of Radical Embodied Cognitive Neuroscience is to investigate the phenomenon of skilled intentionality from the perspective of the self-organization of the brain-body-environment system, while doing justice to the phenomenology of skilled action. In previous work, we have characterized skilled intentionality as the organism's tendency toward an optimal grip on multiple relevant affordances simultaneously. Affordances are possibilities for action provided by the environment. In the first part of this paper, we introduce the notion of skilled intentionality and the phenomenon of responsiveness to a field of relevant affordances. Second, we use Friston's work on neurodynamics, but embed a very minimal version of his Free Energy Principle in the ecological niche of the animal. Thus amended, this principle is helpful for understanding the embeddedness of neurodynamics within the dynamics of the system "brain-body-landscape of affordances." Next, we show how we can use this adjusted principle to understand the neurodynamics of selective openness to the environment: interacting action-readiness patterns at multiple timescales contribute to the organism's selective openness to relevant affordances. In the final part of the paper, we emphasize the important role of metastable dynamics in both the brain and the brain-body-environment system for adequate affordance-responsiveness. We exemplify our integrative approach by presenting research on the impact of Deep Brain Stimulation on affordance responsiveness of OCD patients.

Global Trends in the Affordability of Sugar-Sweetened Beverages, 1990-2016.

Science.gov (United States)

Blecher, Evan; Liber, Alex C; Drope, Jeffrey M; Nguyen, Binh; Stoklosa, Michal

2017-05-04

The objective of this study was to quantify changes in the affordability of sugar-sweetened beverages, a product implicated as a contributor to rising rates of obesity worldwide, as a function of product price and personal income. We used international survey data in a retrospective analysis of 40 high-income and 42 low-income and middle-income countries from 1990 to 2016. Prices of sugar-sweetened beverages were from the Economist Intelligence Unit's World Cost of Living Survey. Income and inflation data were from the International Monetary Fund's World Economic Outlook Database. The measure of affordability was the average annual percentage change in the relative-income price of sugar-sweetened beverages, which is the annual rate of change in the proportion of per capita gross domestic product needed to purchase 100 L of Coca-Cola in each country in each year of the study. In 79 of 82 countries, the proportion of income needed to purchase sugar-sweetened beverages declined on average (using annual measures) during the study period. This pattern, described as an increase in the affordability of sugar-sweetened beverages, indicated that sugar-sweetened beverages became more affordable more rapidly in low-income and middle-income countries than in high-income countries, a fact largely attributable to the higher rate of income growth in those countries than to a decline in the real price of sugar-sweetened beverages. Without deliberate policy action to raise prices, sugar-sweetened beverages are likely to become more affordable and more widely consumed around the world.

77 FR 70583 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

Science.gov (United States)

2012-11-26

... Parts 144, 147, 150, et al. Patient Protection and Affordable Care Act; Health Insurance Market Rules... and 156 [CMS-9972-P] RIN 0938-AR40 Patient Protection and Affordable Care Act; Health Insurance Market... Affordable Care Act with respect to health insurance issuers and group health plans that are non-federal...

High Working Memory Load Increases Intracortical Inhibition in Primary Motor Cortex and Diminishes the Motor Affordance Effect.

Science.gov (United States)

Freeman, Scott M; Itthipuripat, Sirawaj; Aron, Adam R

2016-05-18

Motor affordances occur when the visual properties of an object elicit behaviorally relevant motor representations. Typically, motor affordances only produce subtle effects on response time or on motor activity indexed by neuroimaging/neuroelectrophysiology, but sometimes they can trigger action itself. This is apparent in "utilization behavior," where individuals with frontal cortex damage inappropriately grasp affording objects. This raises the possibility that, in healthy-functioning individuals, frontal cortex helps ensure that irrelevant affordance provocations remain below the threshold for actual movement. In Experiment 1, we tested this "frontal control" hypothesis by "loading" the frontal cortex with an effortful working memory (WM) task (which ostensibly consumes frontal resources) and examined whether this increased EEG measures of motor affordances to irrelevant affording objects. Under low WM load, there were typical motor affordance signatures: an event-related desynchronization in the mu frequency and an increased P300 amplitude for affording (vs nonaffording) objects over centroparietal electrodes. Contrary to our prediction, however, these affordance measures were diminished under high WM load. In Experiment 2, we tested competing mechanisms responsible for the diminished affordance in Experiment 1. We used paired-pulse transcranial magnetic stimulation over primary motor cortex to measure long-interval cortical inhibition. We found greater long-interval cortical inhibition for high versus low load both before and after the affording object, suggesting that a tonic inhibition state in primary motor cortex could prevent the affordance from provoking the motor system. Overall, our results suggest that a high WM load "sets" the motor system into a suppressed state that mitigates motor affordances. Is an irrelevant motor affordance more likely to be triggered when you are under low or high cognitive load? We examined this using physiological measures

Do advanced cancer patients in Denmark receive the help they need?

DEFF Research Database (Denmark)

Johnsen, Anna Thit; Petersen, Morten Aagaard; Pedersen, Lise

2013-01-01

The aim of the study was to investigate the adequacy of help delivered by the healthcare system for 12 symptoms/problems in a national, randomly selected sample of advanced cancer patients in Denmark.......The aim of the study was to investigate the adequacy of help delivered by the healthcare system for 12 symptoms/problems in a national, randomly selected sample of advanced cancer patients in Denmark....

Implementing the Affordable Care Act: Promoting Competition in the Individual Marketplaces.

Science.gov (United States)

Cusano, David; Lucia, Kevin

2016-02-01

A main goal of the Affordable Care Act is to provide Americans with access to affordable coverage in the individual market, achieved in part by pro­moting competition among insurers on premium price and value. One primary mechanism for meeting that goal is the establishment of new individual health insurance marketplaces where consumers can shop for, compare, and purchase plans, with subsidies if they are eligible. In this issue brief, we explore how the Affordable Care Act is influencing competition in the individual marketplaces in four states--Kansas, Nevada, Rhode Island, and Washington. Strategies include: educating consumers and providing coverage information in one place to ease decision-making; promoting competition among insurers; and ensuring a level playing field for premium rate development through the rate review process.

Economics of Cancer Medicines: For Whose Benefit?

Science.gov (United States)

Gyawali, Bishal; Sullivan, Richard

2017-04-01

Although new cancer drugs are continually getting approved and used, the value that these drugs add is very debatable. Because of the skyrocketing cost of the new drugs, each new approval represents a multibillion market. However, unlike other branches of economics, cancer drugs are intricately associated with socio-political issues, emotional overlay, public pressure, industry manipulation and propaganda. In this article, we review the value added by new cancer drugs and examine the socio-political agenda around them with highlights on the increasing gulf between high-income and low-middle income countries regarding the affordability to these drugs. Finally, we also suggest a way forward to address this highly complex issue.

Towards Affordable Disclosure of Spoken Word Archives

NARCIS (Netherlands)

Ordelman, Roeland J.F.; Heeren, W.F.L.; Huijbregts, M.A.H.; Hiemstra, Djoerd; de Jong, Franciska M.G.; Larson, M; Fernie, K; Oomen, J; Cigarran, J.

2008-01-01

This paper presents and discusses ongoing work aiming at affordable disclosure of real-world spoken word archives in general, and in particular of a collection of recorded interviews with Dutch survivors of World War II concentration camp Buchenwald. Given such collections, the least we want to be

Towards Affordable Disclosure of Spoken Heritage Archives

NARCIS (Netherlands)

Larson, M; Ordelman, Roeland J.F.; Heeren, W.F.L.; Fernie, K; de Jong, Franciska M.G.; Huijbregts, M.A.H.; Oomen, J; Hiemstra, Djoerd

2009-01-01

This paper presents and discusses ongoing work aiming at affordable disclosure of real-world spoken heritage archives in general, and in particular of a collection of recorded interviews with Dutch survivors of World War II concentration camp Buchenwald. Given such collections, we at least want to

Situational Affordance - Appreciating human Interpretations in New Product Development

DEFF Research Database (Denmark)

Mathiasen, John Bang; Koch, Christian

2009-01-01

New Product Development (NPD) takes place within a web of connected actors who do not master fully the objects of the process, but rather they interpret the affordance - the en-abling and constraining framing by objects such as sketches, drawings, specifications, mock-ups and prototypes. The arti......New Product Development (NPD) takes place within a web of connected actors who do not master fully the objects of the process, but rather they interpret the affordance - the en-abling and constraining framing by objects such as sketches, drawings, specifications, mock-ups and prototypes....... The article draws on critical comments and extends Hutchby’s concept of affordance. Even if Hutchby does not study an artefact as a micro-level phe-nomenon from an engineering perspective and only considers the consumption of an arte-fact, we use him to study the development of artefacts in NPD. Hutchby...... to negotiate technical and non-technical aspects alike, while Sierra uses a CAD-system to support joint-development crossing organisational boundaries. The cases share features such as triadic relations; customer’s problem, product designers and artefact. For example, a wheelchair is presented to Sierra...

Affordances of Spreadsheets In Mathematical Investigation: Potentialities For Learning

Directory of Open Access Journals (Sweden)

Nigel Calder

2009-10-01

Full Text Available This article, is concerned with the ways learning is shaped when mathematics problems are investigated in spreadsheet environments. It considers how the opportunities and constraints the digital media affords influenced the decisions the students made, and the direction of their enquiry pathway. How might the learning trajectory unfold, and the learning process and mathematical understanding emerge? Will the spreadsheet, as the pedagogical medium, evoke learning in a distinctive manner? The article reports on an aspect of an ongoing study involving students as they engage mathematical investigative tasks through digital media, the spreadsheet in particular. It considers the affordances of this learning environment for primary-aged students.

Costs of an ostomy self-management training program for cancer survivors.

Science.gov (United States)

Hornbrook, Mark C; Cobb, Martha D; Tallman, Nancy J; Colwell, Janice; McCorkle, Ruth; Ercolano, Elizabeth; Grant, Marcia; Sun, Virginia; Wendel, Christopher S; Hibbard, Judith H; Krouse, Robert S

2018-03-01

To measure incremental expenses to an oncologic surgical practice for delivering a community-based, ostomy nurse-led, small-group, behavior skills-training intervention to help bladder and colorectal cancer survivors understand and adjust to their ostomies and improve their health-related quality of life, as well as assist family caregivers to understand survivors' needs and provide appropriate supportive care. The intervention was a 5-session group behavior skills training in ostomy self-management following the principles of the Chronic Care Model. Faculty included Wound, Ostomy, and Continence Nurses (WOCNs) using an ostomy care curriculum. A gender-matched peer-in-time buddy was assigned to each ostomy survivor. The 4-session survivor curriculum included the following: self-management practice and solving immediate ostomy concerns; social well-being; healthy lifestyle; and a booster session. The single family caregiver session was coled by a WOCN and an ostomy peer staff member and covered relevant caregiver and ostomate support issues. Each cohort required 8 weeks to complete the intervention. Nonlabor inputs included ostomy supplies, teaching materials, automobile mileage for WOCNs, mailing, and meeting space rental. Intervention personnel were employed by the University of Arizona. Labor expenses included salaries and fringe benefits. The total incremental expense per intervention cohort of 4 survivors was $7246 or $1812 per patient. A WOCN-led group self-help ostomy survivorship intervention provided affordable, effective, care to cancer survivors with ostomies. Copyright © 2017 John Wiley & Sons, Ltd.

Understanding the adoption dynamics of medical innovations: affordances of the da Vinci robot in the Netherlands.

Science.gov (United States)

Abrishami, Payam; Boer, Albert; Horstman, Klasien

2014-09-01

This study explored the rather rapid adoption of a new surgical device - the da Vinci robot - in the Netherlands despite the high costs and its controversial clinical benefits. We used the concept 'affordances' as a conceptual-analytic tool to refer to the perceived promises, symbolic meanings, and utility values of an innovation constructed in the wider social context of use. This concept helps us empirically understand robot adoption. Data from 28 in-depth interviews with diverse purposively-sampled stakeholders, and from medical literature, policy documents, Health Technology Assessment reports, congress websites and patients' weblogs/forums between April 2009 and February 2014 were systematically analysed from the perspective of affordances. We distinguished five interrelated affordances of the robot that accounted for shaping and fulfilling its rapid adoption: 'characteristics-related' affordances such as smart nomenclature and novelty, symbolising high-tech clinical excellence; 'research-related' affordances offering medical-technical scientific excellence; 'entrepreneurship-related' affordances for performing better-than-the-competition; 'policy-related' affordances indicating the robot's liberalised provision and its reduced financial risks; and 'communication-related' affordances of the robot in shaping patients' choices and the public's expectations by resonating promising discourses while pushing uncertainties into the background. These affordances make the take-up and use of the da Vinci robot sound perfectly rational and inevitable. This Dutch case study demonstrates the fruitfulness of the affordances approach to empirically capturing the contextual dynamics of technology adoption in health care: exploring in-depth actors' interaction with the technology while considering the interpretative spaces created in situations of use. This approach can best elicit real-life value of innovations, values as defined through the eyes of (potential) users

Refusal to enrol in Ghana's National Health Insurance Scheme: is affordability the problem?

Science.gov (United States)

Kusi, Anthony; Enemark, Ulrika; Hansen, Kristian S; Asante, Felix A

2015-01-17

Access to health insurance is expected to have positive effect in improving access to healthcare and offer financial risk protection to households. Ghana began the implementation of a National Health Insurance Scheme (NHIS) in 2004 as a way to ensure equitable access to basic healthcare for all residents. After a decade of its implementation, national coverage is just about 34% of the national population. Affordability of the NHIS contribution is often cited by households as a major barrier to enrolment in the NHIS without any rigorous analysis of this claim. In light of the global interest in achieving universal health insurance coverage, this study seeks to examine the extent to which affordability of the NHIS contribution is a barrier to full insurance for households and a burden on their resources. The study uses data from a cross-sectional household survey involving 2,430 households from three districts in Ghana conducted between January-April, 2011. Affordability of the NHIS contribution is analysed using the household budget-based approach based on the normative definition of affordability. The burden of the NHIS contributions to households is assessed by relating the expected annual NHIS contribution to household non-food expenditure and total consumption expenditure. Households which cannot afford full insurance were identified. Results show that 66% of uninsured households and 70% of partially insured households could afford full insurance for their members. Enroling all household members in the NHIS would account for 5.9% of household non-food expenditure or 2.0% of total expenditure but higher for households in the first (11.4%) and second (7.0%) socio-economic quintiles. All the households (29%) identified as unable to afford full insurance were in the two lower socio-economic quintiles and had large household sizes. Non-financial factors relating to attributes of the insurer and health system problems also affect enrolment in the NHIS. Affordability

The Role of Affordances in the Evolutionary Process Reconsidered A Niche Construction Perspective

NARCIS (Netherlands)

Withagen, Rob; van Wermeskerken, Margot

Gibson asserted that affordances are the primary objects of perception. Although this assertion is especially attractive when considered in the context of evolutionary theory, the role that affordances play in the evolution of animals' perceptual and action systems is still unclear. Trying to

Practical measurement of affordability: An application to medicines

NARCIS (Netherlands)

L.M. Niëns (Laurens); E. Van de Poel (Ellen); A. Cameron (ALexandra); M. Ewen (Margaret); R. Laing (Richard); W.B.F. Brouwer (Werner)

2012-01-01

markdownabstract__Objective:__ To develop two practical methods for measuring the affordability of medicines in developing countries. __Methods:__ The proposed methods - catastrophic and impoverishment methods - rely on easily accessible aggregated expenditure data and take into account a

The Medicaid Rebate: Changes in Oncology Drug Prices After the Affordable Care Act.

Science.gov (United States)

Bonakdar Tehrani, Ali; Carroll, Norman V

2017-08-01

Prescription drug spending is a significant component of Medicaid total expenditures. The Affordable Care Act (ACA) includes a provision that increases the Medicaid rebate for both brand-name and generic drugs. This study examines the extent to which oncology drug prices changed after the increase in the Medicaid rebate in 2010. A pre-post study design was used to evaluate the correlation between the Medicaid rebate increase and oncology drug prices after 2010 using 2006-2013 State Drug Utilization Data. The results show that the average annual price of top-selling cancer drugs in 2006, adjusted for inflation and secular changes in drug prices, have increased by US$154 and US$235 for branded and competitive brand drugs, respectively, following the 2010 ACA; however, generic oncology drug prices showed no significant changes. The findings from this study indicate that oncology drug prices have increased after the 2010 ACA, and suggest that pharmaceutical companies may have increased their drug prices to offset increases in Medicaid rebates.

Students' Affordance of Teleologic Explanations and Anthropomorphic Language in Eliciting Concepts in Physics

Science.gov (United States)

Bautista, Romiro G.

2015-01-01

This study ascertains that the students' affordance of teleologic explanations and anthropomorphic language in eliciting concepts in Physics is influenced by their age and learning exposure and experience. Using Explicative-Reductive Method of Descriptive Research, this study focused on the determinants of students' affordance of…

Assessing the engineering performance of affordable net-zero energy housing

Science.gov (United States)

Wallpe, Jordan P.

The purpose of this research was to evaluate affordable technologies that are capable of providing attractive, cost-effective energy savings to the housing industry. The research did so by investigating the 2011 Solar Decathlon competition, with additional insight from the Purdue INhome. Insight from the Purdue INhome verified the importance of using a three step design process to design a net-zero energy building. In addition, energy consumption values of the INhome were used to compare and contrast different systems used in other houses. Evaluation of unbiased competition contests gave a better understanding of how a house can realistically reach net-zero. Upon comparison, off-the-shelf engineering systems such as super-efficient HVAC units, heat pump hot water heaters, and properly designed photovoltaic arrays can affordably enable a house to become net-zero. These important and applicable technologies realized from the Solar Decathlon will reduce the 22 percent of all energy consumed through the residential sector in the United States. In conclusion, affordable net-zero energy buildings can be built today with commitment from design professionals, manufacturers, and home owners.

Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer.

Science.gov (United States)

Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher

Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Radiation and chemoradiation treatment of esophagus cancer

International Nuclear Information System (INIS)

Azhigaliev, N.; Kusherbaev, S.; Abdrakhmanov, Zh.

1988-01-01

Indications and contraindications for radiation treatment of esophagus cancer are presented. The role of chemoradiation among esophagus cancer treatment methods is determined.Thechnical, dosimetric and clinical data are sequently delivered. Preparation of a patient for chemoradiation is described. Recommendations on their most efficient use are given

Fisiognomica emozionale. Affordances, estasi, atmosfere

Directory of Open Access Journals (Sweden)

Tonino Griffero

2015-06-01

Full Text Available Through an atmospherological approach, primarily inspired by the so-called Aisthetik or New Aesthetics (Gernot Böhme and the New Phenomenology (Hermann Schmitz, the paper defines the atmospheric perception as a first pathemic impression and investigates the relationship between this kind of perception and the expressive qualities of the surrounding spaces. The aim is to understand atmospheres as (amodal, transmodal, sinaesthetic affordances that permeate the lived space, namely as ‘ecological’ and affective invites or meanings which are ontologically rooted in things and quasi-things.

Closing the Communal Gap: The Importance of Communal Affordances in Science Career Motivation.

Science.gov (United States)

Brown, Elizabeth R; Thoman, Dustin B; Smith, Jessi L; Diekman, Amanda B

2015-12-01

To remain competitive in the global economy, the United States (and other countries) is trying to broaden participation in science, technology, engineering, and mathematics (STEM) by graduating an additional 1 million people in STEM fields by 2018. Although communion (working with, helping, and caring for others) is a basic human need, STEM careers are often (mis)perceived as being uncommunal. Across three naturalistic studies we found greater support for the communal affordance hypothesis, that perceiving STEM careers as affording greater communion is associated with greater STEM career interest, than two alternative hypotheses derived from goal congruity theory. Importantly, these findings held regardless of major (Study 1), college enrollment (Study 2), and gender (Studies 1-3). For undergraduate research assistants, mid-semester beliefs that STEM affords communion predicted end of the semester STEM motivation (Study 3). Our data highlight the importance of educational and workplace motivational interventions targeting communal affordances beliefs about STEM.

Novel MUC1 aptamer selectively delivers cytotoxic agent to cancer cells in vitro.

Directory of Open Access Journals (Sweden)

Yan Hu

Full Text Available Chemotherapy is a primary treatment for cancer, but its efficacy is often limited by the adverse effects of cytotoxic agents. Targeted drug delivery may reduce the non-specific toxicity of chemotherapy by selectively directing anticancer drugs to tumor cells. MUC1 protein is an attractive target for tumor-specific drug delivery owning to its overexpression in most adenocarcinomas. In this study, a novel MUC1 aptamer is exploited as the targeting ligand for carrying doxorubicin (Dox to cancer cells. We developed an 86-base DNA aptamer (MA3 that bound to a peptide epitope of MUC1 with a K(d of 38.3 nM and minimal cross reactivity to albumin. Using A549 lung cancer and MCF-7 breast cancer cells as MUC1-expressing models, MA3 was found to preferentially bind to MUC1-positive but not MUC1-negative cells. An aptamer-doxorubicin complex (Apt-Dox was formulated by intercalating doxorubicin into the DNA structure of MA3. Apt-Dox was found capable of carrying doxorubicin into MUC1-positive tumor cells, while significantly reducing the drug intake by MUC1-negative cells. Moreover, Apt-Dox retained the efficacy of doxorubicin against MUC1-positive tumor cells, but lowered the toxicity to MUC1-negative cells (P<0.01. The results suggest that the MUC1 aptamer may have potential utility as a targeting ligand for selective delivery of cytotoxic agent to MUC1-expressing tumors.

Affordable mobile robotic platforms for teaching computer science at African universities

OpenAIRE

Gyebi, Ernest; Hanheide, Marc; Cielniak, Grzegorz

2015-01-01

Educational robotics can play a key role in addressing some of the challenges faced by higher education in Africa. One of the major obstacles preventing a wider adoption of initiatives involving educational robotics in this part of the world is lack of robots that would be affordable by African institutions. In this paper, we present a survey and analysis of currently available affordable mobile robots and their suitability for teaching computer science at African universities. To this end, w...

Affordability as a discursive accomplishment in a changing National Health Service.

Science.gov (United States)

Russell, Jill; Greenhalgh, Trisha

2012-12-01

Health systems worldwide face the challenges of rationing. The English National Health Service (NHS) was founded on three core principles: universality, comprehensiveness, and free at the point of delivery. Yet patients are increasingly hearing that some treatments are unaffordable on the NHS. We considered affordability as a social accomplishment and sought to explore how those charged with allocating NHS resources achieved this in practice. We undertook a linguistic ethnography to examine the work practices of resource allocation committees in three Primary Care Trusts (PCTs) in England between 2005 and 2012, specifically deliberations over 'individual funding requests' (IFRs)--requests by patients and their doctors for the PCT to support a treatment not routinely funded. We collected and analysed a diverse dataset comprising policy documents, legal judgements, audio recordings, ethnographic field notes and emails from PCT committee meetings, interviews and a focus group with committee members. We found that the fundamental values of universality and comprehensiveness strongly influenced the culture of these NHS organisations, and that in this context, accomplishing affordability was not easy. Four discursive practices served to confer legitimacy on affordability as a guiding value of NHS health care: (1) categorising certain treatments as only eligible for NHS funding if patients could prove 'exceptional' circumstances; (2) representing resource allocation decisions as being not (primarily) about money; (3) indexical labelling of affordability as an ethical principle, and (4) recontextualising legal judgements supporting refusal of NHS treatment on affordability grounds as 'rational'. The overall effect of these discursive practices was that denying treatment to patients became reasonable and rational for an organisation even while it continued to espouse traditional NHS values. We conclude that deliberations about the funding of treatments at the margins of NHS

Paying for Cures: Perspectives on Solutions to the "Affordability Issue".

Science.gov (United States)

Schaffer, Sarah Karlsberg; Messner, Donna; Mestre-Ferrandiz, Jorge; Tambor, Ellen; Towse, Adrian

2018-03-01

Curative therapies and other medicines considered "game-changing" in terms of health gain can be accompanied by high demand and high list prices that pose budget challenges to public and private payers and health systems-the so-called affordability issue. These challenges are exacerbated when longer term effectiveness, and thus value for money, is uncertain, but they can arise even when treatments are proven to be highly cost-effective at the time of launch. This commentary reviews innovative payment solutions proposed in the literature to address the affordability issue, including the use of credit markets and of staged payments linked to patient outcomes, and draws on discussions with payers in the United States and Europe on the feasibility or desirability of operationalizing any of the alternative financing and payment strategies that appear in the literature. This included a small number of semistructured interviews. We conclude that there is a mismatch between the enthusiasm in the academic literature for developing new approaches and the scepticism of payers that they can work or are necessary. For the foreseeable future, affordability pressures will continue to be handled by aggressive price bargaining, high co-pays (in systems in which this is possible), and restricting access to subgroups of patients. Of the mechanisms we explored, outcomes-based payments were of most interest to payers, but the costs associated with operating such schemes, together with implementation challenges, did not make them an attractive option for managing affordability. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Feasibility study of a randomized controlled trial of a telephone-delivered problem-solving-occupational therapy intervention to reduce participation restrictions in rural breast cancer survivors undergoing chemotherapy.

Science.gov (United States)

Hegel, Mark T; Lyons, Kathleen D; Hull, Jay G; Kaufman, Peter; Urquhart, Laura; Li, Zhongze; Ahles, Tim A

2011-10-01

Breast cancer patients receiving adjuvant chemotherapy often experience functional effects of treatment that limit participation in life activities. The purpose of this study was to examine the feasibility of conducting a randomized controlled trial (RCT) of a novel intervention for these restrictions, determine acceptability of the intervention, and preliminarily assess its effects. A pilot RCT of a telephone-delivered Problem-solving and Occupational Therapy intervention (PST-OT) to improve participation restrictions in rural breast cancer patients undergoing chemotherapy. Thirty-one participants with Stages 1-3 breast cancer were randomized to 6 weekly sessions of PST-OT (n = 15) and usual care (n = 16). The primary study outcome was the feasibility of conducting the trial. Secondary outcomes were functional, quality of life and emotional status as assessed at baseline, 6 and 12 weeks. Of 46 patients referred 31 were enrolled (67% recruitment rate), of which 6 participants withdrew (81% retention rate). Twenty-four participants completed all study-related assessments (77%). Ninety-two percent of PST-OT participants were highly satisfied with the intervention, and 92% reported PST-OT to be helpful/very helpful for overcoming participation restrictions. Ninety-seven percent of planned PST-OT treatment sessions were completed. Completion rates for PST-OT homework tasks were high. Measures of functioning, quality of life, and emotional state favored the PST-OT condition. This pilot study suggests that an RCT of the PST-OT intervention is feasible to conduct with rural breast cancer patients undergoing adjuvant chemotherapy and that PST-OT may have positive effects on function, quality of life, and emotional state. 2010 John Wiley & Sons, Ltd.

Essential Medicines in Nigeria: Foregrounding Access to Affordable ...

African Journals Online (AJOL)

Abstract. Within every functional healthcare system, access to quality and affordable essential medicine stands out as one of the building blocks. However ... Keywords: Access to medicines, Essential medicines, Healthcare, Public health facilities, Counterfeit medicines, Traditional medicines, Health systems, Systems theory ...

New modalities in radiation therapy for treatment of cancer

International Nuclear Information System (INIS)

Kumar, Deepak

2013-01-01

Cancer is a generic term for a large group of diseases characterized by rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs. Cancer mortality is the second and most common cause of death in the USA and in most European countries. In India, it is the fourth leading disease and the major cause of death. Cancer remains one of the most dreadful disease and approximately ten million cases of cancer occur in the world every year. The course of cancer treatment depends on the type of cancer, its location, and its state of advancement. Cancer is treated with surgery, chemotherapy, radiation therapy, hormone therapy, biological therapy and targeted therapy. Radiation therapy is an important an affordable modality for cancer treatment with minimal side effects. Radiation kills cancer cells with high-energy rays targeted directly to the tumor. Radiation therapy works by damaging the DNA and preventing its replication: therefore, it preferentially kills cancer cells, which rapidly divides. Radiation therapy is used for cure, control, and palliation of cancers in more than 60% of cancer patients. The goal of radiotherapy is to treat the cancer and spare the normal tissue as much as possible. Advances have been made in radiotherapy that allow delivery of higher doses of radiation to the tumor while sparing a greater amount of surrounding tissue, thus achieving more cures and fewer acute and long-term side effects. Technological advances and research are being continued to result in improvements in the field. Several new devices and techniques are used these days in radiotherapy for accurate treatment of cancer. Teletherapy (external radiation therapy) used focused radiation beams targeting well defined tumor through extremely detailed imaging scans. Conventional external beam radiation therapy (2DXRT) is delivered via two-dimensional beams using linear accelerator machines (X

New perspectives of curcumin in cancer prevention

Science.gov (United States)

Park, Wungki; Amin, A.R.M Ruhul; Chen, Zhuo Georgia; Shin, Dong M.

2013-01-01

Numerous natural compounds have been extensively investigated for their potential for cancer prevention over decades. Curcumin, from Curcuma longa, is a highly promising natural compound that can be potentially used for chemoprevention of multiple cancers. Curcumin modulates multiple molecular pathways involved in the lengthy carcinogenesis process to exert its chemopreventive effects through several mechanisms: promoting apoptosis, inhibiting survival signals, scavenging reactive oxidative species (ROS), and reducing the inflammatory cancer microenvironment. Curcumin fulfills the characteristics for an ideal chemopreventive agent with its low toxicity, affordability, and easy accessibility. Nevertheless, the clinical application of curcumin is currently compromised by its poor bioavailability. Here we review the potential of curcumin in cancer prevention, its molecular targets, and action mechanisms. Finally, we suggest specific recommendations to improve its efficacy and bioavailability for clinical applications. PMID:23466484

How should we discuss genetic testing with women newly diagnosed with breast cancer? Design and implementation of a randomized controlled trial of two models of delivering education about treatment-focused genetic testing to younger women newly diagnosed with breast cancer

Directory of Open Access Journals (Sweden)

Watts Kaaren J

2012-07-01

Full Text Available Abstract Background Germline BRCA1 and BRCA2 mutation testing offered shortly after a breast cancer diagnosis to inform women’s treatment choices - treatment-focused genetic testing ‘TFGT’ - has entered clinical practice in specialist centers and is likely to be soon commonplace in acute breast cancer management, especially for younger women. Yet the optimal way to deliver information about TFGT to younger women newly diagnosed with breast cancer is not known, particularly for those who were not suspected of having a hereditary breast cancer syndrome prior to their cancer diagnosis. Also, little is known about the behavioral and psychosocial impact or cost effectiveness of educating patients about TFGT. This trial aims to examine the impact and efficiency of two models of educating younger women newly diagnosed with breast cancer about genetic testing in order to provide evidence for a safe and effective future clinical pathway for this service. Design/methods In this non-inferiority randomized controlled trial, 140 women newly diagnosed with breast cancer (aged less than 50 years are being recruited from nine cancer centers in Australia. Eligible women with either a significant family history of breast and/or ovarian cancer or with other high risk features suggestive of a mutation detection rate of > 10% are invited by their surgeon prior to mastectomy or radiotherapy. After completing the first questionnaire, participants are randomized to receive either: (a an educational pamphlet about genetic testing (intervention or (b a genetic counseling appointment at a family cancer center (standard care. Each participant is offered genetic testing for germline BRCA mutations. Decision-related and psychosocial outcomes are assessed over 12 months and include decisional conflict (primary outcome;uptake of bilateral mastectomy and/or risk-reducing salpingo-oophorectomy; cancer-specific- and general distress; family involvement in decision

Breast Cancer In Pregnancy: Management Approach

African Journals Online (AJOL)

reflecting the more advanced stage of the disease at diagnosis. An approach to the management of breast cancer in pregnancy is presented by a case illustration and a review of literature. KEY WORDS: Breast Cancer, ... function tests, haemogram and ultra— sound. She delivered a live female baby weighing 2.8 kilogram's ...

Global Trends in the Affordability of Sugar-Sweetened Beverages, 1990–2016

Science.gov (United States)

Blecher, Evan; Liber, Alex C.; Nguyen, Binh; Stoklosa, Michal

2017-01-01

Introduction The objective of this study was to quantify changes in the affordability of sugar-sweetened beverages, a product implicated as a contributor to rising rates of obesity worldwide, as a function of product price and personal income. Methods We used international survey data in a retrospective analysis of 40 high-income and 42 low-income and middle-income countries from 1990 to 2016. Prices of sugar-sweetened beverages were from the Economist Intelligence Unit’s World Cost of Living Survey. Income and inflation data were from the International Monetary Fund’s World Economic Outlook Database. The measure of affordability was the average annual percentage change in the relative-income price of sugar-sweetened beverages, which is the annual rate of change in the proportion of per capita gross domestic product needed to purchase 100 L of Coca-Cola in each country in each year of the study. Results In 79 of 82 countries, the proportion of income needed to purchase sugar-sweetened beverages declined on average (using annual measures) during the study period. This pattern, described as an increase in the affordability of sugar-sweetened beverages, indicated that sugar-sweetened beverages became more affordable more rapidly in low-income and middle-income countries than in high-income countries, a fact largely attributable to the higher rate of income growth in those countries than to a decline in the real price of sugar-sweetened beverages. Conclusion Without deliberate policy action to raise prices, sugar-sweetened beverages are likely to become more affordable and more widely consumed around the world. PMID:28472607

Delivering prostate cancer prevention messages to the public: how the National Cancer Institute (NCI) effectively spread the word about the Prostate Cancer Prevention Trial (PCPT) results.

Science.gov (United States)

Croker, Kara Smigel; Ryan, Anne; Morzenti, Thuy; Cave, Lynn; Maze-Gallman, Tamara; Ford, Leslie

2004-01-01

The Prostate Cancer Prevention Trial was the first clinical trial to show that a direct intervention (5 mg of finasteride daily for 7 years) could reduce a man's risk of developing prostate cancer. Initial results also suggested that men taking finasteride had an increased risk of developing what appeared to be higher-grade disease (Gleason score 7-10). The National Cancer Institute has a congressional mandate to communicate health information to the public and has established methods to reach the public directly and to reach information intermediaries in the media, professional societies, and advocacy groups. The groundbreaking yet complicated results of the Prostate Cancer Prevention Trial were widely disseminated by National Cancer Institute using the social marketing and public-relations strategies and tactics detailed here. Copyright 2004 Elsevier Inc.

Concepts in Biotechnology An Affordable Overview of Biotechnology ...

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 2; Issue 9. Concepts in Biotechnology An Affordable Overview of Biotechnology Through Self Study ... Author Affiliations. Narayan S Punekar1. Molecular Enzymology Group, Biotechnology Centre, Indian Institute of Technology, Mumbai 400 076, India.

Affordances of Instrumentation in General Chemistry Laboratories

Science.gov (United States)

Sherman, Kristin Mary Daniels

2010-01-01

The purpose of this study is to find out what students in the first chemistry course at the undergraduate level (general chemistry for science majors) know about the affordances of instrumentation used in the general chemistry laboratory and how their knowledge develops over time. Overall, students see the PASCO(TM) system as a useful and accurate…

Leveraging the Affordances of the Emerging 3d Internet for Entrepreneurial ”Next Practices”

DEFF Research Database (Denmark)

Frølunde, Lisbeth; Flåten, Bjørn-Tore

” for entrepreneurial practices? Our second research question focuses on understanding how entrepreneurs utilize their social networks. Our approach to entrepreneurship is social-- concerned with the dynamics of social interactions and networked information ecology. Methods We are currently conducting 10 case studies...... for entrepreneurship. Unfortunately, the literature offers sparse knowledge at the industry level. There is a lack of overview regarding 3D Internet entrepreneurship practices and the real challenges faced by entrepreneurs. In this study, we explore the potential as well as the hindrances to new venture creation...... related to the 3D Internet. Our theoretical basis is affordances, or the material and social properties of any technology in relation to affording actions by humans. Our first research question focuses on the perception of affordances by entrepreneurs: what does the 3D Internet offer or afford as a “space...

Proton beam therapy how protons are revolutionizing cancer treatment

CERN Document Server

Yajnik, Santosh

2013-01-01

Proton beam therapy is an emerging technology with promise of revolutionizing the treatment of cancer. While nearly half of all patients diagnosed with cancer in the US receive radiation therapy, the majority is delivered via electron accelerators, where photons are used to irradiate cancerous tissue. Because of the physical properties of photon beams, photons may deposit energy along their entire path length through the body. On the other hand, a proton beam directed at a tumor travels in a straight trajectory towards its target, gives off most of its energy at a defined depth called the Bragg peak, and then stops. While photons often deposit more energy within the healthy tissues of the body than within the cancer itself, protons can deposit most of their cancer-killing energy within the area of the tumor. As a result, in the properly selected patients, proton beam therapy has the ability to improve cure rates by increasing the dose delivered to the tumor and simultaneously reduce side-effects by decreasing...

Changing physician incentives for affordable, quality cancer care: results of an episode payment model.

Science.gov (United States)

Newcomer, Lee N; Gould, Bruce; Page, Ray D; Donelan, Sheila A; Perkins, Monica

2014-09-01

This study tested the combination of an episode payment coupled with actionable use and quality data as an incentive to improve quality and reduce costs. Medical oncologists were paid a single fee, in lieu of any drug margin, to treat their patients. Chemotherapy medications were reimbursed at the average sales price, a proxy for actual cost. Five volunteer medical groups were compared with a large national payer registry of fee-for-service patients with cancer to examine the difference in cost before and after the initiation of the payment change. Between October 2009 and December 2012, the five groups treated 810 patients with breast, colon, and lung cancer using the episode payments. The registry-predicted fee-for-service cost of the episodes cohort was $98,121,388, but the actual cost was $64,760,116. The predicted cost of chemotherapy drugs was $7,519,504, but the actual cost was $20,979,417. There was no difference between the groups on multiple quality measures. Modifying the current fee-for-service payment system for cancer therapy with feedback data and financial incentives that reward outcomes and cost efficiency resulted in a significant total cost reduction. Eliminating existing financial chemotherapy drug incentives paradoxically increased the use of chemotherapy. Copyright © 2014 by American Society of Clinical Oncology.

Getting a grip on affordances, attention and visual fields

OpenAIRE

Linden, Lotje van der; Theeuwes, Jan; Ellis, Rob

2013-01-01

van der Linden, L., Theeuwes, J., & Ellis, R. (2012). Getting a grip on affordances, attention, and visual fields. Poster presented at the 2012 William James Graduate School Symposium, Amsterdam, The Netherlands.

Tobacco affordability, sales and excise revenues in the 28 European Union countries in 2011-2014

OpenAIRE

Konstantin Krasovsky

2017-01-01

Introduction The Guidelines for the FCTC Article 6 state: When establishing their levels of taxation, Parties should make tobacco products less affordable over time in order to reduce consumption. The objective is to estimate the impact of changes in tobacco affordability on tobacco consumption and tobacco excise revenues in 2011-2014 in 28 European Union countries. Material and Methods Tobacco affordability index was calculated using the Eurostat data on harmonized consumer price i...

Web-based interventions for caregivers of cancer patients: A review of literatures

Directory of Open Access Journals (Sweden)

Winnie PY Tang

2014-06-01

Full Text Available Diagnosed with cancer is a traumatic event; it does not only affect the diagnosed patients, but also their caregivers. It brings along negative impacts on biopsychosocial health to the caregivers. Supportive interventions are essential for the caregivers to go through the cancer trajectory. In the past, interventions were being delivered in either face-to-face format or delivering written documents. Although Internet becomes a popular platform for delivering interventions given its substantial growth in usage, the effectiveness of this mode of intervention delivery is unclear. The aim of this review is to review existing literatures regarding efficacy of web-based interventions in psychological outcomes of cancer caregivers. A Literature search was performed in December 2012 from seven databases, including, Ovid MEDLINE, EMBASE, PsycINFO, CINHAL, ERIC, British Nursing Index and EBM Reviews. The following keywords were used in the search but were not limited to "paediatric", "parent", "caregiver", "cancer", "web-based", and "psycho education". Totally 4668 citations were identified, after excluding the duplicated and irrelevant citations; finally six studies were included in this review. A review of the literatures identified that the web-based interventions including either online support group only or a combination of informational website and online support group significantly improved coping skills, in a way reduced anxiety, stress, depression, burden, as well as negative mood and perceived bonding in cancer caregivers. It is concluded that a web-based format as a potential platform for delivering intervention to the caregivers of cancer patients for its unique advantage of easy accessibility, and no geographic or time barriers.

Tempting foods and the affordability axiom: Food cues change beliefs about the costs of healthy eating.

Science.gov (United States)

Hill, Sarah E; Baskett, Kaily; Bradshaw, Hannah K; Prokosch, Marjorie L; DelPriore, Danielle J; Rodeheffer, Christopher D

2016-12-01

Many consumers report that healthy eating is more expensive than unhealthy eating (the affordability axiom). We hypothesize that endorsement of this belief may be driven by the motivation to eat unhealthy foods. We tested this hypothesis in three studies. Study 1 revealed that the affordability axiom is associated with poorer eating habits and higher Body Mass Index (BMI). Study 2 found that the presence of a tasty food cue in the environment increased endorsement of affordability axiom. Study 3 found that these effects were moderated by one's food intake goals. Food cues led non-dieters to increase endorsement of the affordability axiom, but had the opposite effect among those seeking to restrict their calorie intake. The affordability axiom might persist as a means of validating unhealthy food choices. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessing Community Cancer care after insurance ExpanSionS (ACCESS study protocol

Directory of Open Access Journals (Sweden)

H. Angier

2017-09-01

Full Text Available Background: Cancer is the second most common cause of mortality in the United States. Cancer screening and prevention services have contributed to improved overall cancer survival rates in the past 40 years. Vulnerable populations (i.e., uninsured, low-income, and racial/ethnic minorities are disproportionately affected by cancer, receive significantly fewer cancer prevention services, poorer healthcare, and subsequently lower survival rates than insured, white, non-Hispanic populations. The Affordable Care Act (ACA aims to provide health insurance to all low-income citizens and legal residents, including an expansion of Medicaid eligibility for those earning ≤138% of federal poverty level. As of 2012, Medicaid was expanded in 32 states and the District of Columbia, while 18 states did not expand, creating a ‘natural experiment’ to assess the impact of Medicaid expansion on cancer prevention and care. Methods: We will use electronic health record data from up to 990 community health centers available up to 24-months before and at least one year after Medicaid expansion. Primary outcomes include health insurance and coverage status, and type of insurance. Additional outcomes include healthcare delivery, number and types of encounters, and receipt of cancer prevention and screening for all patients and preventive care and screening services for cancer survivors. Discussion: Cancer morbidity and mortality is greatly reduced through screening and prevention, but uninsured patients are much less likely than insured patients to receive these services as recommended. This natural policy experiment will provide valuable information about cancer-related healthcare services as the US tackles the distribution of healthcare resources and future health reform. Trial Registration: Clinicaltrails.gov identifier NCT02936609. Keywords: Cancer, Medicaid, Affordable Care Act, Natural experiment, Screening, Preventive services

Affordable comfort 95 - investing in our energy future

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-31

This report describes the topics from the conference on Affordable Comfort, held March 26-31, 1995. Topics are concerned with energy efficiency in homes, retrofitting, weatherization, and monitoring of appliances, heating, and air conditioning systems for performance, as well as topics on electric utilities.

Self-organization, free energy minimization, and optimal grip on a field of affordances

Directory of Open Access Journals (Sweden)

Jelle eBruineberg

2014-08-01

Full Text Available In this paper, we set out to develop a theoretical and conceptual framework for the new field of Radical Embodied Cognitive Neuroscience. This framework should be able to integrate insights from several relevant disciplines: theory on embodied cognition, ecological psychology, phenomenology, dynamical systems theory, and neurodynamics. We suggest that the main task of Radical Embodied Cognitive Neuroscience is to investigate the phenomenon of skilled intentionality from the perspective of the self-organization of the brain-body-environment system, while doing justice to the phenomenology of skilled action. In previous work, we have characterized skilled intentionality as the organism’s tendency towards an optimal grip on multiple relevant affordances simultaneously. Affordances are possibilities for action provided by the environment. In the first part of this paper, we introduce the notion of skilled intentionality and the phenomenon of responsiveness to a field of relevant affordances. Second, we use Friston’s work on neurodynamics, but embed a very minimal version of his Free Energy Principle in the ecological niche of the animal. Thus amended, this principle is helpful for understanding the embeddedness of neurodynamics within the dynamics of the brain-body-environment system. Next, we show how we can use this adjusted principle to understand the neurodynamics of selective openness to the environment: interacting action-readiness patterns at multiple timescales contribute to the organism’s selective openness to relevant affordances. In the final part of the paper, we emphasize the important role of metastable dynamics in both the brain and the brain-body-environment system for adequate affordance-responsiveness. We exemplify our integrative approach by presenting research on the impact of Deep Brain Stimulation on affordance responsiveness of OCD patients.

Maternal lung cancer and testicular cancer risk in the offspring.

Science.gov (United States)

Kaijser, Magnus; Akre, Olof; Cnattingius, Sven; Ekbom, Anders

2003-07-01

It has been hypothesized that smoking during pregnancy could increase the offspring's risk for testicular cancer. This hypothesis is indirectly supported by both ecological studies and studies of cancer aggregations within families. However, results from analytical epidemiological studies are not consistent, possibly due to methodological difficulties. To further study the association between smoking during pregnancy and testicular cancer, we did a population-based cohort study on cancer risk among offspring of women diagnosed with lung cancer. Through the use of the Swedish Cancer Register and the Swedish Second-Generation Register, we identified 8,430 women who developed lung cancer between 1958 and 1997 and delivered sons between 1941 and 1979. Cancer cases among the male offspring were then identified through the Swedish Cancer Register. Standardized incidence ratios were computed, using 95% confidence intervals. We identified 12,592 male offspring of mothers with a subsequent diagnosis of lung cancer, and there were 40 cases of testicular cancer (standardized incidence ratio, 1.90; 95% confidence interval, 1.35-2.58). The association was independent of maternal lung cancer subtype, and the risk of testicular cancer increased stepwise with decreasing time interval between birth and maternal lung cancer diagnosis. Our results support the hypothesis that exposure to cigarette smoking in utero increases the risk of testicular cancer.

Motorcycle helmets in Vietnam: ownership, quality, purchase price, and affordability.

Science.gov (United States)

Hung, Dang Viet; Stevenson, Mark R; Ivers, Rebecca Q

2008-06-01

This study investigated motorcycle helmet ownership, quality, purchase price, and affordability in Vietnam. A random sample of motorcyclists was interviewed to investigate aspects of helmet ownership, the purchase price, and affordability of a motorcycle helmet. Multivariate modeling conducted to determine factors associated with the purchase price and affordability of motorcycle helmets. Helmet quality was assessed based on current legal requirements in Vietnam. The prevalence of helmet use in Vietnam remains low (23.3%) despite a high level of helmet ownership (94%), indicating that this is an important area for public health intervention. Overall the quality of helmets appeared to be good; however, few helmets displayed legally required information. Motorcyclists with a high income purchase more helmets for their household rather than more expensive helmets. To ensure that helmets are accessible to the community, policy-makers need to consider pricing motorcycle helmets at a price indicated by the results of this study. Prior to universal motorcycle helmet legislation, the government will also need to ensure that standard helmets are available and that enforcement is at a level to ensure that motorcycle helmets are actually used.

Extending Marketplace Tax Credits Would Make Coverage More Affordable for Middle-Income Adults.

Science.gov (United States)

Liu, Jodi; Eiber, Christine

2017-07-01

ISSUE: Affordability of health coverage is a growing challenge for Americans facing rising premiums, deductibles, and copayments. The Affordable Care Act's tax credits make marketplace insurance more affordable for eligible lower-income individuals. However, individuals lose tax credits when their income exceeds 400 percent of the federal poverty level, creating a steep cliff. GOALS: To analyze the effects of extending eligibility for tax credits to individuals with incomes above 400 percent of the federal poverty level. METHODS: We used RAND's COMPARE microsimulation model to examine changes in insurance coverage and health care spending. KEY FINDINGS AND CONCLUSIONS: Extending tax-credit eligibility increases insurance enrollment by 1.2 million, at a total federal cost of $6.0 billion. Those who would benefit from the tax-credit extension are mostly middle-income adults ages 50 to 64. These new enrollees would be healthier than current enrollees their age, which would improve the risk pool and lower premiums. Eliminating the cliff at 400 percent of the federal poverty level is one policy option that may be considered to increase affordability of insurance.

Nanomedicine for prostate cancer using nanoemulsion: A review.

Science.gov (United States)

Sasikumar, Aravindsiva; Kamalasanan, Kaladhar

2017-08-28

Prostate cancer (PCa) is a worldwide issue, with burgeoning rise in prevalence, morbidity and mortality. Targeted drug delivery, a long sort solution in this regard using controlled release (CR) - nanocarriers, is still a challenge. There is an emerging criticism that, the challenges are due to less appreciation for the biological barriers and lack of corresponding newer technologies. Over the years, more understanding about the biological barriers has come with the progress in characterization techniques. Correspondingly, there is a change in opinion about approaches in clinical trial that; focus of the end point need to be shifted towards disease stabilization for these explorative technologies. Currently, there is a requirement to overcome these newly identified challenges to develop newer affordable therapeutics. The ongoing clinical protocol for therapy using CR-nanocarriers is intravenous injection followed by local targeting to cancer site. This is the most accepted protocol and new CR-nanocarriers are being developed to suit this protocol. In this review, recent progress in treatment of PCa using CR-nanocarriers is analyzed with respect to newly identified biological barriers and design challenges. Possibilities of exploring nanoemulsion (NE) platform for targeted drug delivery to PCa are examined. Repurposing of drugs and combination therapy using NE platform targeted to PCa can be explored for design and development of affordable nanomedicine. In 20yrs. from now there expected to be numerous affordable nanomedicine technologies available in market exploring these lines. Copyright © 2017 Elsevier B.V. All rights reserved.

A study of social information control affordances and gender difference in Facebook self-presentation.

Science.gov (United States)

Kuo, Feng-Yang; Tseng, Chih-Yi; Tseng, Fan-Chuan; Lin, Cathy S

2013-09-01

Affordances refer to how interface features of an IT artifact, perceived by its users in terms of their potentials for action, may predict the intensity of usage. This study investigates three social information affordances for expressive information control, privacy information control, and image information control in Facebook. The results show that the three affordances can significantly explain how Facebook's interface designs facilitate users' self-presentation activities. In addition, the findings reveal that males are more engaged in expressing information than females, while females are more involved in privacy control than males. A practical application of our study is to compare and contrast the level of affordances offered by various social network sites (SNS) like Facebook and Twitter, as well as differences in online self-presentations across cultures. Our approach can therefore be useful to investigate how SNS design features can be tailored to specific gender and culture needs.

Reliability and Maintainability Engineering - A Major Driver for Safety and Affordability

Science.gov (United States)

Safie, Fayssal M.

2011-01-01

The United States National Aeronautics and Space Administration (NASA) is in the midst of an effort to design and build a safe and affordable heavy lift vehicle to go to the moon and beyond. To achieve that, NASA is seeking more innovative and efficient approaches to reduce cost while maintaining an acceptable level of safety and mission success. One area that has the potential to contribute significantly to achieving NASA safety and affordability goals is Reliability and Maintainability (R&M) engineering. Inadequate reliability or failure of critical safety items may directly jeopardize the safety of the user(s) and result in a loss of life. Inadequate reliability of equipment may directly jeopardize mission success. Systems designed to be more reliable (fewer failures) and maintainable (fewer resources needed) can lower the total life cycle cost. The Department of Defense (DOD) and industry experience has shown that optimized and adequate levels of R&M are critical for achieving a high level of safety and mission success, and low sustainment cost. Also, lessons learned from the Space Shuttle program clearly demonstrated the importance of R&M engineering in designing and operating safe and affordable launch systems. The Challenger and Columbia accidents are examples of the severe impact of design unreliability and process induced failures on system safety and mission success. These accidents demonstrated the criticality of reliability engineering in understanding component failure mechanisms and integrated system failures across the system elements interfaces. Experience from the shuttle program also shows that insufficient Reliability, Maintainability, and Supportability (RMS) engineering analyses upfront in the design phase can significantly increase the sustainment cost and, thereby, the total life cycle cost. Emphasis on RMS during the design phase is critical for identifying the design features and characteristics needed for time efficient processing

TECHNICAL AND ECONOMIC SUBSTANTIATION OF PROJECTS OF THE AFFORDABLE HOUSING CONSTRUCTION

Directory of Open Access Journals (Sweden)

KRAVCHUNOVSKA T. S.

2015-12-01

Full Text Available Summary. Problem statement. The development of inhabitant locality of Ukraine is characterized by significant differences in levels of socio and economic development. An excessive concentration of population and industry in large cities, inefficient, slow development of most medium and small cities, towns and villages, considerable territorial disproportions of economic development of the country, considerable shortcomings in the territorial organization of society are observed. At the same time the tendency of the total area of increasing of inhabitant locality. The lands are used inefficiently. Among the most common problems of inhabitant locality is the housing problem. When making a decision on the design of affordable housing construction is one of the most important stages in the development of the technique and economic substantiation of the project is determination of the advisability and effectiveness of construction. The substantiation of advisability and effectiveness of affordable housing based on the definition of technical and economic indicators of projects, one of the most important among them is the cost, in its calculation is necessary to take into account the influence of organizational and technological factors, reflecting the features of construction in condition of compacted construction. Purpose. Development of methodical recommendations on substantiation of cost construction of affordable housing in the conditions of compacted construction. Conclusion. To provide a processing and the analysis of data is necessary development of the applied software on the basis of the developed block scheme of justification of cost construction of affordable housing.

Perceptions of risk and barriers to cervical cancer screening at Moi ...

African Journals Online (AJOL)

Background: Affordable screening cervical cancer methods using visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI) are being developed. Scaling up of screening services requires an understanding of the user perceptions about screening. Objectives: Determine the perceptions of risk and barriers to ...

Options for Affordable Fission Surface Power Systems

International Nuclear Information System (INIS)

Houts, Mike; Gaddis, Steve; Porter, Ron; Van Dyke, Melissa; Martin, Jim; Godfroy, Tom; Bragg-Sitton, Shannon; Garber, Anne; Pearson, Boise

2006-01-01

Fission surface power systems could provide abundant power anywhere on the surface of the moon or Mars. Locations could include permanently shaded regions on the moon and high latitudes on Mars. To be fully utilized, however, fission surface power systems must be safe, have adequate performance, and be affordable. This paper discusses options for the design and development of such systems. (authors)

An Investigation Into Design Criteria for Affordable Housing Supply

Directory of Open Access Journals (Sweden)

Olanrewaju Abdul Lateef

2017-01-01

Full Text Available Affordable housing provision constitutes a very large scheme in any countries due to income distribution and national development. The supply of housing depends on many activities and processes. The purpose of the houses is to meet the requirement of the householders therefore design criteria must address the users’ requirements. The establishment of the design criteria constitutes an important activity at the initial phase of the housing development. The design criteria are prepared by the design team in collaboration with many stakeholders especially the householders. Housinsg design criteria are the requirements that must be considered prior to construction of the housing. Lack of adequate information on the design criteria would lead to poor householders’ satisfactions, increase in maintenance cost, abandonments and completed but not occupy housing. In Malaysia, many of these consequences are prevalent. However, while information on the house owners’ requirements is inconclusive, this current research set out to investigate the design criteria of affordable housing. The increase in the affordable housing gap in Malaysia can be reduced if the designers have a comprehensive understanding of users’ requirements and the design criteria. Through a cross sectional survey questionnaire, comprising 25 criteria, 7 criteria were found to be extremely critical. The Kaiser-Meyer-Olkin measure of sampling adequacy indicated that the strength of the relationships among variables was strong (KMO =0.716. Bartlett’s test of sphericity, which tests the overall significance of all the correlations within the correlation matrix, was significant χ2 (325 = 1825.075, p<0.001, indicating the data were drawn from the same population and that the criteria were related.Sustainability considerations are now being considered by the providers of affordable housing. Deductively, the results lead to the conclusion that a major factor responsible for the poor

Country and regional variations in purchase prices for essential cancer medications.

Science.gov (United States)

Cuomo, Raphael E; Seidman, Robert L; Mackey, Tim K

2017-08-24

Accessibility to essential cancer medications in low- and middle-income countries is threatened by insufficient availability and affordability. The objective of this study is to characterize variation in transactional prices for essential cancer medications across geographies, medication type, and time. Drug purchase prices for 19 national and international buyers (representing 29 total countries) between 2010 and 2014 were obtained from Management Sciences for Health. Median values for drug pricing were computed, to address outliers in the data. For comparing purchase prices across geographic units, medications, and over time; Mann-Whitney U tests were used to compare two groups, Kruskal Wallis H tests were used to compare more than two groups, and linear regression was used to compare across continuous independent variables. During the five-year data period examined, the median price paid for a package of essential cancer medication was $12.63. No significant differences in prices were found based on country-level wealth, country-level disease burden, drug formulation, or year when medication was purchased. Statistical tests found significant differences in prices paid across countries, regions, individual medications, and medication categories. Specifically, countries in the Africa region appeared to pay more for a package of essential cancer medication than countries in the Latin America region, and cancer medications tended to be more expensive than anti-infective medications and cardiovascular medications. Though preliminary, our study found evidence of variation in prices paid by health systems to acquire essential cancer medications. Primarily, variations in pricing based on geographic location and cancer medication type (including when comparing to essential medicines that treat cardiovascular and infectious diseases) indicate that these factors may impact availability, affordability and access to essential cancer drugs. These factors should be taken into

24 CFR 1000.101 - What is affordable housing?

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What is affordable housing? 1000.101 Section 1000.101 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND...

75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

Science.gov (United States)

2010-06-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act Medicare...

Understanding Structures and Affordances of Extended Teams in Global Software Development

DEFF Research Database (Denmark)

Ali Babar, Muhammad; Zahedi, Mansooreh

2013-01-01

Growing popularity of Global Software Development (GSD) has resulted in an increasing number of cross-organizational teams that are formed according to Extended Team Model (ETM). There is little known about the structures (work, social, and communication) that may exist in ETM and what affordances...... in the studied team help deal with different GSD challenges, these structures appear to have certain challenges inherent in them and the affordances they provide. We make a few recommendations for improving the current structures to deal with the observed challenges. Our findings are expected to provide insights...

Can poor consumers pay for energy and water? An affordability analysis for transition countries

International Nuclear Information System (INIS)

Frankhauser, S.; Sladjana Tepic

2007-01-01

Low-income households spend a substantial share of their income on utility services such as electricity, heating and water. The difficulty of these socially vulnerable consumers to absorb further price increases is often used as an argument against tariff reform. However, detailed quantitative information on the affordability of tariff adjustments for low-income consumers is actually quite scarce. Much of the available information is based on households. This paper takes a more detailed look at the affordability of electricity, district heating and water for low-income consumers in transition countries. While the available data are incomplete, the paper finds that affordability is a problem for low-income consumers in most countries, in particular in the water sector and in the Commonwealth of Independent States (CIS). The affordability consequences of tariff reform ultimately depend on the speed of tariff adjustments relative to the growth in household income, the level of tariffs needed for cost recovery, the level of effective tariffs at the outset (tariffs adjusted for non-payment) and the demand response to the tariff increase. The paper finds that delaying tariff reform by a few years makes little difference to affordability constraints, and may therefore not be an effective way to mitigate the social impact of utility reform. (author)

Can poor consumers pay for energy and water? An affordability analysis for transition countries

International Nuclear Information System (INIS)

Fankhauser, Samuel; Tepic, Sladjana

2007-01-01

Low-income households spend a substantial share of their income on utility services such as electricity, heating and water. The difficulty of these socially vulnerable consumers to absorb further price increases is often used as an argument against tariff reform. However, detailed quantitative information on the affordability of tariff adjustments for low-income consumers is actually quite scarce. Much of the available information is based on households. This paper takes a more detailed look at the affordability of electricity, district heating and water for low-income consumers in transition countries. While the available data are incomplete, the paper finds that affordability is a problem for low-income consumers in most countries, in particular in the water sector and in the Commonwealth of Independent States (CIS). The affordability consequences of tariff reform ultimately depend on the speed of tariff adjustments relative to the growth in household income, the level of tariffs needed for cost recovery, the level of effective tariffs at the outset (tariffs adjusted for non-payment) and the demand response to the tariff increase. The paper finds that delaying tariff reform by a few years makes little difference to affordability constraints, and may therefore not be an effective way to mitigate the social impact of utility reform

Effects of the Affordable Care Act on part-time employment: Early evidence

OpenAIRE

Dillender, Marcus; Heinrich, Carolyn J.; Houseman, Susan N.

2016-01-01

The Affordable Care Act (ACA) requires employers with at least 50 full-time-equivalent employees to offer "affordable" health insurance to employees working 30 or more hours per week. If employers do not comply with the mandate, they may face substantial financial penalties. Employers can potentially circumvent the mandate by reducing weekly hours below the 30-hour threshold or by using other nonstandard employment arrangements (direct-hire temporaries, agency temporaries, small contractors, ...

The Influence of Affordable Daycare on Women's Empowerment in ...

International Development Research Centre (IDRC) Digital Library (Canada)

The Influence of Affordable Daycare on Women's Empowerment in India ... services for the poor likely contribute to gender inequality by restricting women's educational ... a state that performs poorly in terms of women's empowerment in India.

Affordances shape pass kick behavior in association football : effects of distance and social context

NARCIS (Netherlands)

Pepping, Gert-Jan; Heijmerikx, Johan; de Poel, Harjo J.

2011-01-01

A prerequisite for accurate passing in association football is that a player perceives the affordances, that is, the opportunities for action, of a given situation. The present study examined how affordances shape passing in association football by comparing the performance of pass-kicks in two task

77 FR 9882 - Arsenic Small Systems Compliance and Alternative Affordability Criteria Working Group; public...

Science.gov (United States)

2012-02-21

... affordability criteria that give extra weight to small, rural, and lower income communities. This meeting will... held via the Internet using a Webcast and teleconference. Registrants will receive an Internet access... affordability criteria that give extra weight to small, rural, and lower income communities. Based upon input...

Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis.

Science.gov (United States)

Iyengar, Swathi; Tay-Teo, Kiu; Vogler, Sabine; Beyer, Peter; Wiktor, Stefan; de Joncheere, Kees; Hill, Suzanne

2016-05-01

ledipasvir/sofosbuvir in Poland (PPP$118,754) were at least 1.09 and 1.63 times higher, respectively than in the US (PPP$64,680 and PPP$72,765). Based on PPP-adjusted TPE and without the cost of ribavirin and other treatment costs, treating the entire HCV viraemic population with these regimens at the PPP-adjusted prices with a 23% price reduction would amount to at least one-tenth of current TPE across the countries included in this study, ranging from 10.5% of TPE in the Netherlands to 190.5% of TPE in Poland. In 12 countries, the price of a course of sofosbuvir without other costs was equivalent to 1 y or more of the average annual wage of individuals, ranging from 0.21 y in Egypt to 5.28 y in Turkey. This analysis relies on the accuracy of price information and infection prevalence estimates. It does not include the costs of diagnostic testing, supplementary treatments, treatment for patients with reinfection or cirrhosis, or associated health service costs. Current prices of these medicines are variable and unaffordable globally. These prices threaten the sustainability of health systems in many countries and prevent large-scale provision of treatment. Stakeholders should implement a fairer pricing framework to deliver lower prices that take account of affordability. Without lower prices, countries are unlikely to be able to increase investment to minimise the burden of hepatitis C.

Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis.

Directory of Open Access Journals (Sweden)

Swathi Iyengar

2016-05-01

,331 and of ledipasvir/sofosbuvir in Poland (PPP$118,754 were at least 1.09 and 1.63 times higher, respectively than in the US (PPP$64,680 and PPP$72,765. Based on PPP-adjusted TPE and without the cost of ribavirin and other treatment costs, treating the entire HCV viraemic population with these regimens at the PPP-adjusted prices with a 23% price reduction would amount to at least one-tenth of current TPE across the countries included in this study, ranging from 10.5% of TPE in the Netherlands to 190.5% of TPE in Poland. In 12 countries, the price of a course of sofosbuvir without other costs was equivalent to 1 y or more of the average annual wage of individuals, ranging from 0.21 y in Egypt to 5.28 y in Turkey. This analysis relies on the accuracy of price information and infection prevalence estimates. It does not include the costs of diagnostic testing, supplementary treatments, treatment for patients with reinfection or cirrhosis, or associated health service costs.Current prices of these medicines are variable and unaffordable globally. These prices threaten the sustainability of health systems in many countries and prevent large-scale provision of treatment. Stakeholders should implement a fairer pricing framework to deliver lower prices that take account of affordability. Without lower prices, countries are unlikely to be able to increase investment to minimise the burden of hepatitis C.

Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis

Science.gov (United States)

Tay-Teo, Kiu; Vogler, Sabine; Beyer, Peter; Wiktor, Stefan; de Joncheere, Kees; Hill, Suzanne

2016-01-01

$101,063 and PPP$70,331) and of ledipasvir/sofosbuvir in Poland (PPP$118,754) were at least 1.09 and 1.63 times higher, respectively than in the US (PPP$64,680 and PPP$72,765). Based on PPP-adjusted TPE and without the cost of ribavirin and other treatment costs, treating the entire HCV viraemic population with these regimens at the PPP-adjusted prices with a 23% price reduction would amount to at least one-tenth of current TPE across the countries included in this study, ranging from 10.5% of TPE in the Netherlands to 190.5% of TPE in Poland. In 12 countries, the price of a course of sofosbuvir without other costs was equivalent to 1 y or more of the average annual wage of individuals, ranging from 0.21 y in Egypt to 5.28 y in Turkey. This analysis relies on the accuracy of price information and infection prevalence estimates. It does not include the costs of diagnostic testing, supplementary treatments, treatment for patients with reinfection or cirrhosis, or associated health service costs. Conclusions Current prices of these medicines are variable and unaffordable globally. These prices threaten the sustainability of health systems in many countries and prevent large-scale provision of treatment. Stakeholders should implement a fairer pricing framework to deliver lower prices that take account of affordability. Without lower prices, countries are unlikely to be able to increase investment to minimise the burden of hepatitis C. PMID:27243629

Are Housing Markets Decoupled? A Case Study of Residential Real Estate Affordability in Austria

Directory of Open Access Journals (Sweden)

Florian PHILIPP

2015-09-01

Full Text Available Real estate arguably forms the most important asset to most households and the basis for their wealth. Around this context a model has been set up testing the relative affordability of real estate for the median household in Austria and the consequences of lower borrowing costs between 2004 and 2013 by vintage year. In this paper the hypothesis that the significant decline in base interest rates is not sufficient to offset the relative affordability loss caused by declining net household incomes and the simultaneous increase of real estate prices. To test this hypothesis a model has been set up comparing two different Housing Affordability Indices – one including and one excluding financing effects, having been compared via a multi factor model. Based on this calculation the author finds decreased base interest rates to offset relative affordability losses by only approximately 50%, verifying the hypothesis. The paper therefore argues for a potential decoupling of the residential housing market in Austria.

Delivering Online Examinations: A Case Study

Directory of Open Access Journals (Sweden)

John MESSING

2004-07-01

Full Text Available Delivering Online Examinations: A Case Study Jason HOWARTH John MESSING Irfan ALTAS Charles Sturt University Wagga Wagga-AUSTRALIA ABSTRACT This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master’s degree at Charles Sturt University (CSU. The Industry Master’s degree is an academic program for students currently employed in the IT industry. Using Internet Based Testing (IBT, these students are examined in test centres throughout the world. This offers many benefits. For example, students have the freedom of sitting exams at any time during a designated interval. Computer-based testing also provides instructors with valuable feedback through test statistics and student comments. In this paper, we document CSU’s use of the IBT system, including how tests are built and delivered, and how both human and statistical feedback is used to evaluate and enhance the testing process.

Women’s Satisfaction with Genetic Counseling for Hereditary Breast-Ovarian Cancer: Psychological Aspects

OpenAIRE

Tercyak, Kenneth P.; DeMarco, Tiffani A.; Mars, Bryn D.; Peshkin, Beth N.

2004-01-01

Women who participate in BRCA1/2 cancer genetic counseling do so for a variety of reasons, including learning quantitative risk information about their chances of developing hereditary breast-ovarian cancer at some point during their lifetimes. For these women, obtaining pre-test and disclosure genetic counseling with a professional affords them numerous potential benefits, including adequate preparation for, and accurate interpretation of, their test results. In consequence, women commonly r...

Smart bomb for cancer

International Nuclear Information System (INIS)

Karagiannis, Tom

2006-01-01

recognise cell-surface receptors on cancer cells that are either not found on healthy cells or that are found on healthy cells but are expressed at much lower levels. The main focus of our research in the Molecular Radiation Biology Laboratory at the Peter MacCallum Cancer Centre is to develop a type of monoclonal antibody-based cancer therapy referred to as radio-immunotherapy. In its simplest form, radio-immunotherapy involves the use of a monoclonal antibody to deliver a radioactive atom specifically to cancer cells. The idea is that targeting the radiation specifically to cancer cells using a monoclonal antibody will deliver a sufficient radiation dose to kill diseased cells, while minimising the damage to healthy surrounding tissue. To date, the monoclonal antibodies ibritumomab tiuxetan (Zevalin) and tositumomab (Bexxar), which are labelled with a radioactive atom, have been approved by the US Food and Drug Administration for radio-immunotherapy of non-Hodgkin's lymphoma. Our strategy is a more complex multi-step approach. It involves targeting the radioactive atom not only to cancer cells but also to the DNA of those cells. Our smart molecular bombs that consist of three different parts. The first part is a special type of radioactive atom known as an Auger electron-emitting isotope, which is used to destroy the cancer cell. The radioactive atom is then linked to a small drug molecule that binds very tightly to DNA. This DNA-binding drug delivers the radiation in close proximity to the DNA so that the radioactive atom can kill the cancer cell by breaking the genetic material. To make our potential therapy specific for cancer cells we then chemically link the radiation-containing DNA-binding drug to an anti-cancer monoclonal antibody

The Role of Probabilistic Design Analysis Methods in Safety and Affordability

Science.gov (United States)

Safie, Fayssal M.

2016-01-01

For the last several years, NASA and its contractors have been working together to build space launch systems to commercialize space. Developing commercial affordable and safe launch systems becomes very important and requires a paradigm shift. This paradigm shift enforces the need for an integrated systems engineering environment where cost, safety, reliability, and performance need to be considered to optimize the launch system design. In such an environment, rule based and deterministic engineering design practices alone may not be sufficient to optimize margins and fault tolerance to reduce cost. As a result, introduction of Probabilistic Design Analysis (PDA) methods to support the current deterministic engineering design practices becomes a necessity to reduce cost without compromising reliability and safety. This paper discusses the importance of PDA methods in NASA's new commercial environment, their applications, and the key role they can play in designing reliable, safe, and affordable launch systems. More specifically, this paper discusses: 1) The involvement of NASA in PDA 2) Why PDA is needed 3) A PDA model structure 4) A PDA example application 5) PDA link to safety and affordability.

Comparative cost-effectiveness of fine needle aspiration biopsy versus image-guided biopsy, and open surgical biopsy in the evaluation of breast cancer in the era of Affordable Care Act: a changing landscape.

Science.gov (United States)

Masood, Shahla; Rosa, Marilin; Kraemer, Dale F; Smotherman, Carmen; Mohammadi, Amir

2015-08-01

Proven as a time challenged and cost-effective sampling procedure, the use of FNAB has still remained controversial among the scientific community. Currently, other minimally invasive sampling procedures such as ultrasound guided fine needle aspiration biopsy (US-FNAB) and image guided core needle biopsy (IG-CNB) have become the preferred sampling procedures for evaluation of breast lesions. However, changes in the medical economy and the current growing emphasis on cost containment in the era of the Affordable Care Act make it necessary to stimulate a renewed interest in the use of FNAB as the initial diagnostic sampling procedure. This study was designed to define the changing trend in the practice of tissue sampling during the last several years, and to assess the comparative effectiveness and appropriateness of the procedure of choice for breast cancer diagnosis. After Institutional Review Board (IRB) approval, the computer database of the Pathology Department, University of Florida, College of Medicine-Jacksonville at UF Health was retrospectively searched to identify all breast biopsy pathology reports issued during the period of January 2004 to December 2011. The inclusion criteria were all women that underwent any of the following biopsy types: FNAB, US-FNAB, IG-CNB, and surgical biopsy (SB). Diagnostic procedures were identified using current procedural terminology (CPT) codes recorded on claims from the UF Health Jacksonville patient accounting application files. The data obtained was used to determine which technique has the best cost-effectiveness in the diagnosis of breast cancer. The outcome variable for this project was a positive breast cancer diagnosis resulting from these methodologies. The predictor variable was the biopsy type used for sampling. The rate of cancer detection for each procedure was also determined. Among the four groups of procedures compared, the lower cost was attributed to FNAB, followed by US-FNAB, and SB. IG-CNB was the most

Learning at Work: Organisational Affordances and Individual Engagement

Science.gov (United States)

Bryson, Jane; Pajo, Karl; Ward, Robyn; Mallon, Mary

2006-01-01

Purpose: The purpose of this research is to explore the interaction between organisational affordances for the development of individuals' capability, and the engagement of workers at various levels with those opportunities. Design/methodology/approach: A case study of a large New Zealand wine company, using in-depth interviews. Interviews were…

Interventions to Promote Cancer Awareness and Early Presentation: Systematic Review

OpenAIRE

J Austoker; C Bankhead; Lindsay J. L. Forbes; L Atkins; F Martin; K Robb; J Wardle; A J. Ramirez

2009-01-01

Background: Low cancer awareness contributes to delay in presentation for cancer symptoms and may lead to delay in cancer diagnosis. The aim of this study was to review the evidence for the effectiveness of interventions to raise cancer awareness and promote early presentation in cancer to inform policy and future research. Methods: We searched bibliographic databases and reference lists for randomised controlled trials of interventions delivered to individuals, and controlled or uncontrolled...

Trend in the affordability of tobacco products in Bangladesh: findings from the ITC Bangladesh Surveys.

Science.gov (United States)

Nargis, Nigar; Stoklosa, Michal; Drope, Jeffrey; Fong, Geoffrey T; Quah, Anne C K; Driezen, Pete; Shang, Ce; Chaloupka, Frank J; Hussain, A K M Ghulam

2018-04-19

The price of tobacco products in relation to the income of tobacco users-affordability-is recognised as a key determinant of tobacco use behaviour. The effectiveness of a price increase as a deterrent to tobacco use depends on how much price increases in relation to the income of the potential users. The aim of this paper is to examine the distribution of and trends in the affordability of tobacco products in Bangladesh. Using four waves of International Tobacco Control Survey data on Bangladesh, this study measures affordability of tobacco products at the individual level as the ratio of self-reported price and self-reported income. The trends in affordability by brand categories of cigarettes and of bidi and smokeless tobacco are estimated using multivariate linear regression analysis. Despite significant increase in price, the affordability of cigarettes increased between 2009 and 2014-2015 due to income growth outpacing price increase. The increase was disproportionately larger for more expensive brands. The affordability of bidis increased over this period as well. The affordability of smokeless tobacco products remained unchanged between 2011-2012 and 2014-2015. The tax increases that were implemented during 2009-2015 were not enough to increase tobacco product prices sufficiently to outweigh the effect of income growth, and to reduce tobacco consumption. The findings from this research inform policymakers that in countries experiencing rapid economic growth, significant tax increases are needed to counteract the effect of income growth, in order for the tax increases to be effective in reducing tobacco use. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Find Cancer Early: Evaluation of a Community Education Campaign to Increase Awareness of Cancer Signs and Symptoms in People in Regional Western Australians.

Science.gov (United States)

Croager, Emma Jane; Gray, Victoria; Pratt, Iain Stephen; Slevin, Terry; Pettigrew, Simone; Holman, C D'arcy; Bulsara, Max; Emery, Jon

2018-01-01

Cancer outcomes for people living in rural and remote areas are worse than for those living in urban areas. Although access to and quality of cancer treatment are important determinants of outcomes, delayed presentation has been observed in rural patients. Formative research with people from rural Western Australia (WA) led to the Find Cancer Early campaign. Find Cancer Early was delivered in three regions of WA, with two other regions acting as controls. Staff delivered the campaign using a community engagement approach, including promotion in local media. Television communications were not used to minimize contamination in the control regions. The campaign evaluation was undertaken at 20 months via a computer-assisted telephone interview (CATI) survey comparing campaign and control regions. The primary outcome variable was knowledge of cancer signs and symptoms. Recognition and recall of Find Cancer Early and symptom knowledge were higher in the campaign regions. More than a quarter of those who were aware of the campaign reported seeing the GP as a result of their exposure. Despite limited use of mass media, Find Cancer Early successfully improved knowledge of cancer symptoms and possibly led to changes in behavior. Social marketing campaigns using community development can raise awareness and knowledge of a health issue in the absence of television advertising.

Perceiving the affordance of string tension for power strokes in badminton: expertise allows effective use of all string tensions.

Science.gov (United States)

Zhu, Qin

2013-01-01

Affordances mean opportunities for action. These affordances are important for sports performance and relevant to the abilities developed by skilled athletes. In racquet sports such as badminton, different players prefer widely different string tension because it is believed to provide opportunities for effective strokes. The current study examined whether badminton players can perceive the affordance of string tension for power strokes and whether the perception of affordance itself changed as a function of skill level. The results showed that string tension constrained the striking performance of both novice and recreational players, but not of expert players. When perceptual capability was assessed, perceptual mode did not affect perception of the optimal string tension. Skilled players successfully perceived the affordance of string tension, but only experts were concerned about saving energy. Our findings demonstrated that perception of the affordance of string tension in badminton was determined by action abilities. Furthermore, experts could adjust the action to maintain a superior level of performance based on the perception of affordance.

A feasibility study of using conventional jaws to deliver IMRT plans in the treatment of prostate cancer

International Nuclear Information System (INIS)

Kim, Yongbok; Verhey, Lynn J; Xia Ping

2007-01-01

The aim of this study is to investigate the feasibility of using conventional jaws to deliver inverse planned intensity-modulated radiotherapy (IMRT) plans for patients with prostate cancer. For ten patients, each had one three-dimensional conformal plan (3D plan) and seven inverse IMRT plans using direct aperture optimization. For IMRT plans using conventional jaws (JO plans), the number of apertures per beam angle was set from two to seven while three apertures per beam angle were set for the multi-leaf collimator (MLC) plans. To evaluate each planning method, we compared average dose volume histograms (DVH), the conformal index (COIN), total number of segments and total number of monitor units. Among the JO plans with the number of apertures per beam angle varying from two to seven, no difference was observed in the average DVHs, and the plan conformal index became saturated after four apertures per beam angle. Subsequently, JO plans with four apertures per beam angle (JO-4A) were compared with 3D and MLC plans. Based on the average DVHs, no difference was found among 3D, JO-4A and MLC plans with regard to the planning target volume and rectum, but the DVHs for the bladder and penile bulb were significantly better with inverse IMRT plans than those with 3D plans. When compared with the plan conformity, the average COIN values for 3D, JO-4A and MLC plans were 0.61 ± 0.07, 0.73 ± 0.05 and 0.83 ± 0.05, respectively. In conclusion, inverse IMRT plans using conventional jaws are clinically feasible, achieving better plan quality than 3D-CRT plans

Close interpersonal proximity modulates visuomotor processing of object affordances in shared, social space.

Science.gov (United States)

Saccone, Elizabeth J; Szpak, Ancret; Churches, Owen; Nicholls, Michael E R

2018-01-01

Research suggests that the human brain codes manipulable objects as possibilities for action, or affordances, particularly objects close to the body. Near-body space is not only a zone for body-environment interaction but also is socially relevant, as we are driven to preserve our near-body, personal space from others. The current, novel study investigated how close proximity of a stranger modulates visuomotor processing of object affordances in shared, social space. Participants performed a behavioural object recognition task both alone and with a human confederate. All object images were in participants' reachable space but appeared relatively closer to the participant or the confederate. Results revealed when participants were alone, objects in both locations produced an affordance congruency effect but when the confederate was present, only objects nearer the participant elicited the effect. Findings suggest space is divided between strangers to preserve independent near-body space boundaries, and in turn this process influences motor coding for stimuli within that social space. To demonstrate that this visuomotor modulation represents a social phenomenon, rather than a general, attentional effect, two subsequent experiments employed nonhuman joint conditions. Neither a small, Japanese, waving cat statue (Experiment 2) nor a metronome (Experiment 3) modulated the affordance effect as in Experiment 1. These findings suggest a truly social explanation of the key interaction from Experiment 1. This study represents an important step toward understanding object affordance processing in real-world, social contexts and has implications broadly across fields of social action and cognition, and body space representation.

The European Cancer Patient's Bill of Rights, update and implementation 2016

DEFF Research Database (Denmark)

Højgaard, Liselotte; Löwenberg, Bob; Selby, Peter

2016-01-01

.The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation.The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis...... of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are:Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control...... on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments.Work with other organisations to bring into being a Europe based centre that will (1) systematically...

A cross-country study of cigarette prices and affordability: evidence from the Global Adult Tobacco Survey.

Science.gov (United States)

Kostova, Deliana; Chaloupka, Frank J; Yurekli, Ayda; Ross, Hana; Cherukupalli, Rajeev; Andes, Linda; Asma, Samira

2014-01-01

To describe the characteristics of two primary determinants of cigarette consumption: cigarette affordability and the range of prices paid for cigarettes (and bidis, where applicable) in a set of 15 countries. From this cross-country comparison, identify places where opportunities may exist for reducing consumption through tax adjustments. Self-response data from 45,838 smokers from 15 countries, obtained from the Global Adult Tobacco Survey (GATS) 2008-2011. Using self-response data on individual cigarette expenditure and consumption, we construct a measure of the average cigarette price smokers pay for manufactured cigarettes (and bidis, where applicable) in 15 countries. We use these prices to evaluate cigarette affordability and the range of prices available in each country. These survey-derived measures of cigarette price and affordability are uniquely suited for cross-country comparison because they represent each country's distinctive mix of individual consumption characteristics such as brand choice, intensity of consumption, and purchasing behavior. In this sample of countries, cigarettes are most affordable in Russia, which has the most room for tobacco tax increase. Affordability is also relatively high in Brazil and China for cigarettes, and in India and Bangladesh for bidis. Although the affordability of cigarettes in India is relatively low, the range of cigarette prices paid is relatively high, providing additional evidence to support the call for simplifying the existing tax structure and reducing the width of price options. China has both high affordability and wide price ranges, suggesting multiple opportunities for reducing consumption through tax adjustments.

Lhermitte's Sign Developing after IMRT for Head and Neck Cancer

Directory of Open Access Journals (Sweden)

Dong C. Lim

2010-01-01

Full Text Available Background. Lhermitte's sign (LS is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS.

Affordance Theory and Multiple Language Learning and Teaching

Science.gov (United States)

Kordt, Birgit

2018-01-01

This article argues that the concept of affordances as put forward by James J. Gibson can make a major contribution to our understanding of multilingualism. It can throw some light on multilingualism in general as well as on specific aspects like successful and unsuccessful transfer, the challenges involved in teaching for multilingualism,…

On the relevance of Gibson's affordance concept for geographical information science (GISc).

Science.gov (United States)

Jonietz, David; Timpf, Sabine

2015-09-01

J. J. Gibson's concept of affordances has provided a theoretical basis for various studies in geographical information science (GISc). This paper sets out to explain its popularity from a GISc perspective. Based on a short review of previous work, it will be argued that its main contributions to GISc are twofold, including an action-centered view of spatial entities and the notion of agent-environment mutuality. Using the practical example of pedestrian behavior simulation, new potentials for using and extending affordances are discussed.

The Affordances Of Repackaged Popular Music From The Past

NARCIS (Netherlands)

S.M.R. Driessen (Simone)

2017-01-01

markdownabstractThis thesis explores the affordances of repackaged popular music from the past. Particularly, how they feature in audiences’ reflections on different stages and transitions in their life course. Three case studies highlight different modes of repackaging and illustrate how

The Differential Effects of Social Media Sites for Promoting Cancer Risk Reduction.

Science.gov (United States)

Lauckner, Carolyn; Whitten, Pamela

2016-09-01

Social media are potentially valuable tools for disseminating cancer education messages, but the differential effects of various sites on persuasive outcomes are unknown. In an effort to inform future health promotion, this research tested the effects of Facebook, YouTube, Twitter, and blogs for delivering a cancer risk reduction message. Using an experimental design, participants were randomly placed in several conditions that delivered the same message but with different forms of social media. Effects on comprehension and attitudes were examined, as they are important variables in the behavior change process. YouTube led to higher comprehension and stronger attitudes toward cancer risk reduction than Twitter, but there were no differences between other sites. Additionally, YouTube led to stronger attitudes toward cancer risk reduction as compared to Facebook, but not any other sites. These results demonstrate that, even if the message is kept constant, the form of social media used to deliver content can have an effect on persuasive outcomes. More research is needed to determine the mechanisms behind the differences found, however. Altogether, this line of research is valuable for any individuals seeking to use social media for health promotion purposes and could have direct implications for the development of cancer risk reduction campaigns.

Enhanced Radiosensitization Effect of Curcumin Delivered by PVP-PCL Nanoparticle in Lung Cancer

Directory of Open Access Journals (Sweden)

Cuixia Wen

2017-01-01

Full Text Available Curcumin, the principal polyphenolic curcuminoid, has been reported in numerous studies for its antitumor effect in a series of cancers. It is also reported that curcumin possesses radiosensitization effect in some cancers. However, the poor solubility and unsatisfied bioavailability of curcumin significantly undermine its potential application. Here we prepared curcumin loaded nanoparticles by employing PVP-PCL as drug carrier. Characterization studies indicated the satisfied drug loading efficiency and a sustained in vitro release pattern. Quantification uptake study showed that the uptake efficiency of Cum-NPs by lung cancer cells was time- and dose-dependent. In vitro anticancer study demonstrated the superior cytotoxic effect of Cum-NPs with stronger apoptotic induction over free Cum. Most importantly, there is almost no report on the radiosensitization effect of curcumin loaded nanoparticles. Here, Cum-NPs led to more inhibition of the colony forming ability of A549 cells as compared to the equivalent concentration of free Cum as shown in clonogenic assay. Furthermore, Cum-NPs are much more effective in enhancing the tumor growth inhibitory effect of radiation therapy in a A549 xenograft model. Therefore, results from the current study seem to be the first report on the radiosensitization effect of Cum-NPs and paved the way for a curcumin nanodrug delivery system as a potential radiation adjuvant.

THЕ ANALYSIS OF NORMATIVE AND LEGAL SUPPORT OF CONSTRUCTION OF OBJECTS OF AFFORDABLE HOUSING

Directory of Open Access Journals (Sweden)

MYKHAILOVA I. O.

2017-05-01

Full Text Available Raising of problem. The considering the acute socio-economic problem of forming an affordable housing fund, it is necessary to analyze of the methods of formation, selection and substantiation of project and organizational and technological decisions for the construction of affordable housing. Purpose of the article. The analysis of the methods of forming the choice and justification of project and organizational and technological decisions for the construction of affordable housing, taking into account scientific works, are based on the aspects of technology and the comparison of the factors of influence on the indicators of duration and cost under the conditions of working state mechanisms (programs to implement in order to overcome the problems of construction of affordable housing. Conclusion. The analysis of government mechanisms and statistics has shown that the programs are working, but unfortunately, at a rather low level of power. State mechanisms should be more appropriately implemented, funded, and effectively functioning, which is projected to reduce of the acute situation in improving of the living conditions of Ukrainian citizens who need it.

Affordable housing as a niche product: The case of the Danish “SocialHousing Plus”

DEFF Research Database (Denmark)

Jensen, Jesper Ole; Stensgaard, Anne Gro

Establishing affordable housing is a growing demand in many larger cities there is however a number of challenges related to establishing affordable housing, as well as many different approaches. This paper presents a case-study of an affordable housing concept in the Danish social housing sector......, the “SocialHousing Plus” (“AlmenBolig+”) which is based on lowering production costs as well as operation costs including residential self-management, large-scale production of pre-fab housing units, low-energy solutions and other innovative approaches. The concept was developed in 2007, and has so far...... resulted in the production of more than 1.500 dwellings. The paper will discuss the results of the concept, and the various challenges related to it. Based on the theory of Technological Transition (Geels, 2002) it will discuss the options and limitations of providing affordable housing through developing...

NAVIGATING HOUSING AFFORDABILITY BETWEEN TRANS-DISCIPLINARITY AND LIFE STYLE THEORIES THE CASE OF THE GULF STATES

Directory of Open Access Journals (Sweden)

Ashraf M. Salama

2007-07-01

on a new paradigm of research: trans-disciplinarity; a form of inquiry that crosses the boundaries of different disciplines. Brief notes to highlight affordable housing issues in the Gulf States are outlined. An argument on the impact of trans-disciplinary thinking on understanding affordable housing is developed, then is placed within the perspective of how lifestyle theories and their underlying concepts including place attachment, appropriation, visual preferences, and people satisfaction, can be integrated into a comprehensive investigatory process. In turn, a framework of inquiry is developed while reflected on affordable housing knowledge types. A translation of the framework into a survey tool is conceptualized. The tool is introduced in the form of a questionnaire to be implemented in the context of the Gulf States. The testing of the questionnaire --in the context of the city of Jeddah- - as a tool of inquiry reveals its validity, corroborates the value of integrating different knowledge types into affordable housing practices, and accentuates the value of incorporating lifestyle theories as a new form of transdisciplinary knowledge necessary for affordable housing research and practice.

Circulating miR-29a and miR-150 correlate with delivered dose during thoracic radiation therapy for non-small cell lung cancer

International Nuclear Information System (INIS)

Dinh, Tru-Khang T.; Fendler, Wojciech; Chałubińska-Fendler, Justyna; Acharya, Sanket S.; O’Leary, Colin; Deraska, Peter V.; D’Andrea, Alan D.; Chowdhury, Dipanjan; Kozono, David

2016-01-01

Risk of normal tissue toxicity limits the amount of thoracic radiation therapy (RT) that can be routinely prescribed to treat non-small cell lung cancer (NSCLC). An early biomarker of response to thoracic RT may provide a way to predict eventual toxicities—such as radiation pneumonitis—during treatment, thereby enabling dose adjustment before the symptomatic onset of late effects. MicroRNAs (miRNAs) were studied as potential serological biomarkers for thoracic RT. As a first step, we sought to identify miRNAs that correlate with delivered dose and standard dosimetric factors. We performed miRNA profiling of plasma samples obtained from five patients with Stage IIIA NSCLC at five dose-points each during radical thoracic RT. Candidate miRNAs were then assessed in samples from a separate cohort of 21 NSCLC patients receiving radical thoracic RT. To identify a cellular source of circulating miRNAs, we quantified in vitro miRNA expression intracellularly and within secreted exosomes in five NSCLC and stromal cell lines. miRNA profiling of the discovery cohort identified ten circulating miRNAs that correlated with delivered RT dose as well as other dosimetric parameters such as lung V20. In the validation cohort, miR-29a-3p and miR-150-5p were reproducibly shown to decrease with increasing radiation dose. Expression of miR-29a-3p and miR-150-5p in secreted exosomes decreased with radiation. This was concomitant with an increase in intracellular levels, suggesting that exosomal export of these miRNAs may be downregulated in both NSCLC and stromal cells in response to radiation. miR-29a-3p and miR-150-5p were identified as circulating biomarkers that correlated with delivered RT dose. miR-150 has been reported to decrease in the circulation of mammals exposed to radiation while miR-29a has been associated with fibrosis in the human heart, lungs, and kidneys. One may therefore hypothesize that outlier levels of circulating miR-29a-3p and miR-150-5p may eventually help

Drug affordability-potential tool for comparing illicit drug markets.

Science.gov (United States)

Groshkova, Teodora; Cunningham, Andrew; Royuela, Luis; Singleton, Nicola; Saggers, Tony; Sedefov, Roumen

2018-06-01

The importance of illicit drug price data and making appropriate adjustments for purity has been repeatedly highlighted for understanding illicit drug markets. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has been collecting retail price data for a number of drug types alongside drug-specific purity information for over 15 years. While these data are useful for a number of monitoring and analytical purposes, they are not without their limitations and there are circumstances where additional adjustment needs to be considered. This paper reviews some conceptual issues and measurement challenges relevant to the interpretation of price data. It also highlights the issues with between-country comparisons of drug prices and introduces the concept of affordability of drugs, going beyond purity-adjustment to account for varying national economies. Based on a 2015 European data set of price and purity data across the heroin and cocaine retail markets, the paper demonstrates a new model for drug market comparative analysis; calculation of drug affordability is achieved by applying to purity-adjusted prices 2015 Price Level Indices (PLI, Eurostat). Available data allowed retail heroin and cocaine market comparison for 27 European countries. The lowest and highest unadjusted prices per gram were observed for heroin: in Estonia, Belgium, Greece and Bulgaria (lowest) and Finland, Ireland, Sweden and Latvia (highest); for cocaine: the Netherlands, Belgium and the United Kingdom (lowest) and Turkey, Finland, Estonia and Romania (highest). The affordability per gram of heroin and cocaine when taking into account adjustment for both purity and economy demonstrates different patterns. It is argued that purity-adjusted price alone provides an incomplete comparison of retail price across countries. The proposed new method takes account of the differing economic conditions within European countries, thus providing a more sophisticated tool for cross

Determinants of patient satisfaction with cancer care delivered by the Danish healthcare system

DEFF Research Database (Denmark)

Heerdegen, Anne Christine Stender; Petersen, Gitte Stentebjerg; Jervelund, Signe Smith

2017-01-01

, comorbidity, self-reported health, and region of treatment significantly determined ratings of CDT. Patients who reported negative experiences related to waiting time, information, coordination, and continuity of care during PDC and CDT, respectively, were significantly less likely overall to rate their care......BACKGROUND: Patient-reported quality of care, which is often measured by patients' overall rating of care, is gaining more attention within the field of oncology. The aim of this study was to examine factors that determine adult cancer patients' overall rating of prediagnosis care (PDC) and care......). Multivariable logistic regression models were applied. RESULTS: Overall, 55.1% of patients reported excellent PDC and 61.9% reported excellent CDT. The odds of rating PDC and CDT as excellent differed significantly according to sex, age, and cancer diagnosis. Furthermore, the extent of supportive relatives...

Cancer surveillance using data warehousing, data mining, and decision support systems.

Science.gov (United States)

Forgionne, G A; Gangopadhyay, A; Adya, M

2000-08-01

This article discusses how data warehousing, data mining, and decision support systems can reduce the national cancer burden or the oral complications of cancer therapies, especially as related to oral and pharyngeal cancers. An information system is presented that will deliver the necessary information technology to clinical, administrative, and policy researchers and analysts in an effective and efficient manner. The system will deliver the technology and knowledge that users need to readily: (1) organize relevant claims data, (2) detect cancer patterns in general and special populations, (3) formulate models that explain the patterns, and (4) evaluate the efficacy of specified treatments and interventions with the formulations. Such a system can be developed through a proven adaptive design strategy, and the implemented system can be tested on State of Maryland Medicaid data (which includes women, minorities, and children).

Small businesses and the Affordable Care Act of 2010.

Science.gov (United States)

Collins, Sara R; Davis, Karen; Nicholson, Jennifer L; Stremikis, Kristof

2010-09-01

The Patient Protection and Affordable Care Act (ACA) includes several short- and long-term provisions designed to help small businesses pay for and maintain health insurance for their workers, and to allow workers without employer coverage to gain access to affordable, comprehensive health insurance. Provisions include a small business tax credit to offset premium costs for firms that offer coverage starting this taxable year, establishment of state-based insurance exchanges that promise to lower administrative costs and pool risk more broadly, and creation of new market rules and an essential benefit standard to protect small firms and their workers. Analysis shows that up to 16.6 million workers are in firms that would be eligible for the tax credit in 2010 to 2013. Over the next 10 years, small businesses and organizations could receive an estimated $40 billion in federal support through the premium credit program.

Role of Bhabhatron in rural cancer care

International Nuclear Information System (INIS)

Singh, Manjit

2009-01-01

Radiotherapy, using cobalt-60 is the most cost-effective and the most relevant method of cancer treatment in India. However, there is acute shortage of radiotherapy machines in the country, due the high cost of imported machines. As most of the radiotherapy machines in the country are located in urban areas, patients from rural areas have to travel a long distance and stay there to get treatment. BARC has developed Bhabhatron to meet the demand for affordable telecobalt machines. Compared to any imported unit, the indigenous machine is cheaper, superior in features and more suitable for rural use. Bhabhatrons are installed in many cancer hospitals in the country. (author)

The current status and problems confronted in delivering precision medicine in Japan and Europe.

Science.gov (United States)

Bando, Hideaki

Precision medicine has been defined as "a predictive, preventive, personalized, and participatory health care service delivery model." Today, developments in next-generation sequencing and information technology have made precision medicine possible, with massive amounts of genetic, "omics," clinical, environmental, and lifestyle data now available. Unfortunately, differences in governmental support and health care regulations have resulted in heterogeneous progress among countries. In Japan, for example, precision cancer screening and treatments are increasingly being promoted, with collaboration among research, governmental, and pharmaceutical agencies taking place in the nationwide SCRUM-Japan cancer genome screening project. The missions of SCRUM-Japan are to deliver the most appropriate therapeutic agents to the most suitable patients, and to play key roles in the development of multiplex diagnostic products and new indications for targeted therapy. Starting in February 2015 and ending in March 2017, the aim is to enroll 4750 patients with cancer (2350 patients with lung cancer and 2400 patients with gastrointestinal tract cancer). Compared with other developed countries, investments in scientific innovation for biomedical and omics research are matched or even surpassed in Europe, but regulatory differences in each countries are a major hurdle to rapid implementation. Although market approval for pharmaceuticals is centralized through the European Medicines Agency, access to health care is heterogeneously regulated at national levels, which undermines the consistency, comparability, and quality of precision medicine for cancer patients in Europe. In this review, we focus on the current progress of precision medicine in Japan and Europe, and clarify the differences in progress and the hurdles faced moving forward. Copyright © 2017 Elsevier Inc. All rights reserved.

Biosignal PI, an Affordable Open-Source ECG and Respiration Measurement System

Directory of Open Access Journals (Sweden)

Farhad Abtahi

2014-12-01

Full Text Available Bioimedical pilot projects e.g., telemedicine, homecare, animal and human trials usually involve several physiological measurements. Technical development of these projects is time consuming and in particular costly. A versatile but affordable biosignal measurement platform can help to reduce time and risk while keeping the focus on the important goal and making an efficient use of resources. In this work, an affordable and open source platform for development of physiological signals is proposed. As a first step an 8–12 leads electrocardiogram (ECG and respiration monitoring system is developed. Chips based on iCoupler technology have been used to achieve electrical isolation as required by IEC 60601 for patient safety. The result shows the potential of this platform as a base for prototyping compact, affordable, and medically safe measurement systems. Further work involves both hardware and software development to develop modules. These modules may require development of front-ends for other biosignals or just collect data wirelessly from different devices e.g., blood pressure, weight, bioimpedance spectrum, blood glucose, e.g., through Bluetooth. All design and development documents, files and source codes will be available for non-commercial use through project website, BiosignalPI.org.

flexZhouse: New business model for affordable housing in Malaysia

Directory of Open Access Journals (Sweden)

Mohd Zairul bin Mohd Noor

2017-01-01

Full Text Available Central to this PhD research was the problem of the lack of affordable housing for young starters in Malaysia. The solutions for affordable housing that are available in the market do not truly solve the problem from the customer’s point of view. Hence, it was important to analyse the contributing factors associated with the term ‘affordability’. The term touches upon interconnected elements that cover many issues ranging from demand (housing needs, demographics, household income, quality housing to supply (the authorities’ requirements, design, cost, sustainability and procurement. In this thesis, we discuss some of the problems related to the supply and demand issues and examine a possible intervention to solve the problem. This research contributed to the body of knowledge by employing a prescriptive strategy and designing an innovative flexZhouse business model (BM, and by applying an in-depth strategy that revealed why the problem exists and why there is still no appropriate solution. The result provides a description of the situation that young starters find themselves in, the reactions of the industry’s key players and the policies that hamper innovation in the housing market. Methodology We applied the model of ‘design sciences’ as described by Van Aken (2004. The strategy first helped us to understand the problem (the issues related to the term ‘affordable housing’; the next step was to prescribe solutions for the practice by formulating the draft flexZhouse business model (BM. The mission of this research was to further develop knowledge for the design and understanding the problems that is, to provide alternative solutions to the affordable housing demands in the housing industry in Malaysia. We used the term ‘design research’ from Van Aken (2004 because the ultimate objective of studies in this category is to acquire a knowledge of how to develop solutions to problems in the real world (i.e. the new business

The availability and affordability of orphan drugs for rare diseases in China.

Science.gov (United States)

Gong, Shiwei; Wang, Yingxiao; Pan, Xiaoyun; Zhang, Liang; Huang, Rui; Chen, Xin; Hu, Juanjuan; Xu, Yi; Jin, Si

2016-02-27

Orphan drugs are intended to treat, prevent or diagnose rare diseases. In recent years, China healthcare policy makers and patients have become increasingly concerned about orphan drug issues. However, very few studies have assessed the availability and affordability of orphan drugs for rare diseases in China. The aim of this study was to provide an overview of the availability and affordability of orphan drugs in China and to make suggestions to improve patient access to orphan drugs. Two components of the availability of orphan drugs were examined. Market availability was assessed by the extent to which orphan drugs were marketed in China with a comparison to orphan drugs in international markets, such as the U.S., EU and Japan. We conducted surveys and collected data from 24 tertiary public hospitals in China to measure hospital-level availability of orphan drugs. The affordability of orphan drugs was calculated using hospital dispensary prices and was expressed as days of average daily income required for the cost of a course of treatment. Affordability was also analyzed under the Chinese basic medical insurance system. Orphan drugs approved in the U.S., EU and Japan had 37.8%, 24.6% and 52.4% market availability in China, respectively. Median availability of 31 orphan drugs surveyed at the 24 tertiary public hospitals was 20.8% (very low). Within a periodic treatment course, the average treatment cost of 23 orphan drugs is approximately 4, 843. 5 USD, which equates to 505.6 days of per capita net income for an urban resident with a middle income (187.4 days for a high-income urban resident) or 1,582.8 days's income for a rural resident with a middle income (657.2 days for a high-income rural resident). Except for homoharringtonine, 22 orphan drugs for 14 rare diseases were unaffordable for the most of residents in China. With 5% out-of-pocket expenses, only three generics could be afforded by middle-income residents, whereas seven drugs for high-income urban

Gift Planning: You Can't Afford Not to

Science.gov (United States)

Morley, Richard H.; Gaudette, Mike

2009-01-01

The process of reaching out to donors and securing gifts from alumni and other community members presents its share of challenges for community colleges. But, as funding experts Richard H. Morley and Mike Gaudette of the Council for Resource Development write in "Gift Planning: You Can't Afford Not To," there exists a huge financial incentive for…

Dean C. Bennett d/b/a Affordable Tuckpointing Information Sheet

Science.gov (United States)

Dean C. Bennett d/b/a Affordable Tuckpointing (the Company) is located in Arnold, Missouri. The Complaint involves renovation activities conducted at property constructed prior to 1978, located in St. Louis, Missouri.

We all want it, but we don't know what it is: toward a standard of affordability for health insurance premiums.

Science.gov (United States)

Muennig, Peter; Sampat, Bhaven; Tilipman, Nicholas; Brown, Lawrence D; Glied, Sherry A

2011-10-01

The 2010 Patient Protection and Affordable Care Act (P.L. 111-148), or ACA, requires that U.S. citizens either purchase health insurance or pay a fine. To offset the financial burden for lower-income households, it also provides subsidies to ensure that health insurance premiums are affordable. However, relatively little work has been done on how such affordability standards should be set. The existing literature on affordability is not grounded in social norms and has methodological and theoretical flaws. To address these issues, we developed a series of hypothetical vignettes in which individual and household sociodemographic characteristics were varied. We then convened a panel of eighteen experts with extensive experience in affordability standards to evaluate the extent to which each vignette character could afford to pay for one of two health insurance plans. The panel varied with respect to political ideology and discipline. We find that there was considerable disagreement about how affordability is defined. There was also disagreement about what might be included in an affordability standard, with substantive debate surrounding whether savings, debt, education, or single parenthood is relevant. There was also substantial variation in experts' assessed affordability scores. Nevertheless, median expert affordability assessments were not far from those of ACA.

Delivering high performance BWR fuel reliably

International Nuclear Information System (INIS)

Schardt, J.F.

1998-01-01

Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

Affordability of cataract surgery using the Big Mac prices

Directory of Open Access Journals (Sweden)

Van C. Lansingh

2015-01-01

Conclusion: The price of cataract surgery does not consider the patient's capacity to pay, based on a simple tool such as the BMcI. This suggests affordability issues, particularly when patients work for minimum wages and/or do not have access to free health care.

Breast cancer: surgery at the South egypt cancer institute.

Science.gov (United States)

Salem, Ahmed A S; Salem, Mohamed Abou Elmagd; Abbass, Hamza

2010-09-30

Breast cancer is the most frequent malignant tumor in women worldwide. In Egypt, it is the most common cancer among women, representing 18.9% of total cancer cases (35.1% in women and 2.2% in men) among the Egypt National Cancer Institute's (NCI) series of 10,556 patients during the year 2001, with an age-adjusted rate of 49.6 per 100,000 people. In this study, the data of all breast cancer patients presented to the surgical department of the South Egypt cancer Institute (SECI) hospital during the period from Janurary 2001 to December 2008 were reviewed .We report the progress of the availability of breast cancer management and evaluation of the quality of care delivered to breast cancer patients. The total number of patients with a breast lump presented to the SECI during the study period was 1,463 patients (32 males and 1431 females); 616 patients from the total number were admitted at the surgical department .There was a decline in advanced cases. Since 2001, facilities for all lines of comprehensive management have been made accessible for all patients. We found that better management could lead to earlier presentation, and better overall outcome in breast cancer patients.The incidence is steadily increasing with a tendency for breast cancer to occur in younger age groups and with advanced stages.

Breast Cancer: Surgery at the South Egypt Cancer Institute

Directory of Open Access Journals (Sweden)

Ahmed A.S. Salem

2010-09-01

Full Text Available Breast cancer is the most frequent malignant tumor in women worldwide. In Egypt, it is the most common cancer among women, representing 18.9% of total cancer cases (35.1% in women and 2.2% in men among the Egypt National Cancer Institute’s (NCI series of 10,556 patients during the year 2001, with an age-adjusted rate of 49.6 per 100,000 people. In this study, the data of all breast cancer patients presented to the surgical department of the South Egypt cancer Institute (SECI hospital during the period from Janurary 2001 to December 2008 were reviewed .We report the progress of the availability of breast cancer management and evaluation of the quality of care delivered to breast cancer patients. The total number of patients with a breast lump presented to the SECI during the study period was 1,463 patients (32 males and 1431 females; 616 patients from the total number were admitted at the surgical department .There was a decline in advanced cases. Since 2001, facilities for all lines of comprehensive management have been made accessible for all patients. We found that better management could lead to earlier presentation, and better overall outcome in breast cancer patients.The incidence is steadily increasing with a tendency for breast cancer to occur in younger age groups and with advanced stages.

Cancer Nano medicine

International Nuclear Information System (INIS)

Li, H.; Pike, M.M.; Luo, X.; Liu, L.H.

2013-01-01

Bioengineered nano materials have inspired revolutionary imaging and drug delivery methods whose clinical application in cancer research has resulted in powerful medical devices for early diagnosis, treatment, and prevention of cancer. Recent advances in super imaging agents have resulted in improved resolution and sensitivity. For instance, fluorescent quantum dots with wavelength-tunable emissions, plasmon-resonant gold nano structures with shape-controlled near-infrared absorptions, and MRI-active iron oxide nanoparticles are well-established molecular imaging probes for noninvasive cancer imaging. Nano materials are also considered to be the most effective vectors that can break through transport bio barriers and deliver a constant dose of multiple therapeutic agents to tumors and intracellular endocytic compartments for cancer gene therapy, immunotherapy, or chemotherapy. Furthermore, nano wire- or nano tube-based electronic devices demonstrate extraordinary sensitivity capable of detection at the single molecule or protein level. It is anticipated that developing nano technology-driven imaging, sensing, and therapeutic systems will dramatically advance cancer research and clinical treatments.

Polymeric nanoparticles for the intracellular delivery of paclitaxel in lung and breast cancer

Science.gov (United States)

Zubris, Kimberly Ann Veronica

Nanoparticles are useful for addressing many of the difficulties encountered when administering therapeutic compounds. Nanoparticles are able to increase the solubility of hydrophobic drugs, improve pharmacokinetics through sustained release, alter biodistribution, protect sensitive drugs from low pH environments or enzymatic alteration, and, in some cases, provide targeting of the drug to the desired tissues. The use of functional nanocarriers can also provide controlled intracellular delivery of a drug. To this end, we have developed functional pH-responsive expansile nanoparticles for the intracellular delivery of paclitaxel. The pH-responsiveness of these nanoparticles occurs due to a hydrophobic to hydrophilic transition of the polymer occurring under mildly acidic conditions. These polymeric nanoparticles were systematically evaluated for the delivery of paclitaxel in vitro and in vivo to improve local therapy for lung and breast cancers. Nanoparticles were synthesized using a miniemulsion polymerization process and were subsequently characterized and found to swell when exposed to acidic environments. Paclitaxel was successfully encapsulated within the nanoparticles, and the particles exhibited drug release at pH 5 but not at pH 7.4. In addition, the uptake of nanoparticles was observed using flow cytometry, and the anticancer efficacy of the paclitaxel-loaded nanoparticles was measured using cancer cell lines in vitro. The potency of the paclitaxel-loaded nanoparticles was close to that of free drug, demonstrating that the drug was effectively delivered by the particles and that the particles could act as an intracellular drug depot. Following in vitro characterization, murine in vivo studies demonstrated the ability of the paclitaxel-loaded responsive nanoparticles to delay recurrence of lung cancer and to prevent establishment of breast cancer in the mammary fat pads with higher efficacy than paclitaxel alone. In addition, the ability of nanoparticles to

An affordable and easy-to-use diagnostic method for keratoconus detection using a smartphone

Science.gov (United States)

Askarian, Behnam; Tabei, Fatemehsadat; Askarian, Amin; Chong, Jo Woon

2018-02-01

Recently, smartphones are used for disease diagnosis and healthcare. In this paper, we propose a novel affordable diagnostic method of detecting keratoconus using a smartphone. Keratoconus is usually detected in clinics with ophthalmic devices, which are large, expensive and not portable, and need to be operated by trained technicians. However, our proposed smartphone-based eye disease detection method is small, affordable, portable, and it can be operated by patients in a convenient way. The results show that the proposed keratoconus detection method detects severe, advanced, and moderate keratoconus with accuracies of 93%, 86%, 67%, respectively. Due to its convenience with these accuracies, the proposed keratoconus detection method is expected to be applied in detecting keratoconus at an earlier stage in an affordable way.

78 FR 73204 - Announcement of Requirements and Registration for “Innovation in Affordable Housing Student...

Science.gov (United States)

2013-12-05

... response to a real life affordable housing design issue. The goals of this new competition are: To... competition will officially open on January 6, 2014, when the real life affordable housing design issue is... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [FR-5745-N-01] Announcement of Requirements and...

Knowledge and Preferences of Primary Care Providers in Delivering Head and Neck Cancer Survivorship Care.

Science.gov (United States)

Berkowitz, Callie; Allen, Deborah H; Tenhover, Jennifer; Zullig, Leah L; Ragsdale, John; Fischer, Jonathan E; Pollak, Kathryn I; Koontz, Bridget F

2017-07-14

Long-term care for head and neck cancer (HNC) survivors is complex and requires coordination among multiple providers. Clinical practice guidelines highlight the role of primary care providers (PCPs) in screening for secondary cancer/recurrence, assessment of late/long-term side effects, and referrals for appropriate specialty management of toxicity. However, these responsibilities may be difficult to meet within the scope of primary care practice. We conducted this study to explore preferences, comfort, and knowledge of PCPs in the care of HNC survivors. We piloted a 40-item web-based survey developed with oncologist and PCP input targeted for family medicine and internal medicine providers. Responses were collected within a single university health system over 2 months. PCPs (n = 28; RR = 11.3%) were interested in learning about health promotion after cancer treatment (89%) and generally agree that their current practice patterns address healthy lifestyle behaviors (82%). However, only 32% of PCPs felt confident they could manage late/long-term side effects of chemotherapy, radiation, or surgery. Only 29% felt confident they could provide appropriate cancer screening. Looking at shared care responsibilities with oncology providers, PCPs perceived being responsible for 30% of care in the first year after treatment and 81% of care after 5 years. Seventy-one percent of PCPs agreed that oncologists provided them necessary information, yet 32% of PCPs found it difficult to coordinate with cancer providers. While these PCPs perceive increased care responsibility for long-term survivors, most are uncomfortable screening for recurrence and managing late/long-term side effects. Education and mutual coordination between PCPs and oncology providers may improve survivor care.

Affordability of alcohol as a key driver of alcohol demand in New Zealand: a co-integration analysis.

Science.gov (United States)

Wall, Martin; Casswell, Sally

2013-01-01

To investigate whether affordability of alcohol is an important determinant of alcohol consumption along with price. This will inform effective tax policy to influence consumption. Co-integration analysis was used to analyse relationship between real price, affordability and consumption. Changes in retail availability of wine in 1990 and beer in 1999 were also included in the models. The econometric approach taken allows identification of short- and long-term responses. Separate analyses were performed for wine, beer, spirits and ready-to-drinks (spirits based pre-mixed drinks). New Zealand 1988-2011. Quarterly data on price and alcohol available for consumption for wine, beer, spirits and ready-to-drinks. Price data were analysed as: real price (own price of alcohol relative to the price of other goods) and affordability (average earnings relative to own price). There was strong evidence for co-integration between wine and beer consumption and affordability. There was weaker evidence for co-integration between consumption and real price. The affordability of alcohol is more important than real price in determining consumption of alcohol. This suggests that affordability needs to be considered by policy makers when determining tax and pricing policies to reduce alcohol-related harm. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Proposed regulations could limit access to affordable health coverage for workers' children and family members.

Science.gov (United States)

Jacobs, Ken; Graham-Squire, Dave; Roby, Dylan H; Kominski, Gerald F; Kinane, Christina M; Needleman, Jack; Watson, Greg; Gans, Daphna

2011-12-01

Key Findings. The Patient Protection and Affordable Care Act (ACA) is designed to offer premium subsidies to help eligible individuals and their families purchase insurance coverage when affordable job-based coverage is not available. However, the law is unclear on how this affordability protection is applied in those instances where self-only coverage offered by an employer is affordable but family coverage is not. Regulations recently proposed by the Department of the Treasury would make family members ineligible for subsidized coverage in the exchange if an employee is offered affordable self-only coverage by an employer, even if family coverage is unaffordable. This could have significant financial consequences for low- and moderate-income families that fall in this gap. Using an alternative interpretation of the law could allow the entire family to enter the exchange when family coverage is unaffordable, which would broaden access to coverage. However, this option has been cited as cost prohibitive. In this brief we consider a middle ground alternative that would base eligibility for the individual worker on the cost of self-only coverage, but would use the additional cost to the employee for family coverage as the basis for determining affordability and eligibility for subsidies for the remaining family members. We find that: Under the middle ground alternative scenario an additional 144,000 Californians would qualify for and use premium subsidies in the California Health Benefit Exchange, half of whom are children. Less than 1 percent of those with employer-based coverage would move to subsidized coverage in the California Health Benefit Exchange as a result of having unaffordable coverage on the job.

Find Cancer Early: Evaluation of a Community Education Campaign to Increase Awareness of Cancer Signs and Symptoms in People in Regional Western Australians

Directory of Open Access Journals (Sweden)

Emma Jane Croager

2018-02-01

Full Text Available IntroductionCancer outcomes for people living in rural and remote areas are worse than for those living in urban areas. Although access to and quality of cancer treatment are important determinants of outcomes, delayed presentation has been observed in rural patients.MethodsFormative research with people from rural Western Australia (WA led to the Find Cancer Early campaign. Find Cancer Early was delivered in three regions of WA, with two other regions acting as controls. Staff delivered the campaign using a community engagement approach, including promotion in local media. Television communications were not used to minimize contamination in the control regions. The campaign evaluation was undertaken at 20 months via a computer-assisted telephone interview (CATI survey comparing campaign and control regions. The primary outcome variable was knowledge of cancer signs and symptoms.ResultsRecognition and recall of Find Cancer Early and symptom knowledge were higher in the campaign regions. More than a quarter of those who were aware of the campaign reported seeing the GP as a result of their exposure.ConclusionDespite limited use of mass media, Find Cancer Early successfully improved knowledge of cancer symptoms and possibly led to changes in behavior. Social marketing campaigns using community development can raise awareness and knowledge of a health issue in the absence of television advertising.

Perception of Affordances and Experience of Presence in Virtual Reality

Directory of Open Access Journals (Sweden)

Paweł Grabarczyk

2016-11-01

Full Text Available Recent developments in virtual reality technology raise a question about the experience of presence and immersion in virtual environments. What is immersion and what are the conditions for inducing the experience of virtual presence? In this paper, we argue that crucial determinants of presence are perception of affordances and sense of embodiment. In the first section of this paper, we define key concepts and introduce important distinctions such as immersion and presence. In the second and third sections, we respectively discuss presence, immersion and their determinants in detail. In the fourth and fifth sections, we argue for the importance of perception of affordances and sense of embodiment in increasing the degree of presence. Finally, we show the consequences of our view and discuss possible future implications.

Technical Evaluation of Radiation Dose Delivered in Prostate Cancer Patients as Measured by an Implantable MOSFET Dosimeter

International Nuclear Information System (INIS)

Beyer, Gloria P.; Scarantino, Charles W.; Prestidge, Bradley R.; Sadeghi, Amir G.; Anscher, Mitchell S.; Miften, Moyed; Carrea, Tammy B.; Sims, Marianne C.; Black, Robert D.

2007-01-01

Purpose: To perform a comparison of the daily measured dose at depth in tissue with the predicted dose values from treatment plans for 29 prostate cancer patients involved in a clinical trial. Methods and Materials: Patients from three clinical sites were implanted with one or two dosimeters in or near the prostatic capsule. The implantable device, known as the DVS, is based on a metal-oxide-semiconductor field effect transistor (MOSFET) detector. A portable telemetric readout system couples to the dosimeter antenna (visible on kilovoltage, computed tomography, and ultrasonography) for data transfer. The predicted dose values were determined by the location of the MOSFET on the treatment planning computed tomography scan. Serial computed tomography images were taken every 2 weeks to evaluate any migration of the device. The clinical protocol did not permit alteration of the treatment parameters using the dosimeter readings. For some patients, one of several image-guided radiotherapy (RT) modalities was used for target localization. Results: The evaluation of dose discrepancy showed that in many patients the standard deviation exceeded the previous values obtained for the dosimeter in a phantom. In some patients, the cumulative dose disagreed with the planned dose by ≥5%. The data presented suggest that an implantable dosimeter can help identify dose discrepancies (random or systematic) for patients treated with external beam RT and could be used as a daily treatment verification tool for image-guided RT and adaptive RT. Conclusion: The results of our study have shown that knowledge of the dose delivered per fraction can potentially prevent over- or under-dosage to the treatment area and increase the accuracy of RT. The implantable dosimeter could also be used as a localizer for image-guided RT

Targeted, On-Demand Charge Conversional Nanotherapeutics for Advanced Prostate Cancer

Science.gov (United States)

2016-09-01

nanotherapeutics possess favorable pharmacological features to improve bioavailability. Additionally, such a therapeutic strategy to deliver therapeutic agents...High-Grade Prostate Cancer Characterization Using Fractional Order Calculus Diffusion Weighted MRI ... Pharmacological Blockade of Apurinic/Apyrimidinic Endonuclease 1 Redox Activity Downregulates Survivin Expression and Arrests Prostate Cancer Cell

Delivering high performance BWR fuel reliably

Energy Technology Data Exchange (ETDEWEB)

Schardt, J.F. [GE Nuclear Energy, Wilmington, NC (United States)

1998-07-01

Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

Situational Affordance - Appreciating human Interpretations in New Product Development

DEFF Research Database (Denmark)

Mathiasen, John Bang; Koch, Christian

2009-01-01

New Product Development (NPD) takes place within a web of connected actors who do not master fully the objects of the process, but rather they interpret the affordance - the enabling and constraining framing by objects such as sketches, drawings, specifications, mock-ups and prototypes. The artic...

The ICCE Framework: Framing Learning Experiences Afforded by Games

Science.gov (United States)

Foster, Aroutis; Shah, Mamta

2015-01-01

There is a need for game-based learning frameworks that provide a lens for understanding learning experiences afforded in digital games. These frameworks should aim to facilitate game analyses, identification of learning opportunities, and support for learner experiences. This article uses the inquiry, communication, construction, and expression…

the role of financial institutions towards affordable housing to urban

African Journals Online (AJOL)

Mugumbate

weak positive effect (=.345) of housing finance on affordable housing and contributed to ..... Officers and 81 selected beneficiaries (middle income earners) of the several ..... transaction has to be independently valued by the Chief. Government ...

The role of affordances in children's learning performance and efficiency when using virtual manipulative mathematics touch-screen apps

Science.gov (United States)

Moyer-Packenham, Patricia S.; Bullock, Emma K.; Shumway, Jessica F.; Tucker, Stephen I.; Watts, Christina M.; Westenskow, Arla; Anderson-Pence, Katie L.; Maahs-Fladung, Cathy; Boyer-Thurgood, Jennifer; Gulkilik, Hilal; Jordan, Kerry

2016-03-01

This paper focuses on understanding the role that affordances played in children's learning performance and efficiency during clinical interviews of their interactions with mathematics apps on touch-screen devices. One hundred children, ages 3 to 8, each used six different virtual manipulative mathematics apps during 30-40-min interviews. The study used a convergent mixed methods design, in which quantitative and qualitative data were collected concurrently to answer the research questions (Creswell and Plano Clark 2011). Videos were used to capture each child's interactions with the virtual manipulative mathematics apps, document learning performance and efficiency, and record children's interactions with the affordances within the apps. Quantitized video data answered the research question on differences in children's learning performance and efficiency between pre- and post-assessments. A Wilcoxon matched pairs signed-rank test was used to explore these data. Qualitative video data was used to identify affordance access by children when using each app, identifying 95 potential helping and hindering affordances among the 18 apps. The results showed that there were changes in children's learning performance and efficiency when children accessed a helping or a hindering affordance. Helping affordances were more likely to be accessed by children who progressed between the pre- and post-assessments, and the same affordances had helping and hindering effects for different children. These results have important implications for the design of virtual manipulative mathematics learning apps.

Cultural affordances: Scaffolding local worlds through shared intentionality and regimes of attention

Directory of Open Access Journals (Sweden)

Maxwell James D. Ramstead

2016-07-01

Full Text Available In this paper we outline a framework for the study of the mechanisms involved in the engagement of human agents with cultural affordances. Our aim is to better understand how culture and context interact with human biology to shape human behavior, cognition, and experience. We attempt to integrate several related approaches in the study of the embodied, cognitive, and affective substrates of sociality and culture and the sociocultural scaffolding of experience. The integrative framework we propose bridges cognitive and social sciences to provide (i an expanded concept of ‘affordance’ that extends to sociocultural forms of life, and (ii a multilevel account of the socioculturally scaffolded forms of affordance learning and the transmission of affordances in patterned sociocultural practices and regimes of shared attention. This framework provides an account of how cultural content and normative practices are built on a foundation of contentless basic mental processes that acquire content through immersive participation of the agent in social practices that regulate joint attention and shared intentionality.

Affordable Remote Health Monitoring System for the Elderly Using Smart Mobile Device

Directory of Open Access Journals (Sweden)

Matthew CLARK

2015-01-01

Full Text Available Aging population has been growing as life expectancy increases. In the years to come a much larger percentage of the population will be dependent on others for their daily care. According to a recent report more than 11 million seniors live alone in the USA. These seniors may face serious consequences when they have an emergency situation. However health-monitoring systems are often not affordable for many seniors. The remote health monitoring system presented in this paper addresses the challenge to provide caregivers an emergency alert system for the elderly based on monitoring of their heart rates, breathing activities, and room temperature measurements. The device also allows the dependents to make on demand request for assistance. The remote communication is enabled through the cellular telephone services; so there is no special or additional subscription services needed. This is essential to make the device more affordable for the elderly. We expect that this affordable remote health-monitoring system can be used to help seniors who live alone be safer and healthier.

Accessibility, affordability and use of health services in an urban area in South Africa.

Science.gov (United States)

Stellenberg, Ethelwynn L

2015-03-10

Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa. A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (χ²) test. The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.

Housing Affordability in Ghana: A focus on Kumasi and Tamale ...

African Journals Online (AJOL)

`123456789jkl''''#

Department of Real ... affordable housing delivery system in Ghana. It found that ... markets; and hence has a significant impact on .... housing projects during this era were the ...... Table 4: Construction Materials in Kumasi and Tamale, 2010.

Tools to identify the men with prostate cancer most appropriate for active surveillance?

Directory of Open Access Journals (Sweden)

Robert H Getzenberg

2014-02-01

Full Text Available A great deal of effort is underway in order to identify those men with prostate cancer felicitous for active surveillance with greater precision than that afforded to us today. In the manuscript by Irshad et al. the authors evaluate a novel set of genes associated with senescence and aging as tools that can provide guidance regarding the indolent nature of an individual's prostate cancer with validation using both mRNA and protein analyses. While additional studies are required to understand the full impact of these findings, the innovative approach taken enhances our understanding of distinct phenotypes of prostate cancer.

Materials Delivered by Member States

International Nuclear Information System (INIS)

1966-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1965 in compliance with requests the Agency had made under Article IX. D. Part III contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

Materials Delivered by Member States

International Nuclear Information System (INIS)

1965-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1964 in compliance with requests the Agency had made under Article IX. D. Part II contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

Materials Delivered by Member States

International Nuclear Information System (INIS)

1968-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1968 in compliance with requests the Agency had made under Article IX,D. Part II contains information about materials which had not been delivered by 30 June 1968 but which had been allocated, in accordance with Article XI.F.I of the Statute, to approved Agency projects for which project arrangements were in force on that date

Exosomes in diagnosis and therapy of prostate cancer

OpenAIRE

Pan, Jun; Ding, Meng; Xu, Kai; Yang, Chunhua; Mao, Li-Jun

2017-01-01

Exosomes are small vesicular bodies released by a variety of cells. Exosomes contain miRNAs, mRNAs and proteins with the potential to regulate signaling pathways in recipient cells. Exosomes deliver nucleic acids and proteins to mediate the communication between cancer cells and stroma cells. In this review, we summarize recent progress in our understanding of the role of exosomes in prostate cancer. The tumorigenesis, metastasis and drug resistance of prostate cancer are associated with the ...

Affordances for Second Language Learning in "World of Warcraft"

Science.gov (United States)

Rama, Paul S.; Black, Rebecca W.; van Es, Elizabeth; Warschauer, Mark

2012-01-01

What are the affordances of online gaming environments for second language learning and socialization? To answer this question, this qualitative study examines two college-age Spanish learners' experiences participating in the Spanish language version of the massively multi-player online game "World of Warcraft." Using data culled from participant…

Educational Affordances and Learning Design in Music Software Development

Science.gov (United States)

Cheng, Lee; Leong, Samuel

2017-01-01

Although music software has become increasingly affordable and widely adopted in today's classrooms, concerns have been raised about a lack of consideration for users' needs during the software development process. This paper examines intra- and inter-sectoral communication pertaining to software development and music education to shed light on…

Exploring the Multi-Layered Affordances of Composing and Performing Interactive Music with Responsive Technologies.

Science.gov (United States)

Einarsson, Anna; Ziemke, Tom

2017-01-01

The question motivating the work presented here, starting from a view of music as embodied and situated activity, is how can we account for the complexity of interactive music performance situations. These are situations in which human performers interact with responsive technologies, such as sensor-driven technology or sound synthesis affected by analysis of the performed sound signal. This requires investigating in detail the underlying mechanisms, but also providing a more holistic approach that does not lose track of the complex whole constituted by the interactions and relationships of composers, performers, audience, technologies, etc. The concept of affordances has frequently been invoked in musical research, which has seen a " bodily turn " in recent years, similar to the development of the embodied cognition approach in the cognitive sciences. We therefore begin by broadly delineating its usage in the cognitive sciences in general, and in music research in particular. We argue that what is still missing in the discourse on musical affordances is an encompassing theoretical framework incorporating the sociocultural dimensions that are fundamental to the situatedness and embodiment of interactive music performance and composition. We further argue that the cultural affordances framework, proposed by Rietveld and Kiverstein (2014) and recently articulated further by Ramstead et al. (2016) in this journal, although not previously applied to music, constitutes a promising starting point. It captures and elucidates this complex web of relationships in terms of shared landscapes and individual fields of affordances. We illustrate this with examples foremost from the first author's artistic work as composer and performer of interactive music. This sheds new light on musical composition as a process of construction-and embodied mental simulation-of situations, guiding the performers' and audience's attention in shifting fields of affordances. More generally, we

Family socioeconomic status and the provision of motor affordances in the home

Directory of Open Access Journals (Sweden)

Teresa C. B. Freitas

2013-08-01

Full Text Available BACKGROUND: Socioeconomic status (SES and stimulation provided in the home environment are influential factors in aspects of child well-being including motor development. Little is known regarding the influence of SES on specific aspects of the home environment. OBJECTIVE: To evaluate the availability of affordances in the home to promote infant motor development and family SES. METHOD : The sample consisted of 300 families with infants aged 3 to 18 months. SES was assessed according to family socioeconomic class, income and parental level of education. To evaluate motor affordances found at home, the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS was used. The AHEMD-IS was designed to assess dimensions of the home environment including Physical Space (outside and inside space, Daily Activities and Play Materials (fine-motor and gross-motor toys. RESULTS: SES indicators significantly influenced the availability of Physical Space and Play Materials. The Physical Space dimension was influenced by family economic class and income. The Play Materials dimension was influenced by all SES indicators. Daily Activities were not influenced by any of the SES indicators. Daily activities and play material were influenced by the infant's age. CONCLUSIONS: This study suggests that SES indicators are influential with regard to the provision of motor affordances in the home environment for infants. However, daily activities, which represent an aspect of the environment that is highly dependent on parental generation of situations that are conducive to motor skill development, are independent of family SES.

A Prototype using Territories and an Affordance Tree for Social Simulation Gameplay

DEFF Research Database (Denmark)

Geishauser, Tilman; Cheong, Yun-Gyung; Nelson, Mark

2014-01-01

Smart objects are a representation strategy for games and virtual worlds, in which information about object interac- tions is distributed into the ob jects themselves: an ob ject knows how it can be used, what kinds of effects it has, etc. In this work, we describe a prototype that aims to explore...... so- cial simulation using smart objects. We extend the concept of smart objects to include a model of human behavior with regard to territoriality. To manage complexity in worlds with many such objects we employ a tree structure, which we call an Affordance Tree. The Affordance Tree allows...

MR-only Radiotherapy of prostate cancer

OpenAIRE

Maspero, Matteo

2018-01-01

Radiotherapy is a local approach that involves the use of ionising radiation by exploiting its cell-killing effect to cure cancer. This effect, however, is not specific to damage only cancerous cells and spare healthy cells. Therefore, developments in radiotherapy aimed at reducing treatment uncertainties such that therapeutic radiation dose may be delivered to a malignant tumour while decreasing the dose received by healthy tissues. The recent advances in imaging techniques impacted and radi...

Cost and affordability of healthy food in rural South Australia.

Science.gov (United States)

Ward, P R; Coveney, J; Verity, F; Carter, P; Schilling, M

2012-01-01

As in many other countries, Australian consumers have recently had to accommodate increases in costs of basic food, and during the financial year 2007-2008 overall food prices rose by nearly 4%. Food costs are mediating factors in food choice, especially for low-income groups, where food security is often tenuous. There are reports that rural populations may have higher levels of food insecurity, although the evidence is often contradictory. To assess cost and affordability of food in rural areas this study used the Healthy Food Basket (HFB) methodology, which has been applied in a number of settings. The HFBs were costed at supermarkets and stores in different locations with different degrees of rurality. Compared with metropolitan areas, healthy food is more expensive in rural areas; costs are even higher in more remote areas. The overall affordability of HFB in rural areas was not significantly different from metro areas. The main difference concerned low socio-economic status (SES) groups, where the proportion of household income spent on the HFB was three times that of higher SES groups. The unaffordability of healthy food, or 'food stress' in low SES groups is a concern, especially when this group carries the greatest burden of diet-related disease. Findings suggest that there is a need to consider both rurality and SES when developing policy responses to decrease the cost and increase the affordability of healthy foods in rural and remote areas.

Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel

Science.gov (United States)

Trucks Seattle Bakery Delivers With Biodiesel Trucks to someone by E-mail Share Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Facebook Tweet about Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Twitter Bookmark Alternative Fuels

Overcoming Multidrug Resistance in Cancer Stem Cells

Directory of Open Access Journals (Sweden)

Karobi Moitra

2015-01-01

Full Text Available The principle mechanism of protection of stem cells is through the expression of ATP-binding cassette (ABC transporters. These transporters serve as the guardians of the stem cell population in the body. Unfortunately these very same ABC efflux pumps afford protection to cancer stem cells in tumors, shielding them from the adverse effects of chemotherapy. A number of strategies to circumvent the function of these transporters in cancer stem cells are currently under investigation. These strategies include the development of competitive and allosteric modulators, nanoparticle mediated delivery of inhibitors, targeted transcriptional regulation of ABC transporters, miRNA mediated inhibition, and targeting of signaling pathways that modulate ABC transporters. The role of ABC transporters in cancer stem cells will be explored in this paper and strategies aimed at overcoming drug resistance caused by these particular transporters will also be discussed.

Affordances of Learning Technologies in Higher Education Multicultural Environments

Science.gov (United States)

Arenas, Edilson

2015-01-01

A cluster of research has been conducted in higher education to investigate the affordances (action possibilities) and the influence information and communication technologies (ICT) may have on students' learning experiences and outcomes. Such studies have given rise to the implementation of a wide range of educational frameworks with a great deal…

78 FR 41074 - 60-Day Notice of Proposed Information Collection: Innovation in Affordable Housing Design Student...

Science.gov (United States)

2013-07-09

... real life problem faced by public housing authorities using innovations in affordable housing design... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5689-N-05] 60-Day Notice of Proposed Information Collection: Innovation in Affordable Housing Design Student Competition AGENCY: Office of Policy...

Incentivising flood risk adaptation through risk based insurance premiums : Trade-offs between affordability and risk reduction

NARCIS (Netherlands)

Hudson, Paul F.; Botzen, W.J.W.; Feyen, L.; Aerts, Jeroen C.J.H.

2016-01-01

The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

Incentivising flood risk adaptation through ris based insurance premiums: trade-offs between affordability and risk reduction

NARCIS (Netherlands)

Hudson, P.G.M.B.; Botzen, W.J.W.; Feyen, L.; Aerts, J.C.J.H.

2016-01-01

The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

A comparison of robotic arm versus gantry linear accelerator stereotactic body radiation therapy for prostate cancer.

Science.gov (United States)

Avkshtol, Vladimir; Dong, Yanqun; Hayes, Shelly B; Hallman, Mark A; Price, Robert A; Sobczak, Mark L; Horwitz, Eric M; Zaorsky, Nicholas G

2016-01-01

Prostate cancer is the most prevalent cancer diagnosed in men in the United States besides skin cancer. Stereotactic body radiation therapy (SBRT; 6-15 Gy per fraction, up to 45 minutes per fraction, delivered in five fractions or less, over the course of approximately 2 weeks) is emerging as a popular treatment option for prostate cancer. The American Society for Radiation Oncology now recognizes SBRT for select low- and intermediate-risk prostate cancer patients. SBRT grew from the notion that high doses of radiation typical of brachytherapy could be delivered noninvasively using modern external-beam radiation therapy planning and delivery methods. SBRT is most commonly delivered using either a traditional gantry-mounted linear accelerator or a robotic arm-mounted linear accelerator. In this systematic review article, we compare and contrast the current clinical evidence supporting a gantry vs robotic arm SBRT for prostate cancer. The data for SBRT show encouraging and comparable results in terms of freedom from biochemical failure (>90% for low and intermediate risk at 5-7 years) and acute and late toxicity (6 MV). Finally, SBRT (particularly on a gantry) may also be more cost-effective than conventionally fractionated external-beam radiation therapy. Randomized controlled trials of SBRT using both technologies are underway.

DCP Leading NIH Glycoscience Common Fund Program; Funding Opportunities Open | Division of Cancer Prevention

Science.gov (United States)

NCI's Division of Cancer Prevention is a leading participant for a key initiative in the National Institutes of Health (NIH) Glycoscience Common Fund program. This program supports development of accessible and affordable new tools and technologies for studying the role complex carbohydrates in health and disease. |

A polyethylenimine-modified carboxyl-poly(styrene/acrylamide copolymer nanosphere for co-delivering of CpG and TGF-β receptor I inhibitor with remarkable additive tumor regression effect against liver cancer in mice

Directory of Open Access Journals (Sweden)

Liang SY

2016-12-01

Full Text Available Shuyan Liang,* Jun Hu,* Yuanyuan Xie, Qing Zhou, Yanhong Zhu, Xiangliang Yang National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, People’s Republic of China *These authors contributed equally to this work Abstract: Cancer immunotherapy based on nanodelivery systems has shown potential for treatment of various malignancies, owing to the benefits of tumor targeting of nanoparticles. However, induction of a potent T-cell immune response against tumors still remains a challenge. In this study, polyethylenimine-modified carboxyl-styrene/acrylamide (PS copolymer nanospheres were developed as a delivery system of unmethylated cytosine-phosphate-guanine (CpG oligodeoxynucleotides and transforming growth factor-beta (TGF-β receptor I inhibitors for cancer immunotherapy. TGF-β receptor I inhibitors (LY2157299, LY were encapsulated to the PS via hydrophobic interaction, while CpG oligodeoxynucleotides were loaded onto the PS through electrostatic interaction. Compared to the control group, tumor inhibition in the PS-LY/CpG group was up to 99.7% without noticeable toxicity. The tumor regression may be attributed to T-cell activation and amplification in mouse models. The results highlight the additive effect of CpG and TGF-β receptor I inhibitors co-delivered in cancer immunotherapy. Keywords: CpG, TGF-β receptor I inhibitor, Pst-AAm copolymer nanosphere, immunotherapy

Seven Affordances of Computer-Supported Collaborative Learning: How to Support Collaborative Learning? How Can Technologies Help?

Science.gov (United States)

Jeong, Heisawn; Hmelo-Silver, Cindy E.

2016-01-01

This article proposes 7 core affordances of technology for collaborative learning based on theories of collaborative learning and CSCL (Computer-Supported Collaborative Learning) practices. Technology affords learner opportunities to (1) engage in a joint task, (2) communicate, (3) share resources, (4) engage in productive collaborative learning…

76 FR 41501 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH09-907

Science.gov (United States)

2011-07-14

... network expansion and enhancement. Funding is appropriated under the Affordable Care Act (Pub. L. 111-148... Intent To Award Affordable Care Act (ACA) Funding, EH09-907 AGENCY: Centers for Disease Control and... in their FY 2011 applications submitted under funding opportunity EH09-907, ``National Environmental...

A Challenge Facing the Malaysian Pharmaceutical Sector: Quality and Affordability of the National Medications

OpenAIRE

Abubaker Abdellah; Noordin MI; Shade AM Khalifa; Rafdzah Zaki; Ahmad S Sulaiman; Ali Abdellah; Hesham R El-Seedi

2016-01-01

Background: Enhancing public satisfaction of the quality and affordability of medicines is an important task in health services. Objective: This study was intended to assess the trust and acceptance of public concerning quality and affordability of locally manufactured medicines in Malaysia. Methodology: A cross sectional study was performed, and a validated Likert scale questionnaire was used in this study. The results were analyzed using the statistical Package for Social Sciences (SPSS) so...

Supportive care for children with cancer

NARCIS (Netherlands)

van de Wetering, Marianne D.; Schouten-van Meeteren, Netteke Y. N.

2011-01-01

In developed countries the survival rate of children with cancer exceeds 75%. Optimal supportive care is necessary to deliver the burdensome treatment protocols. As the intensity of primary treatment has escalated, so have the side effects like myelosuppression and infection. Children who receive

76 FR 41263 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH10-1004

Science.gov (United States)

2011-07-13

... $125,000.00 in ACA funding will be awarded to the grantee for network expansion and enhancement... Intent To Award Affordable Care Act (ACA) Funding, EH10-1004 Notice of Intent to award Affordable Care Act (ACA) funding to National Association for Public Health Statistics and Information Systems...

Ibuprofen delivered by poly(lactic-co-glycolic acid (PLGA nanoparticles to human gastric cancer cells exerts antiproliferative activity at very low concentrations

Directory of Open Access Journals (Sweden)

Bonelli P

2012-11-01

Full Text Available Patrizia Bonelli,1 Franca M Tuccillo,1 Antonella Federico,5 Maria Napolitano,2 Antonella Borrelli,1 Daniela Melisi,6 Maria G Rimoli,6 Raffaele Palaia,3 Claudio Arra,4 Francesco Carinci71Laboratory of Molecular Biology and Viral Oncogenesis; 2Department of Clinical Immunology; 3Department of Gastrointestinal-Hepatobiliary-Pancreatic Cancer Oncology Surgery; 4Animal Facility, National Cancer Institute G Pascale, Naples, Italy; 5Microtech Laboratory, Naples, Italy; 6Pharmaceutical and Toxicological Chemistry Department, School of Pharmacy, University "Federico II", Naples, Italy; 7Department of Maxillofacial Surgery, University of Ferrara, Ferrara, ItalyPurpose: Epidemiological, clinical, and laboratory studies have suggested that ibuprofen, a commonly used nonsteroidal anti-inflammatory drug, inhibits the promotion and proliferation of certain tumors. Recently, we demonstrated the antiproliferative effects of ibuprofen on the human gastric cancer cell line MKN-45. However, high doses of ibuprofen were required to elicit these antiproliferative effects in vitro. The present research compared the antiproliferative effects of ibuprofen delivered freely and released by poly(lactic-co-glycolic acid (PLGA nanoparticles (NPs in MKN-45 cells.Methods: MKN-45 human gastric adenocarcinoma cells were treated with ibuprofen-loaded PLGA NPs. The proliferation of MKN-45 cells was then assessed by cell counting. The uptake of NPs was imaged by fluorescence microscopy and flow cytometry. The release of ibuprofen from ibuprofen-loaded PLGA NPs in the cells was evaluated by gas chromatography–mass spectrometry.Results: Dramatic inhibition of cellular proliferation was observed in cells treated with ibuprofen-loaded PLGA NPs versus those treated with free ibuprofen at the same concentration. The localization of NPs was cytoplasmic. The initiation of ibuprofen release was rapid, commencing within 2 hours, and then increased slowly over time, reaching a maximum

Plastic modes of listening: affordance in constructed sound environments

Science.gov (United States)

Sjolin, Anders

This thesis is concerned with how the ecological approach to perception with the inclusion of listening modes, informs the creation of sound art installation, or more specifically as referred to in this thesis as constructed sound environments. The basis for the thesis has been a practiced based research where the aim and purpose of the written part of this PhD project has been to critically investigate the area of sound art, in order to map various approaches towards participating in and listening to a constructed sound environment. The main areas has been the notion of affordance as coined by James J. Gibson (1986), listening modes as coined by Pierre Schaeffer (1966) and further developed by Michel Chion (1994), aural architects as coined by Blesser and Salter (2007) and the holistic approach towards understanding sound art developed by Brandon LaBelle (2006). The findings within the written part of the thesis, based on a qualitative analysis, have informed the practice that has resulted in artefacts in the form of seven constructed sound environments that also functions as case studies for further analysis. The aim of the practice has been to exemplify the methodology, strategy and progress behind the organisation and construction of sound environments The research concerns point towards the acknowledgment of affordance as the crucial factor in understanding a constructed sound environment. The affordance approach govern the idea that perceiving a sound environment is a top-down process where the autonomic quality of a constructed sound environment is based upon the perception of structures of the sound material and its relationship with speaker placement and surrounding space. This enables a researcher to side step the conflicting poles of musical/abstract and non-musical/realistic classification of sound elements and regard these poles as included, not separated elements in the analysis of a constructed sound environment.

Subjective perception versus objective indicators of overcrowding and housing affordability

Czech Academy of Sciences Publication Activity Database

Sunega, Petr; Lux, Martin

2016-01-01

Roč. 31, č. 4 (2016), s. 695-717 ISSN 1566-4910 R&D Projects: GA ČR GB14-36154G Institutional support: RVO:68378025 Keywords : Housing * Indicators * Overcrowding * Housing affordability Subject RIV: AO - Sociology, Demography Impact factor: 1.178, year: 2016

Self-assessment in an open online environment: affordances and practices

NARCIS (Netherlands)

Firssova, Olga; Brouns, Francis; Joosten-ten Brinke, Desirée

2018-01-01

In MOOCs both designed and emerging self-assessments depend on available technologies and their affordances. Learners determine, however, whether these technologies are used as intended, to what extent and to what effect. Stud-ying MOOC self-assessment practice can help understand the mechanisms

A typology of affordances: untangling sociomaterial interactions through video analysis

NARCIS (Netherlands)

van Osch, W.; Mendelson, O.

2011-01-01

In this study we untangle the sociomaterial interactions between developers, users, and artifacts by analyzing what types of affordances occur in the interactions between actors and artifacts in the context of group generativity. Hereto, we conducted an in-depth ethnographic and interaction analysis

The role of business agreements in defining textbook affordability and digital materials: A document analysis

Directory of Open Access Journals (Sweden)

John Raible

2015-12-01

Full Text Available Adopting digital materials such as eTextbooks and e-coursepacks is a potential strategy to address textbook affordability in the United States. However, university business relationships with bookstore vendors implicitly structure which instructional resources are available and in what manner. In this study, a document analysis was conducted on the bookstore contracts for the universities included in the State University System of Florida. Namely, issues of textbook affordability, digital material terminology and seller exclusivity were investigated. It was found that textbook affordability was generally conceived in terms of print rental textbooks and buyback programs, and that eTextbooks were priced higher than print textbooks (25% to 30% markup. Implications and recommendations for change are shared. DOI: 10.18870/hlrc.v5i4.284

Quality indicators for breast cancer

DEFF Research Database (Denmark)

Poortmans, Philip; Aznar, Marianne; Bartelink, Harry

2012-01-01

Radiation therapy for breast cancer has considerably changed over the years, from simple simulator-based 2-dimensional techniques to sophisticated image-guided individualized treatments, with maximally protected normal structures. This has led to a substantial improvement in the outcome of breast...... cancer patients in terms of disease control, survival, and quality of life. This progress is based on clinical research and paralleled by progress in delivering sophisticated radiation treatment. Clinical trials resulted in identifying patients groups who will benefit from radiation treatment. They also...

Unpacking physics representations: Towards an appreciation of disciplinary affordance

Directory of Open Access Journals (Sweden)

Tobias Fredlund

2014-12-01

Full Text Available This theoretical article problematizes the access to disciplinary knowledge that different physics representations have the possibility to provide; that is, their disciplinary affordances. It is argued that historically such access has become increasingly constrained for students as physics representations have been rationalized over time. Thus, the case is made that such rationalized representations, while powerful for communication from a disciplinary point of view, manifest as learning challenges for students. The proposal is illustrated using a vignette from a student discussion in the physics laboratory about circuit connections for an experimental investigation of the charging and discharging of a capacitor. It is concluded that in order for students to come to appreciate the disciplinary affordances of representations, more attention needs to be paid to their “unpacking.” Building on this conclusion, two questions are proposed that teachers can ask themselves in order to begin to unpack the representations that they use in their teaching. The paper ends by proposing directions for future research in this area.

Awareness on Sustainable Affordable Housing Among Homebuyers in Malaysia

Directory of Open Access Journals (Sweden)

Ang Salem

2017-01-01

Full Text Available This paper concerns about the delivery of Sustainable Affordable Housing (SAH in Malaysia. The built environment, operation and demolishment of housing have the profound impact on our nature environment. SAH can be a solution toward sustainability development because it considered from an environmental friendly, socially enhancing, and economically benefits perfectives towards housing development. This paper aims to explore the awareness of homebuyers in Malaysia towards sustainable affordable housing. This research used the method of unstructured interview among homebuyers toward SAH in Malaysia. Based on the finding of the study, the awareness of homebuyers in SAH are relatively inadequate. Respondents are required the brief explanation on concept and elements of SAH for continue the interview. Based on Porter Five Forces Model, homebuyers’ requirements hold the bargaining power of customers to determine the features of housing provided by property provider. The knowledge of homebuyers on SAH is crucial for the sustainable development, because homebuyers are one of the key drivers for implementing the sustainable requirements in housing development.

Sonic mediatization of the book: affordances of the audiobook

Directory of Open Access Journals (Sweden)

Iben Have

2013-06-01

Full Text Available This article addresses cultural changes resulting from the growing number of audiobook users and changes in audiobook use emerging from digital technological developments of the past decade. The sonification of the written text is inscribed in the general transformation and mediatization of the printed book but offers radically different affordances than do visually perceived e-books. New portable digital audio media change the act of reading, moving it towards fields of practice in which reading has not been common before: the gym, the bicycle ride, gardening, resting in the dark, etc. From being a medium typically associated with children, the visually handicapped, or the dyslexic, the audiobook has developed into a popular phenomenon, which, we argue, has as much in common with other kinds of mediated mobile listening practices, like music and radio listening, as it has with the reading of printed books. Taking an inductive approach from the micro-level of the individual’s use, the term affordances will be used as a methodological tool within the concept of mediatization.

Rethinking cancer nanotheranostics

Science.gov (United States)

Chen, Hongmin; Zhang, Weizhong; Zhu, Guizhi; Xie, Jin; Chen, Xiaoyuan

2017-07-01

Advances in nanoparticle synthesis and engineering have produced nanoscale agents affording both therapeutic and diagnostic functions that are often referred to by the portmanteau 'nanotheranostics'. The field is associated with many applications in the clinic, especially in cancer management. These include patient stratification, drug-release monitoring, imaging-guided focal therapy and post-treatment response monitoring. Recent advances in nanotheranostics have expanded this notion and enabled the characterization of individual tumours, the prediction of nanoparticle-tumour interactions, and the creation of tailor-designed nanomedicines for individualized treatment. Some of these applications require breaking the dogma that a nanotheranostic must combine both therapeutic and diagnostic agents within a single, physical entity; instead, it can be a general approach in which diagnosis and therapy are interwoven to solve clinical issues and improve treatment outcomes. In this Review, we describe the evolution and state of the art of cancer nanotheranostics, with an emphasis on clinical impact and translation.

76 FR 41262 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH11-1103

Science.gov (United States)

2011-07-13

...,000 in ACA funding will be awarded to the grantees for network expansion and enhancement. Funding is... Intent To Award Affordable Care Act (ACA) Funding, EH11-1103 Notice of Intent to award Affordable Care Act (ACA) funding to seventeen states and local health departments to develop and implement tracking...

76 FR 41261 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH10-1003

Science.gov (United States)

2011-07-13

...): 93.070. Approximately $124,995.00 in ACA funding will be awarded to the grantee for network expansion... Intent To Award Affordable Care Act (ACA) Funding, EH10-1003 Notice of Intent to award Affordable Care Act (ACA) funding to National Association for Health Data Organizations (NAHDO) to continue with the...

A Framework for Aligning Needs, Abilities and Affordances to Inform Design and Practice of Educational Technologies

Science.gov (United States)

Antonenko, Pavlo D.; Dawson, Kara; Sahay, Shilpa

2017-01-01

This paper addresses the need for enhancing our awareness of user-centered design in educational technology through a more explicit and systematic alignment between the needs of educational technology users (learners and educators) and the affordances provided by the technology. First, we define the term "affordance" and discuss it from…

Impact of higher energy efficiency standards on housing affordability in Alberta

International Nuclear Information System (INIS)

2010-07-01

As a result of changes to provincial and national building and energy costs, the impact of increasing energy efficiency standards on housing affordability has been questioned. Determining housing affordability is a complicated process. This report presented the results of a costing analysis completed for upgrades of EnerGuide 80 levels of energy efficiency in homes in Calgary and Edmonton, Alberta. The elements of residential construction were identified. In order to better understand the cost impact of energy efficiency upgrades on a home, pricing data was obtained. Costing elements that were examined included housing price indexes; construction material price indexes; unionized trade wages; and land value. Specifically, the report presented the new housing price index analysis using material and labour costs. An analysis of energy efficiency improvement was then presented in terms of lifecycle costs (capital costs and life cycle costing results). It was concluded that although the price of labour and materials is increasing, the value of land is the primary driver for rising house prices. The price of housing is strongly correlated to the price of land and not the price of labour or materials. In addition, moving to EnerGuide 80 levels of energy efficiency for housing in Alberta made homes more affordable for homebuyers by lowering their total monthly housing costs. 4 tabs., 3 figs., 3 appendices.

The Roles of Laparoscopy in Treating Ovarian Cancer

Directory of Open Access Journals (Sweden)

Chyi-Long Lee

2009-03-01

Full Text Available Great advances in technology offer meticulous options of minimally invasive surgery to empower the gynecologists to manage patients of early ovarian cancer. Laparoscopy affords improved visualization of the pelvic peritoneum, diaphragm and the deep pelvic structures, and offers many advantages in the avoidance of long abdominal incision, including shorter hospital stay and a more rapid recovery time. Most studies showed that laparoscopy did not compromise the survival and recurrence prognosis in comparison with open abdominal approach of staging surgery. Contrarily, laparoscopy precludes the advantage of open surgery, such as manual examination of the full extent of the bowel and palpation of lymph nodes. Besides, laparoscopy technically hampers the removal of large ovarian mass, and laparoscopic cancer surgery has a potential risk of trocar site metastasis. As the trend shows that laparoscopy has been playing an important role in treating early ovarian cancer, we could expect laparoscopy to become an attractive surgical option in the future for ovarian cancers.

Affordable orphan drugs: a role for not-for-profit organizations.

Science.gov (United States)

Davies, Elin H; Fulton, Emma; Brook, Daniel; Hughes, Dyfrig A

2017-07-01

The success of the Regulation on Orphan Medicinal Products in the European Union is evidenced by the 127 orphan drugs that have had market authorization since 2000. However, the incentives aimed at stimulating research and development have had the unintended consequence of increasing drug cost, resulting in many orphan drugs not being cost-effective. Orphan drugs command an increasing share of the pharmaceutical market and account for a disproportionate amount of healthcare expenditure. Orphan drug ownership by socially motivated, not-for-profit organizations may facilitate access to more affordable orphan drugs, for the benefit of patients and healthcare systems alike. This study aims to describe opportunities for such organizations to become orphan drug Market Authorization Holders. We reviewed data on the ownership of EMA designated and approved orphan drugs, identified funding opportunities and business models for not-for-profit organizations, and summarised relevant legal and policy documents concerning intellectual property rights and drug regulation. Using repurposed drugs as a paradigm, this narrative review navigates the regulatory hurdles, describes the legal context and identifies funding opportunities, in a bid to facilitate and encourage not-for-profit organizations to lead on the development of affordable orphan drugs. Although the regulatory steps required to obtain an MA for an orphan drug are numerous and challenging, they are not insurmountable and can be achieved by not-for-profit organizations that are socially motivated to reduce the costs of orphan drugs to the payers of healthcare. Opportunities for orphan drug development resulting in affordable products lie mainly with repurposed drugs. © 2017 The British Pharmacological Society.

Rethinking Space Design Standards Toward Quality Affordable Housing In Malaysia

Directory of Open Access Journals (Sweden)

Ishak Nor Haniza

2016-01-01

Full Text Available Provision of affordable housing is important to low- and middle-income population. A fit form of house will not only fulfil a basic human need for shelter, but it also contributes to physical and psychological well-being of the occupants. Excellent quality and affordable housing is an indication of a high quality of life. While writings exist on various aspects of the quality of affordable housing in Malaysia, discussion regarding space and design standards has scarcely been given any serious academic attention. Standards concerning residential development usually cover different aspects or stages of the development process. They can include planning standards, design standards, space standards and technical construction standards. The main concern of this paper is on space and design standards specifically. Space standard can be defined as a set of framework which dictates fixed internal space minimums. Meanwhile, design standard indicates design guidelines to ensure the functionality, comfortability and habitability of the house. This paper is concerned exclusively with indoor spaces of a house excluding external circulation spaces and service facilities (in case of strata housing. Its interest is in internal space as an aspect of housing quality. It can be concluded that one of the way forward will be to find the balance between providing adequate minimum spaces for resident satisfactions and having economic values for housing developers. This paper may be used as a valuable reference for authorities and policy makers to better address the best housing space design standards that would benefit not only the occupants, but also the local government and developers alike.

Enabling Mobile Communications for the Needy: Affordability Methodology, and Approaches to Requalify Universal Service Measures

Directory of Open Access Journals (Sweden)

Louis-Francois PAU

2009-01-01

Full Text Available This paper links communications and media usage to social and household economics boundaries. It highlights that in present day society, communications and media are a necessity, but not always affordable, and that they furthermore open up for addictive behaviors which raise additional financial and social risks. A simple and efficient methodology compatible with state-of-the-art social and communications business statistics is developed, which produces the residual communications and media affordability budget and ultimately the value-at-risk in terms of usage and tariffs. Sensitivity analysis provides precious information on bottom-up communications and media adoption on the basis of affordability. This approach differs from the regulated but often ineffective Universal service obligation, which instead of catering for individual needs mostly addresses macro-measures helping geographical access coverage (e.g. in rural areas. It is proposed to requalify the Universal service obligations on operators into concrete measures, allowing, with unchanged funding, the needy to adopt mobile services based on their affordability constraints by bridging the gap to a standard tariff. Case data are surveyed from various countries. ICT policy recommendations are made to support widespread and socially responsible communications access.

Five-Year Outcomes, Cosmesis, and Toxicity With 3-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation

International Nuclear Information System (INIS)

Rodríguez, Núria; Sanz, Xavier; Dengra, Josefa; Foro, Palmira; Membrive, Ismael; Reig, Anna; Quera, Jaume; Fernández-Velilla, Enric; Pera, Óscar; Lio, Jackson; Lozano, Joan; Algara, Manuel

2013-01-01

Purpose: To report the interim results from a study comparing the efficacy, toxicity, and cosmesis of breast-conserving treatment with accelerated partial breast irradiation (APBI) or whole breast irradiation (WBI) using 3-dimensional conformal external beam radiation therapy (3D-CRT). Methods and Materials: 102 patients with early-stage breast cancer who underwent breast-conserving surgery were randomized to receive either WBI (n=51) or APBI (n=51). In the WBI arm, 48 Gy was delivered to the whole breast in daily fractions of 2 Gy, with or without additional 10 Gy to the tumor bed. In the APBI arm, patients received 37.5 Gy in 3.75 Gy per fraction delivered twice daily. Toxicity results were scored according to the Radiation Therapy Oncology Group Common Toxicity Criteria. Skin elasticity was measured using a dedicated device (Multi-Skin-Test-Center MC-750-B2, CKelectronic-GmbH). Cosmetic results were assessed by the physician and the patients as good/excellent, regular, or poor. Results: The median follow-up time was 5 years. No local recurrences were observed. No significant differences in survival rates were found. APBI reduced acute side effects and radiation doses to healthy tissues compared with WBI (P 75% of patients in the APBI arm had excellent or good cosmesis, and these outcomes appear to be stable over time. The percentage of patients with excellent/good cosmetic results was similar in both groups. Conclusions: APBI delivered by 3D-CRT to the tumor bed for a selected group of early-stage breast cancer patients produces 5-year results similar to those achieved with conventional WBI

The Messiness of Meaning Making: Examining the Affordances of ...

African Journals Online (AJOL)

Having incorporated a digital aspect to our academic literacy course, and having monitored this over the last three years, we have come to believe that online mentoring can serve as an essential form of tutoring and mentoring. Our study is located in the field of New Literacy Studies and examines the affordances of a digital ...

Enteral versus parenteral nutrition in cancer patients: evidences and controversies.

Science.gov (United States)

Cotogni, Paolo

2016-01-01

The debate over the use of enteral nutrition (EN) and parenteral nutrition (PN) is an old but evergreen and hot topic. Since many years, studies comparing EN and PN have been a pivotal 'leitmotif' in the published literature on artificial nutrition (AN). Actually, there is a background misunderstanding in this debate; specifically, that EN and PN are competitors in the choice of the route for delivering nutrition support in cancer patients. Conversely, EN and PN have specific indications and contraindications. This review has the purpose to discuss the indications and complications as well as pros and cons of EN and PN in cancer patients, the crucial role of nutrition support in oncology patients during anticancer treatments and throughout the course of disease, and, finally, the role of AN in advanced cancer patients. In summary, we have no evidence-based data able to definitively indicate the optimal method for delivering AN in cancer patients. EN and PN have to be considered equally effective in maintaining or improving nutritional status in cancer patients. Besides, this review strongly supports the recommendation that a baseline nutritional assessment should be carried out by a healthcare professional expert in AN for all cancer patients at the time of diagnosis or anticancer treatment plan, taking the nutritional status, estimated duration of AN, AN-related potential benefits and possible complications into consideration on an individual basis. Moreover, the patient symptoms, performance status, estimated life expectancy, and mainly, will or preferences have to be evaluated and incorporated into the nutrition support plan before the definitive choice of the route for delivering nutrients is decided. Finally, applying a decision-making process tailored to patient needs-regardless of whether receiving or not anticancer treatment-allows to choose reasonably the optimal nutritional support strategy.

Cytotoxicity Enhancement in Breast Cancer Cells with Carbonate Apatite-Facilitated Intracellular Delivery of Anti-Cancer Drugs

Science.gov (United States)

Fatemian, Tahereh; Chowdhury, Ezharul Hoque

2018-01-01

Pharmacotherapy as the mainstay in the management of breast cancer has demonstrated various drawbacks, including non-targeted bio distribution and narrow therapeutic and safety windows. Thus, enhancements in pharmacodynamic and pharmacokinetic profiles of the classical anti-cancer drugs could lead to improved efficacy against cancer cells. Therefore, inorganic pH-dependent carbonate apatite (CA) nanoparticles were utilized to efficiently deliver various drugs into cancer cells. Following characterization and various modifications in the structure of CA complexes with different drugs, lifted outcomes were achieved. Markedly, complexing paclitaxel with CA resulted in 20.71 ± 4.34% loading efficiency together with 24.14 ± 2.21% enhancement in cytotoxicity on MCF-7 cells plus superior in vivo anti-tumour efficacy compared to free paclitaxel. PMID:29401738

Cytotoxicity Enhancement in Breast Cancer Cells with Carbonate Apatite-Facilitated Intracellular Delivery of Anti-Cancer Drugs

Directory of Open Access Journals (Sweden)

Tahereh Fatemian

2018-02-01

Full Text Available Pharmacotherapy as the mainstay in the management of breast cancer has demonstrated various drawbacks, including non-targeted bio distribution and narrow therapeutic and safety windows. Thus, enhancements in pharmacodynamic and pharmacokinetic profiles of the classical anti-cancer drugs could lead to improved efficacy against cancer cells. Therefore, inorganic pH-dependent carbonate apatite (CA nanoparticles were utilized to efficiently deliver various drugs into cancer cells. Following characterization and various modifications in the structure of CA complexes with different drugs, lifted outcomes were achieved. Markedly, complexing paclitaxel with CA resulted in 20.71 ± 4.34% loading efficiency together with 24.14 ± 2.21% enhancement in cytotoxicity on MCF-7 cells plus superior in vivo anti-tumour efficacy compared to free paclitaxel.

Accessibility, affordability and use of health services in an urban area in South Africa

Directory of Open Access Journals (Sweden)

Ethelwynn L. Stellenberg

2015-03-01

Full Text Available Background: Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. Objectives: The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured population in the Western Cape, South Africa. Method: A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6% was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. Results: The hypothesis was accepted. The statistical association between affordability (p = < 0.01, accessibility (p = < 0.01 and the use of health services was found to be significant using the Chi-square (χ² test. Conclusion: The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.

Onchocerciasis control in Nigeria: will households be able to afford community-directed treatment with ivermectin?

Science.gov (United States)

Onwujekwe, O; Shu, E; Onwuameze, O; Ndum, C; Okonkwo, P

2001-12-21

To determine the level of affordability of community-directed treatment with ivermectin (CDTI) to households living in two onchocerciasis endemic Nigerian communities namely Toro in the north and Nike in the south. The proportion of the cost of treating people with ivermectin will deplete in average monthly/projected annual household expenditure on food and health care, and on average monthly and projected annual household income were respectively calculated and used to determine the level of affordability of CDTI. Questionnaires administered to heads of households or their representatives were used to collect information on the household expenditures and income. The suggested unit CDTI cost of $0.20 was used. However, as a test of sensitivity, we also used the unit cost of $0.056 which some community based distributors are charging per treatment. Using $0.20 as the unit treatment cost, this will consume less than 0.05% of average annual household income in both communities. It will equally deplete 0.05% of combined annual household expenditures on food and health care in both communities. However, using $0.056 as the unit treatment cost, then 0.02% of average annual household expenditure on health care, 0.01% average annual expenditure on combined health care and food, and 0.01% of average annual household income will be depleted. The households living in both communities may be able to afford CDTI schemes. However, the final decision on levels of affordability lies with the households. They will decide whether they can afford to trade-off some household income for ivermectin distribution.

Obstacles and Affordances for Integer Reasoning: An Analysis of Children's Thinking and the History of Mathematics

Science.gov (United States)

Bishop, Jessica Pierson; Lamb, Lisa L.; Philipp, Randolph A.; Whitacre, Ian; Schappelle, Bonnie P.; Lewis, Melinda L.

2014-01-01

We identify and document 3 cognitive obstacles, 3 cognitive affordances, and 1 type of integer understanding that can function as either an obstacle or affordance for learners while they extend their numeric domains from whole numbers to include negative integers. In particular, we highlight 2 key subsets of integer reasoning: understanding or…

Battling with breast cancer - addressing the issues

Energy Technology Data Exchange (ETDEWEB)

Amin, S; Wahid, N; Wasim, B; Tabassum, S [Patel Hospital Gulshan-e-Iqbal, Karachi (Pakistan)

2011-06-15

In the background of the current situation of breast cancer in Pakistan, with its rising incidence and mortality, non afford ability and inaccessibility to screening, diagnosis and treatment, Patel Hospital took up the task of addressing these issues at a local level, by initiating an annual free breast camp in the year 2006. In 2008 an inclusion criteria was defined to focus on high risk women for breast cancer. A comparative analysis over a period of three years was done. In the focused camps, in which 28% patients were found to have a positive family history. Most women were symptomatic. Total 11 patients were diagnosed to have cancer after evaluation. Six patients underwent definitive treatment. A problem with lack of awareness, regarding screening and treatment protocols was identified. Family history seems to be an important risk factor in our set up signifying the need to introduce extensive screening programmes. (author)

Battling with breast cancer - addressing the issues

International Nuclear Information System (INIS)

Amin, S.; Wahid, N.; Wasim, B.; Tabassum, S.

2011-01-01

In the background of the current situation of breast cancer in Pakistan, with its rising incidence and mortality, non afford ability and inaccessibility to screening, diagnosis and treatment, Patel Hospital took up the task of addressing these issues at a local level, by initiating an annual free breast camp in the year 2006. In 2008 an inclusion criteria was defined to focus on high risk women for breast cancer. A comparative analysis over a period of three years was done. In the focused camps, in which 28% patients were found to have a positive family history. Most women were symptomatic. Total 11 patients were diagnosed to have cancer after evaluation. Six patients underwent definitive treatment. A problem with lack of awareness, regarding screening and treatment protocols was identified. Family history seems to be an important risk factor in our set up signifying the need to introduce extensive screening programmes. (author)

Crossing 138: two approaches to churn under the Affordable Care Act.

Science.gov (United States)

Ravel, Gabriel; DeSantis, J Angelo

2014-01-01

A predicted side effect of the Medicaid expansion and state-based Exchanges under the Affordable Care Act is churn. Churn is the shifting into and out of eligibility for insurance affordability programs due to income changes. Because the line between Medicaid and Exchange eligibility is fine -138% of the federal poverty level -millions of Americans are expected to gain and lose eligibility. Frequently, this churning undermines continuity of care, raises costs, and frustrates those affected. This article explores two proposed programs to mitigate the effects of churn: the Basic Health Program and the Bridge Program. This article evaluates both programs' ability to mitigate the effects of churn, the likely side effects to states' implementing them, and legal and practical obstacles to their implementation. It concludes that the Bridge Program is the better approach.

Hyaluronan-Based Therapy for Metastatic Prostate Cancer

Science.gov (United States)

2016-09-01

Importantly, the system can target CD44+ prostate cancer stem cells through intrinsic HA-CD44 receptor interactions and deliver drugs directly to...be released by enzymatic degradation via HYAL1. Importantly, the system can target CD44+ prostate cancer stem cells through intrinsic HA-CD44...In Situ DNA Strand Break Labeling (TUNEL assay)—Tumor tissues were recovered from euthanized animals. Sections (5 μm) were cut from 10% neutral

Use of Welcome to Medicare Visits Among Older Adults Following the Affordable Care Act.

Science.gov (United States)

Misra, Arpit; Lloyd, Jennifer T; Strawbridge, Larisa M; Wensky, Suzanne G

2018-01-01

To encourage greater utilization of preventive services among Medicare beneficiaries, the 2010 Affordable Care Act waived coinsurance for the Welcome to Medicare visit, making this benefit free starting in 2011. The objective of this study was to determine the impact of the Affordable Care Act on Welcome to Medicare visit utilization. A 5% sample of newly enrolled fee-for-service Medicare beneficiaries for 2005-2016 was used to estimate changes in Welcome to Medicare visit use over time. An interrupted time series model examined whether Welcome to Medicare visits increased significantly after 2011, controlling for pre-intervention trends and other autocorrelation. Annual Welcome to Medicare visit rates began at 1.4% in 2005 and increased to 12.3% by 2016. The quarterly Welcome to Medicare visit rate, which was almost 1% at baseline, was increasing by 0.06% before the 2011 Affordable Care Act provision (pAct provision, the rate increased by about 1% in the first quarter of 2011 (intercept, pAct trends of lower utilization persisted over time for non-whites and improved less quickly for men, regions other than Northeast, and beneficiaries without any supplemental insurance. The Affordable Care Act, and perhaps the removal of cost sharing, was associated with increased use of the Welcome to Medicare visit; however, even with the increased use, there is room for improvement. Published by Elsevier Inc.

24 CFR 92.252 - Qualification as affordable housing: Rental housing.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Qualification as affordable housing: Rental housing. 92.252 Section 92.252 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Project Requirements § 92.252...

Mesoscopic and Macroscopic Optoacoustic Imaging of Cancer

NARCIS (Netherlands)

Taruttis, Adrian; van Dam, Gooitzen M.; Ntziachristos, Vasilis

2015-01-01

Optoacoustic imaging combines the rich contrast of optical methods with the resolution of ultrasound imaging. It can therefore deliver optical visualization of cancer far deeper in tissue than optical microscopy and other conventional optical imaging methods. Technological progress and novel

Biomarkers: Delivering on the expectation of molecularly driven, quantitative health.

Science.gov (United States)

Wilson, Jennifer L; Altman, Russ B

2018-02-01

Biomarkers are the pillars of precision medicine and are delivering on expectations of molecular, quantitative health. These features have made clinical decisions more precise and personalized, but require a high bar for validation. Biomarkers have improved health outcomes in a few areas such as cancer, pharmacogenetics, and safety. Burgeoning big data research infrastructure, the internet of things, and increased patient participation will accelerate discovery in the many areas that have not yet realized the full potential of biomarkers for precision health. Here we review themes of biomarker discovery, current implementations of biomarkers for precision health, and future opportunities and challenges for biomarker discovery. Impact statement Precision medicine evolved because of the understanding that human disease is molecularly driven and is highly variable across patients. This understanding has made biomarkers, a diverse class of biological measurements, more relevant for disease diagnosis, monitoring, and selection of treatment strategy. Biomarkers' impact on precision medicine can be seen in cancer, pharmacogenomics, and safety. The successes in these cases suggest many more applications for biomarkers and a greater impact for precision medicine across the spectrum of human disease. The authors assess the status of biomarker-guided medical practice by analyzing themes for biomarker discovery, reviewing the impact of these markers in the clinic, and highlight future and ongoing challenges for biomarker discovery. This work is timely and relevant, as the molecular, quantitative approach of precision medicine is spreading to many disease indications.

High School Girls’ Everyday Aesthetics on Instagram: The Affordance Approach

Directory of Open Access Journals (Sweden)

Jou-Chun Su

2018-04-01

Full Text Available This study explores high school girls’ Instagram aesthetic practices based on the affordance theory. We conduct in-depth interviews and photo analyses of 10 subjects to reveal how these girls interact with the app’s interface, and what strategic practices they have developed to interact with the affordances preset by Instagram. The findings demonstrate that Instagram has become a realm for everyday aesthetics due to its design priority on photos. These high school girls navigate in plural art worlds as they share their reframed photos with a variety of social groups, of which each has its own discrete aesthetic convention. This indicates that Instagram’s interface design has successfully associated itself with taste and beauty, eliciting these girls to collect more reframing apps in order to achieve their own distinction. As a result, aesthetics takes shape in everyday life, but they take their own aestheticized life as the real one.

Liver cancer and selective internal radiation therapy

International Nuclear Information System (INIS)

Sutton, C.

2002-01-01

Liver cancer is the biggest cancer-related killer of adults in the world. Liver cancer can be considered as two types: primary and secondary (metastatic). Selective Internal Radiation Therapy (SIRT) is a revolutionary treatment for advanced liver cancer that utilises new technologies designed to deliver radiation directly to the site of tumours. SIRT, on the other hand, involves the delivery of millions of microscopic radioactive spheres called SIR-Spheres directly to the site of the liver tumour/s, where they selectively irradiate the tumours. The anti-cancer effect is concentrated in the liver and there is little effect on cancer at other sites such as the lungs or bones. The SIR-Spheres are delivered through a catheter placed in the femoral artery of the upper thigh and threaded through the hepatic artery (the major blood vessel of the liver) to the site of the tumour. The microscopic spheres, each approximately 35 microns (the size of four red blood cells or one-third the diameter of a strand of hair), are bonded to yttrium-90 (Y-90), a pure beta emitter with a physical half-life of 64.1 hours (about 2.67 days). The microspheres are trapped in the tumour's vascular bed, where they destroy the tumour from inside. The average range of the radiation is only 2.5 mm, so it is wholly contained within the patient's body; after 14 days, only 2.5 percent of the radioactive activity remains. The microspheres are suspended in water for injection. The vials are shipped in lead shields for radiation protection. Treatment with SIR-Spheres is generally not regarded as a cure, but has been shown to shrink the cancer more than chemotherapy alone. This can increase life expectancy and improve quality of life. On occasion, patients treated with SIR-Spheres have had such marked shrinkage of the liver cancer that the cancer can be surgically removed at a later date. This has resulted in a long-term cure for some patients. SIRTeX Medical Limited has developed three separate cancer

The Affordable Care Act: the ethical call to transform the organizational culture.

Science.gov (United States)

Piper, Llewellyn E

2014-01-01

The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture.

Social Policy Trends- Housing Affordability for Families with Low Incomes Across Canada

Directory of Open Access Journals (Sweden)

Margarita (Gres Wilkins

2017-06-01

Full Text Available HOUSING AFFORDABILITY FOR FAMILIES WITH LOW INCOMES ACROSS CANADA Percentage of income devoted to paying lowest-priced rent in a city, by low-income family type, select years, 1990-2015 Much public attention has been directed towards the issue of a Canada-wide housing crisis. The focus has typically been on the cost of housing for an average income Canadian family. Less attention has been paid to families with incomes much lower than those of the average Canadian household, for which the housing crisis is far more severe. Households and individuals with particularly low incomes are at the highest risk of experiencing the worst effects of a lack of housing affordability, including homelessness.

The role of wild fruits and vegetables in delivering a balanced and healthy diet.

Science.gov (United States)

Bvenura, Callistus; Sivakumar, Dharini

2017-09-01

commercial production of wild fruits and vegetables in order to encourage farmers to cultivate them. However, seeds and/or seedlings need to be made available and affordable to the farmers. The 'hidden treasures' in the forests in the form of edible plants could easily play a positive and huge role in delivering a balanced and healthy diet, especially in poor parts of the world. Copyright © 2017 Elsevier Ltd. All rights reserved.

Availability and Affordability of Insurance Under Climate Change. A Growing Challenge for the U.S

International Nuclear Information System (INIS)

Mills, E.; Roth, R.J. Jr; Lecomte, E.

2005-01-01

The paper explores the insurability of risks from climate change, and ways in which insurance affordability and availability could be adversely impacted in the U.S. i n the coming years. It includes examples where affordability and availability of insurance are already at risk from rising weather-related losses and how future financial exposure for insurers, governments, businesses and consumers could worsen if current climate and business trends continue

Materials Delivered by Member States

International Nuclear Information System (INIS)

1962-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered up to 30 September 1962 by Member States in compliance with requests the Agency has made under Article IX. D. Part II contains information about materials which have not yet been delivered but which have been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project agreements were in force on 30 September 1962. Reports on subsequent deliveries of materials and revised information about allocated but undelivered materials will be issued from time to time

Cancer and pregnancy: the clinician's perspective.

Science.gov (United States)

Dotters-Katz, Sarah; McNeil, Michael; Limmer, Jane; Kuller, Jeffrey

2014-05-01

Although uncommon, the incidence of cancer complicating pregnancy is increasing. Managing these pregnancies creates many diagnostic, therapeutic, and ethical dilemmas for the patient, her family, and the medical care team. Despite concerns for fetal well-being, maternal survival should be the first priority. Although surgery and chemotherapy may be used during pregnancy, radiation is generally contraindicated. For most nongynecologic cancers, termination of pregnancy does not improve maternal outcome. Iatrogenic prematurity is the most common pregnancy complication associated with malignancy in pregnancy because many of these infants are delivered early to facilitate maternal treatment. Overall, maternal cancer survival is generally good and does not differ from that of nonpregnant patients.

Paying for Cures: How Can We Afford It? Managed Care Pharmacy Stakeholder Perceptions of Policy Options to Address Affordability of Prescription Drugs.

Science.gov (United States)

Yeung, Kai; Suh, Kangho; Basu, Anirban; Garrison, Louis P; Bansal, Aasthaa; Carlson, Josh J

2017-10-01

High-priced medications with curative potential, such as the newer hepatitis C therapies, have contributed to the recent growth in pharmaceutical expenditure. Despite the obvious benefits, health care decision makers are just beginning to grapple with questions of how to value and pay for curative therapies that may feature large upfront cost, followed by health benefits that are reaped over a patient's lifespan. Alternative policy options have been proposed to promote high value and financially sustainable use of these therapies. It is unclear which policy options would be most acceptable to health care payer and biomedical manufacturer stakeholders. To (a) briefly review pharmaceutical policy options to address health system affordability and (b) assess the acceptability of alternative policy options to health care payers and biomedical manufacturers before and after an Academy of Managed Care Pharmacy (AMCP) continuing pharmacy education (CPE) session. We searched MEDLINE and Cochran databases for pharmaceutical policy options addressing affordability. With input from a focus group of managed care professionals, we developed CPE session content and an 8-question survey focusing on the most promising policy options. We fielded the survey before and after the CPE session, which occurred as part of the 2016 AMCP Annual Meeting. We first conducted a chi-squared goodness-of-fit test to assess response distributions. Next, we tested how responses differed before and after by using an ordered logit and a multinomial logit to model Likert scale and unordered responses, respectively. Although risk-sharing payments over time remained the most favorable choice before (37%) and after (35%) the CPE session, this choice was closely followed by HealthCoin after the session, which increased in favorability from 4% to 33% of responses (P = 0.001). About half of the respondents (54%) indicated that legislative change is the most significant barrier to the implementation of any

24 CFR 1000.242 - When does the requirement for exemption from taxation apply to affordable housing activities?

Science.gov (United States)

2010-04-01

... exemption from taxation apply to affordable housing activities? 1000.242 Section 1000.242 Housing and Urban... ACTIVITIES Indian Housing Plan (IHP) § 1000.242 When does the requirement for exemption from taxation apply to affordable housing activities? The requirement for exemption from taxation applies only to rental...

Social Media and Organizing – An Empirical Analysis of the Role of Wiki Affordances in Organizing Practices

DEFF Research Database (Denmark)

Mansour, Osama; Askenäs, Linda; Ghazawneh, Ahmad

2013-01-01

The evolution of social media has introduced novel possibilities for work and interaction in organizations. The wiki technology is one important kind of social media technologies that is increasingly used to facilitate the creation and sharing of organizational knowledge within communities. Given...... in that they extend the notion of affordance by theorizing new concepts that describe relational dynamics, situated and contextual conditions, and social factors involved in enacting, perceiving, and exploiting affordances.......The evolution of social media has introduced novel possibilities for work and interaction in organizations. The wiki technology is one important kind of social media technologies that is increasingly used to facilitate the creation and sharing of organizational knowledge within communities. Given...... the increasing use of social media in organizations and the lack of knowledge on their consequences for organizing, we use an affordance lens to explore the enactment of organizational wiki affordances. Using qualitative data obtained through interviews, field visits, and documents from two multinational...

Particles that fight cancer: the use of protons and carbon ions in cancer therapy

CERN Multimedia

CERN. Geneva

2014-01-01

Particles that fight cancer: the use of protons and carbon ions in cancer therapy Cancer is a major societal issue. A key challenge for cancer therapy is the complex and multifaceted nature of the disease, which calls for personalised treatment. Radiotherapy has been used to treat tumours for more than a century, and is still a staple in oncology: today, 50 % of cancer patients receive radiotherapy, half of them with curative intent. Hadrontherapy is one of the most technologically advanced methods of delivering radiation dose to the tumour while protecting surrounding healthy tissues. In addition, hadrontherapy can reach otherwise difficult to access deep-seated tumours and can be used for radio resistant tumours as in hypoxia. This year marks 60 years since the first patient was treated with protons in the US and 20 years since the use of carbon ions in Japan. Join us in learning about the journey of particle therapy in Japan and Europe, its challenges, clinical results and future prospects. Thursday 2...

Graduates' Perceptions of Learning Affordances in Longitudinal Integrated Clerkships: A Dual-Institution, Mixed-Methods Study.

Science.gov (United States)

Latessa, Robyn A; Swendiman, Robert A; Parlier, Anna Beth; Galvin, Shelley L; Hirsh, David A

2017-09-01

The authors explored affordances that contribute to participants' successful learning in longitudinal integrated clerkships (LICs). This dual-institutional, mixed-methods study included electronic surveys and semistructured interviews of LIC graduates who completed their core clinical (third) year of medical school. These LIC graduates took part in LICs at Harvard Medical School from 2004 to 2013 and the University of North Carolina School of Medicine-Asheville campus from 2009 to 2013. The survey questions asked LIC graduates to rate components of LICs that they perceived as contributing to successful learning. A research assistant interviewed a subset of study participants about their learning experiences. The authors analyzed aggregate data quantitatively and performed a qualitative content analysis on interview data. The graduates reported multiple affordances that they perceive contributed to successful learning in their LIC. The most reported components included continuity and relationships with preceptors, patients, place, and peers, along with integration of and flexibility within the curriculum. As LIC models grow in size and number, and their structures and processes evolve, learners' perceptions of affordances may guide curriculum planning. Further research is needed to investigate to what degree and by what means these affordances support learning in LICs and other models of clinical education.

Virtual team learning: The role of collaboration process and technology affordance in team decision making

Directory of Open Access Journals (Sweden)

Sean Cordes

2016-12-01

Full Text Available The study examines two dimensions that impact virtual team decision making. One is the influence of collaboration process structure: the sequences, patterns, and routines participants use to interact and solve problems. The other is technology affordance: the strengths and weaknesses of technologies in terms of the usefulness they offer to teams when performing tasks. Some teams used a structured collaboration process with monitoring, coordination, and backup functions during a decision-making discussion. Other teams had no discussion process instructions. In addition, some teams possessed stronger technology affordance including both chat and an editable document. Other teams used chat technology alone, which offered fewer collaboration possibilities. The collaboration process and technology affordance factors were tested in an experiment in which four-person online teams worked as a personnel hiring committee. Information about four job candidates was distributed to create a hidden profile in which some information was shared across all team members, while other information was visible only to specific members. Two hundred and eight students, comprising fifty-two teams completed the study. Teams using the structured collaboration process made more accurate and higher-quality decisions. In addition, scores were higher when technology affordance included both chat and editable document tools, but this influence was not significant.

Comparison of testicular dose delivered by intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in patients with prostate cancer

International Nuclear Information System (INIS)

Martin, Jeffrey M.; Handorf, Elizabeth A.; Price, Robert A.; Cherian, George; Buyyounouski, Mark K.; Chen, David Y.; Kutikov, Alexander; Johnson, Matthew E.; Ma, Chung-Ming Charlie; Horwitz, Eric M.

2015-01-01

A small decrease in testosterone level has been documented after prostate irradiation, possibly owing to the incidental dose to the testes. Testicular doses from prostate external beam radiation plans with either intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) were calculated to investigate any difference. Testicles were contoured for 16 patients being treated for localized prostate cancer. For each patient, 2 plans were created: 1 with IMRT and 1 with VMAT. No specific attempt was made to reduce testicular dose. Minimum, maximum, and mean doses to the testicles were recorded for each plan. Of the 16 patients, 4 received a total dose of 7800 cGy to the prostate alone, 7 received 8000 cGy to the prostate alone, and 5 received 8000 cGy to the prostate and pelvic lymph nodes. The mean (range) of testicular dose with an IMRT plan was 54.7 cGy (21.1 to 91.9) and 59.0 cGy (25.1 to 93.4) with a VMAT plan. In 12 cases, the mean VMAT dose was higher than the mean IMRT dose, with a mean difference of 4.3 cGy (p = 0.019). There was a small but statistically significant increase in mean testicular dose delivered by VMAT compared with IMRT. Despite this, it unlikely that there is a clinically meaningful difference in testicular doses from either modality

Comparison of testicular dose delivered by intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in patients with prostate cancer

Energy Technology Data Exchange (ETDEWEB)

Martin, Jeffrey M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Handorf, Elizabeth A. [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA (United States); Price, Robert A.; Cherian, George [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Buyyounouski, Mark K. [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Chen, David Y.; Kutikov, Alexander [Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Johnson, Matthew E.; Ma, Chung-Ming Charlie [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Horwitz, Eric M., E-mail: eric.horwitz@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)

2015-10-01

A small decrease in testosterone level has been documented after prostate irradiation, possibly owing to the incidental dose to the testes. Testicular doses from prostate external beam radiation plans with either intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) were calculated to investigate any difference. Testicles were contoured for 16 patients being treated for localized prostate cancer. For each patient, 2 plans were created: 1 with IMRT and 1 with VMAT. No specific attempt was made to reduce testicular dose. Minimum, maximum, and mean doses to the testicles were recorded for each plan. Of the 16 patients, 4 received a total dose of 7800 cGy to the prostate alone, 7 received 8000 cGy to the prostate alone, and 5 received 8000 cGy to the prostate and pelvic lymph nodes. The mean (range) of testicular dose with an IMRT plan was 54.7 cGy (21.1 to 91.9) and 59.0 cGy (25.1 to 93.4) with a VMAT plan. In 12 cases, the mean VMAT dose was higher than the mean IMRT dose, with a mean difference of 4.3 cGy (p = 0.019). There was a small but statistically significant increase in mean testicular dose delivered by VMAT compared with IMRT. Despite this, it unlikely that there is a clinically meaningful difference in testicular doses from either modality.

Implementing the Affordable Care Act: State Action to Establish SHOP Marketplaces.

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Dash, Sarah J; Lucia, Kevin W; Thomas, Amy

2014-03-01

The Affordable Care Act seeks to help small employers offer coverage by reforming the small-group market and establishing Small Business Health Options Program (SHOP) marketplaces. Seventeen states and the District of Columbia chose to operate their own SHOP marketplaces in 2014, with the federal government operating the SHOP marketplace in 33 states. This brief examines state decisions to enhance the value of SHOP marketplaces for small employers and finds that most have set predictable participation and eligibility requirements and will offer a competitive choice of insurers and plans. States also are seeking to facilitate small employers' shopping experience through online tools and access to personalized assistance. While not all SHOP marketplaces are yet functioning as intended, their establishment offers an opportunity to identify successful strategies for improving the affordability and accessibility of coverage for small employers.

Do already grasped objects activate motor affordances?

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Iani, Cristina; Ferraro, Luca; Maiorana, Natale Vincenzo; Gallese, Vittorio; Rubichi, Sandro

2018-04-07

This study investigated whether in a stimulus-response compatibility (SRC) task affordance effects in response to picture of graspable objects emerge when these objects appear as already grasped. It also assessed whether the observed effects could be explained as due to spatial compatibility between the most salient part in the object/display and the hand of response rather than to action potentiation. To this aim, we conducted three behavioural experiments in which participants were required to discriminate the vertical orientation (upright vs. inverted) of an object presented in the centre of the screen, while ignoring the right-left orientation of its handle. The object could be presented alone, as already grasped, as partially masked (Experiment 1) or with a human hand close to its graspable side (Experiment 2). In addition, to assess the role of perceptual salience, the object could be presented with a human hand or a non-biological (a geometrical shape) distractor located opposite to the object's graspable side. Results showed faster responses when the object's handle was located on the same side of the responding hand with a larger effect when upright objects were shown as already grasped (Experiment 1) or when a hand was displayed close to its handle (Experiment 2), and a smaller reversed effect when the hand or the geometrical shape was located opposite to the handled side (Experiment 3). We interpreted these findings as indicating that handle orientation effects emerging in SRC tasks may result from the interplay between motor affordance and spatial compatibility mechanisms.

Achieving affordable housing through energy efficiency strategy

International Nuclear Information System (INIS)

Copiello, Sergio

2015-01-01

Cooperation between public and private sector has achieved a remarkable widespread, in the Italian context, over the last two decades. Nevertheless, the increasing difficulty in accessing the capital market and the rising cost of funding sources, both noticeable over the past few years, led to a slowdown of Public–Private Partnership (PPP) initiatives. Meanwhile, the community is expressing new needs to be satisfied, such as the conversion of brownfields, the recovery of housing stock dating back to former times, as well as the refurbishment of public offices or schools. Emerging priorities include the supply of affordable dwellings for low to medium income households. This essay aims to examine a case study in which PPP and buildings energy efficiency have been successfully combined, in order to jointly contribute to the achievement of a social housing settlement. Thanks to energy efficiency measures—concerning building envelope insulation, heating system and other installations—the agreed rent results far higher than social rent of protected tenancies, and furthermore above the range of fair rents characterising other regulated tenancies, but mildly lower than market rents. All this allows to achieve an equity yield rate satisfying from the perspective of a venture philanthropy investment. -- Highlights: •Provision of affordable dwellings is an emerging priority within Italian context. •Lack of public funds leads to promote Public–Private Partnership schemes. •Without public grants the adoption of a venture philanthropy approach is needed. •The examined case study allows to explain the role of buildings energy efficiency. •Buildings energy efficiency may boost feasibility of social housing transactions

Policy approaches to improve availability and affordability of medicines in Mexico - an example of a middle income country.

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Moye-Holz, Daniela; van Dijk, Jitse P; Reijneveld, Sijmen A; Hogerzeil, Hans V

2017-08-01

The World Health Organization recommends establishing and implementing a national pharmaceutical policy (NPP) to guarantee effective and equitable access to medicines. Mexico has implemented several policy approaches to regulate the pharmaceutical sector, but it has no formal NPP. This article describes the approach that the Mexican government has taken to improve availability and affordability of essential medicines. Descriptive policy analysis of public pharmaceutical policy proposals and health action plans on the basis of publicly available data and health progress reports, with a focus on availability and affordability of medicines. The government has implemented pooled procurement, price negotiations, and an information platform in the public sector to improve affordability and availability. The government mainly reports on the savings that these strategies have generated in the public expenditure but their full impact on availability and affordability has not been assessed. To increase availability and affordability of medicines in the public sector, the Mexican government has resorted on isolated strategies. In addition to efficient procurement, price negotiations and price information, other policy components and pricing interventions are needed. All these strategies should be included in a comprehensive NPP.

Phytochemicals in Skin Cancer Prevention and Treatment: An Updated Review

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Chau Yee Ng

2018-03-01

Full Text Available Skin is the largest human organ, our protection against various environmental assaults and noxious agents. Accumulation of these stress events may lead to the formation of skin cancers, including both melanoma and non-melanoma skin cancers. Although modern targeted therapies have ameliorated the management of cutaneous malignancies, a safer, more affordable, and more effective strategy for chemoprevention and treatment is clearly needed for the improvement of skin cancer care. Phytochemicals are biologically active compounds derived from plants and herbal products. These agents appear to be beneficial in the battle against cancer as they exert anti-carcinogenic effects and are widely available, highly tolerated, and cost-effective. Evidence has indicated that the anti-carcinogenic properties of phytochemicals are due to their anti-oxidative, anti-inflammatory, anti-proliferative, and anti-angiogenic effects. In this review, we discuss the preventive potential, therapeutic effects, bioavailability, and structure–activity relationship of these selected phytochemicals for the management of skin cancers. The knowledge compiled here will provide clues for future investigations on novel oncostatic phytochemicals and additional anti-skin cancer mechanisms.

Domesticating Cancer: An Evolutionary Strategy in the War on Cancer

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Gustav van Niekerk

2017-12-01

Full Text Available Since cancer shares the same molecular machinery as the host, most therapeutic interventions that aim to target cancer would inadvertently also adversely affect the host. In addition, cancer continuously evolves, streamlining its host-derived genome for a new single-celled existence. In particular, short-term clinical success observed with most antineoplastic therapies directly relate to the fact that cancer is constantly evolving. However, the clonal evolution of cancer occasionally also render cancer cells uniquely susceptible to therapeutic interventions, as is exemplified by the clinical relevance of synthetic lethality. Synthetic lethality describes a situation where the simultaneous loss of function in two genes results in lethality, but where a loss of function in either single gene is tolerated. This observation suggests that the evolution of cancer, usually seen as a major clinical challenge, may also afford a key opportunity in lowering on-target toxicities accosted with chemotherapy. As an example, by subjecting cancer to specific selection regimes, cancer can in effect be placed on evolutionary trajectories leading to the development of “targetable” phenotypes such as synthetic lethal interactions. However, such a selection regime would have to overcome a range of obstacles such as on-target toxicity and the selection of an evolvable trait. Since the majority of cancer evolution manifests as a loss of function, we suggest that the induction of auxotrophic phenotypes (i.e., where an organism lose the ability to synthesize specific organic compounds required for growth and thus become dependent on it from dietary sources may represent an attractive therapeutic option. As an example, animals can obtain vitamin C either by de novo synthesis or from their diet. However, since the maintenance of synthetic pathways is costly, such pathways are often lost if no longer necessary, resulting in the organism being auxotrophic toward the

Teaching Text Structure: Examining the Affordances of Children's Informational Texts

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Jones, Cindy D.; Clark, Sarah K.; Reutzel, D. Ray

2016-01-01

This study investigated the affordances of informational texts to serve as model texts for teaching text structure to elementary school children. Content analysis of a random sampling of children's informational texts from top publishers was conducted on text structure organization and on the inclusion of text features as signals of text…

Affordances and Alignments: Continuing Challenges in Advising Undergraduate Psychology Majors

Science.gov (United States)

Landrum, R. Eric

2018-01-01

Challenges abound in providing accurate and useful information to prospective and declared psychology majors about their career options and how to make decisions that will lead to satisfying and rewarding postgraduate lives. One component of this challenge is that by majoring in psychology, career affordances (i.e., the opportunities and…

Phototherapy of cancer

International Nuclear Information System (INIS)

Morstyn, G.; Kaye, A.H.

1990-01-01

This book delivers a comprehensive review of the evolving field of photodynamic cancer therapy. The first half of the book covers the biologic basis and chemistry of such therapy, the physics of laser systems, and light and thermal dosimetry, while the second half reviews applications of photodynamic therapy to specific disease sites, with reference to the relevant laboratory studies and basic biology. The book ends with a chapter on future directions

PROGRAM OF PALLIATIVE CANCER CARE – OUR EXPERIENCE

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Iva Slánská

2013-01-01

Full Text Available Introduction: Annually more than 27,000 persons die of cancer in the Czech Republic and the overall incidence of malignancies is still increasing. These data shows the need for affordable and good follow-up care especially for patients without any cancer treatment due to irreversible progression of tumor. Currently the outpatient palliative cancer care gets more into the forefront. Prerequisite for a well working outpatient palliative care is cooperation with general practitioners and home health care agencies. The purpose of the so called program of palliative cancer care is to guide a patient in palliative cancer care and to improve the cooperation among health care providers. Methods: During the period from January 2008 to October 2010 we evaluated in patient without any oncology treatment due to irreversible progression of tumor. Results: In palliative outpatient clinic we treated 446 patients, 119 of them received home care services with average length of 27.8 days. 77 patients died at home, 51 in health facilities and 41 in inpatient hospice care. Conclusion: We present pilot study focusing on outpatient palliative cancer care which shows the real benefit from early indication of palliative cancer care. This type of care allows patients to stay as long as possible at home among their close relatives.

Virtual learning environments in the light of the Complexity Paradigm: interface, affordances and equifinality Ambientes virtuais de aprendizagem à luz do Paradigma da Complexidade: interface, affordances e equifinalidade

Directory of Open Access Journals (Sweden)

Valeska Virginia Soares Souza