WorldWideScience

Sample records for delivering affordable cancer

  1. Delivering affordable cancer care in high-income countries.

    Science.gov (United States)

    Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti

    2011-09-01

    The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies

  2. Delivering maximum clinical benefit at an affordable price: engaging stakeholders in cancer care.

    Science.gov (United States)

    Kelly, Ronan J; Smith, Thomas J

    2014-03-01

    Cancer costs continue to increase alarmingly despite much debate about how they can be reduced. The oncology community needs to take greater responsibility for our own practice patterns, especially when using expensive tests and treatments with marginal value: we cannot continue to accept novel therapeutics with very small benefits for exorbitant prices. Patients, payers, and pharmaceutical communities should be constructively engaged to communicate medically and economically possible goals, and eventually, to reduce use and costs. Diagnostic tests and treatments should have to show true value to be added to existing protocols. In this article, we discuss three key drivers of costs: end-of-life care patterns, medical imaging, and drugs. We propose health-care models that have the potential to decrease costs and discuss solutions to maintain clinical benefit at an affordable price. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Urging Affordable Access to High-Value Cancer Drugs

    Science.gov (United States)

    This infographic highlights some of the main messages from the President’s Cancer Panel report Promoting Value, Affordability, and Innovation in Cancer Drug Treatment. The graphic includes the panel’s recommendations to maximize the value and affordability of cancer drug treatment.

  4. 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...

  5. Patterns in Health Care Access and Affordability Among Cancer Survivors During Implementation of the Affordable Care Act.

    Science.gov (United States)

    Nipp, Ryan D; Shui, Amy M; Perez, Giselle K; Kirchhoff, Anne C; Peppercorn, Jeffrey M; Moy, Beverly; Kuhlthau, Karen; Park, Elyse R

    2018-03-29

    Cancer survivors face ongoing health issues and need access to affordable health care, yet studies examining health care access and affordability in this population are lacking. To evaluate health care access and affordability in a national sample of cancer survivors compared with adults without cancer and to evaluate temporal trends during implementation of the Affordable Care Act. We used data from the National Health Interview Survey from 2010 through 2016 to conduct a population-based study of 30 364 participants aged 18 years or older. We grouped participants as cancer survivors (n = 15 182) and those with no reported history of cancer, whom we refer to as control respondents (n = 15 182), matched on age. We excluded individuals reporting a cancer diagnosis prior to age 18 years and those with nonmelanoma skin cancers. We compared issues with health care access (eg, delayed or forgone care) and affordability (eg, unable to afford medications or health care services) between cancer survivors and control respondents. We also explored trends over time in the proportion of cancer survivors reporting these difficulties. Of the 30 364 participants, 18 356 (57.4%) were women. The mean (SD) age was 63.5 (23.5) years. Cancer survivors were more likely to be insured (14 412 [94.8%] vs 13 978 [92.2%], P care (odds ratio [OR], 1.38; 95% CI, 1.16-1.63), forgone medical care (OR, 1.76; 95% CI, 1.45-2.12), and/or inability to afford medications (OR, 1.77; 95% CI, 1.46-2.14) and health care services (OR, 1.46; 95% CI, 1.27-1.68) (P care decreased each year (B = 0.47; P = .047), and the proportion of those needing and not getting medical care also decreased each year (B = 0.35; P = .04). In addition, the proportion of cancer survivors who reported being unable to afford prescription medication decreased each year (B=0.66; P = .004) and the proportion of those unable to afford at least 1 of 6 services decreased each year (B = 0

  6. Cancer preventive services, socioeconomic status, and the Affordable Care Act.

    Science.gov (United States)

    Cooper, Gregory S; Kou, Tzuyung Doug; Dor, Avi; Koroukian, Siran M; Schluchter, Mark D

    2017-05-01

    Out-of-pocket expenditures are thought to be an important barrier to the receipt of cancer preventive services, especially for those of a lower socioeconomic status (SES). The Affordable Care Act (ACA) eliminated out-of-pocket expenditures for recommended services, including mammography and colonoscopy. The objective of this study was to determine changes in the uptake of mammography and colonoscopy among fee-for-service Medicare beneficiaries before and after ACA implementation. Using Medicare claims data, this study identified women who were 70 years old or older and had not undergone mammography in the previous 2 years and men and women who were 70 years old or older, were at increased risk for colorectal cancer, and had not undergone colonoscopy in the past 5 years. The receipt of procedures in the 2-year period before the ACA's implementation (2009-2010) and after its implementation (2011 to September 2012) was also identified. Multivariate generalized estimating equation models were used to determine the independent association and county-level quartile of median income and education with the receipt of testing. For mammography, a lower SES quartile was associated with less uptake, but the post-ACA disparities were smaller than those in the pre-ACA period. In addition, mammography rates increased from the pre-ACA period to the post-ACA period in all SES quartiles. For colonoscopy, in both the pre- and post-ACA periods, there was an association between uptake and educational level and, to some extent, income. However, there were no appreciable changes in colonoscopy and SES after implementation of the ACA. The removal of out-of-pocket expenditures may overcome a barrier to the receipt of recommended preventive services, but for colonoscopy, other procedural factors may remain as deterrents. Cancer 2017;123:1585-1589. © 2017 American Cancer Society. © 2017 American Cancer Society.

  7. Partner-delivered reflexology: effects on cancer pain and anxiety.

    Science.gov (United States)

    Stephenson, Nancy L N; Swanson, Melvin; Dalton, Joann; Keefe, Frances J; Engelke, Martha

    2007-01-01

    To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety. The experimental pretest/post-test design included patient-partner dyads randomly assigned to an experimental or control group. Four hospitals in the southeastern United States. 42 experimental and 44 control subjects comprised 86 dyads of patients with metastatic cancer and their partners, representing 16 different types of cancer; 23% of patients had lung cancer, followed by breast, colorectal, and head and neck cancer and lymphoma. The subjects had a mean age of 58.3 years, 51% were female, 66% had a high school education or less, and 58% were Caucasian, 40% were African American, and 1% were Filipino. The intervention included a 15- to 30-minute teaching session on foot reflexology to the partner by a certified reflexologist, an optional 15- to 30-minute foot reflexology session for the partner, and a 30-minute, partner-delivered foot reflexology intervention for the patient. The control group received a 30-minute reading session from their partners. Pain and anxiety. Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety. A nurse reflexologist taught partners how to perform reflexology on patients with metastatic cancer pain in the hospital, resulting in an immediate decrease in pain intensity and anxiety; minimal changes were seen in the control group, who received usual care plus attention. Hospitals could have qualified professionals offer reflexology as a complementary therapy and teach interested partners the modality.

  8. 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.

  9. 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

  10. Affordability of cancer treatment for aging cancer patients in Singapore: an analysis of health, lifestyle, and financial burden.

    Science.gov (United States)

    Chan, Alexandre; Chiang, Yu Yan; Low, Xiu Hui; Yap, Kevin Yi-Lwern; Ng, Raymond

    2013-12-01

    With the expected rise in newly diagnosed cancer cases among the elderly in Singapore, the affordability of cancer treatments, particularly of targeted therapies, will be a growing concern for patients. This study examines the perspectives of aging cancer patients on the financial burden of their cancer treatments. A single-center, prospective study was conducted in the largest ambulatory cancer center in Singapore. Older (50 years old and above) cancer patients receiving treatment were recruited. Patients completed three sets of self-reporting tools assessing their (a) demographics and lifestyles, (b) health-related quality of life, and (c) perceptions of cancer treatment costs. The association between targeted therapy utilities and their perceived financial burden was evaluated using a multivariable logistic regression. Five hundred and sixteen patients were included in the study. The majority of the respondents (69.6 %) were between 50 and 64 years old. The majority were Singaporeans (97.7 %), belonged to the ethnic Chinese group (88.4 %), and most were female (59.1 %). The users of targeted therapies were 2.92 times more likely to perceive that the amount of cash that they spent on cancer treatment was more than expected and 2.52 times more likely to have difficulty paying for cancer treatments. Fortunately, the majority of the respondents (70.6 %) found their existing financial schemes helpful in reducing the necessary out-of-pocket expenses. Although aging cancer patients feel that the financial schemes in Singapore have helped them tremendously, the general perception is that they require further help to offset their out-of-pocket expenses. This is especially true for users of targeted therapies and those who have a poorer health status.

  11. Insurance denials for cancer clinical trial participation after the Affordable Care Act mandate.

    Science.gov (United States)

    Mackay, Christine B; Antonelli, Kaitlyn R; Bruinooge, Suanna S; Saint Onge, Jarron M; Ellis, Shellie D

    2017-08-01

    The Affordable Care Act (ACA) includes a mandate requiring most private health insurers to cover routine patient care costs for cancer clinical trial participation; however, the impact of this provision on cancer centers' efforts to accrue patients to clinical trials has not been well described. First, members of cancer research centers and community-based institutions (n = 252) were surveyed to assess the status of insurance denials, and then, a focused survey (n = 77) collected denial details. Univariate and multivariate analyses were used to examine associations between the receipt of denials and site characteristics. Overall, 62.7% of the initial survey respondents reported at least 1 insurance denial during 2014. Sites using a precertification process were 3.04 times more likely to experience denials (95% confidence interval, 1.55-5.99; P ≤ .001), and similar rates of denials were reported from sites located in states with preexisting clinical trial coverage laws versus states without them (82.3% vs 85.1%; χ = 50.7; P ≤ .001). Among the focused survey sites, academic centers reported denials more often than community sites (71.4% vs 46.4%). The failure of plans to cover trial participation was cited as the most common reason provided for denials (n = 33 [80.5%]), with nearly 80% of sites (n = 61) not receiving a coverage response from the insurer within 72 hours. Despite the ACA's mandate for most insurers to cover routine care costs for cancer clinical trial participation, denials and delays continue. Denials may continue because some insurers remain exempt from the law, or they may signal an implementation failure. Delays in coverage may affect patient participation in trials. Additional efforts to eliminate this barrier will be needed to achieve federal initiatives to double the pace of cancer research over the next 5 years. Future work should assess the law's effectiveness at the patient level to inform these efforts

  12. Effects of the Affordable Care Act on Young Women With Gynecologic Cancers.

    Science.gov (United States)

    Smith, Anna Jo Bodurtha; Fader, Amanda N

    2018-06-01

    To evaluate the effects of the dependent coverage mandate of the 2010 Affordable Care Act (ACA) on insurance status, stage at diagnosis, and receipt of fertility-sparing treatment among young women with gynecologic cancer. We used a difference-in-differences design to assess insurance status, stage at diagnosis (stage I-II vs III-IV), and receipt of fertility-spearing treatment before and after the 2010 ACA among young women aged 21-26 years vs women aged 27-35 years. We used the National Cancer Database with the 2004-2009 surveys as the pre-ACA years and the 2011-2014 surveys as the post-ACA years. Women with uterine, cervical, ovarian, vulvar, or vaginal cancer were included. We analyzed outcomes for women overall and by cancer and insurance type, adjusting for race, nonrural area, and area-level household income and education level. A total of 1,912 gynecologic cancer cases pre-ACA and 2,059 post-ACA were identified for women aged 21-26 years vs 9,782 cases pre-ACA and 10,456 post-ACA for women aged 27-35 years. The ACA was associated with increased insurance (difference in differences 2.2%, 95% CI -4.0 to 0.1, P=.04) for young women aged 21-26 years vs women aged 27-35 years and with a significant improvement in early stage at cancer diagnosis (difference in differences 3.6%, 95% CI 0.4-6.9, P=.03) for women aged 21-26 years. Receipt of fertility-sparing treatment increased for women in both age groups post-ACA (P for trend=.004 for women aged 21-26 years and .001 for women aged 27-35 years); there was no significant difference in differences between age groups. Privately insured women were more likely to be diagnosed at an early stage and receive fertility-sparing treatment than publicly insured or uninsured women throughout the study period (P<.001). Under the ACA's dependent coverage mandate, young women with gynecologic cancer were more likely to be insured and diagnosed at an early stage of disease.

  13. 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.

  14. Training radiographers to deliver an intervention to promote early presentation of breast cancer

    International Nuclear Information System (INIS)

    Burgess, Caroline; Teasdale, Emma; Omar, Lynne; Tucker, Lorraine; Ramirez, Amanda-Jane

    2012-01-01

    Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

  15. Pelvic Radiotherapy for Cancer of the Cervix: Is What You Plan Actually What You Deliver?

    International Nuclear Information System (INIS)

    Lim, Karen; Kelly, Valerie; Stewart, James; Xie, Jason; Cho, Young-Bin; Moseley, Joanne B.; Brock, Kristy; Fyles, Anthony; Lundin, Anna; Rehbinder, Henrik; Milosevic, Michael

    2009-01-01

    Purpose: Whole pelvic intensity-modulated radiotherapy (IMRT) is increasingly being used to treat cervix cancer and other gynecologic tumors. However, tumor and normal organ movement during treatment can substantially detract from the benefits of this approach. This study explored the effect of internal anatomic changes on the dose delivered to the tumor and organs at risk using a strategy integrating deformable soft-tissue modeling with simulated dose accumulation. Methods and Materials: Twenty patients with cervix cancer underwent baseline and weekly pelvic magnetic resonance imaging during treatment. Interfraction organ motion and delivered (accumulated) dose was modeled for three treatment scenarios: four-field box, large-margin whole pelvic IMRT (20-mm planning target volume, but 10 mm inferiorly) and small-margin IMRT (5-mm planning target volume). Results: Individually, the planned dose was not the same as the simulated delivered dose; however, when taken as a group, this was not statistically significant for the four-field box and large-margin IMRT plans. The small-margin IMRT plans yielded adequate target coverage in most patients; however, significant target underdosing occurred in 1 patient who displayed excessive, unpredictable internal target movement. The delivered doses to the organs at risk were significantly reduced with the small-margin plan, although substantial variability was present among the patients. Conclusion: Simulated dose accumulation might provide a more accurate depiction of the target and organ at risk coverage during fractionated whole pelvic IMRT for cervical cancer. The adequacy of primary tumor coverage using 5-mm planning target volume margins is contingent on the use of daily image-guided setup.

  16. 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.

  17. The affordances of broken affordances

    DEFF Research Database (Denmark)

    Grünbaum, Martin Gielsgaard; Simonsen, Jakob Grue

    2015-01-01

    We consider the use of physical and virtual objects having one or more affordances associated to simple interactions with them. Based on Kaptelinin and Nardi’s notion of instrumental affordance, we investigate what it means to break an affordance, and the two ensuing questions we deem most import...

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

    Science.gov (United States)

    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.

  19. Peptide-targeted, stimuli-responsive polymersomes for delivering a cancer stemness inhibitor to cancer stem cell microtumors.

    Science.gov (United States)

    Karandish, Fataneh; Froberg, James; Borowicz, Pawel; Wilkinson, John C; Choi, Yongki; Mallik, Sanku

    2018-03-01

    Often cancer relapses after an initial response to chemotherapy because of the tumor's heterogeneity and the presence of progenitor stem cells, which can renew. To overcome drug resistance, metastasis, and relapse in cancer, a promising approach is the inhibition of cancer stemness. In this study, the expression of the neuropilin-1 receptor in both pancreatic and prostate cancer stem cells was identified and targeted with a stimuli-responsive, polymeric nanocarrier to deliver a stemness inhibitor (napabucasin) to cancer stem cells. Reduction-sensitive amphiphilic block copolymers PEG 1900 -S-S-PLA 6000 and the N 3 -PEG 1900 -PLA 6000 were synthesized. The tumor penetrating iRGD peptide-hexynoic acid conjugate was linked to the N 3 -PEG 1900 -PLA 6000 polymer via a Cu 2+ catalyzed "Click" reaction. Subsequently, this peptide-polymer conjugate was incorporated into polymersomes for tumor targeting and tissue penetration. We prepared polymersomes containing 85% PEG 1900 -S-S-PLA 6000 , 10% iRGD-polymer conjugate, and 5% DPPE-lissamine rhodamine dye. The iRGD targeted polymersomes encapsulating the cancer stemness inhibitor napabucasin were internalized in both prostate and pancreatic cancer stem cells. The napabucasin encapsulated polymersomes significantly (p < .05) reduced the viability of both prostate and pancreatic cancer stem cells and decreased the stemness protein expression notch-1 and nanog compared to the control and vesicles without any drug. The napabucasin encapsulated polymersome formulations have the potential to lead to a new direction in prostate and pancreatic cancer therapy by penetrating deeply into the tumors, releasing the encapsulated stemness inhibitor, and killing cancer stem cells. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. 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.

  1. 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.

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

    Science.gov (United States)

    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.

  3. 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

  4. 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.

  5. 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

  6. 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...

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. Can radiographers be trained to deliver an intervention to raise breast cancer awareness, and thereby promote early presentation of breast cancer, in older women?

    International Nuclear Information System (INIS)

    Omar, L.; Burgess, C.C.; Tucker, L.D.; Whelehan, P.; Ramirez, A.J.

    2010-01-01

    Aims: To assess the feasibility of training radiographers to deliver a one-to-one intervention to raise breast cancer awareness among older women. The ultimate aim is to increase the likelihood of early presentation of breast cancer by older women and improve survival from the disease. Method: Four radiographers were trained to deliver a 10-min scripted one-to-one intervention. Key elements of training included rehearsal of the intervention using role-play with actors and colleagues and practice interviews with women attending NHS breast screening clinics. All practice interventions were videotaped to facilitate positive, constructive feedback on performance. Competence to deliver the intervention was assessed on delivery of the key messages and the style of delivery. Radiographers' experiences of training and intervention delivery were collated from reflective diaries. Results: Three radiographers were assessed as competent after training and all four increased in confidence to deliver the intervention. Reported benefits to radiographers included increased awareness of communication skills and enhanced interaction with women attending breast screening. Radiographers reported challenges relating to mastering the prescriptive nature of the intervention and to delivering complex health messages within time constraints. Discussion: It was feasible but challenging for radiographers to be trained to deliver a one-to-one intervention designed to raise breast cancer awareness and thereby to promote early presentation of breast cancer. If the intervention is found to be cost-effective it may be implemented across the NHS Breast Screening Programme with diagnostic radiographers playing a key role in promoting early presentation of breast cancer.

  14. IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients

    International Nuclear Information System (INIS)

    Fregnani, Eduardo Rodrigues; Parahyba, Cláudia Joffily; Morais-Faria, Karina; Fonseca, Felipe Paiva; Ramos, Pedro Augusto Mendes; Moraes, Fábio Yone de; Conceição Vasconcelos, Karina Gondim Moutinho da; Menegussi, Gisela; Santos-Silva, Alan Roger; Brandão, Thais B.

    2016-01-01

    Radiotherapy (RT) is frequently used in the treatment of head and neck cancer, but different side-effects are frequently reported, including a higher frequency of radiation-related caries, what may be consequence of direct radiation to dental tissue. The intensity-modulated radiotherapy (IMRT) was developed to improve tumor control and decrease patient’s morbidity by delivering radiation beams only to tumor shapes and sparing normal tissue. However, teeth are usually not included in IMRT plannings and the real efficacy of IMRT in the dental context has not been addressed. Therefore, the aim of this study is to assess whether IMRT delivers lower radiation doses to dental structures than conformal 3D radiotherapy (3DRT). Radiation dose delivery to dental structures of 80 patients treated for head and neck cancers (oral cavity, tongue, nasopharynx and oropharynx) with IMRT (40 patients) and 3DRT (40 patients) were assessed by individually contouring tooth crowns on patients’ treatment plans. Clinicopathological data were retrieved from patients’ medical files. The average dose of radiation to teeth delivered by IMRT was significantly lower than with 3DRT (p = 0.007); however, only patients affected by nasopharynx and oral cavity cancers demonstrated significantly lower doses with IMRT (p = 0.012 and p = 0.011, respectively). Molars received more radiation with both 3DRT and IMRT, but the latter delivered significantly lower radiation in this group of teeth (p < 0.001), whereas no significant difference was found for the other dental groups. Maxillary teeth received lower doses than mandibular teeth, but only IMRT delivered significantly lower doses (p = 0.011 and p = 0.003). Ipsilateral teeth received higher doses than contralateral teeth with both techniques and IMRT delivered significantly lower radiation than 3DRT for contralateral dental structures (p < 0.001). IMRT delivered lower radiation doses to teeth than 3DRT, but only for some groups of patients and

  15. IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients.

    Science.gov (United States)

    Fregnani, Eduardo Rodrigues; Parahyba, Cláudia Joffily; Morais-Faria, Karina; Fonseca, Felipe Paiva; Ramos, Pedro Augusto Mendes; de Moraes, Fábio Yone; da Conceição Vasconcelos, Karina Gondim Moutinho; Menegussi, Gisela; Santos-Silva, Alan Roger; Brandão, Thais B

    2016-09-07

    Radiotherapy (RT) is frequently used in the treatment of head and neck cancer, but different side-effects are frequently reported, including a higher frequency of radiation-related caries, what may be consequence of direct radiation to dental tissue. The intensity-modulated radiotherapy (IMRT) was developed to improve tumor control and decrease patient's morbidity by delivering radiation beams only to tumor shapes and sparing normal tissue. However, teeth are usually not included in IMRT plannings and the real efficacy of IMRT in the dental context has not been addressed. Therefore, the aim of this study is to assess whether IMRT delivers lower radiation doses to dental structures than conformal 3D radiotherapy (3DRT). Radiation dose delivery to dental structures of 80 patients treated for head and neck cancers (oral cavity, tongue, nasopharynx and oropharynx) with IMRT (40 patients) and 3DRT (40 patients) were assessed by individually contouring tooth crowns on patients' treatment plans. Clinicopathological data were retrieved from patients' medical files. The average dose of radiation to teeth delivered by IMRT was significantly lower than with 3DRT (p = 0.007); however, only patients affected by nasopharynx and oral cavity cancers demonstrated significantly lower doses with IMRT (p = 0.012 and p = 0.011, respectively). Molars received more radiation with both 3DRT and IMRT, but the latter delivered significantly lower radiation in this group of teeth (p dental groups. Maxillary teeth received lower doses than mandibular teeth, but only IMRT delivered significantly lower doses (p = 0.011 and p = 0.003). Ipsilateral teeth received higher doses than contralateral teeth with both techniques and IMRT delivered significantly lower radiation than 3DRT for contralateral dental structures (p radiation doses to teeth than 3DRT, but only for some groups of patients and teeth, suggesting that this decrease was more likely due to the protection of

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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...

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. Influence of definitive radiation therapy for primary breast cancer on ability to deliver adjuvant chemotherapy

    International Nuclear Information System (INIS)

    Lippman, M.E.; Edwards, B.K.; Findlay, P.; Danforth, D.W. Jr.; MacDonald, H.; D'Angelo, T.; Gorrell, C.

    1986-01-01

    Primary radiotherapy as a means of managing stage I and II breast cancer is receiving increasing attention. In a prospectively randomized trial comparing modified radical mastectomy to lumpectomy followed by definitive radiotherapy, we evaluated whether radiotherapy has a deleterious effect on the ability to administer adjuvant doxorubicin and cyclophosphamide to patients with histologically positive axillary lymph nodes. All patients were treated with an identical regimen, and doses were escalated to the same degree until myelosuppression occurred. There were no significant differences in the amount of chemotherapy administered to either treatment group. Patients in both groups received approximately 100% of the predicted dose of doxorubicin and approximately 117% of the predicted dose of cyclophosphamide. At present, we have no evidence that there are differences in recurrence rates as a function of the quantity of drug received, although longer follow-up is required

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. Dose delivered from Varian's CBCT to patients receiving IMRT for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wen Ning; Guan Huaiqun; Hammoud, Rabih; Pradhan, Deepak; Nurushev, T; Li Shidong; Movsas, Benjamin [Henry Ford Health System, Detroit, MI (United States)

    2007-04-21

    With the increased use of cone beam CT (CBCT) for daily patient setup, the accumulated dose from CBCT may be significantly higher than that from simulation CT or portal imaging. The objective of this work is to measure the dose from daily pelvic scans with fixed technical settings and collimations. CBCT scans were acquired in half-fan mode using a half bowtie and x-rays were delivered in pulsed-fluoro mode. The skin doses for seven prostate patients were measured on an IRB-approved protocol. TLD capsules were placed on the patient's skin at the central axis of three beams: AP, left lateral (Lt Lat) and right lateral (Rt Lat). To avoid the ring artefacts centred in the prostate, the treatment couch was dropped 3 cm from the patient's tattoo (central axis). The measured AP skin doses ranged 3-6 cGy for 20-33 cm separation. The larger the patient size the less the AP skin dose. Lateral doses did not change much with patient size. The Lt Lat dose was {approx}4.0 cGy, which was {approx}40% higher than the Rt Lat dose of {approx}2.6 cGy. To verify this dose asymmetry, surface doses on an IMRT QA phantom (oval shaped, 30 cm x 20 cm) were measured at the same three sites using TLD capsules with 3 cm table-drop. The dose asymmetry was due to: (1) kV source rotation which always starts from the patient's Lt Lat and ends at Lt Lat. Gantry rotation gets much slower near the end of rotation but dose rate stays constant and (2) 370{sup 0} scan rotation (10{sup 0} scan overlap on the Lt Lat side). In vivo doses were measured inside a Rando pelvic heterogeneous phantom using TLDs. The left hip (femoral head and neck) received the highest doses of {approx}10-11 cGy while the right hip received {approx}6-7 cGy. The surface and in vivo doses were also measured for phantoms at the central-axis setup. The difference was less than {approx}12% to the table-drop setup.

  17. Dose delivered from Varian's CBCT to patients receiving IMRT for prostate cancer

    International Nuclear Information System (INIS)

    Wen Ning; Guan Huaiqun; Hammoud, Rabih; Pradhan, Deepak; Nurushev, T; Li Shidong; Movsas, Benjamin

    2007-01-01

    With the increased use of cone beam CT (CBCT) for daily patient setup, the accumulated dose from CBCT may be significantly higher than that from simulation CT or portal imaging. The objective of this work is to measure the dose from daily pelvic scans with fixed technical settings and collimations. CBCT scans were acquired in half-fan mode using a half bowtie and x-rays were delivered in pulsed-fluoro mode. The skin doses for seven prostate patients were measured on an IRB-approved protocol. TLD capsules were placed on the patient's skin at the central axis of three beams: AP, left lateral (Lt Lat) and right lateral (Rt Lat). To avoid the ring artefacts centred in the prostate, the treatment couch was dropped 3 cm from the patient's tattoo (central axis). The measured AP skin doses ranged 3-6 cGy for 20-33 cm separation. The larger the patient size the less the AP skin dose. Lateral doses did not change much with patient size. The Lt Lat dose was ∼4.0 cGy, which was ∼40% higher than the Rt Lat dose of ∼2.6 cGy. To verify this dose asymmetry, surface doses on an IMRT QA phantom (oval shaped, 30 cm x 20 cm) were measured at the same three sites using TLD capsules with 3 cm table-drop. The dose asymmetry was due to: (1) kV source rotation which always starts from the patient's Lt Lat and ends at Lt Lat. Gantry rotation gets much slower near the end of rotation but dose rate stays constant and (2) 370 0 scan rotation (10 0 scan overlap on the Lt Lat side). In vivo doses were measured inside a Rando pelvic heterogeneous phantom using TLDs. The left hip (femoral head and neck) received the highest doses of ∼10-11 cGy while the right hip received ∼6-7 cGy. The surface and in vivo doses were also measured for phantoms at the central-axis setup. The difference was less than ∼12% to the table-drop setup

  18. 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.

  19. 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

  20. 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...

  1. 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...

  2. 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.

  3. 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....

  4. Exosomes serve as nanoparticles to suppress tumor growth and angiogenesis in gastric cancer by delivering hepatocyte growth factor siRNA.

    Science.gov (United States)

    Zhang, Haiyang; Wang, Yi; Bai, Ming; Wang, Junyi; Zhu, Kegan; Liu, Rui; Ge, Shaohua; Li, JiaLu; Ning, Tao; Deng, Ting; Fan, Qian; Li, Hongli; Sun, Wu; Ying, Guoguang; Ba, Yi

    2018-03-01

    Exosomes derived from cells have been found to mediate signal transduction between cells and to act as efficient carriers to deliver drugs and small RNA. Hepatocyte growth factor (HGF) is known to promote the growth of both cancer cells and vascular cells, and the HGF-cMET pathway is a potential clinical target. Here, we characterized the inhibitory effect of HGF siRNA on tumor growth and angiogenesis in gastric cancer. In addition, we showed that HGF siRNA packed in exosomes can be transported into cancer cells, where it dramatically downregulates HGF expression. A cell co-culture model was used to show that exosomes loaded with HGF siRNA suppress proliferation and migration of both cancer cells and vascular cells. Moreover, exosomes were able to transfer HGF siRNA in vivo, decreasing the growth rates of tumors and blood vessels. The results of our study demonstrate that exosomes have potential for use in targeted cancer therapy by delivering siRNA. © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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.

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

    Science.gov (United States)

    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.

  11. 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.

  12. 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.

  13. 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.

  14. 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...

  15. 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...

  16. 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.

  17. 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.

  18. Counseling interventions delivered in women with breast cancer to improve health-related quality of life: a systematic review.

    Science.gov (United States)

    D'Egidio, V; Sestili, C; Mancino, M; Sciarra, I; Cocchiara, R; Backhaus, I; Mannocci, A; De Luca, Alessandro; Frusone, Federico; Monti, Massimo; La Torre, G

    2017-10-01

    Higher survival rates for breast cancer patients have led to concerns in dealing with short- and long-term side effects. The most common complications are impairment of shoulder functions, pain, lymphedema, and dysesthesia of the injured arm; psychological consequences concern: emotional distress, anxiety, and depression, thereby, deeply impacting/affecting daily living activity, and health-related quality of life. To perform a systematic review for assessing the efficacy or effectiveness of interventions aiming at improving health-related quality of life, return to daily activity, and correct lifestyles among breast cancer patients. A literature search was conducted in December 2016 using the databases PubMed and Scopus. Search terms included: (counseling) AND (breast cancer) AND (quality of life). Articles on counseling interventions to improve quality of life, physical and psychological outcomes were included. Thirty-five articles met the inclusion criteria. The interventions were grouped in five main areas: concerning lifestyle counseling interventions, related to combined interventions (physical activity and nutritional counseling), physical therapy, peer counseling, multidisciplinary approach, included psychological, psycho-educational interventions, and cognitive-behavior therapy (CBT). Exercise counseling as well as physical therapy are effective to improve shoulder mobility, healing wounds, and limb strength. Psychological therapies such as psychoeducation and CBT may help to realize a social and psychological rehabilitation. A multidisciplinary approach can help in sustaining and restoring impaired physical, psychosocial, and occupational outcomes of breast cancer patients.

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

    DEFF Research Database (Denmark)

    Zachariae, Robert; Amidi, Ali; Damholdt, Malene F

    2018-01-01

    Background: 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...

  20. Internet-delivered cognitive-behavioral therapy for insomnia in women treated for breast cancer: a randomized controlled trial

    DEFF Research Database (Denmark)

    Zachariae, Robert Hugh; Amidi, Ali; Damholdt, Malene

    2018-01-01

    Background 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....

  1. 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

  2. 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…

  3. 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.

  4. Antiproliferative effect of ASC-J9 delivered by PLGA nanoparticles against estrogen-dependent breast cancer cells.

    Science.gov (United States)

    Verderio, Paolo; Pandolfi, Laura; Mazzucchelli, Serena; Marinozzi, Maria Rosaria; Vanna, Renzo; Gramatica, Furio; Corsi, Fabio; Colombo, Miriam; Morasso, Carlo; Prosperi, Davide

    2014-08-04

    Among polymeric nanoparticles designed for cancer therapy, PLGA nanoparticles have become one of the most popular polymeric devices for chemotherapeutic-based nanoformulations against several kinds of malignant diseases. Promising properties, including long-circulation time, enhanced tumor localization, interference with "multidrug" resistance effects, and environmental biodegradability, often result in an improvement of the drug bioavailability and effectiveness. In the present work, we have synthesized 1,7-bis(3,4-dimethoxyphenyl)-5-hydroxyhepta-1,4,6-trien-3-one (ASC-J9) and developed uniform ASC-J9-loaded PLGA nanoparticles of about 120 nm, which have been prepared by a single-emulsion process. Structural and morphological features of the nanoformulation were analyzed, followed by an accurate evaluation of the in vitro drug release kinetics, which exhibited Fickian law diffusion over 10 days. The intracellular degradation of ASC-J9-bearing nanoparticles within estrogen-dependent MCF-7 breast cancer cells was correlated to a time- and dose-dependent activity of the released drug. A cellular growth inhibition associated with a specific cell cycle G2/M blocking effect caused by ASC-J9 release inside the cytosol allowed us to put forward a hypothesis on the action mechanism of this nanosystem, which led to the final cell apoptosis. Our study was accomplished using Annexin V-based cell death analysis, MTT assessment of proliferation, radical scavenging activity, and intracellular ROS evaluation. Moreover, the intracellular localization of nanoformulated ASC-J9 was confirmed by a Raman optical imaging experiment designed ad hoc. PLGA nanoparticles and ASC-J9 proved also to be safe for a healthy embryo fibroblast cell line (3T3-L1), suggesting a possible clinical translation of this potential nanochemotherapeutic to expand the inherently poor bioavailability of hydrophobic ASC-J9 that could be proposed for the treatment of malignant breast cancer.

  5. 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

  6. 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

  7. Nanoparticle delivered vascular disrupting agents (VDAs): use of TNF-alpha conjugated gold nanoparticles for multimodal cancer therapy.

    Science.gov (United States)

    Shenoi, Mithun M; Iltis, Isabelle; Choi, Jeunghwan; Koonce, Nathan A; Metzger, Gregory J; Griffin, Robert J; Bischof, John C

    2013-05-06

    Surgery, radiation and chemotherapy remain the mainstay of current cancer therapy. However, treatment failure persists due to the inability to achieve complete local control of the tumor and curtail metastatic spread. Vascular disrupting agents (VDAs) are a class of promising systemic agents that are known to synergistically enhance radiation, chemotherapy or thermal treatments of solid tumors. Unfortunately, there is still an unmet need for VDAs with more favorable safety profiles and fewer side effects. Recent work has demonstrated that conjugating VDAs to other molecules (polyethylene glycol, CNGRCG peptide) or nanoparticles (liposomes, gold) can reduce toxicity of one prominent VDA (tumor necrosis factor alpha, TNF-α). In this report, we show the potential of a gold conjugated TNF-α nanoparticle (NP-TNF) to improve multimodal cancer therapies with VDAs. In a dorsal skin fold and hindlimb murine xenograft model of prostate cancer, we found that NP-TNF disrupts endothelial barrier function and induces a significant increase in vascular permeability within the first 1-2 h followed by a dramatic 80% drop in perfusion 2-6 h after systemic administration. We also demonstrate that the tumor response to the nanoparticle can be verified using dynamic contrast-enhanced magnetic resonance imaging (MRI), a technique in clinical use. Additionally, multimodal treatment with thermal therapies at the perfusion nadir in the sub- and supraphysiological temperature regimes increases tumor volumetric destruction by over 60% and leads to significant tumor growth delays compared to thermal therapy alone. Lastly, NP-TNF was found to enhance thermal therapy in the absence of neutrophil recruitment, suggesting that immune/inflammatory regulation is not central to its power as part of a multimodal approach. Our data demonstrate the potential of nanoparticle-conjugated VDAs to significantly improve cancer therapy by preconditioning tumor vasculature to a secondary insult in a targeted

  8. 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...

  9. 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.

  10. 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

  11. Anatomic-Based Three-Dimensional Planning Precludes Use of Catheter-Delivered Contrast for Treatment of Prostate Cancer

    International Nuclear Information System (INIS)

    Boersma, Melisa; Swanson, Gregory; Baacke, Diana C.; Eng, Tony

    2008-01-01

    Purpose: Retrograde urethrography is a standard method to identify the prostatic apex during planning for prostate cancer radiotherapy. This is an invasive and uncomfortable procedure. With modern three-dimensional computed tomography planning, we explored whether retrograde urethrography was still necessary to accurately identify the prostatic apex. Methods and Materials: Fifteen patients underwent computed tomography simulation with and without bladder, urethral, and rectal contrast. The prostatic base and apex were identified on both scans, using contrast and anatomy, respectively. The anatomic location of the prostatic apex as defined by these methods was confirmed in another 57 patients with postbrachytherapy imaging. Results: The prostatic base and apex were within a mean of 3.8 mm between the two scans. In every case, the beak of the retrograde urethrogram abutted the line drawn parallel to, and bisecting, the pubic bone on the lateral films. With these anatomic relationships defined, in the postbrachytherapy patients, the distance from the prostatic apex to the point at which the urethra traversed the pelvic floor was an average of 11.7 mm. On lateral films, we found that the urethra exited the pelvis an average of 16.6 mm below the posterior-most fusion of the pubic symphysis. On axial images, this occurred at a mean separation of the ischia of about 25 mm. Conclusion: With a knowledge of the anatomic relationships and modern three-dimensional computed tomography planning equipment, the prostatic apex can be easily and consistently identified, obviating the need to subject patients to retrograde urethrography

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. 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 ...

  8. 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…

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

    Science.gov (United States)

    Bonelli, Patrizia; Tuccillo, Franca M; Federico, Antonella; Napolitano, Maria; Borrelli, Antonella; Melisi, Daniela; Rimoli, Maria G; Palaia, Raffaele; Arra, Claudio; Carinci, Francesco

    2012-01-01

    Purpose 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 concentration at 24 hours. The inhibition of proliferation was confirmed to be due to the intracellular release of ibuprofen from the NPs. Using PLGA NPs as carriers, ibuprofen exerted an antiproliferative activity at concentrations > 100 times less than free ibuprofen, suggesting greater efficiency and less cellular toxicity. In addition, when carried by PLGA NPs, ibuprofen more quickly induced the expression of transcripts involved in proliferation and invasiveness processes. Conclusion Ibuprofen exerted an antiproliferative effect on MKN-45 cells at low concentrations. This effect was achieved using PLGA NPs as carriers of low doses of ibuprofen. PMID:23180963

  10. 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

  11. 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.

  12. GCN2 and FGF21 are likely mediators of the protection from cancer, autoimmunity, obesity, and diabetes afforded by vegan diets.

    Science.gov (United States)

    McCarty, Mark F

    2014-09-01

    Third World quasi-vegan cultures have been characterized by low risks for "Western" cancers, autoimmune disorders, obesity, and diabetes. The relatively low essential amino acid contents of many vegan diets may play a role in this regard. It is proposed that such diets modestly activate the kinase GCN2 - a physiological detector of essential amino acid paucity - within the liver, resulting in up-regulated production of fibroblast growth factor 21 (FGF21). FGF21, by opposing the stimulatory effect of growth hormone on hepatic IGF-I production, may be responsible for the down-regulation of plasma IGF-I observed in vegans consuming diets of modest protein content. Decreased IGF-I bioactivity throughout life can be expected to have a favorable impact on cancer risk, as observed in rodents that are calorie restricted or genetically defective in IGF-I activity. Increased FGF21 in vegans might also contribute to their characteristic leanness and low LDL cholesterol by promoting hepatic lipid oxidation while inhibiting lipogenesis. Direct trophic effects of FGF21 on pancreatic beta-cells may help to explain the low risk for diabetes observed in vegans, and the utility of vegan diets in diabetes management. And up-regulation of GCN2 in immune cells, by boosting T regulatory activity, might play some role in the reduced risk for autoimmunity reported in some quasi-vegan cultures. The fact that bone density tends to be no greater in vegans than omnivores, despite consumption of a more "alkaline" diet, might be partially attributable to the fact that FGF21 opposes osteoblastogenesis and decreases IGF-I. If these speculations have merit, it should be possible to demonstrate that adoption of a vegan diet of modest protein content increases plasma FGF21 levels. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. 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...

  14. 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....

  15. 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?

  16. 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...

  17. 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...

  18. 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

  19. 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.

  20. 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 ...

  1. 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

  2. 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.

  3. 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...

  4. 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. ...

  5. Blocking hepatic metastases of colon cancer cells using an shRNA against Rac1 delivered by activatable cell-penetrating peptide.

    Science.gov (United States)

    Bao, Ying; Guo, Huihui; Lu, Yongliang; Feng, Wenming; Sun, Xinrong; Tang, Chengwu; Wang, Xiang; Shen, Mo

    2016-11-22

    Hepatic metastasis is one of the critical progressions of colon cancer. Blocking this process is key to prolonging survival time in cancer patients. Studies on activatable cell-penetrating peptides (dtACPPs) have demonstrated their potential as gene carriers. It showed high tumor cell-targeting specificity and transfection efficiency and low cytotoxicity in the in vitro settings of drug delivery. However, using this system to silence target genes to inhibit metastasis in colorectal cancer cells has not been widely reported and requires further investigation. In this study, we observed that expression of Rac1, a key molecule for cytoskeletal reorganization, was higher in hepatic metastatic tumor tissue compared with prime colon cancer tissue and that patients with high Rac1-expressing colon cancer showed shorter survival time. Base on these findings, we created dtACPP-PEG-DGL (dtACPPD)/shRac1 nanoparticles and demonstrated that they downregulated Rac1 expression in colon cancer cells. Moreover, we observed inhibitory effects on migration, invasion and adhesion in HCT116 colorectal cancer cells in vitro, and our results showed that Rac1 regulated colon cancer cell matrix adhesion through the regulation of cytofilament dynamics. Moreover, mechanically, repression of Rac1 inhibiting cells migration and invasion by enhancing cell to cell adhesion and reducing cell to extracellular matrix adhesion. Furthermore, when atCDPPD/shRac1 nanoparticles were administered intravenously to a HCT116 xenograft model, significant tumor metastasis to the liver was inhibited. Our results suggest that atCDPP/shRac1 nanoparticles may enable the blockade of hepatic metastasis in colon cancer.

  6. 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.

  7. 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.

  8. PATI: Patient accessed tailored information: A pilot study to evaluate the effect on preoperative breast cancer patients of information delivered via a mobile application.

    Science.gov (United States)

    Foley, N M; O'Connell, E P; Lehane, E A; Livingstone, V; Maher, B; Kaimkhani, S; Cil, T; Relihan, N; Bennett, M W; Redmond, H P; Corrigan, M A

    2016-12-01

    The information needs of cancer patients are highly variable. Literature suggests an improved ability to modulate personalised stress, increased patient involvement with decision making, greater satisfaction with treatment choices and reduced anxiety levels in cancer patients who have access to information. The aim of this project was to evaluate the effects of a mobile information application on anxiety levels of patients undergoing surgery for breast cancer. An application was developed for use with Apple iPad containing information on basic breast cancer biology, different treatments used and surgical techniques. Content and face validity studies were performed. A randomized control trial was designed, with a 1:2 allocation. Data collected include basic demographics and type of surgery. Questionnaires used included: the HADS, Mini-MAC, information technology familiarity and information satisfaction. A total of 39 women participated. 13 women had access to an iPad containing additional information and 26 women acted as controls. The mean age was 54 and technology familiarity was similar among both groups. Anxiety and depression scores at seven days were significantly lower in control patients without access to the additional information provided by the mobile application (p = 0.022 and 0.029 respectively). Anxiety and depression in breast cancer patients is both multifactorial and significant, with anxiety levels directly correlating with reduced quality of life. Intuitively, information should improve anxiety levels, however, we have demonstrated that surgical patients with less information reported significantly lower anxiety. We advise the thorough testing and auditing of information initiatives before deployment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. 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.

  10. A snapshot of cancer in Chile: analytical frameworks for developing a cancer policy.

    Science.gov (United States)

    Jimenez de 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; McNerney, Eileen; Sullivan, Richard; Owen, Gareth I

    2015-01-26

    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. Evaluate existing cancer policy, the extent of national investigation and the socio-economic impact of cancer to deliver guidelines for the framing of an equitable national cancer policy. Burden, research and care-policy systems were assessed by triangulating objective system metrics--epidemiological, economic, etc.--with political and policy analysis. Analysis of the literature and governmental databases was performed. The oncology community was interviewed and surveyed. Chile utilizes 1% of its gross domestic product on cancer care and treatment. We estimate that the economic impact as measured in Disability Adjusted Life Years to be US$ 3.5 billion. Persistent inequalities still occur in cancer distribution and treatment. A high quality cancer research community is expanding, however, insufficient funding is directed towards disproportionally prevalent stomach, lung and gallbladder cancers. Chile has a rapidly ageing population wherein 40% smoke, 67% are overweight and 18% abuse alcohol, and thus the corresponding burden of cancer will have a negative impact on an affordable health care system. We conclude that the Chilean government must develop a national cancer strategy, which the authors outline herein and believe is essential to permit equitable cancer care for the country.

  11. 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.

  12. 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.

  13. Delivering migrant workers' remittances

    OpenAIRE

    Ballard, Roger

    2004-01-01

    As globalization has led to ever higher levels of labour mobility, so the volume of funds remitted to their families by workers employed in countries far distant from their homes has increased by leaps and bounds. The total volume of such transfers currently amounts to over $100 billion per annum, the greater part of which flows from economically advanced regions in the West and North to developing countries in the East and South. Delivering those funds swiftly, reliably and cheaply to relati...

  14. 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

  15. 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

  16. 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.

  17. SU-E-P-55: The Reaserch of Cervical Cancer Delivered with Constant Dose Rate and Gantry Speed Arc Therapy(CDR-CAS-IMAT) On Conventional Linac

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, R; Bai, W; Chi, Z; Gao, C; Xiaomei, F [The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei (China); Gao, Y [Hebei General Hospital, Shijiazhuang, Hebei (China)

    2015-06-15

    Purpose: Postoperative cervical cancer patients with large target volume and the target shape is concave, treatmented with static intensity-modulated radiotherapy (IMRT) is time consuming. The purpose of this study is to investigate using constant dose rate and gantry speed arc therapy(CDR-CAS-IMAT) on conventional linear accelrator, by comparing with the IMRT technology to evaluate the performance of CDR-CAS-IMAT on postoperative cervical cancer patients. Methods: 18 cervical cancer patients treated with IMRT on Varian 23IX were replanted using CDR-CAS-IMAT. The plans were generated on Oncentra v4.1 planning system, PTV was prescribed to 50.4 Gy in 28 fractions. Plans were evaluated based on the ability to meet the dose volume histogram. The homogeneity index (HI), conformity index (CI) of target volume, the dose of organs at risk, radiation delivery time and monitor units were also compared. SPSS 19.0 software paired T-test analysis was carried out on the two sets of data. Results: Compared with the IMRT plans PTV’s CI (t= 3.85, P =0.001), CTV’s CI, HI, D90, D95, D98, V95, V98, V100 (t=4.21, −3.18, 2.13, 4.65, 7.79, 2.29, 6.00, 2.13, p=0.001, 0.005, 0.049, 0.000, 0.000, 0.035, 0.000, 0.049), and cord D2 and rectum V40 (t=−2.65, −2.47, p= P =0.017, 0.025), and treatment time and MU (t=−36.0, −6.26, P =0.000, 0.000) were better than that of IMRT group. But the IMRT plans in terms of decreasing bladder V50, bowel V30 (t=2.14, 3.00, P =0.048, 0.008) and low dose irradiation volume were superior to that of CDR-CAS-IMAT plans. There were no significant differences in other statistical index. Conclusion: Cervical cancer patients with CDR-CAS-IMAT on Varian Clinical 23IX can get equivalent or superior dose distribution compared with the IMRT technology. IMAT have much less treatment time and MU can reduce the uncertainty factor and patient discomfort in treatment. This work was supported by the Medical Science Foundation of the health department of Hebei

  18. Pathways of cellular internalisation of liposomes delivered siRNA and effects on siRNA engagement with target mRNA and silencing in cancer cells.

    Science.gov (United States)

    Alshehri, Abdullah; Grabowska, Anna; Stolnik, Snow

    2018-02-28

    Design of an efficient delivery system is a generally recognised bottleneck in translation of siRNA technology into clinic. Despite research efforts, cellular processes that determine efficiency of siRNA silencing achieved by different delivery formulations remain unclear. Here, we investigated the mechanism(s) of cellular internalisation of a model siRNA-loaded liposome system in a correlation to the engagement of delivered siRNA with its target and consequent silencing by adopting siRNA molecular beacon technology. Probing of cellular internalisation pathways by a panel of pharmacological inhibitors indicated that clathrin-mediated (dynamin-dependent) endocytosis, macropinocytosis (dynamine independent), and cell membrane cholesterol dependent process(es) (clathrin and caveolea-independent) all play a role in the siRNA-liposomes internalization. The inhibition of either of these entry routes was, in general, mirrored by a reduction in the level of siRNA engagement with its target mRNA, as well as in a reduction of the target gene silencing. A dramatic increase in siRNA engagement with its target RNA was observed on disruption of endosomal membrane (by chloroquine), accompanied with an increased silencing. The work thus illustrates that employing molecular beacon siRNA technology one can start to assess the target RNA engagement - a stage between initial cellular internalization and final gene silencing of siRNA delivery systems.

  19. 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.

  20. Transperineal Injection of Hyaluronic Acid in Anterior Perirectal Fat to Decrease Rectal Toxicity From Radiation Delivered With Intensity Modulated Brachytherapy or EBRT for Prostate Cancer Patients

    International Nuclear Information System (INIS)

    Prada, Pedro J.; Fernandez, Jose; Martinez, Alvaro A.; Rua, Angeles de la; Gonzalez, Jose M.; Fernandez, Jose M.; Juan, German

    2007-01-01

    Purpose: Rectal toxicity remains a serious complication affecting quality of life for prostate cancer patients treated with radiotherapy. We began an investigational trial injecting hyaluronic acid (HA) in the perirectal fat to increase the distance between the prostate and the anterior rectal wall. This is the first report using HA injection in oncology. Methods and Materials: This is a trial of external beam radiation therapy with HDR brachytherapy boosts in prostate cancer. During the two high-dose-rate (HDR) fractions, thermoluminescent dosimeter dosimeters were placed in the urethra and in the rectum. Before the second HDR fraction, 3-7 mL (mean, 6 mL) of HA was injected under transrectal ultrasound guidance in the perirectal fat to systematically create a 1.5-cm space. Urethral and rectal HDR doses were calculated and measured. Computed tomography and magnetic resonance imaging were used to assess the stability of the new space. Results: Twenty-seven patients enrolled in the study. No toxicity was produced from the HA or the injection. In follow-up computed tomography and magnetic resonance imaging, the HA injection did not migrate or change in mass/shape for close to 1 year. The mean distance between rectum and prostate was 2.0 cm along the entire length of the prostate. The median measured rectal dose, when normalized to the median urethral dose, demonstrated a decrease in dose from 47.1% to 39.2% (p < 0.001) with or without injection. For an HDR boost dose of 1150 cGy, the rectum mean Dmax reduction was from 708 cGy to 507 cGy, p < 0.001, and the rectum mean Dmean drop was from 608 to 442 cGy, p < 0.001 post-HA injection. Conclusion: The new 2-cm distance derived from the HA injection significantly decreased rectal dose in HDR brachytherapy. Because of the several-month duration of stability, the same distance was maintained during the course of external beam radiation therapy

  1. Folate-targeted amphiphilic cyclodextrin nanoparticles incorporating a fusogenic peptide deliver therapeutic siRNA and inhibit the invasive capacity of 3D prostate cancer tumours.

    Science.gov (United States)

    Evans, James C; Malhotra, Meenakshi; Sweeney, Katrina; Darcy, Raphael; Nelson, Colleen C; Hollier, Brett G; O'Driscoll, Caitriona M

    2017-10-30

    The main barrier to the development of an effective RNA interference (RNAi) therapy is the lack of a suitable delivery vector. Modified cyclodextrins have emerged in recent years for the delivery of siRNA. In the present study, a folate-targeted amphiphilic cyclodextrin was formulated using DSPE-PEG 5000 -folate to target prostate cancer cells. The fusogenic peptide GALA was included in the formulation to aid in the endosomal release of siRNA. Targeted nanoparticles were less than 200nm in size with a neutral surface charge. The complexes were able to bind siRNA and protect it from serum nucleases. Incubation with excess free folate resulted in a significant decrease in the uptake of targeted nanoparticles in LNCaP and PC3 cells, both of which have been reported to have differing pathways of folate uptake. There was a significant reduction in the therapeutic targets, ZEB1 and NRP1 at mRNA and protein level following treatment with targeted complexes. In preliminary functional assays using 3D spheroids, treatment of PC3 tumours with targeted complexes with ZEB1 and NRP1 siRNA resulted in more compact colonies relative to the untargeted controls and inhibited infiltration into the Matrigel™ layer. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Delivering the right dose

    International Nuclear Information System (INIS)

    Shaw, A

    2004-01-01

    For treatment with high intensity focused ultrasound (HIFU), delivering the correct amount of energy to the patient is critical. This paper describes a novel design of sensor based on the pyroelectric principle for monitoring the output power from HIFU transducers of the type used for tissue ablation. The sensor is intended to be minimally perturbing to the ultrasound field, so that it can remain in the ultrasound field throughout treatment and provide a constant monitor of ultrasound power. The main advantages of the technique are: power can be measured or monitored without dismantling the HIFU system, thus reducing equipment downtime; power can be measured immediately before or during every patient treatment, thus ensuring accurate dosimetry; power can be measured at the output levels used for treatment (whereas a radiation force balance may be damaged by overheating); the method uses components which are robust and simple to use compared to radiation force balances or hydrophone scanning systems

  3. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35 tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which finished its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. "The production is proceeding well and we expect to be complete in October as previously foreseen," said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have been delivered.

  4. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35-tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which completed its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. 'The production is proceeding well and we expect to be complete in October as foreseen,' said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have already been delivered.

  5. Implementing an Internet-Delivered Skin Cancer Genetic Testing Intervention to Improve Sun Protection Behavior in a Diverse Population: Protocol for a Randomized Controlled Trial.

    Science.gov (United States)

    Hay, Jennifer L; Berwick, Marianne; Zielaskowski, Kate; White, Kirsten Am; Rodríguez, Vivian M; Robers, Erika; Guest, Dolores D; Sussman, Andrew; Talamantes, Yvonne; Schwartz, Matthew R; Greb, Jennie; Bigney, Jessica; Kaphingst, Kimberly A; Hunley, Keith; Buller, David B

    2017-04-25

    Limited translational genomic research currently exists to guide the availability, comprehension, and appropriate use of personalized genomics in diverse general population subgroups. Melanoma skin cancers are preventable, curable, common in the general population, and disproportionately increasing in Hispanics. Variants in the melanocortin-1 receptor (MC1R) gene are present in approximately 50% of the population, are major factors in determining sun sensitivity, and confer a 2-to-3-fold increase in melanoma risk in the general population, even in populations with darker skin. Therefore, feedback regarding MC1R risk status may raise risk awareness and protective behavior in the general population. We are conducting a randomized controlled trial examining Internet presentation of the risks and benefits of personalized genomic testing for MC1R gene variants that are associated with increased melanoma risk. We will enroll a total of 885 participants (462 participants are currently enrolled), who will be randomized 6:1 to personalized genomic testing for melanoma risk versus waiting list control. Control participants will be offered testing after outcome assessments. Participants will be balanced across self-reported Hispanic versus non-Hispanic ethnicity (n=750 in personalized genomic testing for melanoma risk arm; n=135 in control arm), and will be recruited from a general population cohort in Albuquerque, New Mexico, which is subject to year-round sun exposure. Baseline surveys will be completed in-person with study staff and follow-up measures will be completed via telephone. Aim 1 of the trial will examine the personal utility of personalized genomic testing for melanoma risk in terms of short-term (3-month) sun protection and skin screening behaviors, family and physician communication, and melanoma threat and control beliefs (ie, putative mediators of behavior change). We will also examine potential unintended consequences of testing among those who receive

  6. 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.

  7. Radiation dose delivered to the proximal penis as a predictor of the risk of erectile dysfunction after three-dimensional conformal radiotherapy for localized prostate cancer

    International Nuclear Information System (INIS)

    Wernicke, A. Gabriella; Valicenti, Richard; DiEva, Kelly; Houser, Christopher; Pequignot, Ed

    2004-01-01

    Purpose/objective: In this study, we evaluated in a serial manner whether radiation dose to the bulb of the penis is predictive of erectile dysfunction, ejaculatory difficulty (EJ), and overall satisfaction with sex life (quality of life) by using serial validated self-administered questionnaires. Methods and materials: Twenty-nine potent men with AJCC Stage II prostate cancer treated with three-dimensional conformal radiation therapy alone to a median dose 72.0 Gy (range: 66.6-79.2 Gy) were evaluated by determining the doses received by the penile bulb. The penile bulb was delineated volumetrically, and the dose-volume histogram was obtained on each patient. Results: The median follow-up time was 35 months (range, 16-43 months). We found that for D 30 , D 45 , D 60 , and D 75 (doses to a percent volume of PB: 30%, 45%, 60%, and 75%), higher than the corresponding median dose (defined as high-dose group) correlated with an increased risk of impotence (erectile dysfunction firmness score = 0) (odds ratio [OR] = 7.5, p = 0.02; OR = 7.5, p = 0.02; OR = 8.6, p = 0.008; and OR = 6.9, p = 0.015, respectively). Similarly, for EJD D 30 , D 45 , D 60 , and D 75 , doses higher than the corresponding median ones correlated with worsening ejaculatory function score (EJ = 0 or 1) (OR = 8, p = 0.013; OR = 8, p 0.013; OR = 9.2, p = 0.015; and OR = 8, p = 0.026, respectively). For quality of life, low (≤median dose) dose groups of patients improve over time, whereas high-dose groups of patients worsen. Conclusions: This study supports the existence of a penile bulb dose-volume relationship underlying the development of radiation-induced erectile dysfunction. Our data may guide the use of inverse treatment planning to maximize the probability of maintaining sexual potency after radiation therapy

  8. Measuring uncertainty in dose delivered to the cochlea due to setup error during external beam treatment of patients with cancer of the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Yan, M.; Lovelock, D.; Hunt, M.; Mechalakos, J.; Hu, Y.; Pham, H.; Jackson, A., E-mail: jacksona@mskcc.org [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065 (United States)

    2013-12-15

    Purpose: To use Cone Beam CT scans obtained just prior to treatments of head and neck cancer patients to measure the setup error and cumulative dose uncertainty of the cochlea. Methods: Data from 10 head and neck patients with 10 planning CTs and 52 Cone Beam CTs taken at time of treatment were used in this study. Patients were treated with conventional fractionation using an IMRT dose painting technique, most with 33 fractions. Weekly radiographic imaging was used to correct the patient setup. The authors used rigid registration of the planning CT and Cone Beam CT scans to find the translational and rotational setup errors, and the spatial setup errors of the cochlea. The planning CT was rotated and translated such that the cochlea positions match those seen in the cone beam scans, cochlea doses were recalculated and fractional doses accumulated. Uncertainties in the positions and cumulative doses of the cochlea were calculated with and without setup adjustments from radiographic imaging. Results: The mean setup error of the cochlea was 0.04 ± 0.33 or 0.06 ± 0.43 cm for RL, 0.09 ± 0.27 or 0.07 ± 0.48 cm for AP, and 0.00 ± 0.21 or −0.24 ± 0.45 cm for SI with and without radiographic imaging, respectively. Setup with radiographic imaging reduced the standard deviation of the setup error by roughly 1–2 mm. The uncertainty of the cochlea dose depends on the treatment plan and the relative positions of the cochlea and target volumes. Combining results for the left and right cochlea, the authors found the accumulated uncertainty of the cochlea dose per fraction was 4.82 (0.39–16.8) cGy, or 10.1 (0.8–32.4) cGy, with and without radiographic imaging, respectively; the percentage uncertainties relative to the planned doses were 4.32% (0.28%–9.06%) and 10.2% (0.7%–63.6%), respectively. Conclusions: Patient setup error introduces uncertainty in the position of the cochlea during radiation treatment. With the assistance of radiographic imaging during setup

  9. Cardiac Toxicity After Radiotherapy for Stage III Non–Small-Cell Lung Cancer: Pooled Analysis of Dose-Escalation Trials Delivering 70 to 90 Gy

    Science.gov (United States)

    Eblan, Michael J.; Deal, Allison M.; Lipner, Matthew; Zagar, Timothy M.; Wang, Yue; Mavroidis, Panayiotis; Lee, Carrie B.; Jensen, Brian C.; Rosenman, Julian G.; Socinski, Mark A.; Stinchcombe, Thomas E.; Marks, Lawrence B.

    2017-01-01

    Purpose The significance of radiotherapy (RT) –associated cardiac injury for stage III non–small-cell lung cancer (NSCLC) is unclear, but higher heart doses were associated with worse overall survival in the Radiation Therapy Oncology Group (RTOG) 0617 study. We assessed the impact of heart dose in patients treated at our institution on several prospective dose-escalation trials. Patients and Methods From 1996 to 2009, 127 patients with stage III NSCLC (Eastern Cooperative Oncology Group performance status, 0 to 1) received dose-escalated RT to 70 to 90 Gy (median, 74 Gy) in six trials. RT plans and cardiac doses were reviewed. Records were reviewed for the primary end point: symptomatic cardiac events (symptomatic pericardial effusion, acute coronary syndrome, pericarditis, significant arrhythmia, and heart failure). Cardiac risk was assessed by noting baseline coronary artery disease and calculating the WHO/International Society of Hypertension score. Competing risks analysis was used. Results In all, 112 patients were analyzed. Median follow-up for surviving patients was 8.8 years. Twenty-six patients (23%) had one or more events at a median of 26 months to first event (effusion [n = 7], myocardial infarction [n = 5], unstable angina [n = 3], pericarditis [n = 2], arrhythmia [n = 12], and heart failure [n = 1]). Heart doses (eg, heart mean dose; hazard ratio, 1.03/Gy; P = .002,), coronary artery disease (P < .001), and WHO/International Society of Hypertension score (P = .04) were associated with events on univariable analysis. Heart doses remained significant on multivariable analysis that accounted for baseline risk. Two-year competing risk–adjusted event rates for patients with heart mean dose < 10 Gy, 10 to 20 Gy, or ≥ 20 Gy were 4%, 7%, and 21%, respectively. Heart doses were not associated with overall survival. Conclusion Cardiac events were relatively common after high-dose thoracic RT and were independently associated with both heart dose and

  10. Encapsulating the delivery of affordable housing: An overview of Malaysian practice

    Directory of Open Access Journals (Sweden)

    Jamaluddin Nor Baizura

    2016-01-01

    Full Text Available Urban population increases much faster than other geographical areas and this brings huge challenges to Malaysian government especially those responsible for the provision of housing. Moreover, the rise of living cost and pressure towards the current economic situation had inevitably led to huge demands for affordable housing. Thus, affordability and inaccessibility of people in owning a house has become one of the major issues in Malaysia. These issues are not only faced by the low-income group but mostly experienced by urban dwellers including the middle-income group whom are not eligible to apply for low-cost housing delivered by the government, yet cannot afford to buy a house. Hence, the Malaysian government had therefore established the Perumahan Rakyat 1 Malaysia (PR1MA as the catalyst in providing adequate, quality and affordable houses. Furthermore, the Syarikat Perumahan Negara Berhad (SPNB and the state governments also play their big role in providing affordable house at the state level. In trying to ensure smooth delivery of affordable housing, a systematic approach is required. This paper intends to examine the delivery of affordable housing in Malaysia. The objective was to assess the parties involved, and the various stages of the process. The methodology adopted for this study includes in-depth interviews with affordable housing agencies. Investigation showed that the major problem relates to a mismatch in the delivery of affordable housing. Moreover, the political and economic aspects, as well as the organization situation had also influenced the inefficiency of affordable housing delivery system. Additionally, the significant of this paper is expected to formulate an improved strategy and guidance in delivery system, thus ensuring that the method of practice is applicable throughout the country.

  11. 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.

  12. 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...

  13. 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.

  14. 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...

  15. 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

  16. 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…

  17. 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…

  18. Can industry afford solar energy

    Science.gov (United States)

    Kreith, F.; Bezdek, R.

    1983-03-01

    Falling oil prices and conservation measures have reduced the economic impetus to develop new energy sources, thus decreasing the urgency for bringing solar conversion technologies to commercial readiness at an early date. However, the capability for solar to deliver thermal energy for industrial uses is proven. A year-round operation would be three times as effective as home heating, which is necessary only part of the year. Flat plate, parabolic trough, and solar tower power plant demonstration projects, though uneconomically operated, have revealed engineering factors necessary for successful use of solar-derived heat for industrial applications. Areas of concern have been categorized as technology comparisons, load temperatures, plant size, location, end-use, backup requirements, and storage costs. Tax incentives have, however, supported home heating and not industrial uses, and government subsidies have historically gone to conventional energy sources. Tax credit programs which could lead to a 20% market penetration by solar energy in the industrial sector by the year 2000 are presented.

  19. 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.

  20. Fidelity considerations in translational research: Eating As Treatment - a stepped wedge, randomised controlled trial of a dietitian delivered behaviour change counselling intervention for head and neck cancer patients undergoing radiotherapy.

    Science.gov (United States)

    Beck, Alison Kate; Baker, Amanda; Britton, Ben; Wratten, Chris; Bauer, Judith; Wolfenden, Luke; Carter, Gregory

    2015-10-15

    The confidence with which researchers can comment on intervention efficacy relies on evaluation and consideration of intervention fidelity. Accordingly, there have been calls to increase the transparency with which fidelity methodology is reported. Despite this, consideration and/or reporting of fidelity methods remains poor. We seek to address this gap by describing the methodology for promoting and facilitating the evaluation of intervention fidelity in The EAT (Eating As Treatment) project: a multi-site stepped wedge randomised controlled trial of a dietitian delivered behaviour change counselling intervention to improve nutrition (primary outcome) in head and neck cancer patients undergoing radiotherapy. In accordance with recommendations from the National Institutes of Health Behaviour Change Consortium Treatment Fidelity Workgroup, we sought to maximise fidelity in this stepped wedge randomised controlled trial via strategies implemented from study design through to provider training, intervention delivery and receipt. As the EAT intervention is designed to be incorporated into standard dietetic consultations, we also address unique challenges for translational research. We offer a strong model for improving the quality of translational findings via real world application of National Institutes of Health Behaviour Change Consortium recommendations. Greater transparency in the reporting of behaviour change research is an important step in improving the progress and quality of behaviour change research. ACTRN12613000320752 (Date of registration 21 March 2013).

  1. 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

  2. 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 ...

  3. 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...

  4. 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...

  5. 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.

  6. Quantifying the Reproducibility of Heart Position During Treatment and Corresponding Delivered Heart Dose in Voluntary Deep Inhalation Breath Hold for Left Breast Cancer Patients Treated With External Beam Radiotherapy

    International Nuclear Information System (INIS)

    McIntosh, Alyson; Shoushtari, Asal N.; Benedict, Stanley H.; Read, Paul W.; Wijesooriya, Krishni

    2011-01-01

    Purpose: Voluntary deep inhalation breath hold (VDIBH) reduces heart dose during left breast irradiation. We present results of the first study performed to quantify reproducibility of breath hold using bony anatomy, heart position, and heart dose for VDIBH patients at treatment table. Methods and Materials: Data from 10 left breast cancer patients undergoing VDIBH whole-breast irradiation were analyzed. Two computed tomography (CT) scans, free breathing (FB) and VDIBH, were acquired to compare dose to critical structures. Pretreatment weekly kV orthogonal images and tangential ports were acquired. The displacement difference from spinal cord to sternum across the isocenter between coregistered planning Digitally Reconstructed Radiographs (DRRs) and kV imaging of bony thorax is a measure of breath hold reproducibility. The difference between bony coregistration and heart coregistration was the measured heart shift if the patient is aligned to bony anatomy. Results: Percentage of dose reductions from FB to VDIBH: mean heart dose (48%, SD 19%, p = 0.002), mean LAD dose (43%, SD 19%, p = 0.008), and maximum left anterior descending (LAD) dose (60%, SD 22%, p = 0.008). Average breath hold reproducibility using bony anatomy across the isocenter along the anteroposterior (AP) plane from planning to treatment is 1 (range, 0–3; SD, 1) mm. Average heart shifts with respect to bony anatomy between different breath holds are 2 ± 3 mm inferior, 1 ± 2 mm right, and 1 ± 3 mm posterior. Percentage dose changes from planning to delivery: mean heart dose (7%, SD 6%); mean LAD dose, ((9%, SD 7%)S, and maximum LAD dose, (11%, SD 11%) SD 11%, p = 0.008). Conclusion: We observed excellent three-dimensional bony registration between planning and pretreatment imaging. Reduced delivered dose to heart and LAD is maintained throughout VDIBH treatment.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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...

  12. 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.

  13. 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…

  14. 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....

  15. 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....

  16. A snapshot of cancer in Chile: analytical frameworks for developing a cancer policy

    Directory of Open Access Journals (Sweden)

    Jorge Jimenez de la Jara

    2015-01-01

    Full Text Available 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 impact of cancer to deliver guidelines for the framing of an equitable national cancer policy. METHODS: Burden, research and care-policy systems were assessed by triangulating objective system metrics -epidemiological, economic, etc. - with political and policy analysis. Analysis of the literature and governmental databases was performed. The oncology community was interviewed and surveyed. RESULTS: Chile utilizes 1% of its gross domestic product on cancer care and treatment. We estimate that the economic impact as measured in Disability Adjusted Life Years to be US$ 3.5 billion. Persistent inequalities still occur in cancer distribution and treatment. A high quality cancer research community is expanding, however, insufficient funding is directed towards disproportionally prevalent stomach, lung and gallbladder cancers. CONCLUSIONS: Chile has a rapidly ageing population wherein 40% smoke, 67% are overweight and 18% abuse alcohol, and thus the corresponding burden of cancer will have a negative impact on an affordable health care system. We conclude that the Chilean government must develop a national cancer strategy, which the authors outline herein and believe is essential to permit equitable cancer care for the country.

  17. 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…

  18. 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...

  19. SU-F-T-57: Delivered Activity Accuracy of Radium 223 Dichloride Injections, When Being Administrated for Castration Resistant Prostate Cancer, Symptomatic Bone Metastases. The Impact of Residual Activity in the Spent Syringe and Dispensing Accuracy of Ra 223

    International Nuclear Information System (INIS)

    Jennings, G

    2016-01-01

    Purpose: To quantify the delivered activity accuracy of Radium 223 dichloride injections, when being administrated for castration – resistant prostate cancer, symptomatic bone metastases. The impact of residual activity in the spent syringe and dispensing accuracy of Ra 223. Methods: The administration is by slow intravenous injection over 1 minute followed by double flushing of the 10 mL syringe and IV with saline. Eighty (80) procedures was used to investigate variations in the activity from the amount prescribed (µCi) = 1.35 × Patient weight Kg. The Activity dispensed into a 10mL syringe using a NIST traceable Capintec CRC-25R Chamber and a cross calibrated capintec CRC-15R to measure activity in the syringe immediately before and after administration Results: The patients weight range from 121Ib to 235lb and doses ranging 74.25 µCi to 144.2 µCi. The deviation of dispensed dose vs Prescribed dose average +2.1% with a range of −1.1% to +5.7%. The Dose measured before administration ranges 79.3 µCi to 154.9 µCi. Deviation from the dispensed dose was show to average +2.9% with a range of −0.8% to +7.3%. The average residual dose post injection was 2.5 µCi or 2.2% of the pre injection activity. Ranging from 0.9 µCi to 6.2 µCi, 0.7% to 5.4% respectively. Subtracting the residual activity from that measured activity before injection and comparing it to prescription dose was shown to have an average variation of +2.7% with a range of −0.8% to 7.4%. Conclusion: The case resulted in the 6.2 µCi maximum residual dose had two syringes. A small, 82.8 µCi activity, case resulted in the 7.4% maximum variation in measures less residual verses prescription dose. The average +2.1 % dispenses activity of Ra 223 over the prescription dosage was seen to counteract the average 2.2% residual dosage found to remain in the syringe

  20. SU-F-T-57: Delivered Activity Accuracy of Radium 223 Dichloride Injections, When Being Administrated for Castration Resistant Prostate Cancer, Symptomatic Bone Metastases. The Impact of Residual Activity in the Spent Syringe and Dispensing Accuracy of Ra 223

    Energy Technology Data Exchange (ETDEWEB)

    Jennings, G [Marsden Medical Physics Associates, Denville, NJ (United States)

    2016-06-15

    Purpose: To quantify the delivered activity accuracy of Radium 223 dichloride injections, when being administrated for castration – resistant prostate cancer, symptomatic bone metastases. The impact of residual activity in the spent syringe and dispensing accuracy of Ra 223. Methods: The administration is by slow intravenous injection over 1 minute followed by double flushing of the 10 mL syringe and IV with saline. Eighty (80) procedures was used to investigate variations in the activity from the amount prescribed (µCi) = 1.35 × Patient weight Kg. The Activity dispensed into a 10mL syringe using a NIST traceable Capintec CRC-25R Chamber and a cross calibrated capintec CRC-15R to measure activity in the syringe immediately before and after administration Results: The patients weight range from 121Ib to 235lb and doses ranging 74.25 µCi to 144.2 µCi. The deviation of dispensed dose vs Prescribed dose average +2.1% with a range of −1.1% to +5.7%. The Dose measured before administration ranges 79.3 µCi to 154.9 µCi. Deviation from the dispensed dose was show to average +2.9% with a range of −0.8% to +7.3%. The average residual dose post injection was 2.5 µCi or 2.2% of the pre injection activity. Ranging from 0.9 µCi to 6.2 µCi, 0.7% to 5.4% respectively. Subtracting the residual activity from that measured activity before injection and comparing it to prescription dose was shown to have an average variation of +2.7% with a range of −0.8% to 7.4%. Conclusion: The case resulted in the 6.2 µCi maximum residual dose had two syringes. A small, 82.8 µCi activity, case resulted in the 7.4% maximum variation in measures less residual verses prescription dose. The average +2.1 % dispenses activity of Ra 223 over the prescription dosage was seen to counteract the average 2.2% residual dosage found to remain in the syringe.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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)

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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…

  11. 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

  12. 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

  13. 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

  14. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1969-01-01

    In this document 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 1969 in compliance with requests the Agency had made under Article IX. D

  15. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1975-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 30 June 1975, in compliance with requests the Agency had made under Article IX. D

  16. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1974-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 31 March 1974, in compliance with requests the Agency had made under Article IX. D

  17. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1971-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1970, in compliance with requests the Agency had made under Article IX. D

  18. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1973-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1972, in compliance with requests the Agency had made under Article IX. D

  19. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1972-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1971, in compliance with requests the Agency had made under Article IX. D

  20. 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

  1. 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...

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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....

  9. 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.

  10. 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.

  11. Contraceptive Coverage and the Affordable Care Act.

    Science.gov (United States)

    Tschann, Mary; Soon, Reni

    2015-12-01

    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Affordable Laser Communication in the Classroom

    Science.gov (United States)

    Walker, Constance E.; Sparks, R.; Pompea, S.

    2006-12-01

    Several companies sell systems that illustrate laser communication such as Arbor Scientific1. These systems can be too expensive for classroom use. We will demonstrate a technique to modulate a standard diode laser using a microphone or other sound source that is capable of transmitting voice and music. This affordable system can transmit over 350 feet using simple, inexpensive parts readily available at your local electronics store. We will provide a list of parts necessary for assembly, detailed assembly instructions, as well as some suggested investigations using the laser communication system. This system can be used in the classroom either as a demonstration or hands-on activity to explore the physics and technology involved, citing more sophisticated laser communication systems on board spacecraft such as the Mercury Messenger Mission and the Mars Telecommunications Orbiter. 1http://www.arborsci.com

  19. Visual Descriptor Learning for Predicting Grasping Affordances

    DEFF Research Database (Denmark)

    Thomsen, Mikkel Tang

    2016-01-01

    by the task of grasping unknown objects given visual sensor information. The contributions from this thesis stem from three works that all relate to the task of grasping unknown objects but with particular focus on the visual representation part of the problem. First an investigation of a visual feature space...... consisting of surface features was performed. Dimensions in the visual space were varied and the effects were evaluated with the task of grasping unknown object. The evaluation was performed using a novel probabilistic grasp prediction approach based on neighbourhood analysis. The resulting success......-rates for predicting grasps were between 75% and 90% depending on the object class. The investigations also provided insights into the importance of selecting a proper visual feature space when utilising it for predicting affordances. As a consequence of the gained insights, a semi-local surface feature, the Sliced...

  20. Affordable Hybrid Heat Pump Clothes Dryer

    Energy Technology Data Exchange (ETDEWEB)

    TeGrotenhuis, Ward E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Butterfield, Andrew [Jabil, St. Petersburg, FL (United States); Caldwell, Dustin D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Crook, Alexander [Jabil, St. Petersburg, FL (United States)

    2016-06-30

    This project was successful in demonstrating the feasibility of a step change in residential clothes dryer energy efficiency by demonstrating heat pump technology capable of 50% energy savings over conventional standard-size electric dryers with comparable drying times. A prototype system was designed from off-the-shelf components that can meet the project’s efficiency goals and are affordable. An experimental prototype system was built based on the design that reached 50% energy savings. Improvements have been identified that will reduce drying times of over 60 minutes to reach the goal of 40 minutes. Nevertheless, the prototype represents a step change in efficiency over heat pump dryers recently introduced to the U.S. market, with 30% improvement in energy efficiency at comparable drying times.

  1. Do already grasped objects activate motor affordances?

    Science.gov (United States)

    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.

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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...

  7. 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.

  8. 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.

  9. Embodiment as First Affordance: Tinkering, Tuning, Tracking

    Directory of Open Access Journals (Sweden)

    Ben Spatz

    2017-01-01

    Full Text Available This article begins from a discussion of philosophical realism and the turn towards close analysis of skilled material practices that characterizes many recent critical interventions. I examine the roots of this turn and suggest that skilled practice is a privileged site for the enactment and testing of realist ontologies. However, I question the extent to which realist thinkers have emphasized practices in which materials outside the human body are central over those in which embodiment itself is the primary medium of practice. Thinkers of realist ontology, I argue, have neglected embodiment as the primary site of an engagement with the fine-grained detail of the world. In contrast, I propose that realist ontologies developed through reference to technological engagements not only apply equally well to embodied practices but actually find their original and primary manifestation there. The body itself is the ‘first affordance’ and the site at which questions of realism and objectivity are first encountered and resolved in practice. I illustrate this point by considering how three modes of material engagement — tinkering, tuning, and tracking — manifest in embodied practices ranging from dance and sport to those of everyday life. I conclude by emphasizing the continuing political importance of embodiment as first affordance and its crucial place as a ‘fragile junction’ between ecology and technology.

  10. Income dynamics and the Affordable Care Act.

    Science.gov (United States)

    Shore-Sheppard, Lara D

    2014-12-01

    To examine the sources of family income dynamics leading to movement into and out of Medicaid expansion and subsidy eligibility under the Affordable Care Act. Survey of Income and Program Participation (SIPP): 1996, 2001, 2004, 2008 panels. Considering four broad subsidy eligibility categories for monthly Modified Adjusted Gross Income (MAGI) (400 percent FPL), I use duration analysis to examine determinants of movements between categories over the course of a year. Using detailed monthly data, I determine the members of tax-filing units and calculate an approximation of MAGI at the monthly level. The analysis sample is adults ages 22-64 years. Incomes are highly variable within a year, particularly at the lower end of the income distribution. Employment transitions, including transitions not involving a period of nonemployment, and family structure changes strongly predict sufficient income volatility to trigger a change in subsidy category. Income volatility arising from employment and family structure changes is likely to trigger changes in subsidy eligibility within the year, but the sources and effects of the volatility differ substantially depending on the individual's position in the income distribution. © Health Research and Educational Trust.

  11. Creating Affording Situations: Coaching through Animate Objects.

    Science.gov (United States)

    Baber, Chris; Khattab, Ahmad; Russell, Martin; Hermsdörfer, Joachim; Wing, Alan

    2017-10-11

    We explore the ways in which animate objects can be used to cue actions as part of coaching in Activities of Daily Living (ADL). In this case, changing the appearance or behavior of a physical object is intended to cue actions which are appropriate for a given context. The context is defined by the intention of the users, the state of the objects and the tasks for which these objects can be used. We present initial design prototypes and simple user trials which explore the impact of different cues on activity. It is shown that raising the handle of a jug, for example, not only cues the act of picking up the jug but also encourages use of the hand adjacent to the handle; that combinations of lights (on the objects) and auditory cues influence activity through reducing uncertainty; and that cueing can challenge pre-learned action sequences. We interpret these results in terms of the idea that the animate objects can be used to create affording situations, and discuss implications of this work to support relearning of ADL following brain damage or injury, such as might arise following a stroke.

  12. Creating Affording Situations: Coaching through Animate Objects

    Directory of Open Access Journals (Sweden)

    Chris Baber

    2017-10-01

    Full Text Available We explore the ways in which animate objects can be used to cue actions as part of coaching in Activities of Daily Living (ADL. In this case, changing the appearance or behavior of a physical object is intended to cue actions which are appropriate for a given context. The context is defined by the intention of the users, the state of the objects and the tasks for which these objects can be used. We present initial design prototypes and simple user trials which explore the impact of different cues on activity. It is shown that raising the handle of a jug, for example, not only cues the act of picking up the jug but also encourages use of the hand adjacent to the handle; that combinations of lights (on the objects and auditory cues influence activity through reducing uncertainty; and that cueing can challenge pre-learned action sequences. We interpret these results in terms of the idea that the animate objects can be used to create affording situations, and discuss implications of this work to support relearning of ADL following brain damage or injury, such as might arise following a stroke.

  13. 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

  14. 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.

  15. Environmental Protection: Can We Afford It

    Science.gov (United States)

    1993-04-01

    losing ground to Japan, Germany, and the Asian Tigers . Closer to home, Mexico, with its abundant work force, low wages, and slack environmental enforce...pollution (such as respiratory cancer, chronic bronchitis, pneumonia, emphysema, asthma , and the common cold) to be about $2 billion.Y In a 1991 report

  16. 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.

  17. 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,

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. Affordable Energy-Efficient New Housing Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Chandra, Subrato; Widder, Sarah H.; Bartlett, Rosemarie; McIlvaine, Janet; Chasar, David; Beal, David; Sutherland, Karen; Abbott, , K.; Fonorow, Ken; Eklund, Ken; Lubliner, Michael; Salzberg, Emily; Peeks, B.; Hewes, T.; Kosar, D.

    2012-05-31

    Since 2010, the U.S. Department of Energy’s Building America has sponsored research at PNNL to investigate cost-effective, energy-saving home-building technologies and to demonstrate how high-performance homes can deliver lower utility bills, increased comfort, and improved indoor air quality, while maintaining accessibility for low-income homeowners. PNNL and its contractors have been investigating 1) cost-effective whole-house solutions for Habitat for Humanity International (HFHI) and specific HFH affiliates in hot-humid and marine climates; 2) cost-effective energy-efficiency improvements for heating, ventilation, and air-conditioning (HVAC) systems in new, stick-built and manufactured homes; and 3) energy-efficient domestic hot-water systems.

  3. Ground Processing Affordability for Space Vehicles

    Science.gov (United States)

    Ingalls, John; Scott, Russell

    2011-01-01

    Launch vehicles and most of their payloads spend the majority of their time on the ground. The cost of ground operations is very high. So, why so often is so little attention given to ground processing during development? The current global space industry and economic environment are driving more need for efficiencies to save time and money. Affordability and sustainability are more important now than ever. We can not continue to treat space vehicles as mere science projects. More RLV's (Reusable Launch Vehicles) are being developed for the gains of reusability which are not available for ELV's (Expendable Launch Vehicles). More human-rated vehicles are being developed, with the retirement of the Space Shuttles, and for a new global space race, yet these cost more than the many unmanned vehicles of today. We can learn many lessons on affordability from RLV's. DFO (Design for Operations) considers ground operations during design, development, and manufacturing-before the first flight. This is often minimized for space vehicles, but is very important. Vehicles are designed for launch and mission operations. You will not be able to do it again if it is too slow or costly to get there. Many times, technology changes faster than space products such that what is launched includes outdated features, thus reducing competitiveness. Ground operations must be considered for the full product Lifecycle, from concept to retirement. Once manufactured, launch vehicles along with their payloads and launch systems require a long path of processing before launch. Initial assembly and testing always discover problems to address. A solid integration program is essential to minimize these impacts, as was seen in the Constellation Ares I-X test rocket. For RLV's, landing/recovery and post-flight turnaround activities are performed. Multi-use vehicles require reconfiguration. MRO (Maintenance, Repair, and Overhaul) must be well-planned--- even for the unplanned problems. Defect limits and

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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)

  9. The Affording Mars Workshop: Background and Recommendations

    Science.gov (United States)

    Thronson, Harley A.; Carberry, Christopher

    2014-01-01

    . The workshop was organized around three topical breakout sessions: 1. The ISS and the path to Mars: The critical coming decade 2. Affordability and sustainability: what does it mean and what are its implications within guidelines established at the start of the workshop? 3. Notional sequence(s) of cost-achievable missions for the 2020s to 2030s, including capability objectives at each stage and opportunities for coordinated robotic partnerships.

  10. Prospective Study Delivering Simultaneous Integrated High-dose Tumor Boost (≤70 Gy) With Image Guided Adaptive Radiation Therapy for Radical Treatment of Localized Muscle-Invasive Bladder Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hafeez, Shaista, E-mail: Shaista.Hafeez@icr.ac.uk [The Institute of Cancer Research, London (United Kingdom); The Royal Marsden National Health Service Foundation Trust, London (United Kingdom); Warren-Oseni, Karole [The Royal Marsden National Health Service Foundation Trust, London (United Kingdom); McNair, Helen A.; Hansen, Vibeke N.; Jones, Kelly; Tan, Melissa; Khan, Attia [The Institute of Cancer Research, London (United Kingdom); The Royal Marsden National Health Service Foundation Trust, London (United Kingdom); Harris, Victoria; McDonald, Fiona; Lalondrelle, Susan; Mohammed, Kabir; Thomas, Karen; Thompson, Alan; Kumar, Pardeep [The Royal Marsden National Health Service Foundation Trust, London (United Kingdom); Dearnaley, David; Horwich, Alan; Huddart, Robert [The Institute of Cancer Research, London (United Kingdom); The Royal Marsden National Health Service Foundation Trust, London (United Kingdom)

    2016-04-01

    Purpose: Image guided adaptive radiation therapy offers individualized solutions to improve target coverage and reduce normal tissue irradiation, allowing the opportunity to increase the radiation tumor dose and spare normal bladder tissue. Methods and Materials: A library of 3 intensity modulated radiation therapy plans were created (small, medium, and large) from planning computed tomography (CT) scans performed at 30 and 60 minutes; treating the whole bladder to 52 Gy and the tumor to 70 Gy in 32 fractions. A “plan of the day” approach was used for treatment delivery. A post-treatment cone beam CT (CBCT) scan was acquired weekly to assess intrafraction filling and coverage. Results: A total of 18 patients completed treatment to 70 Gy. The plan and treatment for 1 patient was to 68 Gy. Also, 1 patient's plan was to 70 Gy but the patient was treated to a total dose of 65.6 Gy because dose-limiting toxicity occurred before dose escalation. A total of 734 CBCT scans were evaluated. Small, medium, and large plans were used in 36%, 48%, and 16% of cases, respectively. The mean ± standard deviation rate of intrafraction filling at the start of treatment (ie, week 1) was 4.0 ± 4.8 mL/min (range 0.1-19.4) and at end of radiation therapy (ie, week 5 or 6) was 1.1 ± 1.6 mL/min (range 0.01-7.5; P=.002). The mean D{sub 98} (dose received by 98% volume) of the tumor boost and bladder as assessed on the post-treatment CBCT scan was 97.07% ± 2.10% (range 89.0%-104%) and 99.97% ± 2.62% (range 96.4%-112.0%). At a median follow-up period of 19 months (range 4-33), no muscle-invasive recurrences had developed. Two patients experienced late toxicity (both grade 3 cystitis) at 5.3 months (now resolved) and 18 months after radiation therapy. Conclusions: Image guided adaptive radiation therapy using intensity modulated radiation therapy to deliver a simultaneous integrated tumor boost to 70 Gy is feasible, with acceptable toxicity, and will be

  11. 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)

  12. Three-dimensional conformal radiation may deliver considerable dose of incidental nodal irradiation in patients with early stage node-negative non-small cell lung cancer when the tumor is large and centrally located

    International Nuclear Information System (INIS)

    Zhao Lujun; Chen Ming; Haken, Randall ten; Chetty, Indrin; Chapet, Olivier; Hayman, James A.; Kong Fengming

    2007-01-01

    Background and purpose: To determine the dose to regional nodal stations in patients with T 1-3 N 0 M 0 non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiation therapy (3DCRT) without intentional elective nodal irradiation (ENI). Materials and methods: Twenty-three patients with medically inoperable T 1-3 N 0 M 0 NSCLC were treated with 3DCRT without ENI. Hilar and mediastinal nodal regions were contoured on planning CT. The prescription dose was normalized to 70 Gy. Equivalent uniform dose (EUD) and other dosimetric parameters (e.g., V 40 ) were calculated for each nodal station. Results: The median EUD for the whole group ranged from 0.4 to 4.4 Gy for all elective nodal regions. Gross tumor volume (GTV) and the relationship between GTV and hilum were significantly correlated with irradiation dose to ipsilateral hilar nodal regions (P 3 (diameter ∼ 4 cm) and or having any overlap with hilum, the median EUDs were 9.6, 22.6, and 62.9 Gy for ipsilateral lower paratracheal, subcarinal, and ipsilateral hilar regions, respectively. The corresponding median V 40 were 32.5%, 39.3%, and 97.6%, respectively. Conclusions: Although incidental nodal irradiation dose is low in the whole group, the dose to high-risk nodal regions is considerable in patients with T 1-3 N 0 NSCLC when the primary is large and/or centrally located

  13. 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.

  14. 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.

  15. 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....

  16. 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

  17. 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.

  18. 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.

  19. 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 ...

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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...

  5. 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...

  6. 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...

  7. 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.

  8. Particle tracker system delivered to CERN

    CERN Multimedia

    Pitcher, Graham

    2006-01-01

    "The CCLRC Rutherford Appleton Laboratory (RAL) has delivered a system to CERN that will help to process the vast amounts of data generated by the silicon tracking detector within the Compact Muon Solenoid experiment." (1/2 page)

  9. Delivering construction projects using innovative building technologies

    CSIR Research Space (South Africa)

    Ampofo-Anti, Naalamkai

    2017-07-01

    Full Text Available . Figure 1: IBT delivery flowchart Proceedings 11th Built Environment Conference 6 th August – 8 th August 2017 Delivering construction projects using innovative building technologies Durban, South Africa 5. REFERENCES Ampofo-Anti, N...

  10. 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)

  11. Cancer

    Science.gov (United States)

    Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms ... be benign or malignant. Benign tumors aren't cancer while malignant ones are. Cells from malignant tumors ...

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Palliative Care: Delivering Comprehensive Oncology Nursing Care.

    Science.gov (United States)

    Dahlin, Constance

    2015-11-01

    To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. The Role of Motor Affordances in Visual Working Memory

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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. !

  4. 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.

  5. Delivering service adaptation with 3G technology

    NARCIS (Netherlands)

    Liotta, A.; Yew, A.; Bohoris, C.; Pavlou, G.; Feridun, M.; Kropf, P.G.; Babin, G.

    2002-01-01

    Now that 3G technologies have reached their maturity, newly advanced services can be delivered to the mobile user. These include context- aware services, adaptable services and Virtual Home Environment (VHE)-like services. Important research issues relate, however, to managing such services through

  6. Utah Delivers Opportunities for Career Exploration

    Science.gov (United States)

    Dobson, Kristine; Fischio, Shannon

    2006-01-01

    Providing information and resources to support career exploration is key to the mission of career and technical education (CTE) in Utah. Utah CTE has responded in a variety of ways to meet the career exploration needs of students of all ages. This article discusses how the career and technical education in Utah delivers opportunities for career…

  7. Is International Accounting Education Delivering Pedagogical Value?

    Science.gov (United States)

    Patel, Chris; Millanta, Brian; Tweedie, Dale

    2016-01-01

    This paper examines whether universities are delivering pedagogical value to international accounting students commensurate with the costs of studying abroad. The paper uses survey and interview methods to explore the extent to which Chinese Learners (CLs) in an Australian postgraduate accounting subject have distinct learning needs. The paper…

  8. 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.

  9. How natural capital delivers ecosystem services

    NARCIS (Netherlands)

    Smith, A.C.; Harrison, P.A.; Pérez Soba, M.; Archaux, F.; Blicharska, M.; Egoh, B.N.; Erős, T.; Fabrega Domenech, N.; György, I.; Haines-Young, R.; Li, S.; Lommelen, E.; Meiresonne, L.; Miguel Ayala, L.; Mononen, L.; Simpson, G.; Stange, E.; Turkelboom, F.; Uiterwijk, M.; Veerkamp, C.J.; Wyllie de Echeverria, V.

    2017-01-01

    There is no unified evidence base to help decision-makers understand how the multiple components of natural capital interact to deliver ecosystem services. We systematically reviewed 780 papers, recording how natural capital attributes (29 biotic attributes and 11 abiotic factors) affect the

  10. 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.

  11. 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.

  12. 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

  13. Teaching Text Structure: Examining the Affordances of Children's Informational Texts

    Science.gov (United States)

    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…

  14. 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…

  15. 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

  16. 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…

  17. 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…

  18. 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.

  19. 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…

  20. 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

  1. 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.

  2. 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...

  3. 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 ...

  4. 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 ...

  5. 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…

  6. 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…

  7. 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...

  8. 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…

  9. 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

  10. Material Affordances: The Potential of Scrapbooks in the Composition Classroom

    Science.gov (United States)

    Alexander, Kara Poe

    2013-01-01

    A multiliteracies pedagogy has renewed our interest in materiality, or how the physical text interacts with the author's choices and the context to contribute to the message, yet little attention has been paid to materiality in analog texts, such as the scrapbook, even though this medium contains affordances (capabilities and limitations) that…

  11. 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,…

  12. 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.

  13. 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

  14. A simple circuit to deliver bubbling CPAP.

    Science.gov (United States)

    Kaur, Charanjit; Sema, Akatoli; Beri, Rajbir S; Puliyel, Jacob M

    2008-04-01

    Nasal continuous positive airway pressure (CPAP), especially bubbling CPAP, is known to reduce the need for more invasive ventilation. We here describe a circuit that can deliver bubbling CPAP in resource poor settings. We describe how the oxygen concentration can be altered from 98% to 21% oxygen using this system. Addition of a humidifier in the circuit has the effect of reducing the oxygen concentration by 1 to 5%. The cost of putting together the system is approximately Rs 5000.

  15. Impact of peer delivered wellness coaching.

    Science.gov (United States)

    Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W

    2016-09-01

    People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. System Qualities Ontology, Tradespace and Affordability (SQOTA) Project: Phase 5

    Science.gov (United States)

    2017-04-30

    effectiveness and practicality 3. Balance Agility, Assurance, and Affordability: Develop SE MPTs that work with high assurance in the face of... work supported, in whole or in part, by the U.S. Department of Defense through the Office of the Assistant Secretary of Defense for Research and...model-driven, set-based, full life cycle approaches. These will enable much more rapid, concurrent, flexible, scalable definition and analysis of the

  2. Augmented Reality in science education – affordances for student learning

    OpenAIRE

    Nielsen, Birgitte Lund; Brandt, Harald; Swensen, Håkon

    2016-01-01

    Most extant studies examining augmented reality (AR) have focused on the technology itself. This paper presents findings addressing the issue of AR for educational purposes based on a sequential survey distributed to 35 expert science teachers, ICT designers and science education researchers from four countries. There was consensus among experts in relation to a focus on ‘learning before technology’, and they in particular supplemented affordances identified in literature with perspectives re...

  3. 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.

  4. Monolithic QCL design approaches for improved reliability and affordability

    Science.gov (United States)

    Law, K. K.

    2013-12-01

    Many advances have been made recently in mid-wave infrared and long-wave infrared quantum cascade lasers (QCLs) technologies, and there is an increasing demand for these laser sources for ever expanding Naval, DoD and homeland security applications. We will discuss in this paper a portfolio of various Naval Air Warfare Weapons Division's current and future small business innovative research programs and efforts on significantly improving QCLs' performance, affordability, and reliability.

  5. Structuring Payment to Medical Homes After the Affordable Care Act

    OpenAIRE

    Edwards, Samuel T.; Abrams, Melinda K.; Baron, Richard J.; Berenson, Robert A.; Rich, Eugene C.; Rosenthal, Gary E.; Rosenthal, Meredith B.; Landon, Bruce E.

    2014-01-01

    The Patient-Centered Medical Home (PCMH) is a leading model of primary care reform, a critical element of which is payment reform for primary care services. With the passage of the Affordable Care Act, the Accountable Care Organization (ACO) has emerged as a model of delivery system reform, and while there is theoretical alignment between the PCMH and ACOs, the discussion of physician payment within each model has remained distinct. Here we compare payment for medical homes with that for acco...

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. A better way to deliver bad news.

    Science.gov (United States)

    Manzoni, Jean-François

    2002-09-01

    In an ideal world, a subordinate would accept critical feedback from a manager with an open mind. He or she would ask a few clarifying questions, promise to work on certain performance areas, and show signs of improvement over time. But things don't always turn out that way. Such conversations can be unpleasant. Emotions can run high; tempers can flare. Fearing that the employee will become angry and defensive, the boss all too often inadvertently sabotages the meeting by preparing for it in a way that stifles honest discussion. This unintentional--indeed, unconscious--stress-induced habit makes it difficult to deliver corrective feedback effectively. Insead professor Jean-François Manzoni says that by changing the mind-set with which they develop and deliver negative feedback, managers can increase their odds of having productive conversations without damaging relationships. Manzoni describes two behavioral phenomena that color the feedback process--the fundamental attribution error and the false consensus effect--and uses real-world examples to demonstrate how bosses' critiques can go astray. Managers tend to frame difficult situations and decisions in a way that is narrow (alternatives aren't considered) and binary (there are only two possible outcomes--win or lose). And during the feedback discussion, managers' framing of the issues often remains frozen, regardless of the direction the conversation takes. Manzoni advises managers not to just settle on the first acceptable explanation for a behavior or situation they've witnessed. Bosses also need to consider an employee's circumstances rather than just attributing weak performance to a person's disposition. In short, delivering more effective feedback requires an open-minded approach, one that will convince employees that the process is fair and that the boss is ready for an honest conversation.

  11. 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.

  12. 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...

  13. 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.

  14. 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.

  15. 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.

  16. Delivering IT and eBusiness value

    CERN Document Server

    Willcocks, Leslie

    2001-01-01

    Delivering Business Value from IT' is focused on the evaluation issue in IT and how IT evaluation can proceed across the life-cycle of any IT investment and be linked positively to improving business performance. .Chapters 1,2 and 3 detail an approach to IT evaluation whilst chapters 4 and 5 build on these by showing two distinctive approaches to linking IT to business performance. The remaining three chapters deal with a range of evaluation issues emerging as important - specifically Internet evaluation, Y2K and beyond, EMU, quality outsourcing, infrastructure, role of benchmarking, and cost

  17. DESIGNS MATTER: Delivering Information Sources for Tourism

    Directory of Open Access Journals (Sweden)

    Margie A. Nolasco

    2016-11-01

    Full Text Available Tourism has benefits not just for travelers, but also to the local economy. Since, Bicol Region has natural and cultural attractions; it is a potential travel destination in the country. Technology in delivering information sources played vital role for the success of the tourism industry in the Region. This allows travel enthusiasts to get more information about various tourist attractions. This paper analyzes the effectiveness of delivering information sources such as web advertisement and desktop publishing for tourist promotion in the Bicol Region. Specifically, it determined the status of tourism, and identified common forms of promotions for tourism development. The study adopted mixed method of research. This method was utilized to confirm and validate findings. Interviews and focus group discussions were used to gather data from the respondents of the selected Local Government Units, Department of Tourism, Travel Agencies and Hotel Agents in the Region. Based on the findings, of the total foreign visitors in the country, only 9.14% visited Bicol Region in 2014. That is why, domestic tourist showed high percentage against foreign visitors with 25.7%. Brochures with EZ maps as most commonly used desktop publishing materials and websites and social media for web advertisement. Thus, there is a need to reevaluate promotional activities by the DOT and other agencies. Adoption suggestive features for creative desktop publishing materials and web services should be considered to increase tourist visitors in the Region.

  18. Can the Clean Development Mechanism (CDM) deliver?

    International Nuclear Information System (INIS)

    Subbarao, Srikanth; Lloyd, Bob

    2011-01-01

    The paper investigates whether the Clean Development Mechanism (CDM) under the Kyoto Protocol has played a significant role in the development of rural communities, specifically investigating uptake of small-scale renewable energy projects. The investigation involved an assessment of 500 registered small-scale CDM projects under the Kyoto Protocol in terms of their potential impact on the envisaged sustainable development goals for rural communities. Five case studies from the Indian subcontinent were also examined. The paper concludes that the CDM in its current state and design has typically failed to deliver the promised benefits with regard to development objectives in rural areas. Successful projects were found to have had good community involvement and such projects were typically managed by cooperative ventures rather than money making corporations. The paper puts forward a new framework for the assessment of such benefits in the hope that future projects can be better assessed in this regard. The key problem, however, remains on how to deal with the inherent contradiction between development and sustainability. - Research Highlights: → Role of CDM towards sustainable development of rural communities. → Assessment of 500 registered small-scale CDM projects. → CDM in its current state and design has typically failed to deliver. → A new framework for sustainable development assessment of small-scale CDM projects. → Inherent contradiction between development and sustainability.

  19. 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...

  20. Delivering Hubble Discoveries to the Classroom

    Science.gov (United States)

    Eisenhamer, B.; Villard, R.; Weaver, D.; Cordes, K.; Knisely, L.

    2013-04-01

    Today's classrooms are significantly influenced by current news events, delivered instantly into the classroom via the Internet. Educators are challenged daily to transform these events into student learning opportunities. In the case of space science, current news events may be the only chance for educators and students to explore the marvels of the Universe. Inspired by these circumstances, the education and news teams developed the Star Witness News science content reading series. These online news stories (also available in downloadable PDF format) mirror the content of Hubble press releases and are designed for upper elementary and middle school level readers to enjoy. Educators can use Star Witness News stories to reinforce students' reading skills while exposing students to the latest Hubble discoveries.

  1. Delivering advanced therapies: the big pharma approach.

    Science.gov (United States)

    Tarnowski, J; Krishna, D; Jespers, L; Ketkar, A; Haddock, R; Imrie, J; Kili, S

    2017-09-01

    After two decades of focused development and some recent clinical successes, cell and gene therapy (CGT) is emerging as a promising approach to personalized medicines. Genetically engineered cells as a medical modality are poised to stand alongside or in combination with small molecule and biopharmaceutical approaches to bring new therapies to patients globally. Big pharma can have a vital role in industrializing CGT by focusing on diseases with high unmet medical need and compelling genetic evidence. Pharma should invest in manufacturing and supply chain solutions that deliver reproducible, high-quality therapies at a commercially viable cost. Owing to the fast pace of innovation in this field proactive engagement with regulators is critical. It is also vital to understand the needs of patients all along the patient care pathway and to establish product pricing that is accepted by prescribers, payers and patients.

  2. Delivering Results for Peace and Development

    International Nuclear Information System (INIS)

    Pattison, Hazel

    2013-01-01

    The IAEA’s technical cooperation programme is the primary mechanism for delivering the IAEA’s capacity-building services to its Member States. The programme supports the safe and secure application of nuclear technology for sustainable socioeconomic development in Member States. The overall strategic framework of the TC programme is determined by pertinent provisions laid down in key documents of the IAEA. Strategic direction for the multi-annual TC programme is provided by the Agency’s Members States and, more specifically, by relevant advisory and governance entities. The programme concentrates on: improving human health; supporting agriculture, rural development and food security; advancing water resource management; addressing environmental challenges; helping sustainable energy development, including the use of nuclear power for electricity; and promoting safety and security

  3. Combining Technologies to Deliver Distance Education

    Directory of Open Access Journals (Sweden)

    Vicki Freeman

    1999-01-01

    Full Text Available In 1997 a Health Resources and Services Administration (HRSA grant was awarded to the Department of Clinical Laboratory Sciences (CLS at The University of Texas Medical Branch - Galveston (UTMB for support of the Laboratory Education and Advancement Project (LEAP. The project entailed three primary objectives, targeting laboratory practitioners in rural and medically underserved areas of Texas for delivering a bachelor's degree, laboratory-intensive course of study via distance education. Several delivery mechanisms were utilized and evaluated for their effectiveness and friendliness to both the faculty and students. The authors discuss and describe the mechanisms utilized for delivery of courses, the advantages and disadvantages encountered with each mechanism, and subjective evaluation of the effectiveness of the courses. Also discussed are the lessons learned and plans for future development.

  4. Temperature of gas delivered from ventilators.

    Science.gov (United States)

    Chikata, Yusuke; Onodera, Mutsuo; Imanaka, Hideaki; Nishimura, Masaji

    2013-01-01

    Although heated humidifiers (HHs) are the most efficient humidifying device for mechanical ventilation, some HHs do not provide sufficient humidification when the inlet temperature to the water chamber is high. Because portable and home-care ventilators use turbines, blowers, pistons, or compressors to inhale in ambient air, they may have higher gas temperature than ventilators with piping systems. We carried out a bench study to investigate the temperature of gas delivered from portable and home-care ventilators, including the effects of distance from ventilator outlet, fraction of inspiratory oxygen (FIO2), and minute volume (MV). We evaluated five ventilators equipped with turbine, blower, piston, or compressor system. Ambient air temperature was adjusted to 24°C ± 0.5°C, and ventilation was set at FIO2 0.21, 0.6, and 1.0, at MV 5 and 10 L/min. We analyzed gas temperature at 0, 40, 80, and 120 cm from ventilator outlet and altered ventilator settings. While temperature varied according to ventilators, the outlet gas temperature of ventilators became stable after, at the most, 5 h. Gas temperature was 34.3°C ± 3.9°C at the ventilator outlet, 29.5°C ± 2.2°C after 40 cm, 25.4°C ± 1.2°C after 80 cm and 25.1°C ± 1.2°C after 120 cm (P < 0.01). FIO2 and MV did not affect gas temperature. Gas delivered from portable and home-care ventilator was not too hot to induce heated humidifier malfunctioning. Gas soon declined when passing through the limb.

  5. 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...

  6. 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

  7. 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...

  8. 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.

  9. 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.

  10. Understanding on-line community: the affordances of virtual space

    Directory of Open Access Journals (Sweden)

    Karen Ruhleder

    2002-01-01

    Full Text Available Increasing numbers of on-line venues for learning are emerging as virtual communities become more accessible and commonplace. This paper looks at one particular virtual community, an on-line degree programme at the University of Illinois, Urbana-Champaign, which offers an M.S. in Library and Information Science (called LEEP. It draws on a framework presented by Mynatt, et al. (1998, which provides a lens for talking about on-line community as a set of affordances. This framework is applied to illustrate the interactions, artefacts, and expectations that shape this community.

  11. Exploring Affordances of Social Media Use in Election Campaigns

    DEFF Research Database (Denmark)

    Dyrby, Signe; Jensen, Tina Blegind

    case study of the political parties’ use of Facebook in the Danish general election in 2011. Our preliminary findings reveal three main categories of affordances that the political parties wish to pursue: 1) they want to facilitate direct communication to promote political interests and create room...... for dialogue in a controlled environment, 2) they want to project an image of authenticity through an informal media, and 3) they want to create interaction and involvement through dynamic relationships with voters. A closer look at the parties’ actual use of Facebook reveals that their intention of generating...

  12. Learning Objects and Grasp Affordances through Autonomous Exploration

    DEFF Research Database (Denmark)

    Kraft, Dirk; Detry, Renaud; Pugeault, Nicolas

    2009-01-01

    We describe a system for autonomous learning of visual object representations and their grasp affordances on a robot-vision system. It segments objects by grasping and moving 3D scene features, and creates probabilistic visual representations for object detection, recognition and pose estimation...... image sequences as well as (3) a number of built-in behavioral modules on the one hand, and autonomous exploration on the other hand, the system is able to generate object and grasping knowledge through interaction with its environment....

  13. Did the Affordable Care Act's Dependent Coverage Mandate Increase Premiums?

    OpenAIRE

    Briggs Depew; James Bailey

    2014-01-01

    We investigate the impact of the Affordable Care Act's dependent coverage mandate on insurance premiums. The expansion of dependent coverage under the ACA allows young adults to remain on their parent's private health insurance plans until the age of 26. We find that the mandate has led to a 2.5-2.8 percent increase in premiums for health insurance plans that cover children, relative to single-coverage plans. We find no evidence that the mandate caused an increase in the amount of the employe...

  14. 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

  15. Augmented Reality in science education – affordances for student learning

    DEFF Research Database (Denmark)

    Nielsen, Birgitte Lund; Brandt, Harald; Swensen, Hakon

    2016-01-01

    Most extant studies examining augmented reality (AR) have focused on the technology itself. This paper presents findings addressing the issue of AR for educational purposes based on a sequential survey distributed to 35 expert science teachers, ICT designers and science education researchers from...... four countries. There was consensus among experts in relation to a focus on ‘learning before technology’, and they in particular supplemented affordances identified in literature with perspectives related to interactivity, a creator perspective and inquiry based science. Expert reflections were...

  16. The affordances and use of green citizen engagement web tools

    DEFF Research Database (Denmark)

    Scheele, Christian Elling; Hoff, Jens Villiam

    2015-01-01

    The purpose of this paper is to analyse if and how three different green web applications create the basis for different levels of environmental citizen participation. This is relevant in both an e-governance context and an environmental policy context, as it is normally assumed that ICT...... that differences in affordance translates into differences in use. Theoretically, the paper departs from Contextual New Medium Theory. This theory focuses on technological practices, and demonstrates how these are created in interplay between technology, policy ideas and actor skills. Empirically, the paper...

  17. Enabling Dedicated, Affordable Space Access Through Aggressive Technology Maturation

    Science.gov (United States)

    Jones, Jonathan E.; Kibbey, Timothy P.; Cobb, C. Brent; Harris, Lawanna L.

    2014-01-01

    A launch vehicle at the scale and price point which allows developers to take reasonable risks with high payoff propulsion and avionics hardware solutions does not exist today. Establishing this service provides a ride through the proverbial technology "valley of death" that lies between demonstration in laboratory and flight environments. NASA's NanoLaunch effort will provide the framework to mature both earth-to-orbit and on-orbit propulsion and avionics technologies while also providing affordable, dedicated access to low earth orbit for cubesat class payloads.

  18. 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

  19. 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.

  20. Seizing Workplace Learning Affordances in High-Pressure Work Environments

    Science.gov (United States)

    Gnaur, Dorina

    2010-01-01

    Work in call centres is often presented as a form of unskilled labour characterized by routinization, technological surveillance and tight management control aimed at reaching intensive performance targets. Beyond delivering business objectives, this control and efficiency strategy is often held to produce counterproductive effects with regard to…

  1. 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.

  2. 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.

  3. Aldo van Eyck’s Playgrounds: Aesthetics, Affordances, and Creativity

    Directory of Open Access Journals (Sweden)

    Rob Withagen

    2017-07-01

    Full Text Available After World War II, the Dutch architect Aldo van Eyck developed hundreds of playgrounds in the city of Amsterdam. These public playgrounds were located in parks, squares, and derelict sites, and consisted of minimalistic aesthetic play equipment that was supposed to stimulate the creativity of children. Over the last decades, these playgrounds have been studied by sociologists, theorists of art and architecture, and psychologists. Adopting an ecological approach to the human environment, it is argued that the abstract forms of van Eyck’s play sculptures indeed stimulate the creativity of the child. Whereas a slide or a swing almost dictates what a child is supposed to do, van Eyck’s play equipment invites the child to actively explore the numerous affordances (action possibilities it provided. However, it is argued that the standardization (e.g., equal distances between blocks or bars that tends to characterize van Eyck’ play equipment has negative effects on the playability. This standardization, which was arguably the result of the aesthetic motives of the designer, might be appealing to children when simply looking at the equipment, but it is not of overriding importance to them when playing in it. Indeed, a recent study indicates that the affordances provided by messy structures appear to have a greater appeal to playing children.

  4. Cortical processing of object affordances for self and others’ action

    Directory of Open Access Journals (Sweden)

    Monica eMaranesi

    2014-06-01

    Full Text Available The perception of objects does not rely only on visual brain areas, but also involves cortical motor regions. In particular, different parietal and premotor areas host neurons discharging during both object observation and grasping. Most of these cells often show similar visual and motor selectivity for a specific object (or set of objects, suggesting that they might play a crucial role in representing the potential motor act afforded by the object. The existence of such a mechanism for the visuomotor transformation of object physical properties in the most appropriate motor plan for interacting with them has been convincingly demonstrated in humans as well. Interestingly, human studies have shown that visually presented objects can automatically trigger the representation of an action provided that they are located within the observer’s reaching space (peripersonal space. The affordance effect also occurs when the presented object is outside the observer’s peripersonal space, but inside the peripersonal space of an observed agent. These findings recently received direct support by single neuron studies in monkey, indicating that space-constrained processing of objects in the ventral premotor cortex might be relevant to represent objects as potential targets for one’s own or others' action.

  5. 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.

  6. 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.

  7. 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

  8. Apparatus for delivering and receiving radioactive gas

    International Nuclear Information System (INIS)

    Dansky, B.; Epifano, L.; Farella, R.

    1980-01-01

    An apparatus for delivering and receiving gas to and from a patient, such as for lung ventilation studies. In accordance with the invention there is provided a restrictive breathing chamber adapted for coupling to the patient's breathing organs. A system, including a first check valve, is provided for coupling the breathing chamber to an inflatable gas receptacle so as to allow flow only toward the inflatable gas receptacle. Active gas input apparatus, including a second check valve, is also coupled to the breathing chamber, the second check valve allowing flow only toward the breathing chamber means. First and second auxiliary tubes and a gas filter are also provided. A system is provided for coupling the first auxiliary tube from the inflatable receptacle through the gas filter and to an ambient air environment. The second auxiliary tube is coupled from the inflatable receptacle to an ambient air environment. Finally, a gas pump is switchably coupled as between the first and second auxiliary tubes and operative to selectively cause gas flow in the first auxiliary tube toward the ambient environment, and in the second auxiliary tube toward the inflatable receptacle. A gas trap structure is also disclosed

  9. Delivering bad news in emergency care medicine.

    Science.gov (United States)

    Maynard, Douglas W

    2017-01-01

    Forecasting is a strategy for delivering bad news and is compared to two other strategies, stalling and being blunt. Forecasting provides some warning that bad news is forthcoming without keeping the recipient in a state of indefinite suspense (stalling) or conveying the news abruptly (being blunt). Forecasting appears to be more effective than stalling or being blunt in helping a recipient to "realize" the bad news because it involves the deliverer and recipient in a particular social relation. The deliverer of bad news initiates the telling by giving an advance indication of the bad news to come; this allows the recipient to calculate the news in advance of its final presentation, when the deliverer confirms what the recipient has been led to anticipate. Thus, realization of bad news emerges from intimate collaboration, whereas stalling and being blunt require recipients to apprehend the news in a social vacuum. Exacerbating disruption to recipients' everyday world, stalling and being blunt increase the probability of misapprehension (denying, blaming, taking the situation as a joke, etc.) and thereby inhibit rather than facilitate realization. Particular attention is paid to the "perspective display sequence", a particular forecasting strategy that enables both confirming the recipient's perspective and using that perspective to affirm the clinical news. An example from acute or emergency medicine is examined at the close of the paper.

  10. Changes in nurse education: delivering the curriculum.

    Science.gov (United States)

    Carr, Graham

    2008-01-01

    The aim of this study is to examine changes in pre-registration nursing education through the personal accounts of nurse teachers. This paper is based on 37 in-depth interviews within a central London Healthcare Faculty. Each interview was subjected to a process of content analysis described by Miles and Huberman. The interviews took place between August 2003 and March 2004 and totalled 34.4 hours or 305,736 words. There were thirty female and seven male participants, who shared 1015 years of nursing experience, averaging at 27.4 years (min 7-max 42). These were supplemented by 552 years of teaching practice, the average being 15 years (min 0.5-max 29). This paper--delivering the nursing curriculum--identifies that the nature of nursing has changed as it has both expanded and contracted. Participants identified three major changes; the nature of nursing, selection of future nurses and the current impact that large cohorts have on our traditional model of person-centred education. The practice placements remain central to nursing education and it is the nursing role that should define the curriculum and the values of higher education should be supportive of this identity.

  11. Delivering new physics at impressive speed

    CERN Multimedia

    2010-01-01

    The speed with which the heavy ion run at the LHC is delivering new physics is impressive not only for the insights it is bringing to the early Universe, but also for the clear demonstration it gives of the value of competition and complementarity between the experiments.   ALICE was the first off the mark to publish papers from the ion run, as you’d expect from the LHC’s dedicated ion experiment, but results emerging from ATLAS and CMS are bringing new understanding in their own right. Each collaboration’s result plays to the strengths of its detector, and it is by taking all the results together that our knowledge advances. The creation, observation and understanding of the hot dense matter that would have existed in the early Universe, normally known as Quark Gluon Plasma (QGP), is complex science and one of the ion programme’s key goals. Many signals for QGP exist, and like pieces of a puzzle, we must assemble all of them to get the full picture. At th...

  12. 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.

  13. 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.

  14. 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

  15. Simply delivered meals: a tale of collaboration.

    Science.gov (United States)

    Martin, Sarah L; Connelly, Nancy; Parsons, Cassandra; Blackstone, Katlyn

    2018-06-01

    Western medicine is undergoing a transition toward transparency of quality and costs, and healthcare systems are striving to achieve the Triple Aim, a framework for improving the patient experience of care, improving the health of populations, and reducing the per capita cost of healthcare. Meanwhile, there is growing recognition of the impact of social determinants of health and a new federal requirement for nonprofit hospitals to implement prevention strategies. A specialized meal delivery program called Simply Delivered for ME (SDM) was formed in an effort to improve care and reduce 30-day hospital readmission rates.The Maine Medical Center (MMC) partnered with the Southern Maine Agency on Aging to offer SDM on a voluntary basis to high-risk Medicare patients already enrolled in the Community-based Care Transition Program (CCTP) at MMC. We report the results of the 2-year intervention in terms of 30-day hospital readmission rates and cost measures (ie, return on investment and cost savings).Of the 622 MMC patients who received SDM during the 24 months, the 30-day readmission rate was 10.3% (compared with the 16.6% 30-day rate of hospital readmission at baseline [ie, before the adoption of CCTP]) for all-cause readmissions. The cost savings for reduced readmissions were $212,160. The return on investment was 387%, or a benefit-cost ratio of $3.87 for every $1.00 spent on meals. Programs such as SDM may reduce the rate of hospital readmission among high-risk older adults and, thereby, yield lower healthcare costs.

  16. The affordable care ACT on loyalty programs for federal beneficiaries.

    Science.gov (United States)

    Piacentino, Justin J; Williams, Karl G

    2014-02-01

    To discuss changes in the law that allow community pharmacy loyalty programs to include and offer incentives to Medicare and Medicaid beneficiaries. The retailer rewards exception of the Patient Protection and Affordable Care Act of 2010 and its change to the definition of remuneration in the civil monetary penalties of the Anti-Kickback Statute now allow incentives to be earned on federal benefit tied prescription out-of-pocket costs. The criteria required to design a compliant loyalty program are discussed. Community pharmacies can now include Medicare and Medicaid beneficiaries in compliant customer loyalty programs, where allowed by state law. There is a need for research directly on the influence of loyalty programs and nominal incentives on adherence.

  17. AN UNCERTAIN FEDERALISM: THE STATES AND THE AFFORDABLE CARE ACT.

    Science.gov (United States)

    Plein, L Christopher

    2014-01-01

    This article provides an initial assessment of the Affordable Care Act's recent implementation experience in the states. Drawing on state-level and regional analyses that have been coordinated by the ACA Implementation Network--a cooperative effort involving researchers in 35 states--this article highlights the uncertain policy environment associated with the politics and complexities of the ACA. Understanding the ACA implementation experience requires an appreciation for political context, but must also take into account underlying demographic, market, and state administrative capacity issues in the states. There are indications that the ACA implementation experience is moving from a highly charged partisan nature to a more accommodating posture long associated with intergovernmental relations between the federal and state government in health and human services administration. In short, the key questions going forward will turn on how, not whether, the ACA is implemented.

  18. ADAM (Affordable Desktop Application Manager): a Unix desktop application manager

    International Nuclear Information System (INIS)

    Liebana, M.; Marquina, M.; Ramos, R.

    1996-01-01

    ADAM stands for Affordable Desktop Application Manager. It is a GUI developed at CERN with the aim to ease access to applications. The motivation to develop ADAM came from the unavailability of environments like COSE/CDE and their heavy resource consumption. ADAM has proven to be user friendly: new users are able to customize it to their needs in few minutes. Groups of users may share through ADAM a common application environment. ADAM also integrates the Unix and the PC world. PC users can excess Unix applications in the same way as their usual Windows applications. This paper describes all the ADAM features, how they are used at CERN Public Services, and the future plans for ADAM. (author)

  19. Gender performativity in physics: affordances or only constraints?

    Science.gov (United States)

    Danielsson, Anna T.; Lundin, Mattias

    2014-06-01

    In this forum we engage in a dialogue with Allison Gonsalves's paper `"Physics and the girly girl—there is a contradiction somewhere": Doctoral students' positioning around discourses of gender and competence in physics'. In her paper Gonsalves uses a sociocultural approach to examine women doctoral students' stories about becoming physicists. In doing so her paper focuses on how discourses of masculinity and femininity can create available and unavailable positions for the women students. In this dialogue we do a parallel reading of two of the student narratives presented by Gonsalves, using Judith Butler's (1990) concept of discursive agency as a means to more explicitly bring the affordances for women identity constitution offered by their localized physicist context to the fore, rather focusing on its, often more visible, constraints.

  20. Three Words and the Future of the Affordable Care Act.

    Science.gov (United States)

    Bagley, Nicholas

    2015-06-01

    As an essential part of its effort to achieve near universal coverage, the Affordable Care Act (ACA) extends sizable tax credits to most people who buy insurance on the newly established health care exchanges. Yet several lawsuits have been filed challenging the availability of those tax credits in the thirty-four states that refused to set up their own exchanges. The lawsuits are premised on a strained interpretation of the ACA that, if accepted, would make a hash of other provisions of the statute and undermine its effort to extend coverage to the uninsured. The courts should reject this latest effort to dismantle a critical feature of the ACA. Copyright © 2015 by Duke University Press.

  1. Affordances and synchronization in collective creative construction tasks

    DEFF Research Database (Denmark)

    Tylén, Kristian; Fusaroli, Riccardo

    What does it mean to cooperate? How do we share meanings and actions in order to reach a common goal? In this paper we explore the relation between cooperative coordination and heart rate. We argue that in cooperative contexts participants synchronize their heart rhythms according to two factors......: the affordances of the task at hand and the gradual consolidation of collaborative practices. Six groups of participants were instructed to construct LEGO models of six abstract notions (“responsibility”, “knowledge”, “justice” etc.), both individually and in groups. We combine video analysis and heart rate...... measurements and employ recurrence analysis techniques to quantify the mutual adaptability of heart rates among the participants in the different tasks. We show that during individual tasks individual heart rates synchronize both within and between groups (but not with controls) plausibly due...

  2. Design and construction of an optical compact and affordable tweezers

    International Nuclear Information System (INIS)

    Gonzalez, M.C.; Perez Moret, Y.; Arronte, M.; Ponce, L.

    2009-01-01

    The following paper presents a new design allowing a reduction on the amount of required optical elements for the construction of the optical tweezers, which results in a compact and affordable system. The latter is composed by a 40 mW Nd: YAG (532 nm) laser and commercially available optics and mounts. A virtual instrument, developed using Lab View 8.0, controls both a XYZ table and a web camera for visualizing. The quality of the laser beam at the end of optical system was characterized using the knife-edge method, resulting in a Gaussian shaped (TEM00) intensity profile. It is presented as well the necessary information to align and calibrate each optical element. (Author)

  3. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed......The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches...... to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the Hy...

  4. Pico Reentry Probes: Affordable Options for Reentry Measurements and Testing

    Science.gov (United States)

    Ailor, William H.; Kapoor, Vinod B.; Allen, Gay A., Jr.; Venkatapathy, Ethiraj; Arnold, James O.; Rasky, Daniel J.

    2005-01-01

    It is generally very costly to perform in-space and atmospheric entry experiments. This paper presents a new platform - the Pico Reentry Probe (PREP) - that we believe will make targeted flight-tests and planetary atmospheric probe science missions considerably more affordable. Small, lightweight, self-contained, it is designed as a "launch and forget" system, suitable for experiments that require no ongoing communication with the ground. It contains a data recorder, battery, transmitter, and user-customized instrumentation. Data recorded during reentry or space operations is returned at end-of-mission via transmission to Iridium satellites (in the case of earth-based operations) or a similar orbiting communication system for planetary missions. This paper discusses possible applications of this concept for Earth and Martian atmospheric entry science. Two well-known heritage aerodynamic shapes are considered as candidates for PREP: the shape developed for the Planetary Atmospheric Experiment Test (PAET) and that for the Deep Space II Mars Probe.

  5. Seizing Workplace Learning Affordances in High-Pressure Work Environments

    DEFF Research Database (Denmark)

    Gnaur, Dorina

    2010-01-01

    Work in call centres is often presented as a form of unskilled labour characterized by routinization, technological surveillance and tight management control aimed at reaching intensive performance targets. Beyond delivering business objectives, this control and efficiency strategy is often held ...... by individuals with diverse life histories or ontogenies that influence their enactment of work with self-defined interests and identity formation pursuits being directed by their personal agency...

  6. The challenge of making nuclear technologies acceptable, accessible and affordable

    International Nuclear Information System (INIS)

    Ramamurthy, V.S.

    2009-01-01

    Full text: It is more than five decades since the first successful demonstration of nuclear power for commercial electricity production. The same decades have also seen the successful demonstration of several other applications of nuclear technologies that can contribute directly to human development, as for example, in the Food and Agriculture, Human and animal Health, Environment and Water sectors. In spite of several successful demonstrations and applications in these fields, it is somewhat strange that their full potential is yet to be realized. More importantly, their availability to populations across the world is highly skewed. Three barriers have been identified for the wide spread use of nuclear technologies for development- Acceptability, Accessibility and Affordability. It is an unfortunate twist of fate that the first public demonstration of nuclear technology was its destructive power. The following demonization of anything nuclear was further compounded by the discussions on the unresolved questions on tackling long lived radioactive wastes, our inability to arrive at a global consensus on nuclear disarmament and issues of nuclear proliferation. These have certainly had a negative impact on the public acceptance of nuclear technologies across the board. While the recent concerns on the global climate change following the emission of carbon-di-oxide from excessive hydrocarbon burning for meeting our increasing energy needs have revived the interest in nuclear energy, a lot needs to be done to de-demonize nuclear technologies in public mind leading to increased acceptance of nuclear technologies for development. Lack of resources, infrastructure and trained man power also have a negative impact on the accessibility and affordability of the nuclear technologies for development. It is argued that only education holds the key for this. The role of international partnerships is also highlighted in realizing the full potential of nuclear technologies for

  7. Conductive Cotton Filters for Affordable and Efficient Water Purification

    Directory of Open Access Journals (Sweden)

    Fang Li

    2017-09-01

    Full Text Available It is highly desirable to develop affordable, energy-saving, and highly-effective technologies to alleviate the current water crisis. In this work, we reported a low-cost electrochemical filtration device composing of a conductive cotton filter anode and a Ti foil cathode. The device was operated by gravity feed. The conductive cotton filter anodes were fabricated by a facile dying method to incorporate carbon nanotubes (CNTs as fillers. The CNTs could serve as adsorbents for pollutants adsorption, as electrocatalysts for pollutants electrooxidation, and as conductive additives to render the cotton filters highly conductive. Cellulose-based cotton could serve as low-cost support to ‘host’ these CNTs. Upon application of external potential, the developed filtration device could not only achieve physically adsorption of organic compounds, but also chemically oxide these compounds on site. Three model organic compounds were employed to evaluate the oxidative capability of the device, i.e., ferrocyanide (a model single-electron-transfer electron donor, methyl orange (MO, a common recalcitrant azo-dye found in aqueous environments, and antibiotic tetracycline (TC, a common antibiotic released from the wastewater treatment plants. The devices exhibited a maximum electrooxidation flux of 0.37 mol/h/m2 for 5.0 mmol/L ferrocyanide, of 0.26 mol/h/m2 for 0.06 mmol/L MO, and of 0.9 mol/h/m2 for 0.2 mmol/L TC under given experimental conditions. The effects of several key operational parameters (e.g., total cell potential, CNT amount, and compound concentration on the device performance were also studied. This study could shed some light on the good design of effective and affordable water purification devices for point-of-use applications.

  8. Availability, prices and affordability of essential medicines in Haiti.

    Science.gov (United States)

    Chahal, Harinder Singh; St Fort, Nazaire; Bero, Lisa

    2013-12-01

    Haiti is the poorest country in the Western Hemisphere and faces numerous challenges, including inadequate medication access for its residents. The objective of this study was to determine the availability, prices, and affordability of essential medicines in Haiti and compare these findings to other countries. We conducted a cross-sectional nationwide survey in 2011 of availability and consumer prices of 60 essential medicines in Haiti using a standardized methodology developed by the World Health Organization and Health Action International. The survey was conducted in 163 medicine outlets in four health care sectors (public, retail, nonprofit and mixed sectors). Medicine prices were expressed as ratios relative to the International Reference Price. Affordability was calculated by comparing the costs of treatment for common conditions with the salary of the lowest paid government worker and was compared to available data from four Latin American countries. For generic medicines, the availability in public, retail, nonprofit and mixed sectors was 20%, 37%, 24% and 23% of medications, respectively. Most of the available medicines were priced higher than the International Reference Price. The lowest paid government worker would need 2.5 days' wages to treat an adult respiratory infection with generic medicines from the public sector. For treatment of common conditions with originator brands (OB) purchased from a retail pharmacy, costs were between 1.4 (anaerobic bacterial infection) and 13.7 (hyperlipidemia) days' wages, respectively. Treatment of pediatric bacterial infections with the OB of ceftriaxone from a retail pharmacy would cost 24.6 days' wages. Prices in Bolivia, Colombia, Mexico and Nicaragua were frequently lower for comparable medications. The availability of essential medicines was low and prices varied widely across all four sectors. Over 75% of Haitians live on less than US$ 2.00 /day; therefore, most medication regimens are largely unaffordable

  9. 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.

  10. 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...

  11. 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 ...

  12. Oral microflora in infants delivered vaginally and by caesarean section

    DEFF Research Database (Denmark)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

    2011-01-01

    International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

  13. Innovative Processing Methods for the Affordable Manufacture of Multifunctional High Temperature Coatings, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Research is proposed to investigate the feasibility of using advanced manufacturing techniques to enable the affordable application of multi-functional high...

  14. 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.

  15. 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

  16. Faith-Based Organizations and the Affordable Care Act: Reducing Latino Mental Healthcare Disparities

    Science.gov (United States)

    Villatoro, Alice P.; Dixon, Elizabeth; Mays, Vickie M.

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) is expected to increase access to mental healthcare through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino non-elderly adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% of the federal poverty level, subsidizing the purchase of private insurance among individuals not eligible for Medicaid, and requiring employers with 50 or more employees to offer health insurance. An anticipated result of this landmark legislation is improvement in the screening, diagnosis, and treatment of mental disorders in racial/ethnic minorities, particularly for Latinos, who traditionally have had less access to these services. However, these efforts alone may not sufficiently ameliorate mental healthcare disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental healthcare of Latinos by increasing help-seeking, providing religion-based mental health services, and delivering supportive services that address common access barriers among Latinos. Thus, in determining ways to eliminate Latino mental healthcare disparities under the ACA, examining pathways into care through the faith-based sector offers unique opportunities to address some of the cultural barriers confronted by this population. We examine how partnerships between FBOs and primary care patient-centered medical homes (PCMH) may help reduce the gap of unmet mental health needs among Latinos in this era of health reform. We also describe the challenges FBOs and PCMH providers need to overcome in order to be partners in integrated care efforts. PMID:26845492

  17. 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.

  18. Budget impact and cost-effectiveness: can we afford precision medicine in oncology?

    Science.gov (United States)

    Doble, Brett

    2016-01-01

    Over the past decade there have been remarkable advancements in the understanding of the molecular underpinnings of malignancy. Methods of testing capable of elucidating patients' molecular profiles are now readily available and there is an increased desire to incorporate the information derived from such tests into treatment selection for cancer patients. This has led to more appropriate application of existing treatments as well as the development of a number of innovative and highly effective treatments or what is known collectively as precision medicine. The impact that precision medicine will have on health outcomes is uncertain, as are the costs it will incur. There is, therefore, a need to develop economic evidence and appropriate methods of evaluation to support its implementation to ensure the resources allocated to these approaches are affordable and offer value for money. The market for precision medicine in oncology continues to rapidly expand, placing an increased pressure on reimbursement decision-makers to consider the value and opportunity cost of funding such approaches to care. The benefits of molecular testing can be complex and difficult to evaluate given currently available economic methods, potentially causing a distorted appreciation of their value. Funding decisions of precision medicine will also have far-reaching implications, requiring the consideration of both patient and public perspectives in decision-making. Recommendations to improve the value proposition of precision medicine are, therefore, provided with the hopes of facilitating a better understanding of its impact on outcomes and the overall health budget.

  19. Evaluation of nanoparticle delivered cisplatin in beagles

    Science.gov (United States)

    Feldhaeusser, Brittany; Platt, Simon R.; Marrache, Sean; Kolishetti, Nagesh; Pathak, Rakesh K.; Montgomery, David J.; Reno, Lisa R.; Howerth, Elizabeth; Dhar, Shanta

    2015-08-01

    Intracranial neoplasia is a significant cause of morbidity and mortality in both human and veterinary patients, and is difficult to treat with traditional therapeutic methods. Cisplatin is a platinum (Pt)-containing chemotherapeutic agent approved by the Food and Drug Administration; however, substantial limitations exist for its application in canine brain tumor treatment due to the difficulty in crossing the blood-brain barrier (BBB), development of resistance, and toxicity. A modified Pt(iv)-prodrug of cisplatin, Platin-M, was recently shown to be deliverable to the brain via a biocompatible mitochondria-targeted lipophilic polymeric nanoparticle (NP) that carries the drug across the BBB and to the mitochondria. NP mediated controlled release of Platin-M and subsequent reduction of this prodrug to cisplatin allowed cross-links to be formed with the mitochondrial DNA, which have no nucleotide excision repair system, forcing the overactive cancer cells to undergo apoptosis. Here, we report in vitro effects of targeted Platin-M NPs (T-Platin-M-NPs) in canine glioma and glioblastoma cell lines with results indicating that this targeted NP formulation is more effective than cisplatin. In both the cell lines, T-Platin-M-NP was significantly more efficacious compared to carboplatin, another Pt-based chemotherapy, which is used in the settings of recurrent high-grade glioblastoma. Mitochondrial stress analysis indicated that T-Platin-M-NP is more effective in disrupting the mitochondrial bioenergetics in both the cell types. A 14-day distribution study in healthy adult beagles using a single intravenous injection at 0.5 mg kg-1 (with respect to Platin-M) of T-Platin-M-NPs showed high levels of Pt accumulation in the brain, with negligible amounts in the other analyzed organs. Safety studies in the beagles monitoring physical, hematological, and serum chemistry evaluations were within the normal limits on days 1, 7, and 14 after injection of either 0.5 mg kg-1 or 2 mg kg

  20. Developing affordable multi-touch technologies for use in physics

    Science.gov (United States)

    Potter, Mark; Ilie, Carolina; Schofield, Damian; Vampola, David

    2012-02-01

    Physics is one of many areas which has the ability to benefit from a number of different teaching styles and sophisticated instructional tools due to it having both theoretical and practical applications which can be explored. The purpose of this research is to develop affordable large scale multi-touch interfaces which can be used within and outside of the classroom as both an instruction technology and a computer supported collaborative learning tool. Not only can this technology be implemented at university levels, but also at the K-12 level of education. Pedagogical research indicates that kinesthetic learning is a fundamental, powerful, and ubiquitous learning style [1]. Through the use of these types of multi-touch tools and teaching methods which incorporate them, the classroom can be enriched to allow for better comprehension and retention of information. This is due in part to a wider range of learning styles, such as kinesthetic learning, which are being catered to within the classroom. [4pt] [1] Wieman, C.E, Perkins, K.K., Adams, W.K., ``Oersted Medal Lecture 2007: Interactive Simulations for teaching physics: What works, what doesn't and why,'' American Journal of Physics. 76 393-99.

  1. Grasping the World: Object-Affordance Effect in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Jessica Sevos

    2013-01-01

    Full Text Available For schizophrenic patients, the world can appear as deprived of practical meaning, which normally emerges from sensory-motor experiences. However, no research has yet studied the integration between perception and action in this population. In this study, we hypothesize that patients, after having controlled the integrity of their visuospatial integration, would nevertheless present deficit in sensory-motor simulation. In this view, we compare patients to control subjects using two stimulus-response compatibility (SRC tasks. Experiment 1 is performed to ensure that visuo-spatial integration is not impaired (Simon Effect. Experiment 2 replicates a study from Tucker and Ellis (1998 to explore the existence of sensory-motor compatibility between stimulus and response (Object Affordance. In control subjects, the SRC effect appears in both experiments. In schizophrenic patients, it appears only when stimuli and responses share the same spatial localization. This loss of automatic sensory-motor simulation could emerge from a lack of relation between the object and the subject’s environment.

  2. Affordable CZT SPECT with dose-time minimization (Conference Presentation)

    Science.gov (United States)

    Hugg, James W.; Harris, Brian W.; Radley, Ian

    2017-03-01

    PURPOSE Pixelated CdZnTe (CZT) detector arrays are used in molecular imaging applications that can enable precision medicine, including small-animal SPECT, cardiac SPECT, molecular breast imaging (MBI), and general purpose SPECT. The interplay of gamma camera, collimator, gantry motion, and image reconstruction determines image quality and dose-time-FOV tradeoffs. Both dose and exam time can be minimized without compromising diagnostic content. METHODS Integration of pixelated CZT detectors with advanced ASICs and readout electronics improves system performance. Because historically CZT was expensive, the first clinical applications were limited to small FOV. Radiation doses were initially high and exam times long. Advances have significantly improved efficiency of CZT-based molecular imaging systems and the cost has steadily declined. We have built a general purpose SPECT system using our 40 cm x 53 cm CZT gamma camera with 2 mm pixel pitch and characterized system performance. RESULTS Compared to NaI scintillator gamma cameras: intrinsic spatial resolution improved from 3.8 mm to 2.0 mm; energy resolution improved from 9.8% to reconstruction, result in minimized dose and exam time. With CZT cost improving, affordable whole-body CZT general purpose SPECT is expected to enable precision medicine applications.

  3. Strategic options towards an affordable high-performance infrared camera

    Science.gov (United States)

    Oduor, Patrick; Mizuno, Genki; Dutta, Achyut K.; Lewis, Jay; Dhar, Nibir K.

    2016-05-01

    The promise of infrared (IR) imaging attaining low-cost akin to CMOS sensors success has been hampered by the inability to achieve cost advantages that are necessary for crossover from military and industrial applications into the consumer and mass-scale commercial realm despite well documented advantages. Banpil Photonics is developing affordable IR cameras by adopting new strategies to speed-up the decline of the IR camera cost curve. We present a new short-wave IR (SWIR) camera; 640x512 pixel InGaAs uncooled system that is high sensitivity low noise ( 500 frames per second (FPS)) at full resolution, and low power consumption (market adoption by not only demonstrating high-performance IR imaging capability value add demanded by military and industrial application, but also illuminates a path towards justifiable price points essential for consumer facing application industries such as automotive, medical, and security imaging adoption. Among the strategic options presented include new sensor manufacturing technologies that scale favorably towards automation, multi-focal plane array compatible readout electronics, and dense or ultra-small pixel pitch devices.

  4. The Affordable Care Act Medicaid Expansions and Personal Finance.

    Science.gov (United States)

    Caswell, Kyle J; Waidmann, Timothy A

    2017-09-01

    Using a novel data set from a major credit bureau, we examine the early effects of the Affordable Care Act Medicaid expansions on personal finance. We analyze less common events such as personal bankruptcy, and more common occurrences such as medical collection balances, and change in credit scores. We estimate triple-difference models that compare individual outcomes across counties that expanded Medicaid versus counties that did not, and across expansion counties that had more uninsured residents versus those with fewer. Results demonstrate financial improvements in states that expanded their Medicaid programs as measured by improved credit scores, reduced balances past due as a percent of total debt, reduced probability of a medical collection balance of $1,000 or more, reduced probability of having one or more recent medical bills go to collections, reduction in the probability of experiencing a new derogatory balance of any type, reduced probability of incurring a new derogatory balance equal to $1,000 or more, and a reduction in the probability of a new bankruptcy filing.

  5. Practical and affordable ways to cultivate leadership in your organization.

    Science.gov (United States)

    Gaufin, Joyce R; Kennedy, Kathy I; Struthers, Ellen D

    2010-01-01

    Leadership can be cultivated through the intentional actions of managers and others in public health organizations. This article provides a rationale for taking innovative and proactive steps to build leadership, discusses four general strategies for doing so, and presents seven practical, creative, and affordable actions that can have a positive influence on efforts to cultivate leadership qualities in the public health workforce. Each action is illustrated with an actual contemporary example from a local public health agency. The actions include providing formal or informal coaching/mentoring opportunities; assigning staff to lead new projects or collaborations, projects outside their disciplines, projects that cause growth in their information technology capacity, or orphan or struggling projects; facilitating a book club; and institutionalizing reflection. The best way to ensure that effective leadership is available when the organization needs it is to intentionally develop it through an ongoing process. Leadership growth can be supported during the ordinary course of business in a public health organization through thoughtful challenges, sharing ideas and experiences, and especially through the example set by managers and those in positions of authority.

  6. Priority Setting, Cost-Effectiveness, and the Affordable Care Act.

    Science.gov (United States)

    Persad, Govind

    2015-01-01

    The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA's provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither uniformly hostile nor uniformly friendly to efforts to set priorities in ways that promote cost and quality. Second, I argue that the ACA does not take a single, unified approach to priority setting; rather, its guidance varies depending on the aspect of the healthcare system at issue (Patient Centered Outcomes Research Institute, Medicare, essential health benefits) and the factors being excluded from priority setting (age, disability, life expectancy). Third, I argue that cost-effectiveness can be achieved within the ACA's constraints, but that doing so will require adopting new approaches to cost-effectiveness and priority setting. By limiting the use of standard cost-effectiveness analysis, the ACA makes the need for workable rivals to cost-effectiveness analysis a pressing practical concern rather than a mere theoretical worry.

  7. Precise, flexible and affordable gene stacking for crop improvement.

    Science.gov (United States)

    Chen, Weiqiang; Ow, David W

    2017-09-03

    The genetic engineering of plants offers a revolutionary advance for crop improvement, and the incorporation of transgenes into crop species can impart new traits that would otherwise be difficult to obtain through conventional breeding. Transgenes introduced into plants, however, can only be useful when bred out to field cultivars. As new traits are continually added to further improve transgenic cultivars, clustering new DNA near previously introduced transgenes keep from inflating the number of segregating units that breeders must assemble back into a breeding line. Here we discuss various options to introduce DNA site-specifically into an existing transgenic locus. As food security is becoming a pressing global issue, the old proverb resonates true to this day: "give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime." Hence, we describe a recombinase-mediate gene stacking system designed with freedom to operate, providing an affordable option for crop improvement by less developed countries where food security is most at risk.

  8. Structuring payment to medical homes after the affordable care act.

    Science.gov (United States)

    Edwards, Samuel T; Abrams, Melinda K; Baron, Richard J; Berenson, Robert A; Rich, Eugene C; Rosenthal, Gary E; Rosenthal, Meredith B; Landon, Bruce E

    2014-10-01

    The Patient-Centered Medical Home (PCMH) is a leading model of primary care reform, a critical element of which is payment reform for primary care services. With the passage of the Affordable Care Act, the Accountable Care Organization (ACO) has emerged as a model of delivery system reform, and while there is theoretical alignment between the PCMH and ACOs, the discussion of physician payment within each model has remained distinct. Here we compare payment for medical homes with that for accountable care organizations, consider opportunities for integration, and discuss implications for policy makers and payers considering ACO models. The PCMH and ACO are complementary approaches to reformed care delivery: the PCMH ultimately requires strong integration with specialists and hospitals as seen under ACOs, and ACOs likely will require a high functioning primary care system as embodied by the PCMH. Aligning payment incentives within the ACO will be critical to achieving this integration and enhancing the care coordination role of primary care in these settings.

  9. 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

  10. How to design and deliver a local teaching program

    OpenAIRE

    Limb, Christopher; Whitehurst, Katharine; Gundogan, Buket; Koshy, Kiron; Agha, Riaz

    2017-01-01

    Teaching is an invaluable aspect of any medical or surgical career. Many trainees will find themselves delivering teaching at several stages in their career and in this “How to” article we explain how to design, set up, and deliver a successful teaching program, as well as how to evidence this in your portfolio.

  11. 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...

  12. 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…

  13. 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...

  14. 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...

  15. 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

  16. 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...

  17. 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

  18. 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...

  19. 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…

  20. 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.

  1. 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…

  2. 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.

  3. 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

  4. 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...

  5. 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

  6. 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

  7. 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...

  8. 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.

  9. 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...

  10. 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…

  11. Some perspectives on affordable healthcare systems in China.

    Science.gov (United States)

    Zhang, Y T; Yan, Y S; Poon, C C Y

    2007-01-01

    Consistent with the global population trend, China is becoming an aging society. Over one-fifth of the world's elderly population (aged 65 and over) lives in China. Statistics show that the elderly populace in China constitutes 8% of the total population in 2006 and the percentage will be tripled to become 24% in 2050. As a result, there is inevitably an increase in the prevalence of chronic disease that accounted for almost 80% of all deaths in China in 2005. On the other hand, from 1978 to 2003, the total expenditure on healthcare in China increased from 11.02 billion RMB up to 658.41 billion RMB, and in terms of GDP, it is an increase from 3.04% to 5.62%. The annual average increase (12.1%) in healthcare investment is therefore even higher than the annual rate of GDP increase (9.38%) during the last two decades. Meeting the long-term healthcare needs of this growing elderly population and escalating healthcare expenditure pose a grim challenge to the current Chinese healthcare system and the solvency of state budgets. In fact, the healthcare services in China have become less accessible since the early 1980s when its costs soared up. The rising costs have prevented many Chinese people from seeking early medical care. The phenomenon has created a wide disparity in seeking healthcare between urban and rural areas. These trends are of particular concern to the elderly, who have higher healthcare needs yet lesser means to afford the services. Furthermore, according to the 3rd National Health Service Survey, 79.1% of rural residents and 44.8% of urban citizens did not have any form of medical insurance. Such a low percentage of coverage of medical insurance indicates that many people may not be able to afford medical services when they suffer from severe diseases. Therefore, there is a great need of a more effective and low-cost healthcare system. A new system that can allow multi-level, multi-dimensional and standardized healthcare services for urban and rural

  12. Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion

    Science.gov (United States)

    Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.

    2013-01-01

    Nuclear Thermal Propulsion (NTP) is a concept which uses a nuclear reactor to heat a propellant to high temperatures without combustion and can achieve significantly greater specific impulse than chemical engines. NTP has been considered many times for human and cargo missions beyond low earth orbit. A lot of development and technical maturation of NTP components took place during the Rover/NERVA program of the 60's and early 70's. Other NTP programs and studies followed attempting to further mature the NTP concept and identify a champion customer willing to devote the funds and support the development schedule to a demonstration mission. Budgetary constraints require the use of an affordable development and qualification strategy that takes into account all the previous work performed on NTP to construct an existing database, and include lessons learned and past guidelines followed. Current guidelines and standards NASA uses for human rating chemical rocket engines is referenced. The long lead items for NTP development involve the fuel elements of the reactor and ground testing the engine system, subsystem, and components. Other considerations which greatly impact the development plans includes the National Space Policy, National Environmental Policy Act, Presidential Directive/National Security Council Memorandum #25 (Scientific or Technological Experiments with Possible Large-Scale Adverse Environmental Effects and Launch of Nuclear Systems into Space), and Safeguards and Security. Ground testing will utilize non-nuclear test capabilities to help down select components and subsystems before testing in a nuclear environment to save time and cost. Existing test facilities with minor modifications will be considered to the maximum extent practical. New facilities will be designed to meet minimum requirements. Engine and test facility requirements are based on the driving mission requirements with added factors of safety for better assurance and reliability

  13. Affordable Rankine Cycle Waste Heat Recovery for Heavy Duty Trucks

    Energy Technology Data Exchange (ETDEWEB)

    Subramanian, Swami Nathan [Eaton Corporation

    2017-06-30

    Nearly 30% of fuel energy is not utilized and wasted in the engine exhaust. Organic Rankine Cycle (ORC) based waste heat recovery (WHR) systems offer a promising approach on waste energy recovery and improving the efficiency of Heavy-Duty diesel engines. Major barriers in the ORC WHR system are the system cost and controversial waste heat recovery working fluids. More than 40% of the system cost is from the additional heat exchangers (recuperator, condenser and tail pipe boiler). The secondary working fluid loop designed in ORC system is either flammable or environmentally sensitive. The Eaton team investigated a novel approach to reduce the cost of implementing ORC based WHR systems to Heavy-Duty (HD) Diesel engines while utilizing safest working fluids. Affordable Rankine Cycle (ARC) concept aimed to define the next generation of waste energy recuperation with a cost optimized WHR system. ARC project used engine coolant as the working fluid. This approach reduced the need for a secondary working fluid circuit and subsequent complexity. A portion of the liquid phase engine coolant has been pressurized through a set of working fluid pumps and used to recover waste heat from the exhaust gas recirculation (EGR) and exhaust tail pipe exhaust energy. While absorbing heat, the mixture is partially vaporized but remains a wet binary mixture. The pressurized mixed-phase engine coolant mixture is then expanded through a fixed-volume ratio expander that is compatible with two-phase conditions. Heat rejection is accomplished through the engine radiator, avoiding the need for a separate condenser. The ARC system has been investigated for PACCAR’s MX-13 HD diesel engine.

  14. Affordable and personalized lighting using inverse modeling and virtual sensors

    Science.gov (United States)

    Basu, Chandrayee; Chen, Benjamin; Richards, Jacob; Dhinakaran, Aparna; Agogino, Alice; Martin, Rodney

    2014-03-01

    Wireless sensor networks (WSN) have great potential to enable personalized intelligent lighting systems while reducing building energy use by 50%-70%. As a result WSN systems are being increasingly integrated in state-ofart intelligent lighting systems. In the future these systems will enable participation of lighting loads as ancillary services. However, such systems can be expensive to install and lack the plug-and-play quality necessary for user-friendly commissioning. In this paper we present an integrated system of wireless sensor platforms and modeling software to enable affordable and user-friendly intelligent lighting. It requires ⇠ 60% fewer sensor deployments compared to current commercial systems. Reduction in sensor deployments has been achieved by optimally replacing the actual photo-sensors with real-time discrete predictive inverse models. Spatially sparse and clustered sub-hourly photo-sensor data captured by the WSN platforms are used to develop and validate a piece-wise linear regression of indoor light distribution. This deterministic data-driven model accounts for sky conditions and solar position. The optimal placement of photo-sensors is performed iteratively to achieve the best predictability of the light field desired for indoor lighting control. Using two weeks of daylight and artificial light training data acquired at the Sustainability Base at NASA Ames, the model was able to predict the light level at seven monitored workstations with 80%-95% accuracy. We estimate that 10% adoption of this intelligent wireless sensor system in commercial buildings could save 0.2-0.25 quads BTU of energy nationwide.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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

    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

  2. The knowledge and skills gap of medical practitioners delivering ...

    African Journals Online (AJOL)

    The knowledge and skills gap of medical practitioners delivering district hospital ... and quality health services, and also for guiding appropriate undergraduate, ... The uneven skill and knowledge base in aspects of HIV/AIDS management ...

  3. Contractor firm strategies in delivering green project: A review

    Science.gov (United States)

    Powmya, Ayisha; Abidin, Nazirah Zainul; Azizi, Nurul Sakina Mokhtar

    2017-10-01

    Building green requires effort from various parties, from those who plan, design, manage and construct the building. Contractors are responsible for converting the design on paper into a real building and their role at the construction site support environmental sustainability by implementing responsible construction practices. Inefficient or inexperienced contractor in green construction project may find that delivering this type of project is not an easy task due to added requirement in design, stringent practices at site and the use of green technology and materials. Adopting suitable strategies at firm level will assist in preparatory process and readiness of delivering the green project. This paper reviews the strategies at firm level to deliver green construction project. From extensive literature review, it was discovered that there are six strategies to be adopted by the contractor. Understanding these strategies is expected to promote more contractors to be proactive in delivering green projects.

  4. Using technology to deliver quality education in Asia | IDRC ...

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

    2016-06-08

    Jun 8, 2016 ... Using technology to deliver quality education in Asia ... Entrepreneurship has been a major driver of growth and job creation in Southeast Asia. ... to provide access to health services, especially to vulnerable populations.

  5. A dynamic allocation mechanism of delivering capacity in coupled networks

    International Nuclear Information System (INIS)

    Du, Wen-Bo; Zhou, Xing-Lian; Zhu, Yan-Bo; Zheng, Zheng

    2015-01-01

    Traffic process is ubiquitous in many critical infrastructures. In this paper, we introduce a mechanism to dynamically allocate the delivering capacity into the data-packet traffic model on the coupled Internet autonomous-system-level network of South Korea and Japan, and focus on its effect on the transport efficiency. In this mechanism, the total delivering capacity is constant and the lowest-load node will give one unit delivering capacity to the highest-load node at each time step. It is found that the delivering capacity of busy nodes and non-busy nodes can be well balanced and the effective betweenness of busy nodes with interconnections is significantly reduced. Consequently, the transport efficiency such as average traveling time and packet arrival rate is remarkably improved. Our work may shed some light on the traffic dynamics in coupled networks.

  6. Delivering on a gendered definition of health needs in local ...

    African Journals Online (AJOL)

    Delivering on a gendered definition of health needs in local government budgeting: ... of financial grants channelled annually from central to local governments. ... does not reflect the broad community-wide understanding of health needs.

  7. 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

  8. 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.

  9. 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.

  10. Future of Food : Shaping the Food System to Deliver Jobs

    OpenAIRE

    Townsend, Robert; Benfica, Rui Manuel; Prasann, Ashesh; Lee, Maria

    2017-01-01

    Shaping the Food System to Deliver Jobs is the fourth paper in a series on The Future of Food. This paper focuses on how the food system can deliver jobs. It provides a framework for understanding the factors determining the number and quality of jobs in the food system, including inclusion of women and youth. It highlights a set of actions that countries can adopt, adapt, and apply to the...

  11. Delivered Pricing, FOB Pricing, and Collusion in Spatial Markets

    OpenAIRE

    Maria Paz Espinosa

    1992-01-01

    This article examines price discrimination and collusion in spatial markets. The problem is analyzed in the context of a repeated duopoly game. I conclude that the prevailing pricing systems depend on the structural elements of the market. Delivered pricing systems emerge in equilibrium in highly monopolistic and highly competitive industries, while FOB is used in intermediate market structures. The fact driving this result is that delivered pricing policies allow spatial price discrimination...

  12. Early tumor detection afforded by in vivo imaging of near-infrared II fluorescence.

    Science.gov (United States)

    Tao, Zhimin; Dang, Xiangnan; Huang, Xing; Muzumdar, Mandar D; Xu, Eric S; Bardhan, Neelkanth Manoj; Song, Haiqin; Qi, Ruogu; Yu, Yingjie; Li, Ting; Wei, Wei; Wyckoff, Jeffrey; Birrer, Michael J; Belcher, Angela M; Ghoroghchian, P Peter

    2017-07-01

    Cell-intrinsic reporters such as luciferase (LUC) and red fluorescent protein (RFP) have been commonly utilized in preclinical studies to image tumor growth and to monitor therapeutic responses. While extrinsic reporters that emit near infrared I (NIR-I: 650-950 nm) or near-infrared II (NIR-II: 1000-1700 nm) optical signals have enabled minimization of tissue autofluorescence and light scattering, it has remained unclear as to whether their use has afforded more accurate tumor imaging in small animals. Here, we developed a novel optical imaging construct comprised of rare earth lanthanide nanoparticles coated with biodegradable diblock copolymers and doped with organic fluorophores, generating NIR-I and NIR-II emissive bands upon optical excitation. Simultaneous injection of multiple spectrally-unique nanoparticles into mice bearing tumor implants established via intraperitoneal dissemination of LUC + /RFP + OVCAR-8 ovarian cancer cells enabled direct comparisons of imaging with extrinsic vs. intrinsic reporters, NIR-II vs. NIR-I signals, as well as targeted vs. untargeted exogenous contrast agents in the same animal and over time. We discovered that in vivo optical imaging at NIR-II wavelengths facilitates more accurate detection of smaller and earlier tumor deposits, offering enhanced sensitivity, improved spatial contrast, and increased depths of tissue penetration as compared to imaging with visible or NIR-I fluorescent agents. Our work further highlights the hitherto underappreciated enhancements in tumor accumulation that may be achieved with intraperitoneal as opposed to intravenous administration of nanoparticles. Lastly, we found discrepancies in the fidelity of tumor uptake that could be obtained by utilizing small molecules for in vivo as opposed to in vitro targeting of nanoparticles to disseminated tumors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Simple, Affordable and Sustainable Borehole Observatories for Complex Monitoring Objectives

    Science.gov (United States)

    Kopf, A.; Hammerschmidt, S.; Davis, E.; Saffer, D.; Wheat, G.; LaBonte, A.; Meldrum, R.; Heesemann, M.; Villinger, H.; Freudenthal, T.; Ratmeyer, V.; Renken, J.; Bergenthal, M.; Wefer, G.

    2012-04-01

    Around 20 years ago, the scientific community started to use borehole observatories, so-called CORKs or Circulation Obviation Retrofit Kits, which are installed inside submarine boreholes, and which allow the re-establishment and monitoring of in situ conditions. From the first CORKs which allowed only rudimentary fluid pressure and temperature measurements, the instruments evolved to multi-functional and multi-level subseafloor laboratories, including, for example, long-term fluid sampling devices, in situ microbiological experiments or strainmeter. Nonetheless, most boreholes are still left uninstrumented, which is a major loss for the scientific community. In-stallation of CORKs usually requires a drillship and subsequent ROV assignments for data download and instru-ment maintenance, which is a major logistic and financial effort. Moreover, the increasing complexity of the CORK systems increased not only the expenses but led also to longer installation times and a higher sensitivity of the in-struments to environmental constraints. Here, we present three types of Mini-CORKs, which evolved back to more simple systems yet providing a wide range of possible in situ measurements. As a regional example the Nankai Trough is chosen, where repeated subduction thrust earthquakes with M8+ occurred. The area has been investigated by several drilling campaigns of the DSDP, ODP and IODP, where boreholes were already instrumented by different CORKs. Unfortunately, some of the more complex systems showed incomplete functionality, and moreover, the increased ship time forced IODP to rely on third party funds for the observatories. Consequently, the need for more affordable CORKs arose, which may be satisfied by the systems presented here. The first type, the so-called SmartPlug, provides two pressure transducers and four temperature sensors, and monitors a hydrostatic reference section and an isolated zone of interest. It was already installed at the Nankai Trough accretionary

  14. Home is best: Why women in rural Zimbabwe deliver in the community.

    Science.gov (United States)

    Dodzo, Munyaradzi Kenneth; Mhloyi, Marvellous

    2017-01-01

    Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening through a multi-donor pooled funding mechanism. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study we investigate why. We used twelve (12) focus group discussions with child-bearing women and eight (8) key informant interviews (KIIs). Four (4) were traditional birth attendants and four (4) were spiritual birth attendants. A thematic approach was used to analyse the data in Ethnography software. The study shows that women prefer community deliveries due to perceived low economic, social and opportunity costs involved; pliant and flexible services offered; and diminishing quality and appeal of institutional maternity services. We conclude that rural women are very economic, logical and rational in making choices on place of delivery. Delivering in the community offers financial, social and opportunity advantages to disenfranchised women, particularly in remote rural areas. We recommend for increased awareness of the dangers of community deliveries; establishment of basic obstetric care facilities in the community and more efficient emergency referral systems. In the long-term, there should be a sustainable improvement of the public health delivery system to make it accessible, affordable and usable by the public.

  15. SunShot Initiative: Making Solar Energy Affordable for All Americans (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2013-10-01

    Through SunShot, DOE supports efforts by private companies, universities, and national laboratories to drive down the cost of solar electricity to $0.06 per kilowatt-hour, making solar energy affordable for more American families and businesses.

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. 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...

  5. 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

  6. Health-care reform or labor market reform? A quantitative analysis of the affordable care act

    OpenAIRE

    Nakajima, Makoto; Tuzemen, Didem

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) requires all individuals to have health insurance, and introduces penalties to large firms that do not offer affordable coverage to their employees. While the possible effects of the ACA on the insurance decision of individuals have been studied, what is less studied is how the ACA can affect labor demand. In particular, since the ACA does not require small firms to offer health insurance, and does not require firms to offer health insuranc...

  7. 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, ...

  8. 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...

  9. 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...

  10. 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...

  11. Delivered volumes of enteral nutrition exceed prescribed volumes.

    Science.gov (United States)

    Walker, Renee Nichole; Utech, Anne; Velez, Maria Eugenia; Schwartz, Katie

    2014-10-01

    Enteral nutrition (EN) provisions are typically calculated based on a 24-hour infusion period. However, feedings are often interrupted for daily activities, procedures, or gastrointestinal intolerance. The study's objective was to determine the delivered EN quantities provided to stable hospitalized patients, using cellular time and measured volumes to verify our EN calculation adjustment. A supply of consecutively numbered ready-to-hang (RTH) EN product was delivered to the bedside of 26 inpatients with established EN tolerance at goal rates on various types of nursing units. The dietitian weighed the volume remaining in the infusing product and recorded the measurement time. On the following days, the dietitian continued to weigh the infusing RTH product and the empty RTH bottles saved by nursing. The primary outcome was the difference between the prescribed and delivered EN provisions, which was calculated with a paired t test. Patients received significantly more calories in the delivered enteral feeding (mean [SD], 1678 [385] kcal) than prescribed calories in the EN order (1489 [246 kcal]; t = 3.736, P = .001), adjusting for observed time. No significant differences were found between nursing units, product, and rate. EN delivered may actually exceed ordered amounts by 5%–21% (mean, 12%) with feeding pump inaccuracy as the primary contributing factor. This differs from what others have found. Our findings support using a volume-based ordering system vs a rate-based ordering system for more accurate EN delivery.

  12. 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.

  13. 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.

  14. 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.

  15. Health Migration: Crossing Borders for Affordable Health Care

    Directory of Open Access Journals (Sweden)

    Jennifer Miller-Thayer

    2010-10-01

    Full Text Available Approximately 45.7 million people in the United States are uninsured and unknown numbers of this population are underinsured, severely limiting their access to medical care. To address this problem, people use innovative strategies to increase their access through cross-border care options. The U.S.-Mexico border provides unique challenges and opportunities for health care in this context. The lower cost of medical and dental procedures and medications in Mexico makes that country an attractive alternative for low-income populations in the United States. Thus segments of the U.S. population practice transnational medical consumerism in an attempt to optimize their health by using the resources available in both countries. This practice has economic benefits for the people who access health care at an affordable rate and for the medical markets of the country providing the care. Drawing on data collected in the field in 2002, 2004, and 2005, this paper presents some of the complexities and dynamics of medical pluralism occurring at the U.S.-Mexico border.Environ 45,7 millions de personnes vivant aux Etats-Unis n’ont pas de couverture sociale et nombreux sont celles à être sous-assurées, ce qui limite considérablement leur accès aux soins. Face à ce problème, les Américains font preuve d'ingéniosité pour améliorer leur accès aux soins : ils se font soigner au-delà des frontières. Dans ce contexte, la frontière entre les Etats-Unis et le Mexique offre des opportunités uniques de soins. Le Mexique constitue en effet une alternative séduisante pour les Américains à faible revenu, car les tarifs des actes médicaux et dentaires, et des médicaments, sont nettement inférieurs à ceux en vigueur aux Etats-Unis. Ainsi, certains Américains pratiquent le consumérisme médical transnational et recourent aux ressources disponibles dans les deux pays afin d’optimiser leur santé. Cette pratique présente des avantages économiques

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. VET Providers Planning to Deliver Degrees: Good Practice Guide

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2015

    2015-01-01

    This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…

  2. School Nurse-Delivered Adolescent Relationship Abuse Prevention

    Science.gov (United States)

    Raible, Claire A.; Dick, Rebecca; Gilkerson, Fern; Mattern, Cheryl S.; James, Lisa; Miller, Elizabeth

    2017-01-01

    Background: Project Connect is a national program to build partnerships among public health agencies and domestic violence services to improve the health care sector response to partner and sexual violence. Pennsylvania piloted the first school nurse-delivered adolescent relationship abuse intervention in the certified school nurses' office…

  3. Delivering Instruction via Streaming Media: A Higher Education Perspective.

    Science.gov (United States)

    Mortensen, Mark; Schlieve, Paul; Young, Jon

    2000-01-01

    Describes streaming media, an audio/video presentation that is delivered across a network so that it is viewed while being downloaded onto the user's computer, including a continuous stream of video that can be pre-recorded or live. Discusses its use for nontraditional students in higher education and reports on implementation experiences. (LRW)

  4. Hepatitis B virus infection among pregnant women delivering at ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of hepatitis B virus (HBV) carrier and infectivity status among women delivering at Harare Maternity Hospital. Design: A serological survey study of pregnant women admitted for labour and delivery. Setting: Harare Maternity Hospital, Harare, Zimbabwe between June 1996 and June ...

  5. Foresight begins with FMEA. Delivering accurate risk assessments.

    Science.gov (United States)

    Passey, R D

    1999-03-01

    If sufficient factors are taken into account and two- or three-stage analysis is employed, failure mode and effect analysis represents an excellent technique for delivering accurate risk assessments for products and processes, and for relating them to legal liability. This article describes a format that facilitates easy interpretation.

  6. The Challenges of Globalisation: Delivering an MBA Programme in Eritrea.

    Science.gov (United States)

    Dence, Roger; O'Toole, John

    1999-01-01

    Describes the experiences of delivering an MBA (Master in Business Administration) program in Eritrea (North East Africa) through the United Kingdom's Open University. Discusses tutoring teams that travel to Eritrea, localizing case examples and assignments, sensitivity to local cultural contexts, writing assignments, student assessment, and…

  7. post partum haemorhage among women delivered at mbeya referral

    African Journals Online (AJOL)

    death is among women who deliver at home either alone or with tradition birth attendant. (TBA) [9]. To date, effort to reduce maternal mortality through training TBAs have been disappointing [2]. Study population and Methods: This study was a hospital based descriptive retrospective hospital based cross-sectional.

  8. Inefficient charging for delivered gas by local gas distributors

    Directory of Open Access Journals (Sweden)

    Siniša Bikić

    2005-10-01

    Full Text Available In this region, especially in Serbia, common belief is that local distributors of gas used by households don’t charge for gas properly. It is suspected that there are two sources for improper ways of gas charging. Local distributors charge for delivered gas only, according to flow rat but not according to gas quality. It is usual that local distributors deliver gas of different quality than one signed in contract. In this work will be considered only one of aspects inefficient charging for delivered gas by local gas distributors, which is connected to variable atmospheric pressure. There is doubt, that local distributors make mistakes during accounting for delivered gas to costumers in regard atmospheric pressure. At the beginning of every investigation, problem has to be located and recognized. Authors are going to collect as much as possible available data, to elaborate and analyze data by scientific methods and to represent conclusions. So, the aim of this work is to diagnose current state and to approve or disapprove above mentioned suspicions. In our region this theme is very interesting, both because of energy efficiency and air pollution control. In this way both consumer and distributor will know, how mush energy they have really spent.

  9. Capacity to deliver pharmaceutical care by community pharmacies ...

    African Journals Online (AJOL)

    Pharmacy practice has transcended from largely a dispensary practice to pharmaceutical care practice. The capacity of community pharmacies to deliver pharmaceutical care was studied using pretested self survey methods. Ninety five percent (95%) of the respondents always educated customers on drug related needs, ...

  10. Could the Hokusai Impact Have Delivered Mercury's Water Ice?

    Science.gov (United States)

    Ernst, C. M.; Chabot, N. L.; Barnouin, O. S.

    2018-05-01

    Hokusai is the best candidate source crater for Mercury’s water-ice inventory if it was primarily delivered by a single impact event. The Hokusai impact could account for the inventory of water ice on Mercury for impact velocities <30 km/s.

  11. Delivering mental health awareness training to police officers.

    Science.gov (United States)

    Forni, Carlos; Caswell, Nick; Spicer, Jerina

    Police officers regularly come into contact with people with mental health problems but receive relatively little training on the issue. This article outlines an initiative to deliver awareness training to officers, and explores the benefits of such programmes. It also gives details of the evaluation carried out.

  12. Portable devices for delivering imagery and modelling interventions ...

    African Journals Online (AJOL)

    The main objective of this study was to investigate the effectiveness of portable devices (MP4) and a stationary device (DVD and fixed point stationary computer) in delivering imagery and modelling training among female netball players, examining the effect on imagery adherence, performance, self-efficacy, and the relative ...

  13. Delivering a secure electricity supply on a low carbon pathway

    International Nuclear Information System (INIS)

    Boston, Andy

    2013-01-01

    The energy system can only be considered sustainable in the long term if it is low carbon, affordable and secure. These three create a complex trilemma for all stakeholders in the energy business who have to strike a careful balance without neglecting any one aspect. This discussion paper examines the issues surrounding security of supply of the power system which has received less attention than the other aspects. It looks at how threats and mitigation measures can be classified in terms of where they act on the supply chain and the timescale over which they act. Only by considering the full range of timescales from seconds to decades can the full picture emerge of the effects of new technologies on security of supply. An examination of blackouts over the past 40 years sheds light on the causes of failure to supply and the most vulnerable aspects of the supply chain. - Highlights: ► Energy systems are only sustainable if they are low carbon, affordable and secure. ► Threats to security can be classified by timescale and position in the supply chain. ► The impact of new technologies on security must be considered across all timescales. ► Recent blackouts show the network is most vulnerable and weather the leading cause

  14. 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

  15. 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)

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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...